Saturday, May 28, 2016

Saturday Stories: Poverty, Cancer, Self-Criticism, and 13 Tears

Christopher Jenks, in the New York Review of Books, covers why America's poor have become so much more impoverished.

Ginger Gorman, in, with a conversation about cancer no one is having. (It’s not brave. Or inspirational).

Maria Popova, in Brain Pickings, on self-criticism and the Stockholm Syndrome of the super-ego.

Dr. Donna Neufeld with her poem crying 13 tears (via Facebook).

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Friday, May 27, 2016

Bet You've Never Been As Hungry as This Great Dane

Today's Funny Friday.

Just watch it.

Have a great weekend!

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Thursday, May 26, 2016

School "Hot Lunches" Are Beyond Awful. How Did We Let Them Happen?

A friend on Twitter sent the photo up above to me. It's this week's hot lunch offering for his kid's school's kindergartners through Grade 6ers.

Hot dogs, donuts, and juice.


And then of course there's pizza days, sub days, and various other awful food days that not only serve kids literal fast food, but in so doing also teach kids that it's a totally normal/alright to have fast food each and every week.

Parents would jump in front of buses for their children, and yet packing them a healthy lunch everyday isn't doable? Clearly it's not a money thing as $5 for a hot dog, a donut and a juice box certainly doesn't make this hot lunch a value proposition.

How did we get here as a society?

More importantly, how do we leave?

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Tuesday, May 24, 2016

Could "Psychological Stress" Explain The Biggest Losers' Metabolisms?

Seems extremely unlikely to me only in that there's no obvious pathophysiological mechanism that could help to explain why the show's psychological distress led to permanent and disproportionate metabolic adaptation.

And though that's what I told the reporter from the New York Post, she left out the "doubtful" proviso and left in the "possible".

The thing is, it's unclear why The Biggest Loser's contestants' metabolisms seem slower than would be expected simply as a consequence to weight loss. They're also slower than the metabolisms of patients who've had bariatric surgery and lost similar amounts of weight.

Could their greater degrees of metabolic adaptation be due to the nature of the show itself? Sure. But as I told the reporter Maureen Callahan, over and over again in fact, it's also possible that losing 40-50% of your body weight without surgery, regardless of approach, is responsible.

And yes, despite what the article misquoted me as saying, plenty of people have lost 40-50% of their body weights without surgery, but generally those losses occur with extremes of effort (like they do on The Biggest Loser). What I'd like to know is whether or not losing comparable amounts of weight slowly would lead to similar outcomes?

That'd be a challenging thing to figure out because losing that much weight slowly is a rarity. Of course that doesn't mean it doesn't happen, it just means that it's rare. It also means that randomizing people to lose 40-50% of their body weights with non-extreme efforts isn't feasible.

Lastly, though I think when it comes to weight loss The Biggest Loser's Dr. Huizenga is either deluded, unethical, or clueless, I never claimed to know him personally.

Bottom line. The Biggest Loser is a horror show (I've written extensively about it over the years), but so too is Maureen Callaghan's reporting on it for The New York Post.

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Saturday, May 21, 2016

Saturday Stories: OxyContin Hell, Trumpist Mobocracy, Anti-Zionism

Harriet Ryan, Lisa Girion and Scott Glover in the LA Times with a hell of a story about oxycontin hell.

Robert Kagan in the Washington Post on Trump, fascism and "mobocracy".

Frequent Israel critic Michael Koplow on his blog Ottomans and Zionists on what he calls the crisis of anti-zionism.

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Friday, May 20, 2016

If Meat Eaters Acted Like Vegans

Parts of today's Funny Friday video made me laugh out loud.

Have a great weekend!

(and BTW, I've nothing against vegans - but this was damn funny)

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Wednesday, May 18, 2016

Dr. Andrew Stokes On That New Excess Weight is Healthier Study

Last week saw the publication of yet another study looking to quantify risk with weight, and like some studies have found in the past, the conclusion was that some excess weight might in fact be beneficial to health. From my perspective, the question of "what weight is healthiest" is flawed in and of itself. As I tend to prattle on, the goal for all of us, regardless of our weights, should be to stack our personal decks as much as is realistically possible by living with the healthiest life that we can honestly enjoy. These studies, whatever their findings, tend to emphasize that scales can usefully measure health. I don't wholly agree, but that said, I invited Andrew Stokes, a researcher with a special interest in the association between weight and mortality, to give us his take on the new research.
A new study published in JAMA finds that the BMI value associated with the lowest risk of dying shifted from the normal to overweight range between 1976-1978 and 2003-2013. The study is short on explanations for this puzzling finding, but does offer up the possibility that people with overweight and obesity are receiving better treatment and thus living longer than they did in earlier decades.

