Category Archives: Health

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.
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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

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.

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

Let’s Talk About Tattoos

Well folks… #ScienceKara got a tattoo and (obviously) was very intrigued about the process of getting a tattoo and how it heals afterward (I’m a low-level hypochondriac) and thus, a blog post was born. I started writing this and realized that there’s a lot of interesting stuff in the realm of tattoo science, so I’m splitting it into a series of couple of articles.

The Art (and Science) of…

Tattooing

Tattoo Healing

Tattoo Removal

Plus…

What Can Go Seriously Wrong if You Get a Low-quality Tattoo

 

To begin, I want to take a few paragraphs to talk about why I got a tattoo and the social implications of having a tattoo in 2018. I’ve thought about getting a tattoo for a long time, as I am very passionate about self-expression and constant reminders of strength and meaning. But as someone who, realistically, also has to consider what my tattoo will say about me in the workplace, I did some thinking and some serious research on more than just the tattoo healing process before getting my ink.

Social Implications of Getting a Tattoo: How Things Have Changed

There are plenty of Business Insider, Forbes, and Huffington Post articles discussing tattoos and changing social norms, but I scored an even better source: a peer-reviewed journal article from a journal called Human Relations. Let’s chat about the highlights.

The main question: is it still true that people with tattoos are less “employable” than people without tattoos?

Researchers say that discrimination based on an individual having tattoos is a form of “lookism,” which also includes discrimination based on clothing, attractiveness, and body weight. Authors of the 2018 study cited other studies from 1995, 2006, and 2011 that suggested employers are less likely to hire applicants with tattoos. This of course excludes a few specific occupations, like a tattoo artist.

However, the authors also mention a 2016 study that showed that “the prevailing view that body art is associated with both employment and earnings discrimination was challenged by a recent study finding that having a tattoo is not significantly related to employment conditional on labor force participation, nor with earnings conditional on employment.”

The author from the 2018 Human Resources study build a more robust study design as a follow-up to the referenced 2016 study, factoring in a more diverse set of metrics like:

  • Tattoo prevalence and characteristics
  • Labor force participation
  • Labor supply and earnings
  • Socio-demographics
  • Risky behaviors
  • Health status

Ultimately, their study confirmed that they could find “no evidence that tattoos are significantly associated with employment or earnings discrimination.”

I’m not an expert on the evolution of social norms in American culture so I can’t say for sure why tattoos are becoming increasingly accepted in the working world. I’d like to think that Americans are becoming increasingly accepting of all forms of self-expression – in addition to tattoos, things like gender and sexuality. What do you think?

A Sign of Self-expression

Transitioning into talking about why I decided to get my tattoo, I think the easiest way to explain to people why I got my tattoo (a cat looking into a mirror and seeing a lion as his reflection) is to talk about self-expression.

The older I get, the more I feel this gravitational pull of monotony, the transition into the habitual activities of the working world: Wake up, get ready. Eat breakfast, take the dog out. Go to work, do my job. Come home, make dinner. Watch TV or read a book. Go to bed. Repeat.

Add in a few weekends, a few doctor’s appointments, and some fun outings with friends. Nonetheless, I was only a few months in at my new job (my first “real” job working 8-5), and I was feeling apprehensive about falling into the rhythm and waking up in 20 years wondering where the time had gone.

Now, I’m not saying that getting a tattoo is going to solve all my existential philosophical issues, but this single act of permanent self-expression definitely helped me stake my claim that I would not be giving into the monotony. You have to work for a living – I understand that this is how the world works – but I can also devote as much time as I can to bettering myself, learning about the world and about its people, and enjoying all the aspects of life. This is (partly) what my tattoo means to me, reminds me of.

Bettering Myself

As much as I talk (and write) about health, nutrition, exercise, etc., I’m really not as healthy as I can be in my own life. The second part of what my tattoo means to me is that promise to myself that I will devote myself to staying healthy – mind and body – with eating healthy foods, exercising regularly and building my strength, and taking care of my anxiety.

