Introducing: #ResearchMonday Instagram series

Happy October!

So, in my ongoing science communication efforts, I have been experimenting with visual formats for summarizing research/complex scientific concepts in simple-to-understand and fun ways.

Thus, my #ResearchMonday series on Instagram (which, of course, features #ResearchCat). It was during the last live Twitter Chat with our Science Communication Journal Club that I realized something: participants were sharing amazing sources and articles on the topic, but I absolutely knew I was not going to read them in the nearest future considering other priorities. That’s when I wished there could be some simple memes or visual summaries of key points i’d find useful (and that would truly encourage me to read the rest of the paper).

I very much like Instagram’s swiping posts, since it’s fantastic for self-paced story telling. Thus, this is where I’ve been playing with simple overviews of research articles. Click on each to go to see them:

Note: If new to Instagram, hover over the image & note the small arrow buttons on its sides (<)  and  (>). Click these to swipe through the post!

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breakfast  Screen Shot 2017-10-09 at 10.16.35 AM

ai  Screen Shot 2017-10-09 at 10.16.46 AM

So far, I’ve been choosing papers I have most expertise in- health and nutrition. However, as you can see I’ve attempted to cover some very different topics as well (conscious AI!) The format is most definitely NOT set in stone, and I’d love any feedback on improvements.

 

What is epidemiology (in ~ 7 minutes)

EXCITED to have my second science communication video out today!

This was a collaboration with ASU’s Risk Innovation Lab, as I co-wrote the script with Dr. Maynard. In addition, I used the great video making setup in the lab’s facilities (instead of suffering in my own home with a small unstable whiteboard and terrible lighting).

 

The Process. To produce such videos, you first need a good to-the-point succinct script. This is the toughest part for me personally. Once you have that, you need to create the drawings to go along (I enjoy this part the most, though that’s not the case for everyone). Then you’re ready to film!

If you have professional lighting equipment, great camera, and a sturdy whiteboard, you can do it in < 2 hrs, which is how long it took me  (my first video took much much longer- in fact I had to re-record sections on the next day). This part is probably the most tedious and frustrating– for one, try writing in a straight line and with good enough handwriting!! Then you have to record the voiceover- so, read the script you wrote. This can take many tries, but it seems like the simplest part to me!

Finally, you need to edit the video- so, take your recordings and synchronize them so that the images go with the script perfectly. This is not as horrible as you might imagine (iMovie makes it straightforward), but it does take some time. Overall, this video took me about 7 hours to make. My previous one (HERE) took about 16!!

I am very happy with this work (especially the epi detective with a sizable mustache), but I wonder about one element. Originally, I wrote the p-value explanation a bit longer. We then shortened it, but I am curious which version does a better job explaining the concept. Here’s the first writeup:

One standard practice in analyzing data is to look at the P-VLUE (or probability value) to determine if the findings are true or are simply due to chance.

For this, a p-value cut off is set at 0.05: this means that the probability of findings being caused by random chance is 5% or less. P-values above this 0.05 threshold, meaning the probability of chance findings is more than 5%, are considered NOT statistically significant.

In other words: researchers across various scientific fields have arbitrarily decided that out of 100 findings, they are comfortable accepting that 5 of those will actually not be true but will be caused by random variations. And this amount of error is the most they are willing to accept (thus the 0.05 cutoff value).

So, which explanation leaves a non-expert with a better understanding (in the video, it starts at 4:13)? Let me know if you have an opinion, because I honestly can’t tell which is more effective.

Addicted to “Food Addiction”

I recently wrote a short article on “food addiction” for the Risk Innovation Lab’s CrisBits blog (collaboratively published by Arizona State and Michigan University!). This piece mainly focuses on the scientific side of the issue- I really wanted to broadly cover research on the topic, since so many popular articles on food addiction focus on singular studies (and end up being extremely misleading). Yet I also really wanted to address the topic from an anthropological perspective.

… the notion of addictive foods attracts us on a much deeper level as well

So why are we.. almost addicted to the belief that “food addiction” is a thing? If you read my CrisBits article, you’ll see that there is (as of now) no actual evidence for any food ingredients causing addictive-like responses in humans. The field is highly debated, though: there’s plenty of scholars arguing pro and against. On top of that, the media often does a horrible job sensationalizing food addiction research (well, I suppose it does a great job sensationalizing, but a horrible job communicating the results correctly). All of that can surely create the illusion that science actually supports the food addiction theory. However, the notion of addictive foods attracts us on a much deeper level as well…

Image result for food addiction


The allure of addictive foods

There is a strong cultural appeal in the idea that certain “bad” foods or their components can cause dependence and are thus dangerous (e.g. MSG, casein, gluten). This view of overeating as addiction includes the need to “detox” and instead eat a “clean” diet (e.g. this: The Diary of a Sugar Addict in Detox).

