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

Tattoo Healing

30 states require tattoo artists to provide aftercare instructions, and rightly so. Proper aftercare is super important for maintaining the integrity of the design and preventing infections.

Saniderm Tattoo Healing

Every tattoo artist has their own preference for tattoo healing, and the shop I went to – Canvas Tattoo & Art Gallery in Charlotte – prefers tattoo aftercare via Saniderm, an adhesive bandage that lets the tattoo “breathe” while protecting the healing skin from environmental exposure at the same time. Interestingly, similar bandages are used for burn victims.

The folks at Saniderm explain that because recently tattooed skin is indeed an “open wound,” appropriate aftercare is essential to not only make sure the quality of your new ink stays intact, but also to prevent unwanted infections that could ruin your tattoo and be really dangerous. The Saniderm bandage keeps newly tattooed skin moist and clean during the first few days after the initial tattooing when the skin is the most vulnerable.

After completing the tattoo, the fabulous Grace Jang at Canvas (who also designed my tattoo, check out her insta) put a Saniderm bandage on my arm and gave me these instructions:

  • Remove Saniderm bandage after 12-24 hours, gently clean tattoo with antibiotic soap, and pat dry with a paper towel.
  • Put another Saniderm bandage on and leave it on for five days.
  • No scratching or soaking my arm (no baths, but showers okay) for 3 weeks.
  • After removing Saniderm, keep tattoo moist with moisturizing lotion to prevent scarring, which could affect the tattoo design.

I followed her instructions meticulously, and three weeks later, my tattoo looks fabulous. There was a bit of (expected) peeling and it was a little itchy, but I kept it clean and moisturized and everything was fine.

So why is it imperative to keep a new tattoo moisturized? The healing wound will dry up and form a scab (like wounds tend to do) if you don’t keep it moist. While scab formation is a normal part of topical wound healing, excessive scabbing can warp the design of a tattoo as the body gets rid of “damaged” skin cells (in this case, tattooed skin cells likely important to the integrity of your design) and replaces them with new skin cells. Together, using Saniderm immediately after getting a tattoo and relying on moisturizing lotion in days after that is a great way to compromise with your immune system – protecting skin cells without ruining your new tattoo.

Other types of tattoo healing

General advice from MedlinePlus recommends covering a fresh tattoo with petroleum ointment followed with plastic wrap/bandage for at least a few hours. After removing the bandage, wash the tattoo with soap and water and apply more petroleum ointment. After this point, you’re essentially letting the wound heal naturally, keeping it moisturized and protected from the sun. Most experts will advise not scratching the tattoo while it heals and not soaking it in water.

Getting the Tattoo

What’s happening to your skin when you’re getting a tattoo?

Getting a tattoo is like getting multiple injections of ink in a concentrated location on the skin – of course usually in a meaningful pattern according to the tattoo design. Tattoo needles take the ink through the epidermis (outer layer) into the dermis (second layer).

  • The epidermis is responsible for new skin cell production. Think about your skin peeling after a sunburn and scabs forming when you get a cut. This layer of the skin also produces melanin, dictating what color your skin is. Additionally, protective immune cells live in the epidermis. Think about how much nasty stuff your skin is exposed to on a regular basis. These immune cells are hard at work 24/7. First-degree burns are those that affect the epidermis.
  • The dermis has its own set of duties, including sweat production, sensation, hair growing, oil-making, and ferrying blood to and from the epidermis. Second-degree burns are those that affect the epidermis and part of the dermis.

The immune cells living in the epidermis don’t know that the needle piercing the skin is something you’ve voluntarily agreed to do (actually paying someone to do). They react as if the body is under attack, triggering the inflammatory response. You’re familiar with the immune response if you’ve ever cut yourself, scratched a bug bite, or gotten a sunburn. I’m going to go out on a not-to-flimsy limb here and say you’ve definitely experienced the inflammatory response during your lifetime.

When immune cells in the epidermis trigger the inflammatory response, the immune system goes on high alert, sending troops of specialized immune cells to the wound site. This is also why you feel pain during a tattoo (and other wounds) – your body is telling you that you’re under attack and you need to GTFO.

The ink delivered by the tattoo is taken up by immune cells called macrophages, which specialize in engulfing particles and digesting them to “clean up debris” at a wound site. Skin cells called fibroblasts also take up ink. Whichever way the ink goes, those cells stay in the dermis permanently, providing the “a tattoo is forever” quality that makes grandmothers everywhere furrow the brows and purse their lips in disapproval.

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.