I hope that when I look at my tattoo and see the cat and the lion, I can gain inspiration from either character based on what situation I’m in. When I feel like the cat, I’m looking for strength from the lion to be strong or make a hard choice. And when I feel like the lion, I need the cat to help me stay grounded and remember how far I’ve come. I hope that if you’re reading this and you’ve been considering getting a tattoo or some other form of self-expression, that you’ll follow through with it despite any nay-sayers discouraging you. You know what you want and what you need, and life’s too short not to do the things that bring you joy, purpose, and strength.

Stay tuned for the next episode in this series about tattoos.

The Fitbit Philosophy

I bought a Fitbit before my trip to Germany because I wanted to see how many steps we walked each day (and pat myself on the back for all of my 10,000+ days). I have the Fitbit Charge (2?) – the one with the clock display that connects with your phone and reads your texts and notifies you when you have an incoming phone call. I also like to call it “the poor woman’s Apple watch.” It has a plethora of features you can read about on Fitbit.com, but I mostly use it for:

  • Counting steps (more often making myself feel bad for not reaching 10,000 than celebrating for reaching 10,000)
  • Telling the time/date
  • Reading text messages during meetings
  • Looking at my active minutes

This is relatively normal Fitbit activity, and what I really want to talk about today is something I’ve been calling “the Fitbit Philosophy.”

‘If you run three miles but you forgot to wear your FitBit, did you really run three miles?”

You know what I’m talking about. It’s that feeling of disappointment you get when you pull yourself out of bed in the morning or stop at the gym on the way home from work before realizing that you forgot to wear your Fitbit. Yes, you’re going to have an invigorating workout, but your steps, active minutes, calories burned, etc. won’t be calculated and counted by your Fitbit. You won’t get to mentally high-five yourself all day every time you check the time. You won’t get to speak the not-so-humble brag “I’m killin’ my steps today” to coworkers who smile weakly and clearly couldn’t care less. You won’t have the satisfaction of getting a “head start” on the ultimate goal advertised by the Fitbit world – 10,000 steps (on my 10,000+ days this usually occurs around 10:00pm while I’m walking the dog or climbing the stairs to my room one last time. ‘Is that a phone call I’m receiving? No, the computer on my wrist following my movements all day is notifying me of my ten-thousandth step with vibrating fireworks and other celebratory effects.’).

The Fitbit philosophy is born from the classic Fitbit marketing position: walking/running at least 10,000 steps a day will make you a healthier individual, and regularly wearing a Fitbit will help remind you to achieve that goal. There is a lot of research on exercise, physical activity, nutrition, and weight loss, so I’m not writing today trying to say that I have all the answers on fitness and how to lose weight and be healthy. But there is one scientist whose research I’ve read a lot of, and I’ll cite him.

David Nieman, DrPH (Doctor of Public Health), has dedicated his career to the field of exercise immunology, and currently he is the director of the Appalachian State University Human Performance Lab at the North Carolina Research Campus in Kannapolis, just 30 minutes north of Charlotte.

One of Nieman’s studies (from 2016) found that splitting up long periods of intensive exercise into 3-4 ten or fifteen minute sessions is just as healthy as completing one bout of exercise. For some people, exercising in short bouts as opposed to longer sessions actually reduces the amount of post-exercise unhealthy inflammation, muscle damage, and overall stress on the body.

The Data*

75 percent of the people I polled on the Fitbit philosophy have a Fitbit. Here are some reasons why:

  • Calculating calorie intake and calorie expending
  • Motivation to make healthy choices
  • Insight into running workouts and heart rates
  • Earning badges and competing in challenges

For those who did not own a Fitbit, here are some reasons why:

  • Cost too high
  • No desire for fitness direction
  • Preference for maintaining fitness and health without counting calories

Two-thirds of Fitbit owners wear their device every day. The other one-third only wears the device when they happen to remember to do so. All of the Fitbit users had reached the goal of 10,000 steps at one point in their lives:

Over half of Fitbit users feel the sense of “my exercise doesn’t count today” when they forget to wear their Fitbit.

