Successful Aging: Solving a medical mystery, not fixing a machine |

Successful Aging: Solving a medical mystery, not fixing a machine

Angelyn Frankenberg

Angelyn Frankenberg


Read Jay Heinrichs’s “The Storied Man” in Southwest, the Magazine.

A PubMed search will lead you to the hard-core" target="_blank">">hard-core science.

On a flight to Philadelphia last week, something I needed to read found me. It was an early flight, but I was too tired to sleep. I opened Southwest, the Magazine, heading for the crossword puzzle in the back. Someone had already done it, so I reached for the copy in the seatback pocket in front of my husband. But its crossword had been done, too.

I was getting desperate, and the man in the window seat was already asleep, so I reached for his copy. That crossword also had been done, and I wasn’t desperate enough to impose on a flight attendant for a new copy. I started flipping through the pages expecting a little mindless fluff to help me drop off.

But page 54 woke me up: “Flying foxes, Caribbean monkeys, a tiny laboratory in a Wyoming cabin, and a young Mormon missionary who became a Samoan chief before pursuing one of life’s greatest medical mysteries.”

I dove into “The Storied Man” by Jay Heinrichs. It describes the life and work of Paul Alan Cox, a true Renaissance man who has been a Mormon missionary, studies and respects indigenous cultures and speaks “a dozen or so” languages. With degrees in philosophy and botany, ecology and biology, his profession is ethnobotany. He has traveled unbeaten paths to make internationally known contributions to medical research and now runs the Institute for EthnoMedicine in Jackson, Wyoming.

Cox’s unorthodox approach helped him solve the biggest medical mystery of his career. Shortly after World War II, doctors reported a strange neurological illness among the Chamorro people in Guam. It was a devastating combination of Alzheimer’s, Parkinson’s and amyotrophic lateral sclerosis that affected up to a quarter of the Chamorros. After 50 years of study, scientists had not found a cause but had ruled out genetics.

Cox had studied the role of the cycad plant in pollinating rain forests and traced the disease’s cause to a toxin in cycad seeds. But the route was indirect. Flying foxes, giant bats with 5-foot wingspans, ate large quantities of the seeds, and were in turn consumed by the Chamorro people, who considered the bats one of their favorite foods.

Cycad seeds contain large amounts of the amino acid BMAA, which is produced by cyanobacteria in the plant’s roots. Cox and his colleagues thought BMAA, which is neurotoxic in large quantities, might be destroying central nervous system proteins and causing the neurodegenerative disease group known as “lytico-bodig” (listless paralysis) by the Chamorros. But how?

Cox’s scientific method, which draws on connections from different cultures and disciplines, directed him to the answer. With a group of Australian researchers, he learned that BMAA displaces the “good” amino acid, L-serine, in nerve proteins. Then, remembering villagers in Okinawa, which has the highest percentage of centenarians in the world and very low rates of neurodegenerative diseases, he wondered if their natural diet, high in L-serine-rich tofu and seaweed, could offer a neuroprotective effect.

Testing on vervet monkeys showed that to be the case. Brain tissue in the monkeys given BMAA alone looked the same as that of the Chamorro people who had the disease. Vervets who got L-serine and BMAA had half the symptoms as those who got no L-serine.

Cox’s discovery is a lesson for all of us. His path goes against the idea that the body is machine. That dogma guides most medical research today: we look for a broken or malfunctioning part — maybe a gene — and hope we can fix it or create a drug to counter its negative effects.

I’m not a scientist, just a science junkie (and could be a Paul Alan Cox groupie), but I have long railed against that notion. Cox takes it a step further, though. He said, “I decided that neurodegenerative diseases are not malfunctions of the machine. They are the machine.”

His discoveries help us understand how to “disrupt the machine” and have applications far beyond the Chamorro people of Guam. For many diseases, we don’t find a gene or genes that cause it. Multiple genes are implicated in many illnesses but we have genetic tendencies, not certainties, with a greater or lesser chance of getting this or that.

Cyanobacteria, which produces BMAA, is also known as blue green algae. Heinrichs’ story tells how its growth is increasing as our planet gets warmer, in places from Qatar to Biscayne Bay (Miami). Fertilizer runoff and other pollutants are also increasing its occurrence. And neurodegenerative diseases associated with aging — Alzheimer’s, Parkinson’s, and ALS — are on the rise.

Cox’s research helps us look beyond the reductionist idea of fixing the broken part. Understanding interactions between genes and the environment is essential to disrupting a disease’s mechanistic processes to cure, or ideally, to prevent it.

Angelyn Frankenberg is a wellness coach and writer living in Carbondale. She has a master’s in physical education and an undergraduate degree in music. Reach her at

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