Detective Science has done it again . . . freed a prime suspect. It now seems that Inactivity (a.k.a, the Coach Potato) is innocent of the crime of rising obesity levels.
The scene:
It is well known that less active children are fatter, but that does not mean — as most people assume it does — that inactivity leads to fatness. It could equally well be the other way round: that obesity leads to inactivity.
Ah yes, the old “correlation is not causation” bug-a-boo.
Anyone spy an open box of donuts? I’ve got a cup of coffee and could use a little law-enforcement fuel.
Here’s the title of the morning briefing:
Inactivity ‘No Contributor’ to Childhood Obesity Epidemic, New Report Suggests
Okay. But how was this determined? DNA samples, fingerprints on donuts? No. Detective Science put the suspect to a test. You might say an attempt was made to frame Couch Potato.
The test results:
Physical activity had no impact on weight change, but weight clearly led to less activity.
Ho-ho. Inactivity is looking innocent. Lovers of crime stories need not mourn, however. For the mystery remains. And we have other suspects, such as this one:
EarlyBird [Diabetes Study, UK] has already shown how the trajectory leading to obesity is established very early in life, long before children go to school, and how most childhood obesity is associated with obesity in the same-sex parent. [emphasis added]
Hmm. In this round of Clue it is possible will we eventually hear this shocking revelation: It was Same Sex Parent in the kitchen with a box of creme-filled.
In many ways, birds are like humans. Or maybe humans are like birds. No, that’s not right. Maybe both are animals and, as distantly related animals, share some attributes.
For instance, the behavior of both male humans and male birds is influenced by testosterone levels. While male birds don’t have external testes (can you imagine flying with those? — running upright is bad enough!) they do have internal testosterone-producing gonads. And new research has found that male birds with intermediate blood levels tend to do better.
In Costs and Benefits of Testosterone in Birds we learn that having high enough testosterone is good for a male bird’s mating success and survival. Testosterone gives a guy bird the starch in its spine (not the technical language) to acquire and defend a territory as well as the sexual drive to find/attract mates and . . . mate with them.
But while “enough” is good, “even more” is not better. In fact, it’s worse. The experimenters found that of the birds with their levels experimentally manipulated, those with levels near the wild average did the best. Too high means too much risky behavior, which leads to health-endangering fights and predation, etc. Too little means poorer territory (which includes poorer access to food and less desirable/safe nesting sites)as well as poorer reproductive success.
In another bird study, scientists found Wild Birds Opt for Conventional Food Over Organic, Study Shows.
Lead researcher Dr Ailsa McKenzie:
“We showed that when given free choice, wild birds opt for the conventional food over the organic, and the most likely explanation is its higher protein content.”
It may simply be an unfounded stereotype, but many human males, and a fair share of females, too, seem to prefer a fat and protein laden steak dinner over high-vegetable-content alternatives. For dessert: a calorie-rich but nutrition-poor piece of pie. Why? It’s elemental: our evolutionary history placed a premium on what was then higher value foods: protein and calories. Green leafies — a belly full of that would give you the energy to last a day at best. And for building muscles salad alone gets a failing grade.
While animals — birds and humans and thousands of other types — live in a present environment, their body plans and functioning physiology was shaped years ago, in one past. How well do they fit their immediate environments? Only time will tell.
This past weekend I wandered into and out of a health food store. Within I found 101 types of “green” cleaning agents and cosmetics. And some organically grown and bulk foods. And shelf after shelf of supplements and teas and tinctures and…. These might be described as products designed to “help your body heal itself.” Or perhaps: “To optimize your health so as to prevent future ill-health.”
Preventing ill-health. It’s actually a smart way to spend your money. Preventative measures are frequently less costly and distressing than dealing with full-blown disease states down the line.
Of course, whether some/most diseases can actually be prevented, and what means most effectively accomplish this — these are two very important questions. Questions I wouldn’t assume an answer to, one way or the other.
