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Archive for January, 2010

How the stress of caregiving can lead to stroke

Sunday, January 31st, 2010

How the stress of caregiving can lead to stroke

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

The strain of caring for a disabled spouse is associated with an increased risk of stroke, researchers found.

How the stress of caregiving can lead to strokeThe risk is increased for men, and especially African-American men, according to William Haley, PhD, of the University of South Florida, in Tampa, and colleagues.

On the other hand, there was no significant association of any level of caregiving stress with the risk of coronary heart disease, the researchers reported in the February issue of Stroke.

One implication of the study, the researchers wrote, is that men looking after disabled partners may need extra support.

The issue is important because about 12% of Americans older than 45 report they have what the researchers called “family caregiving responsibilities,” they noted. And high caregiver stress has been found to be a risk factor for depressive symptoms and early mortality.

To see how such stress affects cardiovascular health, the researchers turned to the so-called REGARDS study — for REasons for Geographic and Racial Differences in Stroke. It is a continuing epidemiological look at stroke and coronary heart disease incidence and mortality in a large national sample of adults over age 45.

Of the more than 30,000 participants in the study, the researchers found 767 who lived with and cared for a disabled spouse and had no history of stroke or coronary heart disease.

Based on interviews and home visits, the researchers divided the participants into those reporting high, some, or no strain associated with caregiving. They also calculated 10-year stroke and coronary heart disease risk, using Framingham risk scores.

In a multivariate regression analysis, high caregiving strain was associated with a 13.62% 10-year risk of stroke for high-strain caregivers, the researchers reported.

That was 23% higher than the estimated stroke risk of 11.06% for caregivers reporting no strain. The difference was significant at P=0.02.

But Haley and colleagues also found significant interactions between race, sex, and caregiving strains.

When those were taken into account, African-American men with high caregiving stress had an estimated 10-year stroke risk of 26.95% — markedly higher than the risk for any other race or sex group.

Among other groups with high caregiving strain, white men had a 10-year risk of about 15%, while white and African-American women had risks estimated to be between 10% and 12%.

The researchers cautioned that the study is cross-sectional, so it could be that people high in some stroke risk factors may simply find caregiving to be more stressful.

Other limitations included the fact that there were only a small number of highly stressed African-American men, which could have exaggerated the effect in this group, and the use of risk scores rather than observed stroke and cardiovascular events. The REGARDS study will have direct observation of events over time.

Interestingly, men overall in the study reported lower stress than women, perhaps because they tend to use more paid help and have more assistance from extended family, the researchers said.

It may be that the men reporting high caregiving strain lack such outside help, they said.

Visit MedPageToday.com for more stroke news.

Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

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  2. Why juvenile delinquency may lead to poor adult health
  3. A review of the latest stroke studies

Can we grow organs instead of transplanting them?

Sunday, January 31st, 2010

Can we grow organs instead of transplanting them?

Anthony Atala’s lecture at TEDMED 2009, discussing how his state-of-the-art lab grows human organs – from muscles to blood vessels to bladders.

Amazing.

Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

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Should society consider purchasing and selling tissues and organs?

Sunday, January 31st, 2010

Should society consider purchasing and selling tissues and organs?

by Michael Kirsch, MD

Choose the best answer.

To stimulate organ donation, we should provide organ donors with:

* Cold, hard cash
* Upgrades to business class on any flight within the continental United States for 1 year
* College tuition discounts for up to 3 children
* Income tax relief
* First row Bruce Springsteen concert tickets
* A certificate of appreciation

There is a reason that we don’t ask families of kidnapped victims what our policy should be with regard to hostage negotiations. Any family in this situation, including mine, would favor paying the ransom. While this would serve an individual family’s interest, it would conflict with the public’s interest as it would encourage more kidnappings. Thus, the greater good would be compromised.

Similarly, families seeking an organ for a loved one are not the proper source of policy recommendations for organ procurement.

Understandably, they want an organ at any cost. Certainly, if my child needed a liver to survive, I would not want to hear that saving him would amount to an ethical crime against humanity. And, I might not care. For this reason, medical ethical policies should be carefully crafted by thoughtful and dispassionate individuals who can approach the issue from a broad societal perspective. Of course, those who have a personal stake in the game should have a voice at the table, but they should serve as an advisory and informational role. Their views should be considered, but not necessarily adopted. These are heartwrenching and controversial issues, particularly when an individual’s plea for life is deflected off an ethical firewall.

