All posts by Kara Marker

About Kara Marker

I am a scientific journalist and graduate from the University of North Carolina at Chapel Hill. I am passionate about conveying the truth in scientific phenomena and subsequently improving health and public awareness. Check out my science blog: ScienceKara.com. I have a bachelor’s degree in biology with a minor in music, and I have research experience in microbiology, specifically work on the infectious agent Staphylococcus aureus.

You, Your Metabolism, and Science: How Research Studies Can Fight the Obesity Epidemic

Note: This is an article I wrote that was originally published on TransformingScience.com.

The one-of-a-kind Human Whole-Room Calorimeter at the UNC Chapel Hill Nutrition Research Institute can be used for a wide variety of research studies. Read on to learn about how this technology works, how experts at the Appalachian State University Human Performance Laboratory are studying metabolism, how these studies are vital for improving human health, and what a typical day as a study participant is like (including getting paid).

ABOUT THE CHAMBER

What they call the Human Whole-Room Calorimeter or Metabolic Chamber is essentially a small room that can calculate how much energy (calories) a person expends (both while resting or moving). This is balanced with the energy taken in through the diet over a 24-hour period. By controlling what you do and what you eat while in the chamber, researchers can accurately measure how much energy it takes to do certain things.

The metabolic chamber at the Nutrition Research Institute (NRI) is equipped with a bed, toilet, and sink. It also has the space to accommodate a treadmill or a stationary bike depending on the requirements of the study being conducted. Research staff can send food and other items through an airlocked compartment, and there are also ports for blood draws if a certain study requires them. There is also a television and – of course – WiFi.

The metabolic chamber is unique; there are only about 26 other similar rooms in the country, and it’s the only one in the Carolinas. This type of technology is essential for researchers who want to study energy balance and fuel use.

The first chamber study was conducted in 2011. The NRI and teamed up with the Appalachian State University (ASU) Human Performance Laboratory, recruiting 10 male participants to test the effect of 45 minutes of vigorous cycling on post-exercise RMR as measured in the metabolic chamber and contrasted with a rest day to determine how much and how long that exercise affected post-exercise energy expenditure. They found that 45 minutes of vigorous exercise resulted in 519 more calories burned compared to the rest day, and post-exercise calorie-burning was significantly elevated for 14 hours, resulting in an additional 190 calories expended, again compared to the rest day.

PARTICIPATING IN A CHAMBER STUDY 

The DEXA

Orientation and baseline testing is the first step of any chamber study. Before your first day in the metabolic chamber, you’ll have a DEXA (Dual-Energy X-ray Absorptiometry) scan done at the NRI as part of your orientation and baseline testing. This machine provides precise measurements of total and regional body composition through high-resolution imaging. However, it is noninvasive and includes very low radiation exposure. Plus, you’ll be able to have a copy of your DEXA results, which include measurements like percent body fat, resting metabolic rate, and bone mineral density.

On your day in the chamber, you’ll arrive at the NRI in the morning between 7:00 and 7:30 to change into (very comfortable) scrubs and take any necessary measurements before entering the chamber around 8:00. Once you’re in the chamber, you can essentially do whatever you want (read, watch TV, use your laptop) as long as you are seated and remain as still as possible. There will always be a monitor on duty if you need anything. Every hour, the monitor will remind you to stand up, stretch, and walk for about two minutes. They will also give you a sheet of paper to take notes about your activity so you can replicate it to the best of your ability on your second visit. To exit the chamber, all you have to do is turn a big red button, and there’s an arrow pointing to it on the wall. Plus, there’s a window inside the chamber that faces the outdoors. No need to get claustrophobic!

View of the chamber from the entrance.

The monitors serve you breakfast, lunch, and dinner, with a snack in between lunch and dinner. Don’t worry at all about getting hungry – the meals provided are tasty and filling. Plus, thanks to the metabolic chamber providing live data, the staff know your calorie needs at all times.

If it’s your exercise day, you’ll run on the treadmill around mid-morning. You rest for 45 minutes after the exercise, then you use sanitary wipes to feel clean again, and you can change into clean scrubs. If the study requires you to take supplements or provide blood samples, the monitors will tell you what to do. In the chamber, there are two intercoms that you can use to communicate with the monitor, one near the treadmill and one near the bed. There’s also a window where you can see the monitor, and a webcam so they can see you. Don’t forget – the toilet is not within view of the webcam and there is a curtain over the window. Your privacy is respected while you are in the chamber! The lights go out for “bedtime” at 10:00, and you sleep (or stay as still as possible when you’re awake) until 6:45 or so. You will be compensated well for your time, even if you complete just one visit.

