Monthly Archives: March 2014

healthy habits, nutrition, policy, politics

A public health policy disgrace…

A tale of public health advocates double-crossed by big food. Not for the first time, nor will it be the last…

In a sense, this is a battle between altruism and profit. Hardly a fair fight really?

http://www.abc.net.au/radionational/programs/backgroundbriefing/2014-03-30/5350092

Big food fight continues after Senator Fiona Nash controversy

Sunday 30 March 2014 8:05AM

 

The controversy surrounding a plan to put nutrition rating labels on processed foods has already claimed the job of the Assistant Minister for Health’s chief of staff. The stoush has revealed the deep links between ‘big food’ and the government, writes Ann Arnold.

Related story: RN Breakfast report (6 mins)

It sounds innocuous enough—a plan to have clear labelling about the health qualities of processed foods, so that consumers have a better sense of what they’re buying.

But a system that would see star ratings on the front of most edible items on supermarket shelves hit a spectacular hurdle in Parliament House last month.

In what became one of the biggest parliamentary stoushes so far this year, Senator Fiona Nash was forced to defend her chief of staff, Alastair Furnival, after he rang the Department of Health and ordered it to take down a new website that was to be part of the health star ratings system.

We put in a huge amount of time and effort, and did it in good faith, and dealt with this particular section of industry in good faith. Now we see a turning away from that and the use of that standard political tactic when you don’t want something to happen, of delay.

MICHAEL MOORE, AUSTRALIAN PUBLIC HEALTH ASSOCIATION CEO

Alastair Furnival was quickly exposed as a lobbyist for the food industry who had not resigned as a director from his lobbying company, Australian Public Affairs, nor sold his half share in it, while he worked for the Assistant Minister for Health. He subsequently resigned from his job and Senator Nash was censured in the Senate by Labor and the Greens for misleading Parliament.

That whole episode, however, was just the tip of an iceberg. For two years there has been a battle fought out over front of pack labelling. It’s a tale of industry and political connections, expectations dashed and influence wielded.

In one camp are health and consumer advocates concerned about the fact that diet-related illness—or dietary risk—is now the leading cause of death in the world.

In the other camp are some sectors of the food industry: mainly the larger, multinational companies, or ‘big food’, who say the expense of changing their packaging is onerous and business should not have to bear the brunt of it.

The traditionally warring groups were brought together by the federal Labor government in 2012 to thrash out a new labelling system. It was a revolutionary move. Food enemies were sitting at the same table.

Michael Moore, chief executive officer of the Australian Public Health Association, recalls: ‘Actually at the start of the process I think there was quite a lot of trepidation. As the process went on through the first year, I think we all grew in confidence, a great deal of confidence, because we really were working hard to try and find a compromise that would work.

‘When we came up with the star labelling system, because it works on white goods, because it works on movies, because it works on hotels, it would be easy to understand. It would give an overview of the healthiness of the food. I think our optimism grew.’

Soon, his view would change. The Australian Food and Grocery Council, the powerful peak body for the manufactured food industry, had been involved in developing the scheme.

But around the middle of last year, the council started to publicly criticise it. Various anomalies were raised about how particular foods were rated—issues which Mr Moore said were being dealt with by the committees in which the council was represented.

The AFGC also wanted a cost benefit analysis, and ‘more work’ to be done.

Mr Moore told Background Briefing he felt betrayed. ‘We put in a huge amount of time and effort, and did it in good faith, and dealt with this particular section of industry in good faith. Now we see a turning away from that and the use of that standard political tactic when you don’t want something to happen, of delay.’

How does he feel about that whole process now? ‘Oh well, shafted of course.’

This article represents part of a larger Background Briefing investigation. Listen to Ann Arnold’s full report on Sunday at 8.05 am or use the podcast links above after broadcast

The apparent change of heart by the AFGC came after a meeting in June last year of the nation’s health ministers, which, by vote, approved the star rating system. Big business was spooked by the health ministers’ surprise decision to make the voluntary system mandatory within two years if not enough companies had taken it up.

In an interview recorded by ABC TV’s 7.30 in February, Gary Dawson, the AFGC’s CEO, said: ‘It’s a voluntary start up, but it’s a clear threat to force this on food companies from June next year. That’s written up in the decision and so the cost impact is real.’

Processed food is Australia’s largest manufacturing industry, and it’s growing. A Deloitte report released this week forecasts food processing as one of the future growth waves for Australia. Although hit at the moment by a strong Australian dollar, it is poised to make a big impact on the Asian market.

‘We know it [health star labelling] will cost individual companies millions of dollars and of course the industry; we’d estimate around $200 million industry-wide,’ Mr Dawson said.

‘So it’s a significant cost, particularly on an industry that’s in a financial squeeze at the moment. Profits are declining. Companies like SPC or Simplot can hardly afford spending millions of dollars on a scheme where the benefits are far from well understood or proven.’

The managing director of Simplot Australia is Terry O’Brien, who became the chair of the AFGC in February last year. He is a veteran of the Australian food industry, and was previously employed by Cadbury-Schweppes.

Simplot is an American-owned private company whose Australian brands include Edgell, Leggo’s and Chiko (as in Chiko Roll). Background Briefing sought an interview with Mr O’Brien, but he declined.

He was quoted in The Australian in December citing the cost of the new labelling to hiscompany at an estimated $2.5 million.

Simplot was at that stage faced with closing its factory at Bathurst, in NSW. The company has since announced nearly 300 jobs will be cut from Bathurst and another base at Devonport, Tasmania, over the next few years.