Is purchasing tissues and organs a worthy idea for society? Would it violate ethical standards against exploitation? Would it injure the ethical principle of justice?

Many argue that buying organs should be permitted, just as affluent folks can purchase cosmetic surgery, luxury cars or Caribbean vacations. If they can afford to purchase a kidney from a willing seller, they argue, why shouldn’t the transaction take place?

Organ shortages have resulted in a reconsideration of ethical procurement practices that were heretofore prohibited. Many fear that folks at the end of life are already viewed as organ donors in an effort to save others who are awaiting organ transplantation. One way to increase the donor pool with the stroke of a pen is simply to ‘modify’ the definition of death. In the past, dead meant brain death. Nowadays, cardiac death, a new & improved definition of the end of life, has greatly increased organ donor supply. Is this definition-creep motivated by a desire to increase the donor reservoir? Is this the right thing to do? It takes little imagination to foresee how slippery and vertical this slope can become.

Sick and desperate people awaiting organs have rights too. We must be extremely cautious that our zeal to protect society’s rights is not outweighed by their right to life.

It is illegal to purchase organs in the United States, but other countries have different policies. The Wall Street Journal, John Goodman’s Health Policy Blog and NPR reported that Iran will pay citizens to donate and, as a result, they have no organ shortages. Singapore organ-seekers pay tens of thousands of dollars for an organ. Some nations, such as Sweden and Spain, presume consent to donate organs, unless the invidual has actively opted-out of the program.

In the United States, there is no presumed consent. Israel, in response to a low organ donation rate, has just launched a program to reward willing donors by giving them priority should they ever need a transplant. I just learned about an organization here in the United States called LifeSharers, whose members pledge to donate organs and to give fellow members in need priority access of these organs. The organization charges no fee and currently has over 13,000 members.

Maurice Bernstein queried on his provocative Bioethics Discussion Blog if it should be legal to procure organs from dead individuals without consent from the patient or family. There is a long thread of thoughtful comments from readers.

I think we should provide more incentives to donate, although I do not advocate buying and selling organs on the free market. This would lead directly to economic and physician exploitation of our most vulnerable people. I also vigorously oppose bending the definition of death for the purpose of saving others. One life is not worth more than another. Of course, it’s easier to make principled and categorical statements as a blogger. But, don’t ask me for my high and mighty opinion if my child is on the transplant list. I’d pay the ransom.

What are your thoughts to promote organ donation within the boundaries of medical ethics?

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

Submit a guest post and be heard.

Posted at KevinMD.com. Stay updated and subscribe, follow me on Twitter, or connect on Facebook.

Related posts:

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Anne Dilenschneider: Join in Global Prayer for Haiti

Sunday, January 31st, 2010

People all over the world are praying for the people of Haiti, for those involved in relief efforts, and for the leaders of all the governments who are working with the government of Haiti.

Here are a variety of ways you can join in the global prayers for Haiti:

His Holiness, the Dalai Lama, offers this way to pray: “We request you to spend 5 minutes, 10 minutes, and 20 minutes and as much as you can every day or weekly from January 15 to February 15, 2010 to think about the People of Haiti and pray for their well beings and for fast recovery and healing from this massive earthquake effect. . . .”
For more information, go to 
http://apps.facebook.com/causes/432264/15339707?m=9e4cc0c7&ref=mf

Prayers for Haiti can be left on the virtual prayer wall at http://bit.ly/6LI6ri. The prayers that have been posted to date here are being forwarded to Haiti by a team from The United Methodist Church.

There are inspirational music links at a site Yusuf Islam (formerly Cat Stevens) recommends: World Help for Haiti. This site is a global movement for performing musicians to help Haiti. Go to: http://www.worldhelpforhaiti.org

The Roman Catholic Daughters of St. Paul are offering a free book of prayers titled, A World on Its Knees: Praying for and With Our Brothers and Sisters in Haiti. Prayers in the book include “Calm the Shaking of the Earth,” “Solidarity of the Human Family,” “A Prayer of a Rescue Worker,” and “God, What’s Going On?” The Sisters hope to “get this into the hands of millions of people around the world who can’t go to Haiti in person but can pray.” Go to: http://www.pauline.org/FreeEbookofPrayersforHaiti/tabid/375/Default.aspx

Another way to pray is to light a virtual candle at http://www.gratefulness.org This lovely website has been a place of global prayer for several years!