These are not just modern health trends, but a manifestation of a need to understand our world by imposing structure and thus meaning on the untidy experience that is reality. Structure is created by categorizing things into clean/unclean, healthy/unhealthy, pure/dirty- and things that don’t clearly fit into such categories are considered unclean and dangerous. Anthropologist Mary Douglas makes this point in her seminal book, Purity and Danger, as she examines food taboos (cultural rules about what not to eat). Douglas points that prohibited foods are considered “polluting” because they defy easy classification into culturally important categories. The current unease with genetically engineered foods is a fantastic modern example: as a technology that blurs the lines between natural and unnatural domains, it is indeed often termed by opponents as “genetic pollution” or “contamination”.

…prohibited foods are considered “polluting” because they defy easy classification into culturally important categories.

The categories we create to make sense of the world have strong moral overtones, as they allow us to essentially define right and wrong. Indeed, the word “addiction” itself is connected to the moral disapproval of socially undesirable behaviors (e.g. drug abuse). Psychologist Paul Rozin points out how the fear of sugars in American diets, for example, reflects the Puritan belief that things that are very pleasurable must also be bad.

Religious Scholar Alan Levinovitz also emphasizes that people frame eating in terms of morality and religion. He discusses how concepts of healthiness reflect the “myth of paradise past”- the idealistic belief that things were better, healthier, and even morally superior before. From such perspective, novel changes to foods represent our fall from grace- whether via agriculture (e.g. as in paleo diet ideology) or industrialization and technology (as with processed and genetically modified foods).

So, that’s my little anthropological view of food addiction beliefs as a cultural phenomenon. Hope you enjoyed it!


P.S. You might see news reports on studies about food addiction.. but keep in mind that no clinical diagnosis for “food addiction” exists, and most such research uses a self-report questionnaire: the Yale Food Addiction Scale (YFAS). This tool uses DSM-IV’s generic criteria for substance abuse to measure addictive-like eating.

Most importantly, it does not validate the existence of “food addiction” as a true disorder (DSM diagnostic criteria is intended for trained clinicians, not a checklist for self-diagnosis via a simple questionnaire). This is a critical issue to consider, as most food addiction research with humans is based on diagnosing food addiction this way.

The “other countries banned it” argument

Posts like these.. drive me just slightly crazy these days.

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I don’t blame anyone for getting affected by them.. but let me tell you a little story about banning “bad” stuff by other more enlightened countries who are apparently less evil and profit-driven than US (insert eyeroll).

This summer I interviewed participants in Ukraine as part of my project on food and health perceptions. Several of my respondents happened to be lawyers.. One of the topics under discussion was GMOs (genetically modified organisms). The non-GMO stickers have been put on foods in the country since at least 2013 Screen Shot 2016-08-12 at 1.34.56 PMwhen I visited last. Anything from foods to chewing gum to water bottles boasted the round green NO GMO sticker. Most people I discussed it with actually acknowledged it was simple marketing and didn’t place much trust in the stickers anyway..

So when this July my interviewees mentioned that “well, you HAVE to have the non-GMO label in Ukraine”, I thought they meant that brands just needs to keep up with the competition in hopes of selling more of their product under the illusion of naturalness and purity (big deal for Ukrainians, who still live with the Chernobyl accident of 86, and still worry about environmental pollution in foods).

Well, No- i was told. Ukraine in fact passed an actual law somewhat recently forbidding the import, export, production, or sale of foods with any GMOs. So if you want to place a product on the shelves of Ukrainian stores, they simply have to be certified non-GMO.Screen Shot 2016-08-12 at 12.38.56 PM

Oh! OK… what about reality? In actuality, if you’re placing that product on Ukrainian shelves.. you just pay to get the label put on. Ta-da, it’s non-GMO!

It is all so political, that discussions of population health are mostly for decoration..

Posts like that mentioned above are designed to get you thinking with indignation “I can’t believe my country is so interested in profits!.. they sacrifice our health while other countries actually care about their people’s well being..”. But why do you think Ukraine banned GMOs? It’s to make $ off the new certification and labeling procedures, it’s to look cool in front of Europe (we really want to be accepted to EU, mkay), it’s to keep our image as a serious exporter of quality agricultural products (hey, Ukraine wants to stay the famous breadbasket of Europe! And demand for “clean” or eco agriculture is big. You can’t afford to lose your place in that market)…

It is all so political, that discussions of population health are mostly for decoration (not like absolutely nobody cares, but that’s not the main reason for any of these policies). And of course this is not just Ukraine- I’m just telling you a short specific story. Either way, poor regulatory practices in the country mean that anyone can buy that non-GMO label: nobody’s testing anything and nobody is checking compliance, guys.

Eat Less- Live Long? Not so FAST..

Got it- to FAST? 😀
The past week has been a treat in terms of great talks on campus. At ASU we are super-lucky to have the Center for Evolution & Medicine, which holds weekly talks by amazing speakers.

