An article written in the NY Times makes some observations that desperately need to become conventional wisdom:

Our collective failure to keep our resolutions represents an annuity of sorts for health clubs, weight-loss centers and other enterprises that make up what you might call the self-improvement industry. It’s an industry that thrives on our failure to change: recidivism is good for the bottom line.

You can read the rest of the article here.

In general, if you want to improve yourself, you should do it immediately.

New Year’s resolutions are a bastion for procrastination and self-delusion. 

A good rule of thumb for taking on a new project is to replace the word “and” with “or.”

For example, the statement “I’ll try and lose weight when the new year starts and I buy a gym membership and get off my meds” ought to read…

“I’ll try and lose weight when the new year starts or I buy a gym membership or when I get off my meds.”

You get the idea.

Here’s hoping to a productive and fulfilling 2012!

This might be a good read for some of you. A few quick tips on avoiding New Year’s hangovers:

Topping the list? Don’t drink on an empty stomach, said Sam Zakhari, director of the National Institute on Alcohol Abuse and Alcoholism’s metabolism and health effects division. Food helps absorb alcohol and delay its toxic effects on the body.

You can read the rest of the article here.

Have fun, and happy New Years!

Gourmet potato chips brand themselves as healthier than pedestrian ones like Lays, Ruffles, etc. But is there a difference?

The Language of Food did an interesting comparative study:

Josh and I looked at 12 bags of potato chips, 6 more expensive (Boulder, Dirty, Kettle Brand, Popchips, Terra, Season’s, averaging 68 cents per ounce) and 6 less expensive (Hawaiian, Herr’s, Lays, Tim’s, Utz, and Wise, averaging 40 cents per ounce). We coded up all the advertising text from the back of the chips and then examined how the words differed between the two classes of chips.

It turns out there was no difference in health values between the two groups of chips, but they marketed themselves very differently.

What factors characterized expensive chips? You may be surprised to learn that potato chips are a health food; almost all chips (expensive or not) emphasized the healthiness of their products by using phrases like “low fat”, “healthier”, “no cholesterol”, or “lowest sodium level”. But these health-related claims occur on expensive chips 6 times as often as on inexpensive chips (6 times per bag versus once per bag). This difference in health language is not, as far as we can tell, due to actual differences in the chips.

I think a lot of gourmet potato chips advertise themselves on the quality of their ingredients. Only potatoes, oil, salt, without the funny looking ingredients you’re more likely to find in the cheap chips.

That might be a slight advantage, but not enough to categorize the two foods differently.

The Wall Street Journal has an article about the War on Cancer act, which was passed 40 years ago.

What’s changed? 

From the CDC, the amount people who survive cancer after being diagnosed has tripled over the last 30 years:

[[posterous-content:pid___0]]

From the same report, death rates from cancer have been falling for all major demographics, for most of the major types of cancer.

Furthermore, you could posit that cancer treatments are doing a better job at maintaining quality of life after diagnosis. More and more treatments take place in a patients home, or in a social setting, and less often in a lab or hospital. 

From a report from the National Institute of Health, lost years of productivity are dis-proportionately focused in lung cancer patients. This is encouraging in a backhanded way, since lung cancer is mostly the result of smoking, which is a lifestyle issue more than a medical issue.

[[posterous-content:pid___1]]Overall, these are good reasons to be optimistic. There aren’t too many examples of unsolved problems in cancer treatments. The more relevant issue is why it occurs so much in the first place.

The Wall Street Journal has an article about the War on Cancer act, which was passed 40 years ago.

What’s changed? 

From the CDC, the amount people who survive cancer after being diagnosed has tripled over the last 30 years:

From the same report, death rates from cancer have been falling for all major demographics, for most of the major types of cancer.

Furthermore, you could posit that cancer treatments are doing a better job at maintaining quality of life after diagnosis. More and more treatments take place in a patients home, or in a social setting, and less often in a lab or hospital. 

From a report from the National Institute of Health, lost years of productivity are dis-proportionately focused in lung cancer patients. This is encouraging in a backhanded way, since lung cancer is mostly the result of smoking, which is a lifestyle issue more than a medical issue.

This post is an addendum to what was written yesterday about problems interpreting medical research results. 

Here’s an abstract from a paper I read today about how difficult it is to determine the causes of observed relationships in long-term studies. (Bold part added by me)

While some epidemiologists embraced probabilistic concepts of cause and effect, others maintained that causal mechanisms must ultimately be deterministic. The tension between probabilistic risk factors and deterministic causal mechanisms continues to haunt epidemiology today.

In the video yesterday the doctor spoke about the problems with epidemiology studies. You might read an article saying “New 20 year study finds strong correlation between drinking red wine and lower incidence of pancreatic cancer.”

Often those studies are surveys where people answer questionnaires once a year about what they eat on a weekly basis, and report their observable health factors.

Researchers then dice the data to find relationships, which then get reported to the news.

However, for a study like this, the validity of the results might be plagued by these issues:

1). How accurately are people reporting their food intakes? Their health markers? There are a lot of reasons why people might fudge both of those, consciously or not.

2). How do wine drinkers compare to the population at large? They’re probably higher-income and better educated than most, and both of those have strong predictive powers for your health outcomes, regardless of whether you drink wine or not.

3). How do you account for people who drop out of the study as time goes on? What sorts of people actually stick around long enough to complete these studies? Probably nerdy health freaks.