In studies investigating exercise and energy expenditure, the second day is essentially the same as the first but with one key difference: on this visit you will spend 45 minutes on a treadmill, exerting yourself to 75 percent of your “V02 max,” the maximum amount of oxygen that you use during intense exercise (measured as milliliters of oxygen used in one minute per kilogram of body weight). Before you begin the study, they will test your V02 max by having you run on a treadmill at an incline. In the chamber on your exercise day, it’s a tough workout. But you can do it!

Metabolism studies are important because there is an obesity epidemic in the United States, caused by excessive calorie intake and a lack of physical activity: 69 percent of adults are overweight, with a BMI of 25 or higher, and 35 percent of adults are obese, with a BMI of 30 and higher. Obesity increases the risk of a variety of conditions that are linked to heart disease, including high blood pressure, diabetes, and high cholesterol. Heart disease is the leading cause of death for men and women worldwide.

So by studying the human metabolism, researchers from ASU and the NRI also want to help people effectively and safely lose weight to reach a healthy weight, lowering their risk of heart disease and other complications. Here a few simple recommendations:

  • Eat more carbohydrates and dietary fiber from whole grains
  • Eat more fruits and vegetables
  • Eat less fat to reduce overall caloric intake
  • Engage in physical activity most days of the week, with a total of 150-300 minutes per week

ASU and NRI experts have found that limiting calorie intake – eating less – has the biggest impact on weight loss. Exercise helps, but it must be more than 60 minutes per day to be meaningful. In other words, physical activity is more important for improving health (a good thing!) than for accelerating weight loss.

Sources: UNC Nutrition Research InstituteAmerican Heart AssociationASU Human Performance Laboratory

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To Supplement or Not to Supplement: That Is the Question

TIME reported on a new study this week that ultimately concluded that taking nutritional supplements is not the same as eating a healthy diet. Researchers report that you cannot be truly healthy without getting your nutrients from the source – from fruits, vegetables, and other plant-based foods.

My first thought: We call them “supplements” for a reason, right? They are intended to be “supplemental” to a mostly healthy diet. They are “supplements” not “replacements.”

A second thought: Not all supplements are created equal. I’m certainly not an expert on what makes a nutritional supplement effective or not, and I’m not sure how the scientists from this study qualified a “supplement,” but I do feel compelled to mention briefly the philosophy behind the nutritional supplements produced at Standard Process, my current employer.

An SP Aside

Standard Process produces nutritional supplements using ingredients from their organic farm in Palmyra, Wisconsin. Unlike other supplement companies, they boast a whole-food philosophy. This is based on the science of a whole food matrix, the idea that macronutrients (fat, carbohydrate, protein), micronutrients (vitamins, minerals), and phytonutrients (carotenoids, resveratrol, etc.) are the most bioavailable/biologically active/effective when they are consumed in the natural “matrix” in which they are found in nature. This separates Standard Process and other companies with a similar whole food philosophy apart from supplement companies that simply extract vitamin D or beta-carotene and insert them into a capsule to sell as a supplement.

That being said, I should clarify that my personal philosophy is food first, supplements second (if at all). We may not know for sure what types of supplements are most effective or if any are effective at all at improving nutrition, but you certainly can’t go wrong with getting your nutrition straight from the source (plant foods).

Okay, let’s talk about this new research.

TIME reporter Jamie Ducharme begins the story with two important facts:

I think it’s fair to extrapolate from those two statistics that many of those 90% of Americans that do not eat enough fruits and vegetables are among the 75% who are taking dietary supplements, likely because they know that they aren’t getting enough nutrients from their diet. Fair – it’s certainly easier to pop a pill than to get enough servings of leafy greens every day, but those 75% might be wasting their money on supplements that aren’t giving them the nutrition they really need.

The Study: Annals of Internal Medicine

The study’s main point is this: “nutrients consumed via supplements do not improve health and longevity as effectively as those consumed through foods.” Pretty simple. Supplements are not as good as food. Anyone surprised?

