Saturday Stories: How the #UrgencyOfNormal ignores the #UrgencyOfEquity

Melody Schreiber, in The New Republic, on why the #UrgencyOfNormal cabal so badly want kids to be unmasked. 

The #UrgencyOfEquity, which I support, discusses how to best protect our most vulnerable and marginalized students during this pandemic. 

Saturday Stories: #Urgency of Normal Done With COVID x 3 And What To Do Post-Omicron

Ed Yong, in The Atlantic, on how the #UrgencyofNormal/done with COVID talk condemns the immunocompromised

Ramnath Subbaraman,  Michelle Holmes,  and Lakshmi Ganapathi, in Common Dream, on the privilege required to state that you're done with COVID.

Gregg Gonsalves, in The New York Times, on the immorality of #UrgencyofNormal done with COVID takes. 

Gavin Yamey, Abraar Karan and Ranu Dhillon in TIME, on what we need to do with our post-Omicron time.

Saturday Stories: Air, Hopium, And Kids' Masks

Edward A. Nardell, in Time, on how to clean our indoor air.

Gregg Gonsalves, in The Nation, on the dangers of hopium and wishful thinking on COVID.

Melody Schreiber, in The New Republic, on how masks have no impact on child development.

Saturday Stories: Endemicity's Meaninglessness, 1918's Flu, And Hospitals

Jacob Stern and Katherine J. Wu, in The Atlantic, on the meaninglessness of endemicity.

John M. Barry, in The New York Times, on learning from 1918 the risks of pretending it's over before it is.

Ed Yong, in The Atlantic, on the state of our hospitals right now.

Saturday Stories: Endemicity and Japan

Aris Katzourakis, in Nature, on what the word endemic actually means

Hitoshi Oshitani, in the New York Times, on what Japan got right in its approach to the pandemic.

Photo By https://www.flickr.com/photos/reggiepen/ - https://www.flickr.com/photos/reggiepen/17025277650/, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=67128875 

Saturday Stories: Treating the Unvaccinated, Will Omicron Hasten Immunity, And Airborne COVID

Ed Yong, in The Atlantic, on why it's a terrible idea not to treat the unvaccinated.

Katherine J. Wu, also in The Atlantic, on whether Omicron infections will translate into widespread immunity.

The Agenda, with a great segment on how COVID is airborne.

Infographic By Colin D. Funk, Craig Laferrière, and Ali Ardakani - Funk CD, Laferrière C y Ardakani A (2020) Una instantánea de la carrera mundial de vacunas dirigidas contra el SARS-CoV-2 y la pandemia COVID-19. Parte delantera. Pharmacol. 11:937.Funk CD, Laferrière C and Ardakani A (2020) A Snapshot of the Global Race for Vaccines Targeting SARS-CoV-2 and the COVID-19 Pandemic. Front. Pharmacol. 11:937.https://doi.org/10.3389/fphar.2020.00937, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=99473789

Saturday Stories: The Great Surrender, It's Mild, It's So Mild, With COVID

Chuck Wendig, in TerribleMinds, on our great surrender and how we let COVID win.

Bruce Arthur, in The Toronto Star, on the myth of mild Omicron.

Katherine J. Wu, in The Atlantic, on how we're long past the point of hoping 'mild' Omicron will spare us.

Ed Yong, in The Atlantic, on the fallacies swirling around the hospitalized "with" COVID discussion.

Saturday Stories: America's COVID Rules, COVID fatigue, And Omicron Healthcare

Katherine J. Wu, in the Atlantic, on the dumpster fire that is America's COVID rules (and for Canadian readers, much overlap with ours).

Gregg Gonsalves, in The Nation, on the impact of COVID fatigue on our morality. 

Ed Yong, in The Atlantic, on the crushing impact "mild" Omicron has on healthcare delivery.

Saturday Stories: Omicron's Teaching, COVID's Teaching, And Teaching LeBron

Andrew Joseph and Helen Branswell, in STAT, on the lessons we're learning from Omicron.

More Helen Branswell, in STAT, on 10 lessons she's learned covering the pandemic.

Kareem Abdul-Jabbar, in his Substack, helps LeBron James understand the differences between colds, flus, and COVID.

Photo By Keith Allison - https://www.flickr.com/photos/keithallison/31915296404/, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=70713991

Saturday Story: Again Just One And Again It's Omicron

Katherine J. Wu, Ed Yong, and Sarah Zhang, in The Atlantic, on how our response to Omicron to date represents all of our past mistakes on fast forward.

Saturday Story: Ed Yong on Omicron

Ed Yong, the best science journalist of this pandemic, in the Atlantic, discusses Omicron and how we're definitely not ready for it. It's so good it's the only story I'm posting this week. 

Saturday Stories: Treating The Unvaccinated, Omicron, And Mildness

Steven Novella, in Science Based Medicine, on why we cannot and should not withhold medical care from the unvaccinated. 