And, finally, here is a prayer that has been offered for all people from Rabbi Naomi Levy, the author of To Begin Again and Talking to God (a pdf of this prayer is available for download at: http://www.jewishjournal.com/haiti/article/a_prayer_for_haiti_shabbat_download_20100121):

A Prayer for the People of Haiti
by Rabbi Naomi Levy

We pray for Haiti.
Our hearts are breaking, God.
The human mind cannot grasp the enormity of the loss.
The cries echo through the universe.
Innocent blood is calling us
To rise up from our heartbreak and act.
We pray for Haiti.

Help us, God,
To understand that destruction can come in a moment
But healing may take a lifetime.
Teach us perseverance, teach us dedication.
We pray for Haiti.

God of the weak, God of the broken-hearted,
God of the living, God of the dead,
Send healing to Haiti.
Send hope to the children who are lost and alone,
Send strength and resilience to the wounded,
And comfort to the grieving.
Fill the leaders of Haiti with the wisdom to raise their country up.
Fill relief workers with resolve.
Bless the doctors and nurses with the power
And the skill to save as many lives as possible.
Open their eyes, steady their hands.
We pray for Haiti.

Bless us, God,
Work through us.
Remind us that every one of us is filled with the power to heal.
Do not let the passage of time lead us to indifference.
Open our hearts, open our hands.
We pray for Haiti.

Let all nations unite as one in a time of reconstruction and repair.
Raise up the people of Haiti, God, out of helplessness and despair.
Teach them to believe
That cities shall be rebuilt on their ruins
That the cries of the children will soon return to laughter.
Be with them, God, watch over them.
And gather the souls of the dead
Whose homes and schools became their graves
Into Your eternal shelter,
Let them find peace in Your presence, God.
We pray for Haiti.
Amen.

More on Spirituality


Diane Dimond: Mark McGwire Must Think We’re Stupid – The Inadequate Apology

Sunday, January 31st, 2010

Mark McGwire must think we’re stupid.

The former baseball superstar certainly looked the part of a contrite apologist last week during his interview with sportscaster extraordinaire, Bob Costas. With his red eyes brimming and his chin quavering, McGwire finally came clean about his past use of performance enhancing drugs. I truly felt for the man.

“I used steroids during my playing career and I apologize,” McGwire said.

He went on to explain that he first dipped his toe into the fetid steroid pool during the 1989 season. After he was injured in 1993, McGwire admitted, he once again began using both steroids and human growth hormones, and he kept using them right through the 1998 season.

That, of course is when he and slugger Sammy Sosa held the nation spellbound as they battled to see who would break the 37 year old homerun record set by the legendary Roger Maris.

He should have stopped talking right there but he didn’t.

“I did this for health purposes,” McGwire told Costas, explaining that he believed the banned and illegal substances would help him heal faster from his many injuries. “There’s no way I did this for any type of strength use.”

Oh, really? This from a man who, while on the juice, put on 30 pounds of muscle, sported biceps that looked like bazookas and clocked homeruns off checked swings! I guess he really took no pleasure in piling up the homerun stats. Yeah, he was probably just thinking about his injured heels.

Was McGwire actually denying what every other athlete and pro sports trainer believes – that steroids give a person more stamina and power in their swing?

“I was given a gift to hit home runs,” McGwire declared without a hint of irony. He maintained that simply studying pitchers and adjusting his swing is what caused him to end the ‘98 season with a record shattering 70 homeruns to Sosa’s 66. McGwire insisted he could have hit all those homers without the performance enhancing drugs he was taking.

“I truly believe so,” he said.

Again, Mark McGwire must think we’re stupid.

In my book you apologize for accidents or mistakes – not for something you did repeatedly for 10 years! That’s like saying you’re sorry for deliberately cheating at poker games – for 10 years! The best apologies are simple declarations, “I did this and please forgive me” usually suffices. “I did this but let me explain it to you….” just feels less like an apology and more like a strategic statement.

Look, I applaud McGwire for coming clean now, better late than never. And I think he still has a major contribution to make to baseball as the new hitting coach for the St. Louis, Cardinals. But Mark McGwire has to know in his heart that those drugs helped him resurrect a faltering career and then go on to break the homerun record.

I’m betting one guy who’s watching this all play out closer than anyone is Barry Bonds, the current King of both homeruns and steroid suspicion. In 2001 he outdid McGwire’s homeruns by hitting 73 of them. Will Bonds now follow McGwire’s lead and come clean? His reputation and the arrogance of our modern day athletes suggests not.