More specifically, researchers report that nutrients consumed through supplements are not as strongly associated with living a longer life as nutrients consumed through food. The data comes from the National Health and Nutrition Examination Survey (NHANES) 1999-2010, including 30,000 American adults as participants who were followed for about six years (at the end of this period, there were more than 3,600 deaths).

Researchers factored in monthly supplement use and dietary habits when establishing nutrient levels for each participant. This data initially led them to the result that dietary supplements are associated with a lower risk of early death, but that result did not hold true with researchers factored in certain other details about the participants: education levels, socioeconomic status, and demographics. After controlling for these variables, researchers found that it was mostly the higher-income and better educated people who were taking supplements, and this group is on average more likely to be healthy anyway. Put another way: for this group, it wasn’t supplement usage that was improving health, it was the impact of wealth and education on health (another story for another day).

The study showed that sufficient consumption of micronutrients like vitamin A, vitamin K, magnesium, zinc, and copper are associated with a lower risk of dying early, but only when obtained from food – not supplements.

Researchers even mentioned potential negative health associations with supplement usage. For example, high doses of calcium via supplement was associated with a 53% higher risk of dying from cancer compared to people who did not take supplements. Excess calcium from food did NOT have that association.

Regulatory Considerations

I think it’s important to note that the Food and Drug Administration (FDA) not does not regulate nutritional supplements as tightly or in the same way as “conventional” foods and drugs are regulated. Whether it’s safety or efficacy that one is worried about, the regulatory difference is a significant factor.

Supplements for Specific Populations

Lastly, I’ll highlight that the study scientists did mention that nutritional supplements may provide positive health benefits particularly for two groups:

  • The elderly: because the ability to absorb nutrients from food can decrease with age
  • People with dietary restrictions (allergies, vegan, vegetarian, etc.): because they are more likely to have nutrient deficiencies from lacking certain foods

Take-home Points

  1. While I acknowledge that it’s certainly easier said than done (I struggle in my own life), I agree with study co-author Fang Fang Zhang (Tufts University Friedman School of Nutrition Science and Policy) when she recommends that instead of relying on nutritional supplements, people should just eat a healthy diet rich with fruits, vegetables, and whole grains.
  2. There’s always more to the story. That’s why I included my SP aside earlier. The conclusion is never going to be “all supplements are bad” or “all supplements are good.” There are so many factors that affect what makes an effective nutritional supplement, and the only way to truly determine what’s effective and what’s not is to follow reputable research like this study from Zhang and others at Tufts University.

History of Dietary Recommendations in the United States

In some shape or form, as early as the 19th century Americans have been making dietary recommendations and heeding advice provided by experts.

Early 20th Century

Chemist Dr. Wilbur Olin Atwater’s 1904 publication “Principles of Nutrition and Nutritive Value of Food” was based on:

  • Variety
  • Proportionality and moderation
  • Measuring calories
  • An efficient, affordable diet focusing on nutrient-rich foods and less fat, sugar, and starch

Soon after the initial discovery of individual vitamins in 1910, nutritionist Carolina Hunt’s 1916 “Food for Young Children” created new categories: milk and meat, cereals, vegetables and fruits, fats and fatty foods, and sugars and sugary foods.

Mid-20th Century

The first Recommended Dietary Allowances (RDAs) were created in 1941 for calories, protein, iron, calcium, and vitamins A, B1, B2, B3, C, and D. RDAs are now defined as the “average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%-98%) healthy people.” The Food and Nutrition Board of the National Academy of Medicine also defined “adequate intake” (AI; “established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy”) and “tolerable upper intake level” (UL; (maximum daily intake unlikely to cause adverse health effects”).

From 1943 to 1956, the United States Department of Agriculture (USDA) introduced the “Basic 7” a nutritional guide devoted to maintaining standards during wartime food rationing:

  • Green and yellow vegetables
  • Oranges, tomatoes, grapefruit, cabbage, salad greens
  • Potatoes and other vegetables and fruits
  • Milk and dairy products
  • Meat, poultry, fish, eggs, beans, peas, nuts, peanut butter
  • Bread, flour, cereals
  • Butter and fortified margarine

Late 20th Century

The list was condensed down to the “Basic Four” between 1956 and 1992:

  • Vegetable and fruits: 4+ servings recommended daily
  • Milk: 4+ servings for teens and 2+ for adults
  • Meat: 2+ servings
  • Cereals and breads: 2-4 servings

In 1992 came the Food Guide Pyramid, with a particular focus on expressing the recommended servings of each food group based on their location within the pyramid. The first version of the infamous pyramid-shaped chart featured fruits and vegetables as the biggest group. But pressure from the grain, meat, and dairy industries led to the final version of the chart featuring brain, cereal, rice, and pasta as the foundation of the pyramid. The Food Guide Pyramid was replaced with “MyPyramid” in 2005, which reverted to colorful vertical wedges and a running ascending the stairs to highlight the importance of exercise.