The Australian reported that late last year, the AFGC was actively lobbying National Party MPs about the star ratings system.

The former chief of staff to Senator Fiona Nash, Alastair Furnival, was well connected to the AFGC. He had previously worked with at least two companies—Cadbury and Mondelez—whose leaders are on the board of the council.

Gary Dawson, the council’s CEO, had been a senior member of John Howard’s staff.

‘So he would have dealt very regularly with many, many of the members of Parliament who were likely to be ministers, and who have become ministers,’ says Michael Moore.

Mr Dawson told the 7.30 program in February that he did phone Senator Nash’s office on the day the health star ratings website came down.

‘We’ve been in contact with them regularly over a considerable period … so on the day, yes, we expressed the view that it was premature…. we thought it was a sensible decision to take it down while the work is done.’

Mr Dawson said the website should never have gone up without the industry having prior notice. ‘This is a process that has been running for the best part of two years, and to launch the website without any notification of industry we thought was very odd,’ he said.

In fact all parties involved were notified at the same time—the day the website went up and came down. Background Briefing has seen the email from the Department of Health announcing that the new site was now live. Among the 81 addresses are Gary Dawson, Geoffrey Annison; the Food and Grocery Council’s deputy CEO, and others in the industry people who had been involved in the planning.

Mr Dawson, in a part of his recorded interview with 7.30 that was not broadcast, said too much fuss was made about Mr Furnival’s role in taking the website down.

‘Well I think that was a bit of confected outrage, to be honest. People move in and out of political jobs from all sorts of backgrounds. It was a political overreaction. It underlined to me how quickly commonsense can be lost in these food fights.’

The Australia Food and Grocery Council declined to speak to Background Briefing, because, a spokesman said, Gary Dawson is a member of the food labelling oversight committee, where there was agreement at a meeting several weeks ago to limit media debate on this issue.

Food labelling ‘more important than ever’

Honest, simple healthy food labelling is more important than ever, according to veteran nutritionist, educator and campaigner Rosemary Stanton.

‘Australians are not eating well at the moment,’ she said. ‘And whereas when I started working back in the 1960s we had between 600 and 800 foods available, the average supermarket now stocks something in the order of 30,000 different foods, including almost 2,000 snack foods.

‘So, whereas people used to be able to find out very easily what was in their food, and there wasn’t such a huge array to choose from; these days there are so many foods that nobody is going to be able to go around the supermarket and have the time to read the back of the pack.’

Senior South Australian health bureaucrat Kevin Buckett, the current chair of the labelling oversight committee, gave some examples of how foods would fare under the star rating system at a recent food policy forum organised in Sydney by NSW Health.

‘Amongst yoghurts and other cheeses, you’ve got low-fat yoghurt at five stars. And 98% fat-free yoghurt gets two stars, which tells you something about the sugar that is being added there.’

‘And one of the reasons that you do need this sort of system is to cut through some of the marketing hype that would indicate a food is healthy when perhaps it might not be as healthy as you think.’

Business, he says, should not feel threatened.

‘Because if your food is healthy you will get a star rating system with a highly credible government sanctioned label on it, which will be accepted and trusted by the consumer to indicate that the product actually is healthy. If it isn’t a healthy product, stop telling people it is.’

Ann Arnold

 

Transcript

Show

Credits

Reporter
Ann Arnold
Researcher
Anna Whitfeld
Supervising Producer
Linda McGinness
Sound Engineer
Leila Shunnar
Executive Producer
Chris Bullock
facts & data points, healthy habits, nutrition

Benefits of Intermittent Fasting

– weight loss
– postponement of dementia (eq. of 10 yrs)

http://www.nutritionaction.com/daily/diet-and-weight-loss/are-there-benefits-of-intermittent-fasting/

Are There Benefits of Intermittent Fasting?

Here is what researchers have discovered about fasting some days per week

 • March 24, 2014

“We’ve known for a long time that if you reduce the calorie intake of rats or mice, they live much longer,” says Mark Mattson, chief of the laboratory of neurosciences at the National Institute on Aging (NIA) in Baltimore.

What happens in species closer to humans is more complicated. Rhesus monkeys fed 30 percent fewer calories lived longer in a study at the University of Wisconsin, but not in a study at the NIA.

Act now to download your FREE copy of Diet and Weight Loss: Trim Calories Per Bite to Trim Pounds without cost or obligation.

Why the different results? One possibility: The Wisconsin monkeys were fed fewer calories than monkeys fed as much high-sugar, high-fat food as they wanted. In contrast, the NIA monkeys were fed fewer calories than monkeys fed as much (low-sugar, low-fat) food as they needed to maintain their weight.

“One take-home message is that if you are an overweight monkey like those in Wisconsin, cutting back on calories will extend your lifespan,” says Mattson. “Whereas if you are eating a healthy diet and not overweight like the NIA monkeys, cutting back on calories may not extend your life, although you may experience some health benefits.”

What if you’re human? In the first good study in normal-weight or slightly overweight (but not obese) people, researchers asked roughly 150 men and women to consume 25 percent fewer calories at each meal than they needed to maintain their weight, and 75 similar people to follow their normal diet, for two years.

The calorie cutters managed to eat 12 percent fewer calories, and they lost 10 percent of their body weight. That may explain why their blood pressure was lower and their insulin worked better than those who ate their normal diets.

“They lowered their risk factors for heart attack, stroke, and diabetes,” says Eric Ravussin, director of the Nutrition Obesity Research Center at the Pennington Biomedical Research Center in Baton Rouge, Louisiana. The study hasn’t yet been published.

