Monday, July 29, 2019

Most Generous Conclusion Of Chocolate Milk In Exercise Systematic Review And Meta-Analysis? It Will Increase Your Time To Exhaustion By 47 Seconds Over Placebo

Literally every time I write about chocolate milk being a beverage worth actively minimizing in your diet (have the smallest amount of it you need to like your life), someone inevitably chimes in to tell me I'm wrong because it's great for exercise recovery.

And I'm not sure how I missed this when it came out, but last year, the European Journal of Clinical Nutrition, published a systematic review and meta-analysis of randomized controlled trials involving chocolate milk and exercise recovery.

After excluding studies that didn't meet their inclusion criteria, the (non-conflicted) authors were left with 12 studies, 2 deemed of high quality, 9 of fair quality, and 1 of low quality with 11 having extractable data on at least one performance/recovery marker including ratings of perceived exertion, time to exhaustion, heart rate, serum lactate, and serum creatine kinase.

Their overall conclusion?

The systematic review and meta-analysis revealed that chocolate milk consumption had no effect on any of those variables when compared to placebo or other sport drinks.

Their most generous conclusion?

If they excluded one study from their analysis of the effect of chocolate milk on time to exhaustion then chocolate milk was found to increase time to exhaustion by 47 seconds over a placebo beverage. They also found, in another subgroup analysis, that lactate was slightly attenuated in chocolate milk drinkers compared to placebo (a finding that was not present in the high quality RCT looking at same).

(for a brief discussion on the stats involved and the subgroup analysis, here's a post on same from epidemiologist @GidMK who concluded that chocolate milk is "not a fitness drink").

Happy to have this post published so that I can share the next time someone inevitably tries to suggest that chocolate milk is magic.

Saturday, July 27, 2019

Thursday, July 25, 2019

Sorry, Eating Thin People's Poop Isn't Likely To Make You Thin

Though there are certainly some celebrity quacktacular physicians I would like to see eat crap, but what I wouldn't be able to tell them is that doing so would likely have a beneficial impact on their weights.

A recent small study, Effects of Fecal Microbiota Transplantation With Oral Capsules in Obese Patients, found results that to me at least, seemed wholly unsurprising. 22 patients with obesity were randomly assigned to receive either a "fecal microbiota transplantation" from a donor whose BMI was 17.5 or a placebo and to take them for 3 months (and for those curious, the induction dose was 30 capsules).

The transplants were successful in changing the microbiome of the recipients, but alas, did not affect their weights.

Perhaps the only thing surprising about all of this is that there are people out there who strongly believe that a microbiome transplant stands a chance against thousands of genes, dozens of hormones, and a Willy Wonkian food environment all of which being coupled with millions of years of an evolutionary crucible of extreme dietary insecurity.

Monday, July 15, 2019

From The Journal Of If Only It Were That Easy: Walking To School Was Not Associated With Lower Weights In 4-7 Year Olds

Walking school buses for kids are often promoted on the basis that if more kids were involved with them, their weights, fitness, and maybe even learning would improve.

Wouldn't that be great? After all, it's a relatively inexpensive intervention and one it seems everyone can at least theoretically get behind.

But does it work?

This is definitely not a good news story, nor frankly is it all that surprising, but here it is - recently the MOVI‐KIDS Study set out to explore whether or not there was an association between active transport in 4-7 year olds and their weights, fitness, and cognition.

The study involved 1,159 children in Spain and they were categorized on the basis of whether the active components of their school commutes totalled more or less than 15 minutes and then tested and measured to explore walking to school's possible impact. Heights and weight were measured, a validated cardiorespiratory fitness test was administered, as were multiple batteries of validated cognitive tests. Efforts were also made to control for familial socio-economic status, as well as of course the children's ages and sexes.

As you might have gathered, the walkers were found to be no better off on any studied variable with the authors very plainly concluding,
"Walking to school had no positive impact on adiposity, physical fitness, and cognition in 4‐ to 7‐year‐old children."
Too bad. Truly.

I have to say too, I did scratch my head reading the next bit of their conclusion though,
"it would be of interest for future studies to examine the intensity and duration of active commuting to school necessary to provide meaningful benefits for health and cognitive performance."
I can't say I agree with them here as I'm not sure lengthy, intense, daily school commutes for 4 year olds is something we need to explore regardless of their impact on anything. Moreover, I don't need to see "meaningful benefits" to want to continue promoting more movement and play in our children, and if we buy into the need for same, we'll risk the cessation of programs that don't prove themselves to provide perhaps broader reaching or more dramatic outcomes than could ever be fairly expected of them.

Tuesday, July 09, 2019

Only 41% Of People Who Were Given Free Preventive Medications Following Their Heart Attacks Were Still Taking Them 1.5 Years Later

You might think that having a heart attack would be motivating when it came to behaviour change, and that taking medications is a very straightforward behaviour.

And yet.

The Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) trial set out to study whether or not cost had a role to play in why so many patients, even post heart attack, don't take the medications prescribed to them in the hopes of preventing another one by freely providing them with those medications.

Results wise, though the group receiving free preventive medications were taking more of them than the group that did not, at the end 1.5 years, only 41% of those receiving all their medications for free, medications prescribed to them after they had an actual heart attack, were taking them.

So file these results under human beings, even when faced with knowledge, and in this case knowledge coupled with a very real glimpse at mortality, struggle to maintain even the easiest of behaviour changes, and consider that in the context of the trope of education and personal responsibility as the sole means to target diet and weight related diseases. If we want to see population level changes, we're going to need to change the food environment.

Saturday, July 06, 2019

Tuesday, July 02, 2019

Cancer Research UK (@CR_UK) Launches Awful New Fat Shaming Advertising Campaign

According to Cancer Research UK's new public advertisements, obesity is apparently the new smoking.

What that means of course is that by formally adopting, amplifying, and promoting the message that obesity, like smoking, is a choice people make, Cancer Research UK fuels hateful weight based stigma.

More amazing perhaps is that the aim of the campaign is to apparently target the environment with their ads steering people, in the small print that people will likely miss and certainly can't click on in train stations, to their web page calling for an end to junk food advertising to kids.

Obesity is the normal consequence of normal people living in abnormal, obesigenic, environments. Obesity often has hugely negative impacts upon health and quality of life (especially at its extremes), fuelled in no small part by the never ending blame, shame, and scorn heaped upon those who have obesity by society, and yet here is Cancer Research UK's campaign to further justify that weight hate.

Shame on them. They absolutely should have known better.