21st Century

The USDA’s current nutrition guidelines take the form of “MyPlate” – an initiative which began in 2011 and concentrates on five key food groups:

  • 30% grains
  • 30% vegetables
  • 20% fruits
  • 20% protein
  • Small portion of dairy

Additional recommendations include:

  • Portion control
  • Eat whole grains
  • Drink fat-free or low-fat milk over full-fat milk
  • Eat less sodium
  • Drink more water and less sugar-sweetened drinks

Key criticisms of MyPlate stem from the fact that the chart does not highlight plant sources of protein like beans and nuts. A similar but more plant protein-centric chart is Harvard’sHealthy Eating Plate,” which was created in response to deficiencies identified in MyPlate.

This century-long saga of changing recommendations depicts the fickleness of nutrition science and the unfortunate influence of the food industry on governmental dietary recommendations. We’ll never know the full story, but it is likely that nutrition experts in the early nineties involved in developing the Food Guide Pyramid knew full well that the bulk of your plate should be green (i.e. veggies) and not tan (i.e. bread and pasta). But influence from other food industries kept the Food Guide Pyramid from being 100 percent reliable. Who knows how this affected the obesity epidemic that currently plagues our country…

I hope you’ll excuse my rant and accept assurance that I am of course aware that there are a lot of other factors exacerbating the issue of obesity (processed food, fast food, sedentary living and working, etc.). None of us were “in the room where it happens” back in the early nineties (yes, that’s a Hamilton nod), so we can’t say for sure why the Food Guide Pyramid was developed in the way that it was. I also think I’m particularly sensitive about this era of government dietary recommendations because this is the guide that I grew up with, and it was the first major educational exposure I had to what a healthy diet looks like.

All in all, I do think that MyPlate is a great tool and shows that nutrition science (and the USDA) are moving in the right direction. My hope is that nutrition science and governmental recommendations will only get better and more accurate. Plus, did you hear about recent legislation proposed by democratic Congressman Tim Ryan to create a National Nutrition Institute under the National Institutes of Health? So cool.

What’s Killing Us? What We’re NOT Eating

Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
The Lancet

All the major news media outlets are reporting on this story today as if it’s some big surprise. But is it really surprising that a diet high in sodium, processed food, and sugary beverages and low in whole grains, fruits, and vegetables leads to millions of deaths worldwide?

The new study, funded by the Bill & Melinda Gates Foundation and published in The Lancet yesterday, investigated the burden of a diet devoid of healthy foods and its effect on non-communicable diseases.

Non-communicable diseases, also referred to as chronic diseases, are those that are the result of “genetic, psychological, environmental, and behavioral factors,” opposed to being caused by bacteria or other microbial agent. For example, you don’t “catch” heart disease from someone – you develop the disease as a result of factors like what you eat and what genes your parents passed on to you.

More on non-communicable diseases from the World Health Organization.

Researchers evaluated consumption of major foods and nutrients across all of the world’s 195 countries in adults 25 and older, analyzing how a diet lacking healthy food impacts mortality and morbidity.

Note: I didn’t realize that there were 195 countries in the world until I googled it to see how many countries were missing from the study. Here’s one of many resources that said 195 is the correct number.

They took a “comparative risk assessment approach” that accounted for:

  • Intake of each dietary factor
  • Effect size of dietary factor on disease endpoint
  • Level of intake associated with the lowest risk of mortality

Diet factors include:

  • Unhealthy red and processed meats
  • Sugar-sweetened beverages
  • Trans fatty acids
  • Salt
  • Fruits
  • Vegetables
  • Whole grains
  • Milk
  • Calcium
  • Nuts and seeds
  • Fiber
  • Legumes and beans
  • Omega-3 fatty acids and other polyunsaturated fatty acids

They found that the top three dietary risk factors associated with non-communicable disease are high sodium intake, low whole grains intake, and low fruit intake. These three dietary factors account for more than half of all deaths attributable to diet.