The time for McGwire to have (you’ll pardon the pun) stepped up to the plate, was five years ago when Congress summoned him to testify about steroids in pro sports. He refused to “talk about the past” then because, as McGwire now explains, his lawyers told him his answers could be used to file charges against him.

Oh, really? I can’t think of one major league baseball player ever charged with a crime due to steroid use – ever.

Our nation remains gripped in a double-fisted drug problem; illegal street drugs and the proliferation of too many prescription drugs. As parents try to teach their children about the importance of staying away from drugs, being honest and admitting their mistakes how should they explain this guy to the kids?

“Well, Sonny, see, McGwire admitted he did it and he said he’s sorry. So he’s getting this great new high paying job back in baseball. And, it’s all okay because he said the steroids probably didn’t help him beat Roger Maris’ record anyway ….” Sheesh.

McGwire says before he went public with his steroid admission he called one of his longtime supporters, Pat Maris, the widow of the man who held the homerun season record of 61 for more than four decades. “I felt I needed to do that,” he said. He reports she was disappointed to hear the news.

Many of the rest of us were disappointed at his apology. And, by the way, Mr. McGwire, I don’t think you’ve helped your chances of getting into the Baseball Hall of Fame. I’ve been to Cooperstown. You don’t belong there.

Diane Dimond may be reached through her web site: www.DianeDimond.com


Goldman Sachs May Give Record Bonuses — Up To $100 Million To CEO Lloyd Blankfein

Sunday, January 31st, 2010

Goldman Sachs, the world’s richest investment bank, could be about to pay its chief executive a bumper bonus of up to $100 million in defiance of moves by President Obama to take action against such payouts.

More on Banks


Brendan DeMelle: A Silver Lining In The Supreme Court’s Citizens United Decision For Political Prisoner Paul Minor

Sunday, January 31st, 2010

The Supreme Court’s recent decision in Citizens United v. Federal Election Commission – duly criticized for clearing the way for runaway corporate money to further undermine the democratic election process – did contain one silver lining for political prisoner Paul Minor, a former Mississippi plaintiffs’ attorney and prominent Democratic funder who was targeted for prosecution by overzealous U.S. Attorneys in the Bush Administration.

In fact, the SCOTUS ruling provides all the more reason to free Paul Minor, who remains wrongfully convicted of “honest services fraud” despite the total lack of proof of a “quid pro quo” agreement between Minor and the state judges to whom he gave campaign contributions.

In Citizens United, the Supreme Court emphasized that the glue that holds the integrity of America’s campaign financing process together is a fundamental understanding – embedded in every American’s First Amendment right to free speech – that a campaign contributor necessarily hopes to influence the election of one’s favored candidate and ideas, and is not acting corruptly simply by participating in the process. Unless there is explicit proof of a corrupt “quid pro quo” agreement (a “this for that” exchange) between donor and candidate, the Supreme Court correctly ruled that every American has the right to donate money to political candidates without fear of prosecution.

The quid pro quo corruption requirement recognized in Citizens United, and many other Supreme Court and Circuit Court decisions, in effect has dual purposes. It serves to protect the integrity of America’s democratic process. But, just as importantly, it safeguards contributors and public officials, such as Paul Minor and the state court judges whose campaigns he supported, from being accused of bribery without explicit proof that their actions involved “quid pro quo” corruption.

Just imagine if the courts were clogged with bribery allegations every time someone contributes to a political campaign. Everyone who donates to a friend running for political office could be thrown in jail for bribery by an overzealous prosecutor with political or other motivations. That’s why our legal system requires proof of a quid pro quo corrupt agreement in order to convict someone for campaign-related bribery or fraud.

Indeed, politicians of all stripes – and the big corporate political players who bankroll their campaigns – better hope that the courts continue to make that distinction. Otherwise, considering the floodgate of corporate money that the Citizens United decision has now unleashed into America’s political system, they could all be prosecuted and jailed at the whim of a federal prosecutor just for taking part in the campaign finance system.

The irony of that point is worth noting – it is players like the Chamber of Commerce, Big Oil and Wall Street who would be well advised to get in Paul Minor’s corner on this quid pro quo issue. As former ABC News producer Rebecca Abrahams detailed recently, the Chamber has aggressively targeted Democratic judicial candidates and their major funders, including Paul Minor and other plaintiffs’ attorneys.