*I’m going to keep my poll open and update the data section as new responses come through

It’s also important to remember that walking 10,000 steps per day won’t necessarily help you lose weight – eating a balanced diet with lots of vegetables and fruits is just as important as (if not more than) regular exercise. If you’re almost completely inactive and obese, walking 10,000 steps would probably make a huge difference. But the more weight you lose, the harder you have to work to continue losing weight – with regular exercise and healthy diet choices. For exercise to make a big difference on weight loss, it really needs to be 45-60 minutes per day, and your heart rate need to be elevated for most of that time.

Read more on this.

Body Love

All that being said, I like to remind people (and myself!) that eating healthy food and exercising regularly is about more than just losing weight – it’s about being healthy and feeling great – physiologically and mentally. Yes, for many people losing weight is a step to being healthier, but in our society (so focused on numbers and standards – think BMI, everyone is different), I think there is always room for a reminder that being healthy isn’t only about what you weigh. In fact, as a foodie, I definitely believe in the mental health factor of eating your favorite foods (for me? Bojangles, fine cheeses, ice cream) and drinking your favorite drinks (for me? Red wine, craft beer) from time to time. What’s life without a little bit of flavor?

Ever wondered, “Why 10,000?” Here’s a comprehensive article from Mayo Clinic on that.

Just for fun, here are some other Fitbit thoughts:

#TFW your 3:50pm 250-step reminder from Fitbit corresponds with your afternoon trip to the toilet

When you and your deskmate at work both check your Fitbits at ten minutes to the hour, you’ll make eye contact but remain speechless. For you both already know it’s step o’clock.

It’s a text message! It’s an Outlook calendar alert! No, it’s 4:50pm and you’ve barely moved in the last hour.

When you know the “step counting technology” is imperfect, because Fitbit says you walked 15 steps but you know for a fact that you’ve been sitting so long, you’ve actually walked -32 steps.

Do you have an “Appetite for Life?”

The University of North Carolina Nutrition Research Institute (NRI) hosts regular events as a part of a program they call “Appetite for Life.” It’s an initiative to “unlock the promise of personalized nutrition for proactive health management.” In other words, their mission is to show people how to eat for their health, specific to individual genetics and environmental experiences.

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The speaker at the event on September 13 is Steven Zeisel, MD, PhD, and Director of the NRI. Zeisel is world-renowned, a pioneer in the field of personalized nutrition. A nutrient you’ve probably heard of, called choline, is essential for human health, especially concerning pregnant women, and Zeisel is the scientist credited with this discovery.

“I’m not going to tell you what to eat today,” Zeisel says as he begins his talk. Tonight’s event is called “Genetics and Health: Your nutrition needs are as unique as you are,” and the venue, local eatery Restaurant 46, is packed with members of the local community and employees from the neighboring North Carolina Research Campus (NCRC), a 350-acre research center located in Kannapolis, North Carolina.

Zeisel goes on to describe the true meaning of personalized, or precision, medicine and the past, current, and future studies the NRI has in place to make personalized medicine a reality for everyday people concerned with their health.

“Diet can be changed to bypass nutrient deficiencies depicted by the genetic code,” Zeisel goes on. He starts by breaking down the specifics of nutrition science, starting with genetics. He describes single nucleotide polymorphisms (SNPs), common genetic variation that occurs uniquely in all humans, as “spelling errors” in the DNA. Considering that a majority of the audience have a limited understanding of current genetics, Zeisel presents his description of SNPs in an accurate yet simplified manner. After all, what’s the point of talking about bringing personalized medicine to the public if the lay people can’t understand what you’re talking about?

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Zeisel and his colleagues at the NRI are preparing for the future of genetic testing, a technology they predict as being able to sequence an individual’s genetic code to provide a complete record of specific “spelling errors” in the DNA that might make the individual at risk for certain nutrient deficiencies. Being aware of nutrient deficiencies would then allow the individual to change their diet to eat more or less of a certain type of food.