Can using green products — besides, perhaps, keeping less-biodegradible and more . . . toxic? . . . agents from the home environment and water treatment plants, too, maybe — bolster a person’s health, or at least put less stress on it? My guess is that for a minority of individuals with allergies and rare sensitivities, yes. For most people — minimally at best. But that is just a guess. A relatively informed guess, but just a guess. How to know for sure? One word: test. Run it through a few scientific hurdles.
Yogurt is a mainstay in the diet of many a healthy-eating enthusiast. And it seems that at least one pro-biotically enhanced type (now with even more friendly bacteria of the most friendly kind!) has recently cleared a hurdle.
In Yogurt-Like Drink DanActive Reduced Rate of Common Infections in Daycare Children I learned that -
The probiotic yogurt-like drink DanActive reduced the rate of common sicknesses such as ear infections, sinusitis, the flu and diarrhea in daycare children.
Well, that’s good news. So perhaps to the health advice, “sleep well, eat well, and get plenty of exercise,” we should add, “and regularly consume billions of the Lactobacillus casei (L. casei) strain of bacteria.”
[For more of the study details, scroll to the post foot.]
Should the health food store items aimed at prevention of disease be considered “alternative medicine”? Although millions of dollars are likely spent on “alternative medicines” in stores like these and on products of the sort mentioned above, I would use neither alternative nor medicine to describe them.
First, alternative. Alternative to what? Call them holistic, call them gentle, call them traditional. But in terms of medicine, they are not alternative medicine because the vast majority are not yet know to have actual medicinal properties. Call them pre-medicine.
Which brings me to the second point. Medicines and treatments deserve to be called such only if we know they are actually effective to one degree or another. And how do we know they are? Through the frankly non-holistic practice of isolating variables and testing. Measuring results. Otherwise, what have you got but callow hypotheses and guesses? Health is serious business. Why leave it up to guesses?
—
More about the particular scientific hurdle cleared:
The study, titled DRINK (Decreasing the Rates of Illness in Kids), was a randomized, double-blind, placebo-controlled study — the gold standard in clinical research design. It included 638 healthy children, aged three to six, who attended school five days a week. Parents were asked to give their child a daily strawberry yogurt-like drink. Some of the drinks were supplemented with the probiotic strain L. casei DN-114 001 (DanActive), while others had no probiotics (placebo). Neither the study coordinators, the children, nor the parents knew which drink was given to which participant until the study ended. In addition to phone interviews with researchers, parents kept daily diaries of their child’s health and the number of drinks consumed.
Researchers found a 19 percent decrease of common infections among the children who drank the yogurt-like drink with L. casei DN-114 001 compared to those whose drink did not have the probiotic. More specifically, those who drank DanActive had 24 percent fewer gastrointestinal infections (such as diarrhea, nausea, and vomiting), and 18 percent fewer upper respiratory tract infections (such as ear infections, sinusitis and strep). However, the reduction in infections did not result in fewer missed school days or activities — also a primary outcome of the study.
Is the consumption of chocolate good or bad for a person’s health? In my post, Rx.: Chocolate I discussed a study that suggested that a higher chocolate consumption might reduce blood pressure and the risk of heart disease.
I also pointed out the reason for the tentative wording: “suggests” . . . “might.” The study results were not generated by a controlled experiment. Rather, the results were a correlational finding. Statistically, individuals who had consumed more chocolate had an X% lower rate of heart health problems. Did one cause the other?
Happily, a commenter pointed me to a randomized, controlled trial (experiment) that found decreased blood pressure after increased chocolate consumption. Not a huge effect, but a causal effect just the same.
So chocolate is good for you!
Not so fast, sparky. Even if the “good for your cardiovascular health” finding holds up, chocolate may not be good for you in every way.
In news of a recent report published in the Archives of Internal Medicine I learned -
Individuals who screen positive for possible depression appear to consume more chocolate than those not screening positive for depression. [source]
How did the researchers determine this? Here’s how:
Natalie Rose, M.D., of University of California, Davis, and University of California, San Diego, and colleagues examined the relationship between chocolate and mood among 931 women and men who were not using antidepressants. Participants reported how much chocolate they consumed and most also completed a food frequency questionnaire about their overall diet. Their moods were assessed using a previously validated depression scale.
