London Medical Journal: Prevention Is Now a Priority

Dr. Jonathan Fielding of the London School of Hygiene and Tropical Medicine was the first to identify a new gene variant that is associated with CVD. In a study published on October 29, 2017,…

London Medical Journal: Prevention Is Now a Priority

Dr. Jonathan Fielding of the London School of Hygiene and Tropical Medicine was the first to identify a new gene variant that is associated with CVD. In a study published on October 29, 2017, he identified a gene (NCK-ABH7) associated with elevated cholesterol and coronary artery disease (CVD) among Egyptian mummies. This gene variant is also present in other countries, but where Dr. Fielding found the mutation his results were more consistent and repeatable than where another group located the mutation. He also used a statistical model to replicate his findings.

These findings are very important and continue a body of evidence that broadly speaking there are a few things that apply universally to people of different ages and ethnicities. For my belief that smoking is bad for health and my belief that people should quit if they want to decrease their risk of CVD, I was interested to learn that the mutation Dr. Fielding identified occurred in a gene that is partially responsible for the formation of neurons in the hypothalamus, a brain region.

Along with his group of researchers at the University of Oxford and Imperial College London, Dr. Fielding was able to replicate that finding, comparing samples from mummies from various parts of the world. Interestingly, they also found that both the mutation he found and the gene he found are slightly less widespread than Delta. Dr. Fielding informed me that this finding is more likely the result of a third gene that has yet to be identified than the primary cause of the variance that he identified. Dr. Fielding did not find much or any Delta in mummies of the Malagasy population. The Malagasy sample group is only known to consist of males, so when he looked for Delta he was basically searching for commonality in men between the African mainland and Madagascar.

There are aspects of this article I thought I would address. I am not saying that there is no reason to worry about smoking. I have had people tell me that they quit smoking and when they come back in another year they have a significant increase in the numbers of CVD-related symptoms. There are also those who have never smoked a cigarette and come back to me at the end of a year with big scary headaches. There are also those who get repeated migraines regardless of whether they use tobacco or not.

My new realization that this may be due to the latter seems to lead me to believing that it is likely not the smoking itself but an indirect correlation to smoking that could be responsible for the symptom increase. Smoking causes inflammation to the brain. When the brain is exposed to too much pain it can lead to the production of endorphins. Endorphins are chemicals released by the body when it is in pain, which make the pain go away. Because the brain is not involved in processing pain, its sensitivity to pain, it therefore becomes both tough to detect and easier to fake. People who have regular doses of nicotine will produce more endorphins than those who don’t smoke.

This does not mean that smoking should be considered a healthy way to live, and I recommend that everyone who smokes get away from the idea that it is. However, I do think that the rate of increase in many cardiovascular diseases is so much lower than would otherwise be expected. People whose thinking is processed by the brain may find it easier to smoke and smoke more, but none of this means that a person should be smoking five packs of cigarettes a day, or that they should use another form of nicotine or energy-producing substance. If a person is even considering nicotine, getting off of it, to quote a sage, should be a priority, it could save your life.

Jodi Deptford, Ph.D., works in the Department of Medicine and Social Health Sciences at Louisiana State University. Dr. Debut is board certified in internal medicine and in epidemiology and public health.

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