You can put the results through a statistical chop-suey to account for these types of things, but it’s still a blunt tool to arrive at the truth. After you’re done accounting for the above influences, such a study might tell you…..nothing at all.

There’s a decent video by a British doctor on the various problems with the health science industry. His talking is a bit scattered, but for the most part his opinions are interesting, and IMO correct.

If you don’t feel like watching, here are the take home points:

1). News that says “new study suggests x might cause y” should not be trusted. See my post about the problems with interpreting medical research results for more information.

2). The drug industry usually games studies to get things approved.

3). The placebo effect is powerful, but too much emphasis is placed on it in the clinical approval process.

4). Very few important medical decisions are made with appropriate information. Often they’re made with really crappy information.

He ends on a dour note, saying he doesn’t see an easy way to solve any of these problems at the moment, and ends with a vague call to action for an industry wide emphasis on transparency to bring more errors in the medical industry under public scrutiny.

Let me add a few thoughts.

1). I think the human intuition to break everything into discrete categories gets us in trouble with interpreting research results. Research is sort of like a garden with different plants always blooming and dieing, and the overall picture evolves like a kaleidoscope. To zero in on any particular correlation from one study is to commit sins of omission.

2). Experts tend to lament the ignorance of the poor common-folk in their particular field, and yearn for the day when everyone will be well informed about what it is they’re experts in, thus solving the dilemmas in their field. You see this attitude everywhere, and I think it’s a chimera. To really create a solution for something, it needs to work with ignorant people, because that’s not going to change. At least not quickly enough to allow someone’s pet plans to come to fruition.

3). On a similar note, it’s best not to focus on how to ensure people have as much information as possible, but instead focus on how to mitigate the bad consequences of someone making an un-informed decision.

Kenyans and Ethiopians have a well deserved reputation as elite distance runners. 

Kenyan runners toiled in obscurity until the 1968 olympics, when they surprised everyone by showing up with little fanfare, and then gently took an axe to the competition. Led by the charismatic Kipchogo Keino (pic 1), the east africans won 13 distance running medals and outran much better prepared western runners.

The success didn’t stop there. Over the next 40 years Kenyan runners won 40% of all international distance competitions, and acquired 10 of the top 20 cross-country word records.

A closer look at Kenyan runners revealed three surprising facts.

1). Almost without exception, they came from one tribe within the country.

2). Their diet upheld traditional canons of sports nutrition.

3). Their dietary intake uprooted commonly held perceptions about caloric and fluid intake.

Who Were the Kenyan Runners?

See the full gallery on Posterous

Almost every Kenyan runner comes an ethnic tribe called The Kalenjins, who live in the upper rift valley of Kenya. Kalenjins come from Nigoli ethnic descent and consist of a network of 8 smaller tribes that collectively total about 3 million people, about 10% of the Kenyan population and 0.0005% of the world population. 

In Kalenjin villages running is a way of life, and male adolescents are often running 50-70 miles a week. Daily runs with your friends and village races are a way of life and a common way of assigning status within the village. 

The Upper Rift valley is very mountainous and has low oxygen levels, and the terrain, cultural practices, and a few wins in the genetic lottery allowed the Kalenjins to ascertain the status of world’s greatest runners almost by accident. Curiously enough, the major running populations of the world are East Asian/Amerindians (Adriana Fernandez, Harumi Haroyama), northern Africa (Khalid Khannoucchi), and parts of southern Europe (Abel Anton of Spain), all of which share a large history of gene exchange with parts of eastern Africa. It’s an unvalidated and sensationalistic claim, but east africa might be the cradle of human distance running.

What Do Kalenjin’s Eat?

To the disappointment of some, the Kalenjin diet doesn’t contain any exotic superfoods. No seeds, berries, or drinks that gave ordinary runners extraordinary powers. Daily food intake consists mostly of corn, sweet potatoes, and other starchy crops mixed with vegetables. Beverages consisted mostly of water and milky teas, and goat is the meat most commonly consumed.

See the full gallery on Posterous

The staple Kalenjin meal is called Ugali, which is a paste made from cornmeal that’s typically served with stewed vegetables. The primary drink is Mursik, which is spiced fermented milk, somewhat similar to Kefir. 

While the diet is fairly plain, it’s nutritional quality is very high. Kalenjin food is dense in micro-nutrients, and the carb/fat/protein ratio is about 80/10/10, which is close to ideal for intense distance running. Somewhat surprisingly, the Kalenjin diet is not calorically dense. Average caloric intake is about 3300 calories a day. Not much when you’re running 100 miles a week. 

I might have averaged more during the holiday season. Yikes!

Kalenjin Lifestyle

The success of Kenyan runners has changed the modus operandi of Kalenjin runners somewhat. A national survey found that more Kalenjins are running, but economic motivations are occupying a larger portion of Kalenjin mindshare. Of the elite distance runners surveyed, only 4% said they do it for fun, and economic considerations were the biggest reasons most runners competed.

Kenya’s becoming increasingly urbanized, and the traditional tradeoffs seen in other modern countries are observed here as well. Life spans have gone up, and mortality rates and prevalence of infectious disease have gone down, but “diseases of convenience” are slowly beginning to take their toll.

A study published in the International Journal of Pediatric Obesity compared anthropometric data between urban canadian children and urban Kenyan children, and found a striking amount of convergence compared to their rural counterparts.