Why didn’t the calorie cutters cut more? “Eating less than you would like to every day is a struggle,” says Ravussin. “Some people can do it, but many cannot.”

But cutting calories only on some days may be easier.

Mon, Tues, Weds, Thurs, Fri, Sat, Sun

“There’s the alternate-day modified fast,” says Ravussin. “Every other day you eat only one meal with maybe 30 percent of your normal daily calorie intake.”

And there’s the 5:2 diet, in which you eat a normal diet five days of the week, and only 30 percent of what you would normally eat on the other two days.

“Whichever it is, you have to make sure you don’t overeat on the normal days,” cautions Ravussin.

So far, intermittent fasting shows promise in both animals and people.

“Laboratory animals that get no food at all on alternate days live about 30 percent longer than animals that eat their regular diets every day,” says Mattson.

In humans, the 5:2 plan seems to hold an edge over fasting every day.

In two of the best studies, Mattson and colleagues divided 166 overweight middle-aged women into two groups. Both were told to cut calories by 25 percent—one by trimming the calories in each meal, the other by following a 5:2 plan.

In both studies, the women were told to eat a high-protein “Mediterranean-type” diet with fruits, vegetables, whole grains, nuts, seafood, and olive oil, and only moderate amounts of dairy, poultry, eggs, and lean red meat.

On the two fasting days of the 5:2 diet, one study prescribed just four cups of low-fat milk, four servings of vegetables, and one serving of fruit. The other study prescribed about 9 oz. of lean protein, 3 servings of low-fat dairy, 4 servings of low-carb vegetables, and a low-carb fruit. Both also recommended low-calorie drinks and a multivitamin-and-mineral.

In each study, both calorie-cutting groups lost about the same weight. “But insulin resistance declined more in the 5:2 groups than in those who cut calories daily,” says Mattson. And in the three-month trial (the other trial lasted six months) the women on the 5:2 regimen lost more body fat.

Why did the 5:2 dieters do better? They were more likely to stick to their plan. “And on the two days that they ate only 500 to 600 calories, their metabolism shifted to burning fat,” says Mattson.

Brain Diet?

Middle-aged rats, after being deprived of all food every other day for three months, lost 23 percent of their body weight and had better motor coordination and cognitive skills than similar rats who could eat all they wanted.

One possible reason: “Intermittent fasting increases brain levels of a protein that stimulates the growth of new brain cells and the connections between them,” says Mattson.

“We think what’s happening is that when you’re hungry, your brain cells are more active so you can figure out how to find food,” he explains. “During evolution, those who were able to figure out how to get food were the ones who survived.”

Today, our brain cells may respond in a similar way when we’re hungry.

Intermittent fasting also seems to postpone dementia, at least in animals. In mice bred to show signs of Alzheimer’s disease by middle age, eating only every other day delays the onset of dementia by the human equivalent of about 10 years.

“That’s a big effect,” says Mattson. “But we’re nowhere near being able to say the same about humans.”

The bottom line: Cutting calories may not prolong your life, but it may lower your blood pressure and make your insulin work better.

Sources: Science 325: 201, 2009; Nature 489: 318, 2012; Mech. Ageing Dev. 55: 69, 1990; Int. J. Obes. 35: 714, 2011; Br. J. Nutr. 110: 1534, 2013; Age 34: 917, 2012; Endocrinology 144: 2446, 2003; Neurobiol. Dis. 26: 212, 2007.

healthy habits, meaning

Raising successful children…

Interesting insights into what helps children succeed… it’s about developing grit and character, not just smarts.

Author calls for focus on character over homework for kids

Friday 28 March 2014 6:31PM

Many self-help parenting books seem to do little to reduce either the anxiety or fear that many feel about the important job of raising children to become successful members of society.

In contrast, American author Paul Tough argues that the way to happiness and success in children is not to be found through an increased focus on homework or after-school tutoring.

Instead, Tough’s new book How Children Succeed talks up the need for a greater focus on building character traits like like grit, social intelligence and gratitude.

Guests

Paul Tough
Author of How Children Succeed

Credits

Producer
Ali Benton
healthy habits, nutrition, policy

The Atlantic on Katz

 

They conclude that no diet is clearly best, but there are common elements across eating patterns that are proven to be beneficial to health. “A diet of minimally processed foods close to nature, predominantly plants, is decisively associated with health promotion and disease prevention.”

Katz, Meller/Annual Reviews

Science Compared Every Diet, and the Winner Is Real Food

Researchers asked if one diet could be crowned best in terms of health outcomes. If diet is a set of rigid principles, the answer is a decisive no. In terms of broader guidelines, it’s a decisive yes.
Ornamental cabbage and kale in Langley, Washington (Dean Fosdick/AP)

Flailing in the swell of bestselling diet books, infomercials for cleanses, and secret tips in glossy magazines, is the credibility of nutrition science. Watching thoroughly-credentialed medical experts tout the addition or subtraction of one nutrient as deliverance—only to change the channel and hear someone equally-thoroughly-credentialed touting the opposite—it can be tempting to write off nutrition advice altogether. This month we hear something is good, and next we almost expect to hear it’s bad. Why not assume the latest research will all eventually be nullified, and just close our eyes and eat whatever tastes best?