An alternative explanation for these findings is a flawed research design. Although some of the coverage, including on NPR and on Ted Kyle’s obesity blog, pointed out the potential pitfalls of using BMI as a proxy measure of body fat, they miss a more fundamental problem with this study, a problem that is shared by many other studies of the health consequences of obesity.

The problem, which I discussed in a previous post on Yoni’s blog, is the reliance on weight assessed at a single point in time. Disregarding weight history is a problem because people who have long maintained a weight in the normal range are mixed together with those who formerly had overweight or obese and lost weight. Although some of the weight loss in the latter group is healthy weight loss, much of it is tied to conditions such as heart disease, cancer, COPD and other ailments. Because of this—as several recent studies have shown — including the weight losers as part of the normal weight category obscures the substantial benefits associated with maintaining a normal body weight.

In the JAMA study, attempts were made to address this bias (referred to by epidemiologists as confounding by illness) but the measures taken were ad hoc and incomplete, leaving plenty of room for the bias to creep into the estimates. Unfortunately, there is no way of knowing from the data presented how the composition of the normal weight category changed across the cohorts studied. It could be that as a result of differences in age composition or smoking status across cohorts, that a larger fraction of the normal weight group in the later cohort once had overweight or obesity, which could explain the apparent finding of the nadir of the BMI mortality relationship increasing across cohorts.

The substantial discrepancy in length of follow-up across cohorts may have also compromised the comparison (median length of follow-up was 19.8, 11.0 and 4.6 years in the 1976-1978, 1991-1994 and 2003-2013 cohorts, respectively). Length of follow-up has been shown to be a significant effect modifier of the association between excess weight and mortality, with shorter duration follow-up often leading to greatly attenuated effects. The findings of the JAMA study are consistent with bias due to duration effects, with the risks getting progressively weaker between the first cohort in which follow-up was greatest and the last cohort in which follow-up was shortest. Although the authors acknowledge the possibility and present several tables and sensitivity analyses aimed at testing for duration effects, the results are not entirely convincing.

The problems discussed above raise doubts about how much we should take away from the new JAMA study. Although it is possible that the nadir of the BMI-mortality curve has shifted over time, this study is far from conclusive on the matter. A more likely explanation behind the striking pattern is that it is a spurious result of a flawed study design.

Andrew Stokes is an Assistant Professor in the Department of Global Health at Boston University. His research is focused on the causes and consequences of the global obesity epidemic and developing novel approaches to combating obesity at the population level through interventions that target aspects of the social and physical environment. You can also follow him on Twitter.

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Monday, May 16, 2016

No Mott's, Watered Down Juice Doesn't Help Kids #StartStrong

Mott's for Tots is watered down juice. As in they took juice and added water and then sold it to you at the same price as the non-watered down stuff.

Watered down juice is not "love".

Watered down juice won't help your kids "#startstrong"

Watered down juice shouldn't share or exceed the cost of regular.

Juice is not a healthful beverage.

Treat juice like soda pop and give it to your kids in the smallest amounts you can get away with (aim for less than half a cup a day).

[Thanks to Patti for sending my way]

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Saturday, May 14, 2016

Saturday Stories: Discarded Life, Expensive Medicine, and Un-Assimilation

Alexander Masters in The Guardian on the discarded life he found, pieced together, and published.

Antonio Regalado in MIT Technology Review on the lessons learned from the world's most expensive medicine.

Rivka Bond in The Times of Israel with a piece that I strongly relate with on becoming un-assimilated.

[And ICYMI, I wrote a piece for Vox that hit their number one status for a while on whether or not long term weight loss really was impossible.]

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Friday, May 13, 2016

The Must-Watch John Oliver "Science" Video

On the remotely off chance you haven't seen it, today's Funny Friday video is an incredible effort by Last Week Tonight's John Oliver to highlight just how poorly science is covered and publicized as well as "hacked"

Have a great weekend!

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