First
February 18- Arizona State University

When I saw that the upcoming seminar was related to diet and eating..or more specifically NOT eating or “dietary restriction”, I of course RSVPd in a heartbeat.

“Eat breakfast yourself, share dinner with a friend, give the supper to your enemy”- Russian Proverb

I’ve been in fact fascinated with caloric restriction for years now Screen Shot 2016-02-20 at 1.30.46 PM.png(I wrote a whole research paper on it in the first year of my master’s degree). You might have heard of intermittent fasting (e.g. popular in the CrossFit world), or the CR Society ( http://www.crsociety.org/ )- all are related to the concept that restricting food intake results in health benefits (from extending life to preventing and reversing disease).

I’m sure you can Google caloric restriction and find a bunch of information on its reported benefits..you would see this chart at the CR society website- the lifespan of calorie-restricted (CR) mice vs non-CR mice. You can see that those whose food intake was restricted by more & more % lived longer. Screen Shot 2016-02-20 at 1.24.28 PM.pngWhy do many animals (and perhaps humans) appear to be so well-adapted to eating less? The traditional interpretation of this CR phenomenon is that the dietary restriction effect “has evolved as a way to enhance survival & preserve reproduction during periods of naturally occurring food shortage”. In other words- being adapted to do well on restricted food intake during rough times would have helped our ancestors survive them & stay healthy to have kids later when the food situation improves.

The traditional interpretation of this CR phenomenon is that the dietary restriction effect “has evolved as a way to enhance survival & preserve reproduction during periods of naturally occurring food shortage”.

Experimental evidence with animals, however…supports a different hypothesis- the one Dr. Austad (Professor & Chair of the Department of Biology at the University of Alabama) presented to us last week. Again, I wouldn’t be able to cover everything he discussed during the seminar, but I do want to highlight a couple of main points!

I. First, even though the first book on dietary restriction (DR) HowWorks.jpgdates back to the late 16th century, we still do not know the mechanism behind why DR seems to extend life and vigor in animals + delay disease such as cancers. METABOLISM was the original suspect, as metabolic rate goes down with fasting.. however, metabolic rate drops initially yet gradually goes back UP (takes 6-8 weeks to happen).. Since DR changes an unbelievable amount of physiological parameters (see screenshot ->) it is very hard to determine its mechanism.

II. Second, while many sources cite mice experiments showing life extension with caloric restriction.. those experiments are done with lab mice. When DR studies are done with wild mice, DR has no effect on longevity. WHAAAT!! I’ve never heard this before- in fact i was under the impression that CR/DR extends life in animals, period. Well, NO STUDY has ever found that DR extends life or improves health in nature (or even “nature-like” conditions). Mice in the wild actually do not have enough fat stores to reduce feeding except very briefly (wild mice has about 4% fat while a regular lab mice has 15%; also lab mice do not reproduce). In fact, mice in nature simply do not live long enough for the survival benefits of DR to be important. Another challenge to the original hypothesis that adaptation to dietary restriction enhances survival, is that DR increases mortality from some infections. Lastly, DR increases cold sensitivity (and cold is a major source of death in wild mice) and slows down wound healing.

Sounds like animals in the wild would not benefit from adaptation to dietary restriction… yet why is the positive DR effect observed in so many studies so common?

III. Well, even though wild mice do not live longer with restricted diets, DR still results in cancer protection for them. But even more importantly, DR has been found to protect against acute effects of many many toxins! Dr. Austad talks about this discovery in the following way:

 .. if animals can not afford to wait to reproduce..and they have to do it even when food conditions are poor, what they will do is broaden their diet. This means they might be ingesting a lot of toxins they are not normally exposed to (foods infected with fungi, new seed types that are well defended by the chemicals they wouldn’t normally encounter). So the hypothesis is that DR acutely induces broad defense mechanisms from a broad range of toxins

Toxicology studies have shown that mice that are calorically restricted survive a wide range of toxins. DR also acts as an acute (vs. chronic) protectant against other problems (see slide below). Renal ischaemia reperfusion injury (IRI) is a common cause of acute kidney injury and we can see that while ad libitum mice are dying steeply by day 7, those on DR of various proportions survive (30% DR is only 70% of normal food intake; ad libitum stands for eating as much as one wants). This is quite impressive!!!

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These acute benefits of DR have very important implications. We can think about these effects actually protecting the body against the toxins it itself produces (like free radicals).. it also has clinically relevant advantages- e.g. patients on very strong drug cocktails fasting to avoid harsh side-effects. This suggests that the protective effects of DR could have clinical relevance unrelated to chronic benefits like life extension.

The new hypothesis explaining the evolutionary advantage of this paradoxical effect is that dietary restriction arose as a defense against novel exposure to toxins during food shortage.

So in conclusion.. we saw evidence suggesting that dietary restriction would NOT enhance survival in nature. Yet research has shown that DR increases health and life in a diversity of species. The new hypothesis explaining the evolutionary advantage of this paradoxical effect is that dietary restriction arose as a defense against novel exposure to toxins during food shortage.