That notion is at once relatable and tragic, in that diet is inextricable from the amount of healthy time we spend on Earth. Improvements in diet are clearly associated with significant lengthening of lifespan and dramatic decreases in risk of most chronic diseases. Combining disease and longevity into the concept of healthspan, the number of healthy years of life—fundamentally more important but less readily quantifiable than lifespan—the data in favor of optimizing our diets are even more compelling. No one is arguing that diet is less than extremely important to health and well-being, but seemingly everyone is arguing as to what constitutes the best diet.

The voices that carry the farthest over the sea of diet recommendations are those of iconoclasts—those who promise the most for the least, and do so with certainty. Amid the clamor, Dr. David Katz is emerging as an iconoclast on the side of reason. At least, that’s how he describes himself. From his throne at Yale University’s Prevention Research Center, where he is a practicing physician and researcher, said sea of popular diet media is the institution against which he rebels. It’s not that nutrition science is corrupt, just that the empty promises of memetic, of-the-moment diet crazes are themselves junk food. To Katz they are more than annoying and confusing; they are dangerous injustice.

Scientific publisher Annual Reviews asked Katz to compare the medical evidence for and against every mainstream diet. He says they came to him because of his penchant for dispassionate appraisals. “I don’t have a dog in the fight,” he told me. “I don’t care which diet is best. I care about the truth.”

Katz and Yale colleague Stephanie Meller published their findings in the current issue of the journal in a paper titled, “Can We Say What Diet Is Best for Health?” In it, they compare the major diets of the day: Low carb, low fat, low glycemic, Mediterranean, mixed/balanced (DASH), Paleolithic, vegan, and elements of other diets. Despite the pervasiveness of these diets in culture and media, Katz and Meller write, “There have been no rigorous, long-term studies comparing contenders for best diet laurels using methodology that precludes bias and confounding. For many reasons, such studies are unlikely.” They conclude that no diet is clearly best, but there are common elements across eating patterns that are proven to be beneficial to health. “A diet of minimally processed foods close to nature, predominantly plants, is decisively associated with health promotion and disease prevention.”

Katz, Meller/Annual Reviews

Among the salient points of proven health benefits the researchers note, nutritionally-replete plant-based diets are supported by a wide array of favorable health outcomes, including fewer cancers and less heart disease. These diets ideally included not just fruits and vegetables, but whole grains, nuts, and seeds. Katz and Meller found “no decisive evidence” that low-fat diets are better than diets high in healthful fats, like the Mediterranean. Those fats include a lower ratio of omega-6 to omega-3 fatty acids than the typical American diet.

The Mediterranean diet, which is additionally defined by high intake of fiber, moderate alcohol and meat intake, antioxidants, and polyphenols, does have favorable effects on heart disease, cancer risk, obesity, metabolic syndrome, and “is potentially associated with defense against neurodegenerative disease and preservation of cognitive function, reduced inflammation, and defense against asthma.”

They also found carbohydrate-selective diets to be better than categorically low-carbohydrate diets, in that incorporating whole grains is associated with lower risks for cancers and better control of body weight. Attention to glycemic load and index is “sensible at the least.” Eating foods that have high glycemic loads (which Katz says is much more relevant to health outcomes than glycemic index—in that some quality foods like carrots have very high indices, which could be misleading) is associated with greater risk of heart disease.

Finally, in a notable blow to some interpretations of the Paleo diet, Katz and Meller wrote, “if Paleolithic eating is loosely interpreted to mean a diet based mostly on meat, no meaningful interpretation of health effects is possible.” They note that the composition of most meat in today’s food supply is not similar to that of mammoth meat, and that most plants available during the Stone Age are today extinct. (Though it wouldn’t surprise me to learn that Paleo extremists are crowd-funding a Jurassic Park style experiment to bring them back.)

Just because Katz is not one to abandon his scientific compass under duress of passion does not mean he is without passion, or unmoved by it in his own ways. The subjects of media headlines and popular diet books are dark places for Katz. “It’s not just linguistic, I really at times feel like crying, when I think about that we’re paying for ignorance with human lives,” he told me. “At times, I hate the people with alphabet soup after their names who are promising the moon and the stars with certainty. I hate knowing that the next person is already rubbing his or her hands together with the next fad to make it on the bestseller list.”

“The evidence that with knowledge already at our disposal, we could eliminate 80 percent of chronic disease is the basis for everything I do,” Katz said. Just as he was finishing his residency in internal medicine in 1993, influential research in the Journal of the American Medical Association (“Actual Causes of Death in the United States“) put diet on a short list of the lifestyle factors blamed for half of deaths in 1990. “Here we are more than 20 years later and we’ve made just about no progress.”

A nod to the fact that popular media is not totally lost, Katz borrows from the writer Michael Pollan, citing a seminal 2007 New York Times Magazine articleon “nutritionism” in concluding that the mantra, “Eat food, not too much, mostly plants” is sound. “That’s an excellent idea, and yet somehow it turns out to be extremely radical.”

Though Katz also says it isn’t nearly enough. “That doesn’t help you pick the most nutritious bread, or the best pasta sauce. A member of the foodie elite might say you shouldn’t eat anything from a bag, box, bottle, jar, or can.” That’s admittedly impractical. “We do need to look at all the details that populate the space between where we are and where we want to be.”

The current review is in pursuit of that, as is a system for determining the nutritional value of foods that Katz recently spent two years developing. It’s called NuVal, and it offers consumers a single numeric value to determine foods’ worth, as opposed to a complex nutritional panel. The number does things like differentiate intrinsic from added nutrients. “If you don’t do that, the best thing in the whole damn food supply is Total cereal. Total is basically a completely vapid flake delivery system for multivitamins. You could skip the cereal and take the multivitamin.”