Those who screened positive for possible depression consumed an average of 8.4 servings of chocolate per month, compared with 5.4 servings per month among those not screening positive. Those whose scores were even higher, reflecting probable major depression, consumed even more chocolate—11.8 servings per month. [bolds mine]
Good numbers. But yes, a correlational finding. Fortunately, the researchers and the article writer included this very important paragraph, illustrating exactly why a correlational finding must be taken with a grain of salt (and not a square of Belgian dark).
Several explanations for the findings are possible, the authors note. “First, depression could stimulate chocolate cravings as ‘self-treatment’ if chocolate confers mood benefits, as has been suggested in recent studies of rats. Second, depression may stimulate chocolate cravings for unrelated reasons, without a treatment benefit of chocolate (in our sample, if there is a ‘treatment benefit,’ it did not suffice to overcome the depressed mood on average). Third, from cross-sectional data the possibility that chocolate could causally contribute to depressed mood, driving the association, cannot be excluded.”
Well done! Now that’s good, skeptical science and science reporting.
All right, Mr. Jones . . . from your blood results it seems you are going to have to cut down on the red meat, and maybe start eating more chocolate. Or both.
While I doubt doctors will be giving that prescription soon to patients, some people just might take things into their own hands. And get melted chocolate on them. But will it help?
It might. And I’m thankful that the news release about a new study included that very word.
Chocolate Might Reduce Blood Pressure and Risk of Heart Disease, Research Suggests
You catch that? “Suggests” as well. Good tentative science reporting. And why should they be tentative? They did, after all report this significant finding:
[T]hose who ate the most amount of chocolate — an average of 7.5 grams a day — had lower blood pressure and a 39% lower risk of having a heart attack or stroke compared to those who ate the least amount of chocolate.
That’s big. Really big. An almost 40% lower risk of heart attack, thanks to chocolate? Where can I get a prescription for Toblerone filled? I don’t need a prescription? Even better.
But wait. There are reasons for the tentativeness. Here are a couple that give me pause.
First -
The difference between the two groups amounts to six grams of chocolate: the equivalent of less than one small square of a 100g bar.
Six grams is about a fifth of an ounce. Of sugar and milk and chocolate powder. And lecithin and maybe a few other things. That’s the dietary difference between the groups. Mind you, one group didn’t eat no chocolate, and the other some. One group simply ate (reported eating) more. And that group had almost a 40% decreased risk.
The quantity of the data, by the way, wasn’t bad. Nearly 20,000 people age 35 to 65 tracked for ten years.
But here’s the second cause for doubt. Like many epidemiological studies, the subjects weren’t part of a controlled experiment: this group instructed to eat chocolate, this to refrain, etc. Instead, the data collection went like this:
The people in the study were participants in the Potsdam arm of the European Prospective Investigation into Cancer (EPIC). They received medical checks, including blood pressure, height and weight measurements at the start of the study between 1994-1998, and they also answered questions about their diet, lifestyle and health. They were asked how frequently they ate a 50g bar of chocolate, and they could say whether they ate half a bar, or one, two or three bars. They were not asked about whether the chocolate was white, milk or dark chocolate.
What this means is that the finding was a statistical correlation between two of many variables measured. It is a fact of probability that the more variables you measure, the more likely you will find a link between two. A potentially meaningless link. An anomaly of sorts.
So don’t move your investment dollars from Pfizer to Hershey’s just yet. I’d wait for some follow-up research to confirm the possible link. But what a tasty link it would be.
Is quality food the ultimate medicine, perhaps the only medicine we need? Many friends of alternative medicine seem to think so. Comedian and talk-show host Bill Maher is fond of arguing that the reason why Americans are so unhealthy (we are?) is that we “eat like crap.” Processed foods, non-organic vegetables, etc. Is there any truth to this?