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My conclusion? I’m still excited about this topic- more than ever before!!! There is a lot of work done now on the timing of food intake as well (not just restricting the amount, but restricting the timing of eating and human health) and I can’t wait to post more about this (after I collect some necessary data though :).  Watch out for early May as I’ll be sharing some more info!

The SciFiles #2: To Fish or Not to Fish?

Is it end of October already??

My ambitious plan to post simple summaries of cool research studies every Friday did no go as planned this Fall. Not only have I traveled internationally to collect data (dissertation, here I come!), but I also have 5 fantastic undergraduate apprenticeship students “working” in my lab this semester. So- a lot of time has been spent on training, learning how to train, and organizing/cleaning/analyzing the data they help collect for my work. 

Nevertheless, it’s time for another post.


Have you heard that fish is healthy for you? That Omega 3s, the “good” fat, is crucial for health? Or have you heard the opposite and are totally confused?

It wouldn’t be a surprise if you were.. Perhaps you’ve seen Screen Shot 2015-10-21 at 4.04.07 PMnews posts like this ->

In my interviews with folks in US and eastern Europe, the conversation includes”healthy fats” quite often. Everybody “knows” fish is healthy and we should all be trying to eat more omega 3 fats that are abundant in fish products for a healthy heart.

Yet in the last several years, many online sources reported on studies that refute these claims.

In this post I’ll briefly summarize a 2014 paper by Grey & Bolland. I believe you can even access it for free by clicking here.

Full reference: Grey, A., & Bolland, M. (2014). Clinical trial evidence and use of fish oil supplements. JAMA internal medicine, 174(3), 460-462.

What Grey & Bolland did was look for the best scientific work on the topic of omega 3 fats and how it affected sales of these supplements. Grey&Bollard summarized18 randomized clinical trials (between 2005 and 2012) that were published in high impact journals (=highest quality journals respected by the scientific community). Randomized clinical trials (RCTs) are considered the gold standard of research and present the highest level of evidence, so if you’re going to look at scientific support for any idea- clinical trials are the way to go!

What did those 18 studies show: well, only 2 studies reported benefits: a 2007 RCT on ~18000 people and using EPA for major coronary events, and a 2005 meta-analysis of RCTs on ~20000 people looking at effect of omega-3 oils and mortality. The other 16- no benefit… Fish oil sales? In the US between 2007 and 2012 fish oil and omega 3 supplements increased from $425 to $1043 million (!). Similar sales pattern were seen in England and Australia+asia. Technically, that’s not logical- if randomized clinical trials are the best and most robust type of scientific evidence, shouldn’t it influence current practices? The authors write:

“Since 10% of adults in the US take an Omega-3 or fish oil supplement, most commonly for heart health or to lower cholesterol, the null results of 9 of the 10 RCTs and 5 of the 6 meta-analyses studying cardiovascular disease  might have been expected to influence use”

I have pulled up the 2005 meta analysis- one of 2 studies from the review that showed benefit to supplementation- to get a bit more detail on the results. Studer et al (2005)* analyzed 97 studies to examine the safety & efficacy of various lipid-lowering interventions using mortality data (= they looked at lipid-lowering supplement/drug use and how often people who took them and didn’t take them die. The separated deaths into 1)either from all causes, 2)cardiac events, and 3) noncardiovascular causes). Such large-scale analysis of these randomized controlled trials is a very important tool- it allows to look at the overall benefit of interventions. This meta-analysis found that two supplements/drugs had reduce risk of overall and cardiac mortality (deaths from all causes and deaths from cardiac events specifically): statins and Omega-3 fatty acids.

Sounds wonderful, but again: it was only 1 of the 2 studies that showed statistically significant benefit of Omega-3s, while the other 16 did not. (statistically significant= meaning something happened Not by chance alone)

* Full reference:Studer, M., Briel, M., Leimenstoll, B., Glass, T. R., & Bucher, H. C. (2005). Effect of different antilipidemic agents and diets on mortality: a systematic review. Archives of Internal Medicine, 165(7), 725-730.


So why do more people continue taking the supplements? Well, first of all, we can assume the public doesn’t read original studies and can be victim to “industry spin”. The “spin” used by industry is a strategy to hype findings and distort the results of clinical studies. Wang et al. (2014) in fact looked this: they analyzed 47 supplements industry press releases & 91 non-industry press releases in response to 46 clinical studies of supplements (published between 2005 & 2013). Result? 100% industry press releases contained “spin” while only 55% of non-industry media pieces did. Industry press releases also reported less on study details – outcome, sample size, effect size- specifically for studies that found no benefit of supplements.

Full citation: Wang, M. T., Gamble, G., Bolland, M. J., & Grey, A. (2014). Press Releases Issued by Supplements Industry Organisations and Non-Industry Organisations in Response to Publication of Clinical Research Findings: A Case-Control Study.