The report showed that the same risks associated with poor dietary choices affected people regardless of age, sex, and “sociodemographic development of place of residence.”

Finally, the study calls attention to the importance of acting in light of these and other similar findings. Experts call for dietary interventions based on evidence, a way to evaluate health and efficacy of dietary interventions on a regular basis. Past efforts have focused largely on salt, sugar, and fat. While high intake of those things definitely isn’t good for health, the current study highlights a second issue, one that now seems more important: yes, lowering intake of salt, but also increasing intake of healthy foods like whole grains, fruits, vegetables, and other plant-based options.

Cancer Treatment Saves the Life of an HIV Patient – For the Second Time

I’m finally finding time to finish a blog post on the announcement Nature made earlier in March with a pretty big headline subject: for only the second time ever, an individual infected with HIV is “cured” – as much as it is humanly possible to be cured of HIV – via stem cell transplant.

University of Cambridge’s (UK) Ravindra Gupta, MD, led the study of this patient, whose name has not be released (I’ll use the term “2019 patient”). Researchers like Gupta actually warn against using the term “cured” to describe this person’s health status. So why are people (the media) saying that the 2019 patient is cured? Because the 2019 patient stopped taking antiretroviral drugs 18 months ago (16 months after receiving the stem cell transplant), and HIV has not returned.

Plus, the headline “person is cured of HIV” sounds a lot better than “person’s HIV’s levels have not returned after receiving stem cell transplant and halting antiretroviral treatment.” I won’t go on a tear about the issues with sensationalism in science journalism (right now, anyway).

The 2019 patient joins the ranks of Timothy Ray Brown, the ‘Berlin Patient,” who was “cured” in 2018 and still appears HIV free.

Berlin vs. London

Both Brown and the 2019 patient had a form of blood cancer that did not respond to chemotherapy, which prompted doctors to conduct a bone marrow transplant to replace diseased blood cells with healthy stem cells. These stem cells just so happened to also produce a very rare form of HIV-resistance. So these two patients came out of their procedure on their way to being both cancer-free and HIV-free.

In the case of the 2019 patient, doctors purposely chose a bone marrow donor who carried the HIV resistance trait – two copies of a mutation in a gene called CCR5. Experts estimate that just one percent of people of European descent carry the two-copy genetic mutation providing HIV resistance.

The CCR5 gene codes for a white blood cell receptor involved in the immune response to viral invaders like HIV. HIV binds the CCR5 receptor to attack white blood cells. So when CCR5 is not working normally due to a genetic mutation, HIV cannot attack white blood cells in the same way.

Before Brown received his stem cell transplant a decade ago, doctors tried aggressive chemotherapy and radiotherapy to treat his cancer. For the 2019 patient, doctors chose a less aggressive approach consisting of chemotherapy and drugs. Experts from the study acknowledge the difference in treatments as a sign that stem cell transplantation as a treatment for HIV infection does not require aggressive treatments to be effective.

Why only two?

So why not make stem cell transplant a standard procedure to treat HIV infection? The procedure is risky, more so than just continuing to suppress HIV with a daily drug regimen. The transplant could fail, or it could result in a lethal autoimmune attack. Other potential consequences include organ damage, respiratory distress, fluid overload, infection, and low platelets and red blood cells. Plus, HIV infection makes everything more dangerous.

Although stem cell transplants won’t quite work as a catch-all treatment for anyone infected with HIV, the basic concept behind the success of both patients “cured” of HIV yields promise. In laboratories all over the world, scientists are likely hard at work developing gene therapies targeting CCR5.

HIV/AIDS Basics

HIV (human immunodeficiency virus) is the virus – the “microbial agent” – that causes AIDS (acquired immunodeficiency syndrome) – the “disease – just like rhinovirus (“microbial agent”) causes the common cold (“disease”). HIV is a particularly devastating virus because it attacks the very cells employed by the human body to defend itself: CD4 immune cells.

Antiretroviral therapy (ART) does not lead to a cure, but it does improve quality of life and reduce the risk of an HIV-positive person passing the infection to someone else. ART accomplishes both tasks by preventing HIV from multiplying – minimizing the amount of virus in an infected person’s blood and preventing a person with an HIV infection from becoming a person with AIDS.