“If you eat food direct from nature,” Katz added, “you don’t even need to think about this. You don’t have to worry about trans fat or saturated fat or salt—most of our salt comes from processed food, not the salt shaker. If you focus on real food, nutrients tend to take care of themselves.”

The ultimate point of this diet review, which is framed like a tournament, is that there is no winner. More than that, antagonistic talk in pursuit of marketing a certain diet, emphasizing mutual exclusivity—similar to arguments against bipartisan political rhetoric—is damaging to the entire system and conversation. Exaggerated emphasis on a single nutrient or food is inadvisable. The result, Katz and Meller write, is a mire of perpetual confusion and doubt. Public health could benefit on a grand scale from a unified front in health media: Endorsement of the basic theme of what we do know to be healthful eating and candid acknowledgement of the many details we do not know.

“I think Bertrand Russell nailed it,” Katz told me, “when he said that the whole problem with the world is that fools and fanatics are so sure, and wise people always have doubts. Something like that.”

healthy habits, policy

Leeder/Bauman on Standing

 

https://www.mja.com.au/insight/2014/10/stephen-leeder-take-stand

Stephen Leeder: Take a stand

Stephen Leeder

Monday, 24 March, 2014
Stephen Leeder

WHETHER holding a small meeting or for your health’s sake, the hypothesis that standing is better than sitting remains intact.

Standing engages powerful muscle groups in your lower limbs to maintain your stance. This metabolic stimulus does good things to glucose metabolism, and there is evidence to back the claim that standing is a preventive measureagainst obesity and type 2 diabetes. There is further evidence from metabolic studies of the beneficial effects on lipids.

At the same time, management experts have begun to favour meetings where everyone stands or scrums — decisions occur faster and people concentrate better.

It may tickle your sense of humour then to wonder whether standing committees are the most efficacious. And should we have a chairperson?

Rachel Silverman, writing 2 years ago in the Wall Street Journal, put it this way: “Stand-up meetings are part of a fast-moving tech culture in which sitting has become synonymous with sloth. The object is to eliminate long-winded confabs where participants pontificate, play Angry Birds on their cell phones or tune out”.

Silverman, in turn, quotes Allen Bluedorn, a business professor at the University of Missouri, whose studies in 1998 found “that standing meetings were about a third shorter than sitting meetings and the quality of decision-making was about the same”.

How far should the push to abolish sitting take us? Professor Adrian Bauman, a health promotion academic at the University of Sydney, has a longstanding (yes!) interest in the beneficial effects of physical activity on health ranging from mental wellbeing through to the metabolic diseases. He walks everywhere (almost) and sees standing as a health benefit. But he is a scientist and preserves the true scientist’s scepticism.

Incidental exercise, the sort that we all engage in when going to catch the bus, climbing stairs, going shopping, attending to house cleaning and laundry, has much to commend it as it is within the reach of those who are time-poor and cannot afford the gym.

Bauman says: “We often inappropriately think that a single session of exercise will help us fight obesity, but it’s what we do with the other 23 and a half hours in our day that also counts. The two sides of the equation are energy intake and energy expenditure. You won’t expend much energy in terms of weight control if you are in a seat most of the day, even if you did your recommended 30 minutes of physical activity.”

Bauman’s analyses and reviews of over 200 scientific papers about physical activity and standing in particular show a consistent beneficial role, yet he refrains from supporting the enthusiasm of some who would make standing at work an occupational health and safety concern.

Stand-up desks (Winston Churchill was reputed to have used one) and similar refits of the workplace do not come cheaply and while Bauman accepts that in the long term such changes may bring health benefits, he says the evidence is currently not in.

How far should we take this insight? In a recent BMJ article, Dr Mohammed Ahmed Rashid from the University of Cambridge, UK, has suggested that general practice consultations might be crisper, healthier and better for everyone if more of the conversation was had standing up.

The obvious rejoinder is that the majority of patients would not be consulting a doctor if they felt well and like standing up. Hard to know — more experimentation please!

To quote Bauman again: “There’s nothing biologically or environmentally adaptive about sitting.

“As we develop knowledge, we realise that things might not be as we have always believed. Fifty years ago, we didn’t know about the harms of tobacco and high cholesterol. Now we realise that we need to have a prudent diet and not smoke if we want to have a healthy long life.”

Bauman says there is a very easy way to hedge your bets without too much effort — get up on your feet. “The simple act of standing — let alone walking — is beneficial.”

 

Professor Stephen Leeder is the editor-in-chief of the MJA and professor of public health and community medicine at the University of Sydney.

Poll

business, complex adaptive systems, data saving lives, healthcare, rapid learning health systems

Flu Trends fails…

  • “automated arrogance”
  • big data hubris
  • At its best, science is an open, cooperative and cumulative effort. If companies like Google keep their big data to themselves, they’ll miss out on the chance to improve their models, and make big data worthy of the hype. “To harness the research community, they need to be more transparent,” says Lazer. “The models for collaboration around big data haven’t been built.” It’s scary enough to think that private companies are gathering endless amounts of data on us. It’d be even worse if the conclusions they reach from that data aren’t even right.