As you could guess, I’m skeptical. But open-minded. What I am most skeptical of in this case is the simplistic generalization. The always and never, black-and-white thinking.
Also, it seems to me that underlying much of the alt-med philosophy is an idealism. A belief that human beings are created to be perfectly healthy and if we become unhealthy, it is because we have screwed up, or something “un-natural” has screwed us up. So to speak.
Anyone sufficiently familiar with human biology and genetic diversity understands that no two people are the same. Some have innately robust intestinal tracts, for example, while others . . . don’t. In the least, we have different degrees of vulnerability to disease and disorder. Naturally. Many individuals so much as bend over to pick up a pen and suffer a back spasm. Others can shoulder boulders for decades without ill effect. Etc. Etc. Etc. No, we aren’t born perfect and then “poof” something happens to screw us up. It is more complicated than that.
Two recent studies into this topic of food-as-medicine, found over at ScienceDaily, got me thinking about it. But let me warn you up front, if you are looking for a clear-cut answer, read no further. Simplistic answers are for those with superficial worldviews.
The first, Marathon Runners Should Pick Cherries for Speedy Recovery, seems to suggest that, yes, food can be medicinal.
Dr Glyn Howatson, exercise physiologist and Laboratory Director in the School of Psychology and Sports Sciences at Northumbria University, examined the properties of Montmorency cherries in a study that found that athletes who drank the juice recovered faster after Marathon running than a placebo controlled group. [bolds mine]
Placebo controlled, that’s good. Hmm. I wonder what the actual nitty-gritty of the research was. . . . Oh-oh. Only 20 subjects, 10 in each group. Hold the presses. This finding must be considered much more on the “suggestive” end of the spectrum than “conclusive” due to that element alone.
Here’s a second problem: the measured variables. Okay, the cherry juice, no problem with that. But the others? Strength, seems straightforward; inflammation, certainly seems measurable, as far as I know; oxidative stress, I don’t know what this means and how it might be measured. But that could just be a reflection of my ignorance.
What I would really like to know, however, is the measured actual degree of groups differences in these variables. How much did the special cherry juice help? That’s crucial information. And it pertains to the next study.
The second study, Cancer Protective Effect of Fruits and Vegetables May Be Modest at Best, was almost a reverse case.
But first, the background:
It is widely believed that a diet rich in fruits and vegetables can reduce the risk of cancer. In 1990, the World Health Association recommended eating five servings of fruit and vegetables a day to prevent cancer and other diseases. But many studies since then have not been able to confirm a definitive association between fruit and vegetable intake and cancer risk.
And the good news, as far as the science goes: the results were based on data collected from more than 400,000 subjects. Wow.
The bad news, in terms of the results, was indicated in the title. There was -
only a weak association between high fruit and vegetable intake and reduced overall cancer risk, according to a study published online April 6, 2010 in the Journal of the National Cancer Institute.
Again — how weak was that association between variables?
In terms of the research, the bad news is that this was no controlled experiment. The findings are completely based upon questionnaires and medical statistics. Fortunately, the article contained these two, five-star paragraphs:
The authors caution against attributing any risk reduction to diet and they conclude that any cancer protective effect of these foods is likely to be modest, at best.
“In this population, a higher intake of fruits and vegetables was also associated with other lifestyle variables, such as lower intake of alcohol, never-smoking, short duration of tobacco smoking, and higher level of physical activity, which may have contributed to a lower cancer risk,” they write.
Now that’s a good example of how to communicate and model the work of science. Three cheers for it.
So. Any conclusions? From these and other studies it doesn’t seem dietary changes are a magic bullet for all that ails us, for preventing and treating the myriad forms of disorders and disease. Sure, some dietary changes can and do influence some conditions: sugar intake and diabetes is an obvious one. Yet, overall, the general idea of food as the perfect medicine seems to fall far short. Which, personally speaking, is a bit of a bummer. I, for one, would love to have my prescriptions filled at the vegetable market. In the least, I wouldn’t need a spoonful of sugar to make the medicine go down.