So why else? Well, omega 3 supplements aren’t terribly expensive and people don’t associate them with any RISK, so it makes sense that folks would rather be “on the safe side” and take them. Also, the belief that these fats are “good” can be rather long-term and hard to change- I remember my childhood friends in Ukraine suffering through spoonfuls of fish oil given by their parents. So having a strong long-term belief that fish oils/omega 3s are beneficial can create confirmation bias: looking for evidence that you already agree with and dismissing new research that doesn’t fit your view.

Lastly.. how can fish fat not be beneficial? While I, of course, can not answer that question, here is an interesting piece of theScreen Shot 2015-10-22 at 12.20.39 PM puzzle- genetic adaptation. While I was preparing for a lecture on evolution and human diet, I saw a fascinating research piece at the National Institutes for Health website. Originally, the focus on fish oils came from studies with the Inuit and they seemed very healthy on their traditional fat-rich diets (fat coming from marine sources). So it was thought that fish oil would have a protective effect against cardiovascular disease.. But Dr. Nielsen states:

“We’ve now found that they have unique genetic adaptations to this diet, so you cannot extrapolate from them to other populations”; “A diet that is healthy for the Inuit may not necessarily be good for the rest of us.”

Access full article here.


To supplement or not to supplement, then?
Looks like it is not clear whether dietary supplements with omega 3 fats really influence deaths from cardiovascular causes (strokes, heart attacks) or other causes (cancers) in the population. Yet there is also no evidence that we need to advise people to stop taking these supplements. I suppose it doesn’t hurt..unless it hurts your wallet too much.. Your wallet deserves some good support coming from a good number of randomized controlled trials. 😉

Evolution Wants us Happy & Disease-Free… Not

Since I’m part of a reading group on evolutionary medicine this semester (I am no expert of evolution OR medicine, but love to learn from experts!), I wanted to post some cool things I’m learning 😀

[NOTE: To learn more about the topic with in-depth explanations & fascinating examples, please see EVOLUTION AND THE ORIGINS OF DISEASE.]

One fascinating topic is why we humans are susceptible to disease. If natural selection*** shapes successful traits, then why do we catch and develop so many diseases??

Evolutionary medicine is the field that tries to figure out why natural selection has left us so susceptible to illness (physical and mental). Here are some ways to explain our vulnerability to getting sick:

  • Reproduction vs. Health 4111624-heartbreaking (1)

    I feel it is a common misconception that evolution wants us to live longer healthier lives (e.g. when people say that we’ve evolved to eat a certain way that allows us to live long and be disease-free).. and it is disturbing and heartbreaking for some to find out that evolution pretty much doesn’t care about your happiness, health, or longevity. 😦 Natural selection does not shape organisms to increase all those things, it shapes them to improve our fitness (Fitness NOT meaning long healthy lives [and with a six pack, preferably], but having more healthy children). So a trait that actually harms health will still get inherited if it increases reproduction!

    One example I have heard of is having attractive female proportions (waist to hip ratio and all): it increases the chances that you will have more children blaby making a female desirable by men, but it is associated with higher risk of some diseases in old age.Another interesting example is higher mortality of males in adulthood- natural selection can favor such traits as risk taking, (which is important in attracting females as males compete for female attention), though it can decrease the lifespan of people whose personalities allow for increased risk taking.

    I’ve seen that some paleo diet followers discuss evolution as a benevolent force that has figured out a way for humans to live long and prosper, and while that’s not true on the level of the individual (it technically “cares” that the species prospers by spreading), it doesn’t mean that you can’t use evolutionary theory to personally get healthier.

  • Our genes don’t match the environment!

    Humans have created quite amazing conditions for ourselves- sanitation, roads, safe desktop jobs, public transit,  etc.ven Things that make life comfortable and pleasant. And technologically advanced societies see higher rates of various disorders- autoimmune disease, obesity, drug abuse and so on. Many versions of certain genes are only problematic in modern environments. Proponents of all sorts of paleo-related diets, for example, claim our evolved preference for sugar and salt is dangerous in the world where processed foods are cheap and omnipresent (though adaptive in the wild as sugary ripe fruit are nutrient & calorie-rich). Another example is nearsightedness–  it’s a problem in societies where kids begin reading early and is not a problem in populations that hunt & gather.

Other explanations are:

  • Pathogens simply evolve faster than their hosts (ourselves) so we will never have an immune system that is not vulnerable to some disease.
  • There are also tradeoffs: a certain trait can have great benefit in one way, yet it may have negative effect in other respects (again- being a seductive mess on a motorcycle might make females go crazy over you & want to reproduce, but it also makes one susceptible to dying from unsafe choices).