“It takes two to make a thing go right; It takes two to make it outta sight”
A commentary by Science Kara

Now that two people have been “cured” of HIV via the same means, I can’t image that it will be too long before researchers are publishing new studies on CCR5 gene therapy, conducting studies in vitro, in mice, and in chimpanzees. It will be a while until there are studies done with humans (per usual in science), but I don’t think it will be another 11 years before there is another major breakthrough in treatments for HIV more conclusive than ART.

In the midst of all the news reporting on the 2019 patient earlier this month, my favorite piece was from The Daily podcast and host Michael Barbaro from the New York Times. Barbaro goes beyond the science of the matter that I’ve discussed here and talks about the history of the HIV epidemic to truly represent how significant it is to declare the second “cure” of an individual infected with HIV.

References

Matthew Warren’s “Second patient free of HIV after stem-cell therapy.” published online as news for the journal Nature on March 5, 2019.

The National Institutes of Health website “AIDSinfo.”

Johns Hopkins Medicine

Occupied

I remember a time when I did not know what the word “occupied” meant.

I was young, maybe seven years old, when I walked into a bathroom at a restaurant, knocked on the door of a stall and the person inside replied, “occupied.” When I returned to my table where my family was having dinner, I asked my mom what “occupied” meant, and she explained it to me.

That memory is the only one I have of learning a relatively basic word. Sure, we see words all the time that we do not know, especially if you read a lot and in a wide variety of genres (like me). When we are in high school, we learn vocabulary words for the SATs, and often our careers include a specific set of jargon that we learn over time. But how many memories do you have of being a kid, learning a basic word for the first time?

So now my existential question is this: why do I remember the day I learned the meaning of “occupied”? Just for “funsies,” let us look at the six-part definition of “occupied” via Dictionary.com:

  1. to take or fill up (space, time, etc.)
  2. to engage or employ the mind, energy, or attention of
  3. to be a resident or tenant of; dwell in
  4. to hold (a position, office, etc.)
  5. to take possession and control of (a place), as by military invasion
  6. ( usually initial capital letter ) to participate in a protest about (a social or political issue), as by taking possession or control of buildings or public places that are symbolic of the issue

It likely is different for everyone, but my first instinct when conceptualizing “occupied” is closest to definition number one. I think this is the definition that most closely describes what the person in the bathroom stall was conveying when they said “occupied.”

When I ponder the second definition, I think of the word “preoccupied.” I often experience the state of “preoccupation” (is that a word?).

The third definition is one you are likely very familiar with if you work in the rental property arena (i.e “that particular apartment is occupied but the occupants are at the end of their three-year lease”). I have used this form of “occupied” before.

Definition number four is not too different from number three, and number five is very specific to times of war. If you have watched a movie or television show about World War II, you probably heard this form of “occupied” a lot. To be honest, I was not familiar with the use of “occupied” in the context of definition number six – interesting factoid, though.

So, the exploration of these six definitions has not exactly opened my mind as to why I have the memory that I do, but at the very least I think it is intriguing that my instinct understanding of “occupied” is the definition by which I first learned the word (the person in the bathroom stall responded “occupied” when I knocked on the door, indicating she was currently taking up the space about which I was inquiring).

What is the significance of this memory or my reflection of it? I am not sure if there is any.

For anyone who is out there reading my blog, I would love to know if you have any early memories of learning the meanings of new words. Feel free to shoot me an email at sciencekara@gmail.com or leave a comment on the blog.

Algorithm for a Healthy Diet

What can artificial intelligence do for human health? Revolutionize the way we eat, potentially. An opinion article published in the New York Times on Saturday covers the idea of personalized nutrition, made possible by super advanced algorithms and artificial intelligence (A.I.).

The article “The A.I. Diet” is written by cardiologist Eric Topol, and he begins by describing his experience as one of more than a thousand participants in a two-week health study where a sensor and a smartphone app helped track everything he did: eating, sleeping, exercise, and more.

Topol’s data was analyzed by A.I. to ultimately produce a personalized diet algorithm. His results consisted of specific foods receiving a grade, like you would on a test. It seems to me that both his experience and the study design overall highlight the importance of understanding how different foods are good or bad for different people – i.e. blueberries affect me differently than they affect someone else with a different genetic code and lifetime of environmental exposures.

