ED­I­TO­RIAL:

‘Ty­rolean Ice­man’ makes a good ar­gu­ment in re­form de­bate

Modern Healthcare - - NEWS - NEIL MCLAUGH­LIN Man­ag­ing Ed­i­tor

What we can learn from the 5,000-year-old man

Last year, we re­ported on a study (May 30, p. 36) of Egyp­tian mum­mies. One sub­ject was of par­tic­u­lar in­ter­est: a 3,500-yearold princess who be­came the ear­li­est known per­son to have had clogged ar­ter­ies. The princess was part of an ex­am­i­na­tion of 52 mum­mies in Cairo and the U.S. Among those that still had heart tis­sue, about half showed chunks of cal­cium stuck to their ar­ter­ies—an in­di­ca­tion of clog­ging. So much for the idea that heart dis­ease is a mod­ern ail­ment. “Atheroscle­ro­sis clearly ex­isted more than 3,000 years ago,” said Dr. Adel Al­lam, a car­di­ol­ogy pro­fes­sor at Al Azhar Univer­sity in Cairo, who led the study with Gre­gory Thomas, di­rec­tor of nu­clear car­di­ol­ogy ed­u­ca­tion at the Univer­sity of Cal­i­for­nia at Irvine. “We can­not blame this dis­ease on mod­ern civ­i­liza­tion.”

Added Thomas: “We think of atheroscle­ro­sis as a dis­ease of mod­ern life­style, but it’s clear that it also ex­isted 3,500 years ago.”

There was spec­u­la­tion that the diet of the Egyp­tian elite con­trib­uted to their con­di­tion. The princess lived dur­ing pros­per­ous times. Al­lam was quoted as say­ing even poor peo­ple would have eaten a lot of pork and bread mixed with honey, and the no­bil­ity would have con­sumed an even richer diet. But the study au­thors also noted that the princess was no porker and seems to have been pe­tite.

Skip to late last month, with word in the jour­nal Na­ture Com­mu­ni­ca­tions on the lat­est find­ings re­gard­ing an older gentleman nick­named Otzi. He is bet­ter known as the “Ty­rolean Ice­man,” a 5,300-year-old corpse pre­served in ice and snow in the Ital­ian Alps. Since the dis­cov­ery of his body in 1991, sci­en­tists have learned much about his phys­i­cal con­di­tion. He was about 46 years old, had knee prob­lems and died as a re­sult of a vi­o­lent en­counter. He had brown eyes, brown hair and was lac­tose in­tol­er­ant, which is log­i­cal since in Otzi’s time and lo­ca­tion there may have been lit­tle or no cat­tle.

Here comes the con­nec­tion to the first study: Sci­en­tists con­cluded that Otzi har­bored a strong ge­netic pre­dis­po­si­tion to heart dis­ease and showed signs of artery hard­en­ing—al­most 2,000 years be­fore the Egyp­tian princess. Again, the per­cep­tion of heart dis­ease as solely a mod­ern prob­lem as­so­ci­ated with rich food and a lack of phys­i­cal ac­tiv­ity ap­pears flawed. And you clearly can’t at­tribute Otzi’s prob­lems to drink­ing too much milk. And here’s a fa­mil­iar con­clu­sion: “But ob­vi­ously, this dis­ease was present al­ready 5,000 years ago,” said Al­bert Zink, an an­thro­pol­o­gist at the Euro­pean Academy of Re­search in Bolzano, Italy, and one of the study au­thors. “So now we can get a bet­ter un­der­stand­ing why such dis­eases de­velop.”

On our Com­men­tary page in this is­sue (p. 24), the chair­woman of the Amer­i­can Col­lege of Health­care Ex­ec­u­tives cau­tions col­leagues about as­sump­tions and the prob­lems they can cre­ate. It is sage ad­vice. The Egyp­tian and Ital­ian stud­ies sug­gest the pop­u­lar wis­dom is in­com­plete and other fac­tors may be more im­por­tant in heart dis­ease and other ill­nesses as well. Pos­si­bil­i­ties in­clude ge­net­ics or chronic in­flam­ma­tion.

These stud­ies should prompt us to re-ex­am­ine as­sump­tions and en­gen­der a lit­tle hu­mil­ity and com­pas­sion. The health­care re­form de­bate was an oc­ca­sion for some to com­plain that they shouldn’t have to pay for peo­ple who get sick be­cause it’s al­most al­ways their fault. Well, many times yes, and a lot of the time we don’t why. We have in­sur­ance be­cause life is full of un­cer­tain­ties and un­knowns, and ill­ness could hap­pen to you, too. It’s a very, very old story.

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