Sarah Zhang, in The Atlantic, on why Omicron's explosive growth is so concerning. 

Andrew Pekosz, in The New York Times, on how COVID doesn't care about lethality, but that you definitely shouldn't assume it's going to evolve to be milder.

Saturday Stories: Fitness and Health Aren't Enough, 3 Cheers For Our Immune Systems, And Omicron

By Soupvector - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=112983798

Sirin Kale, in The Guardian, with the life and death story of 42 year old triathlete, body builder, and anti-vaxxer John Eyers

Katherine J. Wu, in The Atlantic, on why you should be showing your immune system some love

Ewen Callaway & Heidi Ledford, in Nature, with a piece that may in fact be out of date despite being published 2 days ago, on what we do and don't know about Omicron.

In Yet Another Win, Bariatric Surgery Reduces Cancer Risk In Long Term Study

Before you read any further know that I'm NOT a surgeon.

I think it could be fairly argued that as far as surgical impact and benefits go, there are few that rival bariatric surgery.

Shown to prolong life, regularly push many chronic diseases including type 2 diabetes, hypertension, sleep apnea (and so many more) into remission, and dramatically improve subjective quality of life, for so many, bariatric surgery provides a new lease on life.

Well add to the aforementioned list a reduced risk of cancer. While not particularly surprising of course given the relationship between weight and some of our most common cancers, here's new data from the now over 2 decades old SOS study which demonstrates reduced cancer risk in patients who opted for surgery vs. weight matched medically managed controls. 

For those of us who have the good fortune of working with patients who've had bariatric surgery, we know just how life changing it can be. What's shocking though, is the comfort of those who don't work with this category of patients to look down on surgery, or fearmonger about it, and this sadly also includes people in the health care community..

The data is clear. Bariatric surgery is remarkable. That said, I'm hopeful that in 20-30 years, it'll no longer be necessary and will be replaced by medications that lead to surgical degrees of weight loss without the surgery. Until then however, I'm thankful the option of bariatric surgery exists, and if you're not, you're either ignorant or an ideologue.

Saturday Stories: Testing, Health Professional Long-haulers, And The Holocaust

Katherine J. Wu, in The Atlantic, with everything you really should know about the various modalities of COVID testing.

Ed Yong, also in The Atlantic, on health professionals who themselves are now facing the challenges of long-haul COVID.

Talia Bracha Lavin, on her substack, discusses the moral bankruptcy and abject idiocy of those utilizing Holocaust analogies for anything COVID related.  

[And finally, I'm so close! 90% of the way to my #Movember $3,000 fundraising goal. I'm also pleased to report that my Ted Lasso is doing just fine. If you're able to give, you can give anonymously, every bit counts, and that while I'll make this ask of those of you who are able annually, I promise I'll never charge a penny for anyone to ever read this content. Click here to donate!]

Every Diet Works For Someone, No Diet Works For Everyone, Diets Are Difficult - IF 2021 Edition

Joining an ever increasing cavalcade of studies of different diets that demonstrate they all work as well or as poorly as one another comes this week's A randomised controlled trial of the 5:2 diet published in PLoS. 

In it researchers randomly assigned 300 participants to receive either:

1) "Standard" brief contact in the form of a 20 minute chat, and the provision of a booklet discussing UK's national dietary guidelines and a leaflet of various local weight management resources, 

2) 20 minutes of Q&A on IF dieting and provision of a leaflet describing 5:2 style intermittent fasting (IF - where two non-consecutive days of the week people are instructed to eat 500-600 calories total), or 

3) That same IF leaflet and chat as above plus 6 weekly one hour group support sessions spread over the first 6 weeks of dieting.

What'd they find?

1) There was no difference in weight loss between groups at 6 months or 1 year post randomization (average loss of just under 4lbs but with some individuals up to 20lbs)

2) Roughly 50% of the participants of each group dropped out within the year

So I guess the same old unsexy conclusion as always. 

Every diet works for someone. No diet works for everyone. Why? Because diets are difficult to sustain unless you happen to enjoy the one you're on.

And to that end, stay far away from healthcare providers claiming there's one best way to lose. Your best diet is someone else's worst.

[Also, if you're able, please consider donating to my #Movember fundraising efforts. It's my one and only annual ask and I'm 80% of the way to my $3,000 goal. No amount is too small, you can give anonymously, and tax receipts are provided. Simply click here to donate, and if you're wondering how it's going, will post an updated picture this Saturday]

Saturday Stories: The Health-Care Workers, The Fight To Call It Aerosol, And Narratives, Counter-Narratives, And Social Drama

Ed Yong, in The Atlantic, covers the devastating impact managing patients with COVID has had on the world's health-care workers many of who are calling it quits.

Megan Molteni, in Wired, on the teensy tiny error that helped COVID kill by creating a fight over how it's spread. 