Interestingly, a version of Topol’s study exists as an actual test – commercially available – but analyzes gut microbiome only, not glucose levels or eating habits (here, but it is likely other companies sell something similar).

Topol points out that the main problem is that we often perpetuate the “idea that there is one optimal diet for all people.” More or less, any specific guidance that goes beyond Michael Pollan’s famous quote (and a personal favorite of mine), “Eat food, not too much, mostly plants” is assuming too much about the similarities between individuals, complex and important factors like microbiome status, genetics, and environmental history. Topol: “[This assumption] contradicts the remarkable heterogeneity of human metabolism, microbiome and environment.”

“We know surprisingly little about the science of nutrition.”

Why? Topol cites difficulty with high-quality randomized trials, which are vital for nutrition science (or any type of science for that matter).

“The more understanding we have of foods and nutrition, the more complex food and nutrient interactions become,” explains nutrition scientist Kristine Polley, PhD. “Therefore, controlled and well thought-out study designs are becoming essential to interpret and translate results. High-quality randomized clinical trials provide insight into how nutrients affect human physiology and allow for accurate and critical interpretation of the data collected and the opportunity to apply these outcomes to better overall human health and quality of life.”

Another issue specific to nutrition science studies is that experiments with food habits require strict diet adherence, and there is not always an effective or easy way to ensure study participants are actually following the study’s prescribed diet.

Thirdly, where does the money come from for these types of studies? Unfortunately, often from companies that benefit from the results of the studies, increasing the chances that the results will be swayed one way or the other or misconstrued. In Topol’s words:

“The field [of nutrition science] has been undermined by the food industry, which tries to exert influence over the research it funds.”

The future of individualized/personalized nutrition depends heavily on the success of dependable nutrition studies. This data is vital for building the sophisticated A.I. technology needed to analyze the mass amounts of data to determine each individual’s specific nutritional needs. So the question that remains unanswered is, can nutrition scientists get it together (and find the funding) to obtain the needed results? I think they can.

So You’re A Nerd… Thoughts of An Expert’s Deskmate

Today I want to talk to you about nerds*.

I was eating lunch with several colleagues (almost all PhDs in some sort of biomedical science) and one mentioned a moose (for the life of me, I can’t remember the context). When I used the word “meese” to describe more than one moose, everyone laughed.

“Is that a word? Meese?” Someone asked.

“I don’t know, but I like it**,” I responded. “I love plural forms of words.”

That profession was accompanied by another round of laughter and some weird looks. “I’m a different kind of nerd than all of you,” I said.

This got me thinking. The idea of a “nerd” is so comparable to the technical concept of a “subject matter expert” (SME). Often people use phrases like “I’m a science nerd” or “I’m a Lord of the Rings nerd” or even “I’m a weight-lifting nerd.” For me, I am a word-nerd (This word combination also rhymes. I love rhymes and alliteration, further solidifying my status as a word-nerd.).

Depending on the subjects you’ve studied extensively – whether in the form of an intense PhD program in science or a lifelong obsession with various Lord of the Rings media, you’ll likely consider yourself an SME, a nerd.

I think this is particularly interesting because as kids, if you were a “nerd,” that was a bad thing. You weren’t cool. But I think having a PhD in foods and nutrition is awesome. I think having (both!) an MS in in food policy and nutrition and an MPH in health communications is so impressive. And I think poring over extended editions of Lord of the Rings DVDs and re-reading long, detailed fantasy novels is inspiring. I love nerds because you can learn all sorts of things from them, and the information is delivered so enthusiastically because as nerds, we love the things we know a lot about.

*Note: I wasn’t sure where this post was going to go when I started, but in recent months/years I’ve realized that I am a particularly introspective and inquisitive person. And because this is my blog, I can post all the musings about the world that I want to! Ha!

**Note: The plural form of “moose” is just “moose.” A blog post from Oxford Dictionaries points out the obvious association between goose/geese and moose/meese, so why does the goose/geese rule not apply to moose/meese? The same blog post explains that because “moose” is a “loanword” (taken from the Native American Algonquian language and adpated into English in the early 17th century by British settlers of North America), the plural ending of the noun is identical to the single form. Loanwords either follow this trend, take the standard plural ending (add an “s”), or adopt the plural ending of its original language.