Once again, here is a GREAT read on EVOLUTION AND THE ORIGINS OF DISEASE by Dr. Nesse (MY INSTRUCTOR!) and Dr. Williams with MUCH more comprehensive explanations AND more interesting examples than I have in this blog entry. 😉

KEY POINTS:

  1. Evolution: change in genetic makeup of a population over generations; it requires genetic variation. The variation in genes arises from mutations and recombination. 
  2. Natural selection favors traits that allow an organism to produce more offspring [that is healthy enough to produce its own]
  3. Fitness does not mean personal health & longevity. Fitness means how good you are at leaving a successful offspring. 
  4. Inclusive Fitness: unlike previously thought, evolution doesn’t work on the level of groups/species but on the level of individuals (so traits that aren’t “good” for the whole species but are good for this individual having more kids are going to be selected for). E.g. genes that make one aggressive to others will still pass on if it leads to this individual reproducing successfully.
    HOWEVER, nice helpful personality traits are successful & are passed on (humans are incredibly altruistic vs. other animals) as it makes one do nice things for close relatives. Since you share genetic material (50% with each parent and siblings, 25% with cousins), the individual’s reproductive success actually includes not only how many healthy kids you produce, but how many your closest relatives do also!
  5. There are no traits/genes that are awesome universally. The benefit of a certain trait is always in the context of the environment. E.g. sodium retention is prevalent in people that evolved around the equator since it gave them a selective advantage (salt is necessary to your body but is lost via sweat and urine.. you’d sweat way more in the hot climates).

[***Natural selection: imagine a group of people/dolphins/bugs. If this group’s members differ in some way that influences the likelihood that they’ll be part of the group in the future, this group will end up changing with time. So if some members have a genetic variation that influences how many kids they’ll have, in time this group will change and have more of the genetic trait that resulted in more kids! moth

A popular example is trees that once had light barks but got covered in black soot. The group of moths that used to hang out by the tree had variation in color- some white, some black.. The white ones will end up being eaten up by birds simply because they are now super visible on the dark bark and, in time, majority of moths will be black (the group has changed!) . Thus, a genetic trait is only “successful” in a context of an environment. There is nothing beneficial to being a black moth other than you’re less visible on black bark and thus will end up having more offspring than the white moths in the group.]

Microbiome Vs. Human

If an alien came to Earth and randomly took a gene sample from one of us… they would most likely end up with a microbial, not human gene. Humans are outnumbered: we have 10 times more microbial cells and 100 times more microbial genes than our own. (February 2017 correction: apparently, that 10:1 ratio was based on one sample from the 70s… while actually, the ratio is more 1:1, so a human body has equivalent amounts of microbial and own cells 😉 gut

Today I heard a fantastic talk by Dr. Alcock- a practicing physician and a PhD in evolutionary biology (great combination that more health professionals should/will be getting in the future!). The question he and many other researchers are now asking is: can microbioms manipulate us to behave in their favor? Perhaps we are not autonomous in our eating; perhaps some of our behaviors represent another genetic interest.

The talk included a lot if interesting outcomes from animal studies on the subject, but that is material for a longer post ( by somehow who is more qualified than I). I will simply summarize some interesting points:

  • Microbiota and humans are not enemies- it is a marriage of convenience where the interests of one are also beneficial to the other. The bugs in our gut do need us to stay alive, as it is good for them also. However, microbiota might not always act in the best interest of the host as the interests of two might result in conflict. Even small differences in gene relatedness can result in conflict (pregnant mothers and fetus, for example, share 50% of genes). And there is zero relatedness in humans and bugs in our guts.A cool example of a conflict is mice infected by toxoplasmosis- such mice in fact seek out feline urine and are attracted to it (vs. having an innate aversion in non-infected mice); they thus look for cat urine, increasing the chances of being eaten by a cat and the parasite spreads further. Microbes can manipulate behavior in other ways- the cordyceps fungus causes its hosts (ants) to act completely out of “character” and leave their normal ground habitat to move onto the high leaves, helping the parasite disperse more spores [The Last of Us video game probably has you familiar with this fun fungus!]. Lastly, human organisms harbor known pathogens as well, yet they do not cause us harm (e.g. e-coli); it is interesting that these pathogens do not produce virulent factors when given simple carb solution (sugar!), a nutrient they require and would otherwise need to get aggressive for.FullSizeRender (1)
  • We can surely manipulate our microbioms. The diet we eat has a huge effect on who’s in our guts- a bug profile of a vegetarian and meat eater are quite different (see photo above). There appears to be a witch-hunt for the bacteria that might be responsible for obesity in humans, but this search has been unproductive with the same suspects being either related or completely unrelated to weight gain.What seems to matter most is the diversity of the bacteria, not having a certain type of it. A Mediterranean style diet with high fiber, for example, produces a more diverse gut environment, while a fast food diet creates a limited one. Some other determinants of a diverse vs. limited environment are on the slide below.  Key Point: Low diversity= Bad health outcomes. Some non-dietary ways to ensure a healthy diverse gut population are probiotics intake (and decreasing antibiotic use), vaginal birth, and breastfeeding; Babies not born vaginally in fact acquire a less complex microbiota that harbors more pathogens.FullSizeRender
  • Can microbioms manipulate…us?? That is the question. Can the gut bugs make us behave differently? Can they make us eat badly and become overweight? While we shouldn’t assume anything for humans yet, there are some examples of potential mechanisms through which bacteria could have an effect on the host.
    • Bacteria has been shown to produce hormones (some are important in stimulating appetite) and neurotransmitters (e.g. serononin that makes us feel good). We need to ask though- do these things pass from the gut to the brain and are actually successful in influencing us? The human body does fight these hormones and neurotransmitters by producing enzymes and antibodies that degrade them and prevent them from crossing barriers (another mechanisms is encapsulating the gut in fat, which also protects the body from escaped bacteria “signals”). It is interesting to note that the microbes might have evolved the ability to produce these things before humans did (as environmental microbes do this too, not only ones that inhabit us), thus they are not primarily meant to affect us.

