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Horizon - An exercise in bad science

1/19/2015

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As ever when there is a diet related TV program on prime time I get a raft of comments, some people genuinely asking for my opinion and others, predicting my opinion, hoping for a bite from an irritated Breed! I am obviously happy to oblige in both situations. Last week saw a 3 part Horizon special on ‘finding the right diet for you’. Given the 3 hours of TV time dedicated to this I felt it was worth addressing it through the blog.

The theory behind the program was that there are certain distinct issues that dieters face and that these can be grouped with a certain diet being optimum for each group. The 75 participants for this program were grouped into ‘constant cravers’ – those that snack all day, ‘feasters’ – those that when they sit down to eat don’t know when to stop and ‘emotional eaters’ – those that over eat in response to emotional situations. The constant cravers were put on a 5:2 intermittent fasting protocol. The feasters were on a calorie controlled high protein, low GI approach and the emotional eaters went to slimming world for group support and a calorie controlled protocol and received CBT to help manage their emotions.

The results were exactly as could be predicted – initial early weight loss and high enthusiasm followed by a slowing of progress and, in some cases, regain of weight. At the end of the ‘study’ which only lasted 3 months average weight loss was 7% of body weight.  On the face of it this all seems sensible and promising, however there were, as ever with these sort of programs, some glaring issues which may not be immediately apparent, yet invalidate the entire thing. This piece may seem ‘ranty’ at times yet my aim isn’t purely venting. I hope that with the following explanations I can show you the common issues with pop science programs so you can perform your own analysis and don’t have to take the presenters, often invalid, conclusions at face value.

My first issue with this format is the dramatisation of science. In the first few minutes we were introduced to the ‘nerve centre’ for the research, which was essentially a store cupboard at the University that they had filled with big TVs and had recruited students to stand around in white coats holding clipboards with nothing on them, pretending to have complicated conversations when the camera was pointed at them. If they were filming an episode of Sherlock I could understand but for a real life documentary this is so unnecessary. Then we have the presenters, the engaging Clinical Psychologist Tanya Byron assumed the intelligent role whilst her male Dr Co-presenter bumbled throughout the program acting like he’d been lobotomized, asking the most obvious of questions of the researchers so that us, the presumably thick target audience, could keep up and understand. This dramatisation of science in an effort to make it ‘approachable’ for the lay person has the opposite effect as it makes good science less approachable. People assume that science is for people in white coats and glasses and has to be explained to them in basic English. If the program instead started with a basic explanation of research methods everyone would be good to go and we could actually focus on the findings rather than having everything repeated to us in progressively simple language.

Moving on to the research methods let me start by pointing out that none of the ‘research’ involved in this program could be written up to create a publishable paper. There was a glaring lack of controls throughout which meant the conclusions drawn were erroneous. For example the ‘stress test’ where all the participants were put through a driving test and were then given a buffet from which they could eat ad libitum with the amount of food consumed measured. They then showed how the ‘emotional eaters’ consumed more in response to the stressful situation. This could be a really nice study design, however, they chose to sit all the separate groups together so all the feasters had their own buffet etc. So while the researchers claimed that this task accurately highlighted the ‘emotional eaters’ issue I could just as legitimately claim that this was a great example of social eating patterns and the greater consumption was in response to social pressures of sitting together. Controlling variables is essential to good research yet this is a topic that was never referred to in the program. The most glaring example of this was in the final conclusion drawn in program 3. The presenters excitedly signed off saying that they had proven that creating individualized diets based on certain eating styles was a successful way of dieting. Despite the myriad of smaller issues in this statement, which I will cover later, there is one factor which was again completely overlooked yet invalidates the entire project, which is the lack of a control group.

A control group is used for the purpose of comparison, they go through all the experimental protocols yet never receive the intervention. So in this example they would appear on TV yet never be given a diet to follow, Their weight outcomes would then be used as a comparison point for the intervention groups. The reason a comparison group wasn’t used, I imagine, is that it would have shown that the diets used weren’t all they were built up to be. In fact a more rigorous approach, with tighter controls and more detailed analysis would probably reveal that the best diet for achieving weight loss is to appear on TV in a program about weight loss.

To dig in a little further on some examples of the bad science involved in the show let’s look at another example – the breakfast test. Here some participants were given breakfast whilst others just had water. They were then asked to rate their responses to pictures of food a few hours later. This kind of research is classic University student stuff, simple and cheap and seems to show cause and effect yet in reality is so basic it doesn’t tell us anything. I should know as I had to use a similar method in one of my dissertations. In the Horizon version they showed that the breakfast skippers had a 40% greater response to the food pictures. Sounds impressive, however let’s think back to my post on bad science and representing statistics. What does this 40% actually mean? It means that on a scale of 1-5 the breakfast skippers scored the food pictures on average at 4.2ish whereas the breakfast eaters scored 3.5ish. Hardly jaw dropping is it? So whilst we can pick holes in the methods here that isn’t actually the largest problem. The biggest issue is actually seen in virtually all research on breakfast – the lack of a transitional run in period. What do I mean by this? When you move away from a carb based breakfast your body takes a few days to adjust to running on fat as the dominant fuel. These first few days can be difficult and you may feel sluggish and hungry. However once you’re adapted your energy rockets and your hunger falls. If the researchers had given the breakfast skippers a week of run in on that protocol then it would have been a valid test and the results would have been vastly different. Changing a diet and then testing the same day isn’t a valid research method where a transitional period is going to affect the results.