But then this:
http://www.theatlantic.com/technology/archive/2014/03/in-defense-of-google-flu-trends/359688/

 

http://time.com/23782/google-flu-trends-big-data-problems/

Google’s Flu Project Shows the Failings of Big Data

Google flu trends
GEORGES GOBET/AFP/Getty Images

A new study shows that using big data to predict the future isn’t as easy as it looks—and that raises questions about how Internet companies gather and use information

Big data: as buzzwords go,it’s inescapable. Gigantic corporations like SAS andIBM tout their big data analytics, while experts promise that big data—our exponentially growing ability to collect and analyze information about anything at all—will transform everything from business to sports to cooking. Big data was—no surprise—one of the major themes coming outof this month’s SXSW Interactive conference. It’s inescapable.

One of the most conspicuous examples of big data in action is Google’s data-aggregating tool Google Flu Trends (GFT). The program is designed to provide real-time monitoring of flu cases around the world based on Google searches that match terms for flu-related activity. Here’s how Google explains it:

We have found a close relationship between how many people search for flu-related topics and how many people actually have flu symptoms. Of course, not every person who searches for “flu” is actually sick, but a pattern emerges when all the flu-related search queries are added together. We compared our query counts with traditional flu surveillance systems and found that many search queries tend to be popular exactly when flu season is happening. By counting how often we see these search queries, we can estimate how much flu is circulating in different countries and regions around the world.

Seems like a perfect use of the 500 million plus Google searchesmade each day. There’s a reason GFT became the symbol of big data in action, in books like Kenneth Cukier and Viktor Mayer-Schonberger’s Big Data: A Revolution That Will Transform How We Live, Work and Think. But there’s just one problem: as a new article in Science shows, when you compare its results to the real world, GFT doesn’t really work.

GFT overestimated the prevalence of flu in the 2012-2013 and 2011-2012 seasons by more than 50%. From August 2011 to September 2013, GFT over-predicted the prevalence of the flu in 100 out 108 weeks. During the peak flu season last winter, GFTwould have had us believe that 11% of the U.S. had influenza, nearly double the CDC numbers of 6%. If you wanted to project current flu prevalence, you would have done much better basing your models off of 3-week-old data on cases from the CDC than you would have been using GFT’s sophisticated big data methods. “It’s a Dewey beats Truman moment for big data,” says David Lazer, a professor of computer science and politics at Northeastern University and one of the authors of the Sciencearticle.

Just as the editors of the Chicago Tribune believed it could predict the winner of the close 1948 Presidential election—they were wrong—Google believed that its big data methods alone were capable of producing a more accurate picture of real-time flu trends than old methods of prediction from past data. That’s a form of “automated arrogance,” or big data hubris, and it can be seen in a lot of the hype around big data today. Just because companies like Google can amass an astounding amount of information about the world doesn’t mean they’re always capable of processing that information to produce an accurate picture of what’s going on—especially if turns out they’re gathering the wrong information. Not only did the search terms picked by GFT often not reflect incidences of actual illness—thus repeatedly overestimating just how sick the American public was—it also completely missed unexpected events like the nonseasonal 2009 H1N1-A flu pandemic. “A number of associations in the model were really problematic,” says Lazer. “It was doomed to fail.”

Nor did help that GFT was dependent on Google’s top-secret and always changing search algorithm. Google modifies its search algorithm to provide more accurate results, but also to increase advertising revenue. Recommended searches, based on what other users have searched, can throw off the results for flu trends. While GFT assumes that the relative search volume for different flu terms is based in reality—the more of us are sick, the more of us will search for info about flu as we sniffle above our keyboards—in fact Google itself alters search behavior through that ever-shifting algorithim. If the data isn’t reflecting the world, how can it predict what will happen?

GFT and other big data methods can be useful, but only if they’re paired with what the Science researchers call “small data”—traditional forms of information collection. Put the two together, and you can get an excellent model of the world as it actually is. Of course, if big data is really just one tool of many, not an all-purpose path to omniscience, that would puncture the hype just a bit. You won’t get a SXSW panel with that kind of modesty.

A bigger concern, though, is that much of the data being gathered in “big data”—and the formulas used to analyze it—is controlled by private companies that can be positively opaque. Google has never made the search terms used in GFT public, and there’s no way for researchers to replicate how GFT works. There’s Google Correlate, which allows anyone to find search patterns that purport to map real-life trends, but as the Scienceresearchers wryly note: “Clicking the link titled ‘match the pattern of actual flu actvity (this is how we built Google Flu Trends!)’ will not, ironically, produce a replication of the GFT search terms.” Even in the academic papers on GFT written by Google researchers, there’s no clear contact information, other than a generic Google email address. (Academic papers almost always contain direct contact information for lead authors.)

At its best, science is an open, cooperative and cumulative effort. If companies like Google keep their big data to themselves, they’ll miss out on the chance to improve their models, and make big data worthy of the hype. “To harness the research community, they need to be more transparent,” says Lazer. “The models for collaboration around big data haven’t been built.” It’s scary enough to think that private companies are gathering endless amounts of data on us. It’d be even worse if the conclusions they reach from that data aren’t even right.

management and leadership

Goleman: The Truth About What Makes A Great Leader

Leaders need an inner focus to be aware of their own feelings, values and intuitions, and to manage themselves well. A focus on others allows a leader to read people well, which is key to managing relationships – the art of leading itself. And an outer focus lets a leader understand the larger forces and systems that she must navigate and to determine the best strategy going forward.

 http://www.forbes.com/sites/danschawbel/2014/03/18/daniel-goleman-the-truth-about-what-makes-a-great-leader/
3/18/2014 @ 9:00AM |10,425 views

Daniel Goleman: The Truth About What Makes A Great Leader

I recently had the pleasure of catching up again with Daniel Goleman, who is an internationally known psychologist that lectures frequently to professional groups, business audiences, and on college campuses. Goleman reported on the brain and behavioral sciences for The New York Times for many years. His 1995 book, Emotional Intelligence was on The New York Times bestseller list for a year-and-a-half; with more than five million copies in print worldwide in 30 languages, and has been a best seller in many countries. The HarvardBusiness Review will announce in their April issue that his article “The Focused Leader” won the McKinsey award, which recognizes their best articles of the year. That article was derived from his book, Focus: The Hidden Driver of Excellence,” and that excerpt – along with his key leadership articles from business journals – is included in his new collection What Makes a Leader: Why Emotional Intelligence Matters. In the following brief interview, Goleman talks about the types of leadership characteristics that are most important in the business world, the difference between smart and wise, the leadership triple focus, and what the real definition of leader really is.