In conclusion, what we can take out of this knowledge is that we need to encourage people to have high diversity of bacteria in their gut! A whole food diverse diet is a great way to do so, for example. Should we blame our gut bacteria for making us eat junk? Probably not. We can’t pin the blame for obesity and other chronic conditions on a particular microbe, though an overgrowth of one specific group in the gut might be a conceivable issue with their signals interfering with the bodily signals (e.g. in terms of how to eat via hormones and neurotransmitters).

There is so much more fascinating material to cover on the subject but that is for a later date! Lastly, an interesting question was asked in the audience- obese individuals in fact have a low diversity of bacteria… would unhealthy weight gain then be a bad thing for the microbes? Wouldn’t it be a “win” for the human and loose for the bacteria? Interesting question to test 🙂

All material was obtained by a lecture “Allies or Enemies? Gut micribiota & the war on fat” by Dr. Joe Alcock, MD. 2014.

Online Health Wars: Science vs. Public

Since my research includes asking questions about why people think what they do about health, I spent a lot of time reading various discussion boards and comment sections on different health topics. In the last several days I’ve had such an overload of insane online discussions about vaccines, GMOs, and diets that I almost want to quit… 10559827_1659644964260681_5735123775899498101_nAnd yet the often entertaining arguments keep me coming back! The science folks vs. lay folks debates are also interesting since I am myself an ex anti-science alternative health believer who has now “switched sides” on many issues (or as I prefer/hope to think: turned much more moderate in my views based on understanding scientific evidence better).

Have you ever seen a conversation between a “concerned mom/dad who follow their gut” and a “science proponent with experience in the lab” discussing vaccinations? It is sad and funny as you see things like these:

– science person providing links to peer-reviewed literature (really just abstracts, folks can’t access the full text most of the time), questioning parent’s credentials, attempting to explain herd immunity, claiming they lack understanding of science and suggesting to take an into to epidemiology course, blaming them for increasing rates of preventable disease…and as last resorting to calling them stupid, biased, etc.

concerned parent shares links to blogs and anti-vaccine websites, calls the science person’s degree “useless”, emphasizes their credentials as a parent who “just knows” and does their research (via blogs and specific sites), and very often attacks the science guy/girl as being paid by Monsanto or FDA, being dogmatic and inflexible as their degree was provided by corrupt institutions, being stupid, etc.

10420359_1508161656068484_512410907058098671_nNobody ever appears to switch sides, understand where the other person is coming from, or take their evidence seriously. The process of reading such conversations is often sadly hilarious yet less often informative. But most importantly it shows people’s biases.

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Food Regulation course at O’Neill Institute!

Last week I participated in the Summer Program on Emerging Issues in Food & Drug Law at Screen Shot 2014-07-25 at 11.13.13 AMGeorgetown Law. Other than making D.C. my most favorite US city ever, I met interesting people from various health organizations in US, EU, India, China, and South America!

While a lot of the information went way over my head (considering I have no background in law or drugs!), there are a couple of interesting things I learned:

  • US imports a lot of food! About 80% of seafood and about 50% of fruits and 20% of vegetables is also imported.

This means that food safety monitoring requires a global regulatory environment and FDA (food&drug administration) has posts worldwide (China, India, Mexico, Costa Rica, London, Brussels, Africa). Most people I interview are concerned with food’s effect on their long-term well-being mainly because they don’t see food safety in terms of immediate harm as a big issue. That is the privilege of living in a well-regulated country like the US.

Our speakers gave an example of locally produced cheetos-like snacks somewhere in Africa that, aside from the fact that’s not a healthy thing to consume in general, were found to contain actual orange paint, rat droppings, and some heavy metal contamination. Another example of poor food safety regulation that we don’t have to worry about here is a story from my mom: around the time Ukraine became independent she bought a chocolate bar with raisins. After being unable to chew on the raisin for awhile, she washed it to discover it was a raison-shaped PIECE OF PLASTIC. Now THAT is scary. 😦

  • Differences in the way US and EU (European Union) regulates foods.