There are companies that exist now, like 23andMe, that can provide genetic information from a DNA sample. However, the product a 23andMe customer gets in return for their money and a cheek swab is just pages and pages of combinations of “AGTC” that’s essentially meaningless unless the customer also happens to be an expert in nutrigenetics with a lot of free time.

Zeisel goes on to talk about choline, folate, and other studies from the NRI and other institutions concerned about health and nutrition. He leaves plenty of time for community members to ask their own questions, many about their health and the health of their loved ones.

The NRI’s story is far from over, but after a while questions subside. For now, people head home with a new perspective on individualized nutrition. The next Appetite for Life event is now something to look forward to, a talk by NRI scientist Stephen Hursting on October 18.

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Images from UNC NRI and Kara Marker

What You Haven’t Heard About the “Brain-Eating” Amoeba

A recent report of a death from a specific type of organism that causes brain disease has millions of people concerned about going swimming. The loss of life from this disease is devastating, but there’s actually almost no reason why people should stop going to the U.S. National White Water Center (WWC) in Charlotte, North Carolina, where officials are still not positive the female from Ohio was exposed to the disease-causing organism.

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Naegleria fowleri | Credit: CDC

Naegleria fowleri is an amoeba species that causes an extremely rare infection of the brain called primary amebic meningoencephalitis. Less than ten cases per year have been reported in the United States for the past 50 years, with just 37 infections reported to the Centers for Disease Control and Prevention (CDC) during 2006 and 2015. However rare the disease may be, infections do occur as seen in the unfortunate report of an Ohio female visiting the WWC with a church youth group.

It’s difficult to resist feeling a little bit afraid after hearing this story on the news, especially since the media refers to the amoeba as “brain-eating.” The reality is that N. fowleri breaks down brain tissue, causing death from brain swelling. Meningitis, or the infection of the brain and/or spinal cord, is not unique to N. fowleri. Meningitis occurs much more often as a result of a viral infection than from an amoeba or other parasite.

Additionally, it is important to note that you are only at risk for primary amebic meningoencephalitis if N. fowleri goes up your nose. If you swallow contaminated water, you’re fine. If you’re swimming in the ocean, you’re safe (N. fowleri doesn’t like salty water). The amoeba is only dangerous if it goes up your nose, which contributes to the rarity of this disease.

“The number of yearly cases of death resulting from this rare amoebic infection is so low that there is absolutely no reason to think that the White Water Center is any more dangerous than a lake or any other fresh water body of water,” said molecular biologist Christy Esmahan, PhD. “The media likes to sensationalize rare infections, but the truth is that you are far more likely to die of drowning in a pool than of contracting this infection at the WWC or anywhere else.”

Many Facebook users and Twitter scrollers are probably more likely to click “share” or “retweet” than they are to actually read any of the dozens of news stories covering this incident. Let’s look at some of the lead titles:

“Teen dies from brain-eating amoeba infection after visit to Whitewater Center”

“Brain-Eating Amoeba Eyed in Death of Ohio Teen”

“Ohio woman dies from infection caused by ‘brain-eating amoeba’”

Am I hooked after reading these titles? Yes. Is my mom canceling her trip to the WWC this weekend? Most likely. Does this title really describe the situation? Not entirely.

Let’s go over some of the key points:

  1. Meningitis from this particular amoeba is extremely rare. You’re no more likely to contract this disease from the WWC in Charlotte than you are at any lake, river, or other non-saline body of water in the world.
  2. Officials are not even sure if it was actually the WWC where the amoeba was contracted. The WWC is still running under regular operation, and scientists are testing the water for amoeba right now.
  3. You are not at danger from contracting meningitis from this amoeba by drinking contaminated water. It has to go up your nose to be dangerous.

Know the facts, stay informed, and don’t be afraid!

https://twitter.com/ScienceKara 

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Credit: U.S. National White Water Center