Trisha Greenhalgh, M Ozbilgin, and D Tomlinson, in Authorea, on the narratives, counter-narratives and social dramas that underwrote our discussion on how COVID spreads.

Also, if you're able, please consider donating to my #Movember fundraising efforts. It's my one and only annual ask and I'm 2/3rds of the way to my goal, no amount is too small, and tax receipts are provided. Click here to donate and if you're wondering how it's going, here's my Ted Lasso to date.

The World Health Organization, For #WorldDiabetesDay, Chose Fat Shaming And Stigmatization

Where to start with this?

First off there are more than 2 types of diabetes (I mean even the tweet lists 3), but really, recognizing World Diabetes Day with an infographic of a person with obesity in bare feet on a Lazy-Boy eating a giant bag of chips? 

That's certainly the gluttonous sloth narrative that much of society subscribes to, but the WHO? 

And yes, weight, diet, and physical activity correlate with diabetes risk, but for the WHO to dumb things down to people with type 2 diabetes are fat, lazy, gluttons? The mind boggles.

Never mind genetics, social determinants of health (including poverty, education, caregiving requirements, etc), co-morbid medical conditions, and more, the actual World Health Organization on World Diabetes Day, is stating if you have type 2 diabetes, it's your fault.

This of course also ignores the fact that there is just a staggering amount of privilege required to intentionally and permanently prioritize behaviour change around food and fitness in the name of health, and of course denies the reality of the thousands of genes and hormones known to be involved in the regulation of weight and dietary choices.

Perhaps this will serve as an opportunity for the WHO to take a closer look at weight and diabetes bias and stigma and focus some resources to help educate the world on the dangers and risks therein. For over 24 hours, they'd simply added a tweet to their offensive, misguided, and erroneous thread stating they'll take into account the feedback they've received in future messaging, then yesterday afternoon, they finally took it down. Here's hoping we see a thread about implicit and explicit bias from the WHO down the road

[Also, it's that time of year again, and should any of you want to donate to my Movember fundraising (am just over halfway to goal!), here's the link]

Saturday Stories: Aaron Rodgers, Vaccine Passports, And Doctors' Vaccinations

Kareem Abdul-Jabbar, in his substack, on the damage Aaron Rodgers has wrought on professional sports as a whole. 

Arthur Shaffer, interviewed in Healthy Debates, on the ethics and legalities of vaccine passports. 

Andrew McRae and Andreas Laupacis, in CMAJ, make the case for vaccination as a mandatory requirement for the in person practice of medicine. 

[It's that time of year again, and should any of you like to donate to my Movember fundraising, here's the link]

2021's Dumbest Scientifically Published Exercise Recommendation For The Treatment Of Obesity

[First written blog post since March 2020. What an awful 20 months. Though the pandemic is certainly not over yet, it feels like it's time to start writing again. Not sure what the frequency of posts will be, but it's nice to be back]

I wouldn't have believed it was real if I hadn't seen this phenomenon so many times before - a research study trying to tie their findings to the treatment of obesity despite the findings being either incapable of leading to clinically meaningful weight loss, or ridiculous to suggest in the first place. Here we've got both.

Published in Cell Reports Medicine, the paper Altered brown fat thermoregulation and enhanced cold-induced thermogenesis in young, healthy, winter-swimming men looked at the brown fat stores of Scandinavian men who alternate brief outdoor winter swims with a dash to the sauna 2-3x weekly. 

What'd they find?

The non-randomly selected winter swimmers, all 8 of them, whose average BMIs were 23.7 and whose average age was 25, were found, when exposed to cold, to generate more heat from their brown adipose tissue than their 8 age and weight matched controls. 

How many calories did that brown adipose tissue heat generation burn? If we take their results at face value (their results are orders of magnitude higher than found in a prior study of albeit older subjects), they report that during a "cooling period" of 30 minutes (there was no difference during a "comfort state"), resting energy expenditure was higher in the winter swimmers by an extrapolated 484kcal/24hours. They also reported that winter swimmers spent on average 11 weekly minutes in cold water. So during those 11 minutes the winter swimmers might well be burning 3.7 more calories than their non-winter swimming counterparts - the equivalent number you'd consume eating 1/10th of a carrot. 

The paper is full of various hypotheses to try to tease out the findings from this very small study. 

But what struck me was their final conclusion, 

"Finally, our findings motivate investigations of winter swimming as a lifestyle intervention for increased energy expenditure in obese subjects as a potential weight loss strategy."

Really? Your n=8, non-randomized, observational study of young men without obesity, that didn't control for any weight related variables, which showed that during their 11 minutes of winter-swimming the swimmers might burn 3.7 more calories per week for 4 months than non swimmers motivates investigations of winter swimming as a potential weight loss strategy in people with obesity?

Photo By Jaan Künnap - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=87539864