The most crude way to describe the difference is that EU takes a precautionary approach (e.g. GMOs might have bad effects years later so we’d rather limit them) while US takes a free market approach (there’s no evidence GMOs have adverse health effects, so why limit them?). I have to say most of us in the auditorium sided with the EU mentality as waiting for evidence that something is bad is more reassuring than proceeding due to lack of evidence. We know science takes time and the issue with GMOs is that their safety studies would have to take decades.

  • FDA regulations!asdf

The FDA does a lot of great work yet it can be quite hard to understand this agency’s ways. Mainly I was interested in how they regulate food health claims on products. I found out that if a product
makes a general structure/function claim (e.g. nuts are good for your heart! carrots maintain good eyesight!) the FDA doesn’t care much as they have less authority over such statements. If you, however, make a HEALTH CLAIM (e.g. nuts prevent/cure heart disease!), the FDA has authority to conduct a pre-market review of such health claim.  They need to see that the proposed food’s health claim is TRUE according to a narrow set of guidelines/that the product successfully performs the promised benefit: e.g. that consuming nuts actually affects a certain established biomarker of heart disease (e.g. one established biomarker would be LDL cholesterol). If your product has a health claim the FDA has not reviewed they would send you warming letters and can shut you down.

I understand this part can bother a lot of people who are trying to eat healthily. E.g. several years ago FDA222222 sent warning letters to a walnut company warning them about claiming walnuts prevent heart disease (i believe?). A lot of people in the health community were outraged. But think about a different example- Kellogg mini wheats. They claimed that kids will perform 20% better in school when eating them for breakfast. They then claimed the cereal increases immunity. Then Activia claimed their yoghurt benefits digestion. All lost in lawsuits as their own studies did not support such claims. So, while many of us are biased toward natural foods and were mad about the walnut case, you see where such regulations come handy and are necessary across the board. Also, the claims have to be supported by recognized science, which means that if some studies show your product is amazing for condition X, while others studies show no effect you have to report about both in your claim.

  • Something i was particularly interested in was comparing food quality standards (vs. food safety that FDA is mostly concerned with) in Ukraine and the US.

The Ukrainians I interviewed last summer had very low trust in the quality of food produced in Ukraine. one of the main reasons was the fact that after the fall of USSR, the Government Food Quality Standards became weak and prone to manipulation by the industry. During USSR, there were set food standards called “Recipes” that spelled out what makes up a certain product. E.g. a sausage ought to have a certain percentage of high quality meat.

"Belorussian Goods: High USSR quality". Ukrainians love belorussian foods as the country maintain the high standards for foods created during the Soviet era
“Belorussian Goods: High USSR quality”. Ukrainians love belorussian foods as the country maintains the high standards for foods created during the Soviet era (unlike Ukraine)

Nowadays manufacturers can create their own “recipes” and thus make “sausage” that is 80% soy. I asked the food standards question and learned that US has “standards of identity”  which is also a “recipe”. These standards of identity are mandatory, federally set requirements that determine what a product must contain to be marketed under a certain name in interstate commerce. So an ice-cream is supposed to have real milk, for example, and some other ingredients. Just like in Ukraine, though, manufacturers can bypass these standards by simply labeling their product something else (e.g. “Gelato” you might see on the shelf is not called ice-cream for a reason- it does not have the correct ingredients to be called an ice-cream). Violating standards of identity can be either good or bad for us. Good:  perhaps new recipes of old products can contain healthier products (e.g. almond milk in an ice-cream type of dessert), but the dark side here is that manufacturers can pack products with cheaper unhealthier ingredients. In Ukraine, the second situation is the case: many foods have low quality (e.g. a lot of people distrust Ukrainian butter as majority of it is actually palm oil). More here  http://uspolitics.about.com/od/usgovernment/a/fda_identity.htm

Unrelated to the topic of food.. i learned that counterfeit drugs is a scary issue! Prescription drugs are quite easy to “fake” and most of them look identical to the original product (to the na111ked eye, that is).  The danger of counterfeit drugs is the fact that, while 20 years ago most of them were just placebos, now they contain some amounts of active ingredients that can make a person feel somewhat “better”. The problem is that such various doses of active ingredients are not tested and can cause serious health issues. US has very strong regulation and monitoring of drugs so you are extremely unlikely to just buy some at a local store. You can get exposed to them, however, if you use online pharmacies. Many “fake” pharmacies based in China look legitimate and claim to be based in US or Canada.

For info on safe internet pharmacies: http://www.safemedsonline.org/who-we-are/principles-participation/

BOTTOM LINE: Food policy and regulation is a very complicated issue!!! Obviously a lot is done to keep our food safe, but the food QUALITY subject is very unclear due to different perceptions of “healthy” foods, the complex nature of nutrition science and the huge amount of conflicts of interest.