Daniel Goleman

Daniel Goleman

Dan Schawbel: What types of leadership characteristics typically yield better business results?

Daniel Goleman: Studies conducted by companies evaluating their own executives have proven that the top 10% of performers displayed superior competencies in emotional intelligence, rather than in purely cognitive thinking. Capabilities like self-confidence and initiative; bouncing back from setbacks and staying cool under stress; empathy and powerful communication, collaboration; and teamwork all make for better business results.

Schawbel: What’s the difference between smart and wise and why does it matter?

Goleman: In my book Focus: The Hidden Driver of Excellence I make the distinction between leaders who are “smart,” in the sense of good at running a business and getting quarterly results, and “wise,” meaning leaders who have a larger sense of the social and environmental systems we operate within, as well as an expanded view of stakeholders. The smart leader can get results in the short-term, the wise leader can net results in both the short and the long-term.

Schawbel: What should someone who isn’t passionate about their work do?

Goleman: I like Howard Gardner’s concept of “good work,” which combines what you’re excellent at doing with what engages you and feels meaningful. Someone who is not passionate about the work they do now might consider how to make a portion of their job “good work,” or how to enlarge that portion over the course of their career.

Schawbel: Can you discuss the leader’s “triple focus”?

Goleman: Leaders need an inner focus to be aware of their own feelings, values and intuitions, and to manage themselves well. A focus on others allows a leader to read people well, which is key to managing relationships – the art of leading itself. And an outer focus lets a leader understand the larger forces and systems that she must navigate and to determine the best strategy going forward.

Schawbel: Do you think that managers should all be leaders or that all leaders are managers and why?

Goleman: I view anyone with a sphere of influence as a “leader,” whether or not she has that explicit job description. In that sense every manager is a leader already, or should be.

Dan Schawbel is a workplace speaker and the New York Times best-selling author of Promote Yourself. Subscribe to his free monthly newsletter for more career tips.

data saving lives, entrepreneurship, healthcare, healthy habits, meaning, nutrition, policy, politics, quantified self, quotes & aphorisms, rapid learning health systems

Ornish on Digital Health

The limitations of high-tech medicine are becoming clearer—e.g., angioplasty, stents, and bypass surgery don’t prolong life or prevent heart attacks in stable patient; only one out of 49 men treated for prostate cancer benefit from the treatment, and the other 48 often become impotent, incontinent or both; and drug treatments of type 2 diabetes don’t work nearly as well as lifestyle changes in preventing the horrible complications.

http://www.forbes.com/sites/johnnosta/2014/03/17/the-stat-ten-dean-ornish-on-digital-health-wisdom-and-the-value-of-meaningful-connections/

3/17/2014 @ 11:09AM |1,095 views

The STAT Ten: Dean Ornish On Digital Health, Wisdom And The Value Of Meaningful Connections

STAT Ten is intended to give a voice to those in digital health. From those resonant voices in the headlines to quiet innovators and thinkers behind the scenes, it’s my intent to feature those individuals who are driving innovation–in both thought and deed. And while it’s not an exhaustive interview, STAT Ten asks 10 quick questions to give this individual a chance to be heard.  

Dean Ornish, MD is a fascinating and important leader in healthcare.  His vision has dared to question convention and look at health and wellness from a comprehensive and unique perspective.  He is a Clinical Professor of Medicine, UCSF Founder & President, nonprofit Preventive Medicine Research Institute.

Dr. Ornish’s pioneering research was the first to prove that lifestyle changes may stop or even reverse the progression of heart disease and early-stage prostate cancer and even change gene expression, “turning on” disease-preventing genes and “turning off” genes that promote cancer, heart disease and premature aging. Recently, Medicare agreed to provide coverage for his program, the first time that Medicare has covered an integrative medicine program. He is the author of six bestselling books and was recently appointed by President Obama to the White House Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. He is a member of the boards of directors of the San Francisco Food Bank and the J. Craig Venter Institute. The Ornish diet was rated #1 for heart health by U.S. News & World Report in 2011 and 2012. He was selected as one of the “TIME 100” in integrative medicine, honored as “one of the 125 most extraordinary University of Texas alumni in the past 125 years,” recognized by LIFE magazine as “one of the 50 most influential members of his generation” and by Forbes magazine as “one of the 7 most powerful teachers in the world.”

The lexicon of his career is filled with words that include innovator, teacher and game-changer.  And with this impressive career and his well-established ability to look at health and medicine in a new light, I thought i would be fun–and informative–to ask Dr. Ornish some questions about digital health.

Dean Ornish, MD

Dean Ornish, MD

 1. Digital health—many definitions and misconceptions.  How would describe this health movement in a sentence or two?

“Digital health” usually refers to the idea that having more quantitative information about your health from various devices will improve your health by changing your behaviors.  Information is important but it’s not usually sufficient to motivate most people to make meaningful and lasting changes in healthful behaviors.  If it were, no one would smoke cigarettes.