Many have questioned the Chamber’s political activity and its extensive connections and influence within the courts, suggesting that it has clearly gotten much in exchange for its massive cash outlays during state and federal elections on behalf of Big Business interests. It’s not a stretch to suggest that the Chamber could be successfully prosecuted for quid pro quo corruption, especially if the jury were not clearly instructed that it must have proof of such corruption in order to convict.

So the Supreme Court’s clear reinforcement of the necessity to prove “quid pro quo corruption” is great news for political prisoners like Paul Minor, and the justice system as a whole.

And that’s not the only promising development in Minor’s long struggle for justice. On December 11, the Fifth Circuit Court of Appeals reversed Minor’s conviction under the federal bribery statute, which will reduce his 11-year sentence considerably.

But, as Minor’s attorneys Hiram Eastland and Abbe Lowell argue in a new appeal for a rehearing, the Appeals Court should have also reversed Minor’s “honest services fraud” conviction. They argue that the panel failed to recognize the impact of the improper jury instructions that led to the convictions of Minor and former judges John Whitfield and Wes Teel on honest services fraud charges in 2007.

While the appeals panel correctly identified the legal requirement of providing proof of a “quid pro quo” agreement, it failed to recognize that the jury instructions in Minor’s second trial didn’t meet that critical legal requirement.

That error has huge implications, as the Sun-Herald newspaper notes: “The honest services fraud charges…are the basis for the remaining charges on which Minor was convicted: racketeering and conspiracy. If the fraud charges were reversed, his 11-year sentence would be vacated, as would those of Whitfield and Teel.”

As discussed in detail in Minor’s rehearing brief in front of the Fifth Circuit, there was nothing in the jury instructions that in any way conveyed the necessity for the jury to find a quid pro quo in order to convict Minor.

A little background – in his first trial, with proper jury instructions regarding quid pro quo, Minor was acquitted on most counts and the jury hung on others due to lack of evidence. But when a partisan prosecutor from the Bush Justice Department immediately re-indicted Minor, the jury was incorrectly instructed that it didn’t need proof of a corrupt quid pro quo agreement in order to convict him and the judges he supported.

As Minor’s rehearing petition states:
“This Court properly held that the quid pro quo element for bribery required ‘an exchange of things of value for favorable rulings in the judges’ courts,’ but the actual jury instructions in this case failed to require such a finding.” (Pg 9)

“Unfortunately, this court appears to have misread the actual jury instructions given in this case because that concept was never conveyed to the jury.” (Pg 1)

Quid pro quo is a crystal clear legal concept. In order to convict Minor, the jury must have been properly instructed that the government must furnish clear evidence that Minor’s campaign contributions were made as part of an explicit quid pro quo agreement in exchange for favorable decisions by the judges.

The Bush DOJ prosecutors didn’t even try to convince the second jury that a quid pro quo existed, they simply pursued a conviction for federal bribery without the goods to show for it. The partisan prosecutors had no business whatsoever trying to convict Minor of bribery without proper jury instructions and evidence of a quid pro quo “bribe.”

Like the federal bribery convictions, the district court should have never even entertained the remaining “honest services” charges without clearly requiring quid pro quo proof for the jury to find Minor guilty.

The lack of quid pro quo jury instruction in Paul Minor’s case is not just some technicality. Paul Minor’s case involves profound issues that go to the heart of whether we make political prisoners out of American citizens when the Supreme Court itself recognizes they are entitled to First Amendment protections when participating in our democratic process–especially here, where there was no requirement of proof of “quid pro quo corruption.” (See SCOTUS discussion on pages 40-45)

The Fifth Circuit clearly must reconsider its decision now that this glaring error has been pointed out, and it must reverse all of the honest services fraud-related convictions as a result.

The critical questions remain: How did Minor end up in prison in the first place? And why is he still in prison when he is entitled to bail pending the appeals courts’ resolution of these profound issues?

Those are questions the Obama Justice Department should strongly consider, continue to investigate and take swift and deliberate action on.

Regardless, with the Supreme Court likely to toss the honest services statute entirely, Paul Minor should soon be set free. And not a moment too soon.

More on Gas & Oil


Isabel Cowles: When Yoga and Civilization Collide

Sunday, January 31st, 2010

Last week’s New York Times article, “When Yoga and Chakras Collide,” threw the debate between yogis and civilization into relief. Essentially, the piece can be read to pose the following question: If we practice yoga, are we obliged to withdraw from society?