Thoughts of a Subject Matter Expert’s (SME) Deskmate

I was doing some research for an article I was writing about post-exercise performance and metabolism. The study under review was comparing results between a fasted and fed pre-exercise state. The abstract of the research article I was reading (link) mentioned the acronym “FFA” but did not explain what it meant. In my training as a technical writer, it is certainly “against the rules” to use an acronym before first spelling it out. When you play by the rules, the acronym makes its first appearance only in parenthesis. At least, this is what I was taught.

What does one do when they are not familiar with an acronym? They Google it, of course. But when I Googled “FFA” it should come as no surprise that my first ten Google search results were articles about Future Farmers of America. I knew that was not the FFA I was looking for (see image). Immediately aware that I would to dig through many layers of Google search results before identifying the “true” FFA, I finally remembered that my very own desk mate actually got her PhD in foods and nutrition and her Master’s in exercise physiology.

“Kristine, what would you think ‘FFA’ stands for in the context of post-exercise metabolism?”

Without hesitation, Kristine answers, “free fatty acids.”

Now, I have been writing about health and nutrition professionally for almost four years – many times about the importance of omega-3 and omega-6 fatty acids (check it out), but even I could not come up with the words “free fatty acids” when I came across an unfamiliar acronym. If I had to seek consultation to identify the words, how would a true lay-person with no direct access to PhDs have figured it out?

For those who care at all about scientifically literacy, we know that it is rare for a lay-person to pick up and attempt to read an academic article. There are also some who would argue (including me, depending on my mood) that a lay-person should not attempt to read an academic article, with the concern that the piece – packed with jargon and laden with passive language – would only confuse and dishearten the reader. However, for those who may be on the side of encouraging lay interaction with scientific academia, inclusion of the “FFA” acronym is an issue. What are we going to do about it?

I have some thoughts…

TO BE CONTINUED…

Tattoo Removal

When I think of tattoo removal, I think of Ted Mosby from How I Met Your Mother getting his lower-back butterfly tattoo removed and meeting the infamous Stella in the process. Also this: 

From “We’re the Millers”

I think a lot of us have heard that getting a tattoo removed is even more painful than getting the tattoo in the first place. Other than that, it’s likely you don’t know that much about how a dermatologist actually removes a tattoo.

Tattoo removal specialists are more likely be able to remove a tattoo – and remove the entire design – if:

  • The tattoo was professionally done (not homemade – yikes)
  • The tattoo includes less of the deep black/blue inks
  • More time has passed since getting the tattoo

Even under the most perfect circumstances, scarring, skin color variation, and incomplete removal of the tattoo often result. As it is considered a “aesthetic” or “cosmetic” procedure, tattoo removals are usually not covered by medical insurance. The cost of a tattoo removal procedure will depend on the type of procedure and the type/size/location/age of the tattoo.

There are three main types of tattoo removal according to the American Society for Dermatologic Surgery.

Dermabrasion

Like I explained in a past blog, tattoo ink only permeates into the epidermis and dermis. The idea behind dermabrasion is to remove these layers of the skin affected by tattoo ink in order to remove the tattoo. This approach is lauded for its low costs, outpatient experience, and well-tested assurance. Like other approaches to tattoo removal, dermabrasion is accompanied by a risk of skin color changes and potential scarring. Patients receiving dermabrasion for tattoo removal should expect to experience a two-three week healing time and a feeling of being “wind-burned.” During recovery, patients should avoid exposure to the sun.

Laser surgery

Laser therapy (also called laser surgery or laser rejuvenation) is the preferred treatment for tattoo removal (low-risk, minimal side effects). This treatment option involves targeting a tattoo’s pigment with high-intensity laser beams. Based on what type and how many lasers used as well as various laser settings, this approach can work for different color and size tattoos. Laser therapy limits the amount of scarring that results from tattoo removal because of the laser’s ability to selectively target the tattooed skin without damaging un-tattooed skin.

Surgical excision

Surgical excision is as invasive as it sounds. The dermatologists uses a scalpel to surgically remove the tattoo (this option is rarely used and usually only for small tattoos in special cases). The wound is closed with stitches.

References and sources to learn more

Layers of the skin

Classifications of burns

Science of tattooing

Healing

Removal