2. You’ve spoken of building deep and authentic connection among  patients as key element of your wellness programs.  Can digital health foster that connection or drive more “techno-disconnection”?

Both.  What matters most is the quality and meaning of the interaction, not whether it’s digital or analog (in person).  Study after study have shown that people who are lonely, depressed, and isolated are three to ten times more likely to get sick and die prematurely compared to those who have a strong sense of love and community.  Intimacy is healing.  In our support groups, we create a safe environment in which people can let down their emotional defenses and communicate openly and authentically about what’s really going on in their lives without fear they’ll be rejected, abandoned, or betrayed.  The quality and meaning of this sense of community is often life-transforming.  It can be done digitally, but it’s more effective in person.  A digital hug is not quite as fulfilling, but it’s much better than being alone and feeling lonely.

3. How can we connect clinical validation to the current pop culture trends of “fitness gadgets”?

Awareness is the first step in healing.  In that context, information can raise awareness, but it’s only the first step.

 4. Can digital health help link mind and body wellness?

Yes.  Nicholas Christakis’ research found that if your friends are obese, your risk of obesity if 45% higher.  If your friends’ friends are obese, your risk of obesity if 25% higher.  If your friends’ friends’ friends are obese, your risk is 10% higher—even if you’ve never met them.  That’s how interconnected we are.  Their study also showed that social distance is more important than geographic distance.  Long distance is the next best thing to being there (and in some families, even better…).

5. Are there any particular area of medicine and wellness that might best fit in the context of digital health (diet, exercise, compliance, etc.)?

They all do.

6. There is much talk on the empowerment of the individual and the “democratization of data”.  From your perspective are patients becoming more engaged and involved in their care?

Patients are becoming more empowered in all areas of life, not just with their health care.  Having access to one’s clinical data can be useful, but even more empowering is access to tools and programs that enable people to use the experience of suffering as a catalyst and doorway for transforming their lives for the better.  That’s what our lifestyle program provides.

 7. Is digital health “sticking” in the medical community?  Or are advances being driven more by patients?

Electronic medical records are finally being embraced, in part due to financial incentives.  Also, telemedicine is about to take off, as it allows both health care professionals and patients to leverage their time and resources more efficiently and effectively.  But most doctors are not prescribing digital health devices for their patients.  Not yet.

 8. Do you personally use any devices?  Any success (or failure) stories?

I weigh myself every day, and I work out regularly using weight machines and a treadmill desk.  I feel overloaded by information much of the day, so I haven’t found devices such as FitBit, Nike Plus, and others to be useful.  These days, I find wisdom to be a more precious commodity than information.

 9. What are some of the exciting areas of digital health that you see on the horizon?

The capacity for intimacy using digital platforms is virtually unlimited, but, so far, we’ve only scratched the surface of what’s possible.  It’s a testimony to how primal our need is for love and intimacy that even the rather superficial intimacy of Facebook (or, before that, the chat rooms in AOL, or the lounges in Starbucks) created multi-billion-dollar businesses.

My wife, Anne, is a multidimensional genius who is developing ways of creating intimate and meaningful relationships using the interface of digital technologies and real-world healing environments.  She also designed our web site (www.ornish.com) and created and appears in the guided meditations there; Anne has a unique gift of making everyone and everything around her beautiful.

 10. Medicare is now covering Dr. Dean Ornish’s Program for Reversing Heart Disease as a branded program–a landmark event–and you recently formed a partnership with Healthways to train health care professionals, hospitals, and clinics nationwide.  Why now?

We’re creating a new paradigm of health care—Lifestyle Medicine—instead of sick care, based on lifestyle changes astreatment, not just as prevention.  Lifestyle changes often work better than drugs and surgery at a fraction of the cost—and the only side-effects are good ones.  Like an electric car or an iPhone, this is a disruptive innovation.  After 37 years of doing work in this area, this is the right idea at the right time.

The limitations of high-tech medicine are becoming clearer—e.g., angioplasty, stents, and bypass surgery don’t prolong life or prevent heart attacks in stable patient; only one out of 49 men treated for prostate cancer benefit from the treatment, and the other 48 often become impotent, incontinent or both; and drug treatments of type 2 diabetes don’t work nearly as well as lifestyle changes in preventing the horrible complications.

At the same time, the power of comprehensive lifestyle changes is becoming more well-documented.  In our studies, we proved, for the first time, that intensive lifestyle changes can reverse the progression of coronary heart disease and slow, stop, or reverse the progression of early-stage prostate cancer.  Also, we found that changing your lifestyle changes your genes—turning on hundreds of good genes that protect you while downregulating hundreds of genes that promote heart disease, cancer, and other chronic diseases.  Our most recent research found that these lifestyle changes may begin to reverse aging at a cellular level by lengthening our telomeres, the ends of our chromosomes that control how long we live.

Finally, Obamacare turns economic incentives on their ear, so it becomes economically sustainable for physicians to offer training in comprehensive lifestyle changes to their patients, especially now that CMS is providing Medicare reimbursement and insurance companies such as WellPoint are also doing so.  Ben Leedle, CEO of Healthways, is a visionary leader who has the experience, resources, and infrastructure for us to quickly scale our program to those who most need it.  Recently, we trained UCLA, The Cleveland Clinic, and the Beth Israel Medical Center in New York in our program, and many more are on the way.