The article highlights the tension many yogis face: whether or not to walk away from animal products and eat primarily raw fruits and vegetables. According to Eva Grubler of the Dharma Yoga in New York (one of America’s most revered yoga studios), the ideal yogi diet should consist of, “steamed vegetables, salads and fresh juices.” The article also quotes Steve Ross, author of Happy Yoga: Seven Reasons Why There’s Nothing to Worry About, who explains in his book, “I get a toxic, icky feeling from eating something that’s basically inedible.” By that, he means cooked food.

And yet, as the Times reports, some yoga studios are providing meals–complete with meat, wine and chocolate–at the end of practice. And they are causing quite a stir in the hardcore vegan / rawfoodist yogi camp. While a sweaty studio would not be my eating-place of choice, not a day goes by when I don’t eat cooked food or animal products. And not a day goes by when I don’t practice yoga. Both feel better with company.

Until recently, I felt that my innate appetites and love of cooking were directly at odds with my yoga practice. And yet, when I have tried to eat a primarily raw or vegan diet, I feel profoundly unsatisfied, both physically and socially. After having read Richard Wrangham’s book, Catching Fire: How Cooking Made us Human, I understand why I want and need to eat warm, rich food, which sometimes includes flesh. Moreover, I am hardwired to enjoy it with others.

This is how Wrangham’s argument boils down: the human discovery of fire essentially catapulted some of our ancestors out of the realm of Neanderthal and into the realm of HomoErectus and eventually Sapien. I am not one to distrust a person simply because he or she is not a scholar, but in this case, the distinction is striking. For example, Ross (whose nutritional background appears to be purely anecdotal) claims,”Approximately 85 percent of all vitamins and 100 percent of the enzymes are lost in the cooking process. If you cook anything above 118 degrees F, the enzymes naturally found in that food are destroyed.” Unfortunately, Ross does not cite his source. Wrangham, on the other hand, is the Ruth Moore Professor of Biological Anthropology at Harvard; Curator of Primate Behavioral Biology at the Peabody Museum and Director of the Kibale Chimpanzee Project in Uganda. The scholar devotes the final third of his book to footnotes. Both my gut, and my brain are inclined towards his argument.

Indeed, it is both our guts and our brains that distinguish us from our chimp cousins, Wrangham argues. Physical evidence that human beings evolved to cook food–and evolved because of cooked food–appears in both our stomachs and brains. The relatively small size of our digestive systems indicates that we evolved to eat food that is easy to digest, including cooked meat. Furthermore, the ease of digestion (cooking makes food easier for the body to process) essentially lends calories to whatever we cook, which in turn allowed our ancestors’ brains to develop at a pace unparalleled by any other species. Because their bodies weren’t working all day long to digest raw, fibrous foods, our ancestors’ brains suddenly had the nutrients necessary to grow exponentially in size. We owe our intelligence to cooked food.

In addition to physical benefits, cooking helped foster society. For example, heating food can be preserved longer, therefore guaranteeing more nutrition for longer periods. Cooking also caused early humans to lose their hair, one of our most distinguishing characteristics. Because of an availability of warmth and warm food, early man no longer needed his furry insulation: I’m sure most raw foodists, if given a choice, would opt to eat cooked food rather than grow a coat. Indeed, as many anthropologists have noted, including Jared Diamond in his book, Guns Germs and Steel, it’s the cultivation of agriculture and fire that made it possible for entire civilizations to develop. Without the need to wander in search of food–be it foraged vegetables of wild animals–human beings suddenly had the time and energy to sit together and think. It is because of cooked and cultivated food that man eventually built towns, appointed leaders and had the luxury to create art, literature, music, even yoga.

I know many vegetarians and many vegetarian yogis, whom I respect very much. I even know a few who eat primarily raw food–these are choices that I happily accept. However, when a person tells me that human beings were not designed to eat meat or cooked food, or that my yoga practice is inferior as a result of my diet, I must respectfully disagree. (The common theory that people were not meant to eat meat because of their blunt teeth and small jaws has also been defunct by Wrangham’s work: we are meat eaters, we just eat soft meat–of the cooked variety.)

I used to wonder why I felt so drawn to the stove and to a table full of friends. I long for the very thing provided by yoga studios that offer a communal meal after a communal practice. And yet I felt guilty about it–as though some primal impulse were keeping me from a truly enlightened practice. Now I realize that the opposite is true: the very thing that makes us human is our desire to cook, cultivate, kill and share our food. There is indeed a beast within each of us, calling us to do the same–the Homo Sapien.