Now let’s move to the meat of the issue: the prescribed diets. Each diet was based around some form of caloric restriction, using this information alone we can pull apart the approach without even having to start touching on low GI or whole grains. The weight loss experienced by the dieters followed the classic trajectory of quick initial weight loss followed by a slowing and in some cases a regain of weight. This produced furrowed brows from the presenters and explanations were required from the ‘scientists’. With the use of some fancy apparatus (again boosting the image required for it to be real science we were witnessing) the researchers were able to demonstrate how the metabolisms of the dieters had slowed and therefore they needed to eat less calories. This seems a reasonable explanation but when we use some logic we can see where we might run into problems. Following this theory would suggest that we need to keep reducing calories as our metabolism slows. Where is the end point? Not eating at all? If we consider the evolutionary element of this we can see that the slowing metabolism is a response to the body essentially being starved. It is trying to conserve calories by reducing muscle mass. As I explained in my New Year Fads post on slimming clubs this pattern is all too common. Reduced calories produces weight loss - muscle mass is a large part of this weight loss - metabolism slows making weight loss harder - diet is ended - body is primed for fat storage and regains beyond original weight - metabolism is still slow due to reduced muscle mass - further weight loss becomes harder.

If anyone on this program took a step back and used some of the considerable intelligence you would hope they possessed then they could maybe work out that protecting muscle mass and therefore a faster metabolism is fairly integral to the long term success and health of a diet. This is where moving beyond weight loss as an outcome is important, we need to look at body composition changes to truly evaluate the success of a diet.

So all this being said what would I do if, in the unlikely event, I was handed the reigns to such a show?

I would start by stripping the sciency nonsense, to make the subject approachable you need to be honest with the audience. If you don’t need big TVs and clipboards don’t use them. Lay out the facts, carry out real research with real controls and explain why you are doing so. Give people the knowledge to think for themselves, don’t spoon feed. Next I would break out of the thinking that so many prominent researchers and commentators are stuck in. There is a whole wide world beyond low fat, high carb, restricted calorie diets. Whilst there is some mileage in the categories the researchers discussed I would abandon these in favour of one overarching nutritional approach (low carb, high fat). I would pitch this approach against a control, and a mainstream slimming club diet. I would then discuss ways that you at home could tweak and modify the approach to suit you without giving you a big label to live with. I’d look at the benefits of certain kinds of exercise and discuss psychological approaches to dieting. Writing this out it doesn’t seem so hard does it? Anyone know a producer at Channel 4?

Please share your opinions on the program and this piece in the comments or via social media.

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Reactivity

1/14/2015

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This post addresses a topic that I believe to be central to success, not only in a material sense but also in a more personal sense, helping us to spend more time happier. It is not a new idea and it is not unique to one school of thought. Mentions and descriptions are given to this area from various aspects of psychology and philosophy, from mindfulness meditation to the stoic philosophers. In this blog I endeavor to pull these various elements together to give you an easy to understand guide so you can start implementing the theory in your own lives. To borrow a line from Ryan Holiday “It is simple but it isn’t easy”.

How many of us live our lives like a pinball? We come across an obstacle, whether it be a rude co-worker or an unresponsive computer, and we react, getting angry and frustrated, we then bounce off to the next obstacle, carrying this anger and frustration with us. This process may continue all day. Someone cuts you up on the way home and it’s honking and swearing. Your other half makes an offhand comment and you get upset and sulk all evening. Be honest with yourself now, does that sound like you at all? How does this make you feel? My bet is that you are regularly exhausted and unhappy.

The issue here is one of reactivity. We allow others to dictate our moods by reacting to what they say or do. You may think that this is a natural human reaction and that this is how we are supposed to live our lives. I am here to suggest the very opposite. The following idea sounds really simple but can be a challenge to take on board and apply so give it some serious thought before reading on:

You are your responsible for your own mood. If you become angry then that is a choice you have made.

So how many of us blame our bad mood on a co-worker or on traffic or some other external factor? When you consider the above truth then does this seem a slightly odd way of dealing with the situation? When we get angry or upset then we are the ones that suffer, it is our happiness that we are choosing to compromise and often this spills over to affecting our loved ones also. In such situations if you could take a step back then would you?

The good news is that you have already taken the first step to overcoming the issue of reactivity just by recognizing that you fall prey to it. Perspective is the first tool to use in such situations. When you feel yourself about to react just hit the brakes and take a step back. Give the situation perspective and allow yourself to make a rational choice with how you deal with the situation.

We can also consider perspective when dealing with instances of communication reactions. One of the issues with human communication is that it leaves a lot more open to interpretation than we might think. If we are a reactive sort then it is likely we will interpret any ambiguity in a negative sense, taking it personally and using this as a trigger to launch a bad mood. Again use perspective to take a step back and consider alternative interpretations for what may be being said.

For situations where we are triggered by things that we can do nothing about such as traffic or a computer issue an important phrase to remember is ‘control the controllables’. This means that you can only act on things in your personal control. Traffic and computers are outside your control so it is a total waste of energy to react to them. Our attitude on the other hand is always under our control. Focus your energy on improving your attitude instead, there is always a positive to take from a situation. If your computer deleted your report then just see it as a chance to produce a better one. Even if the situation seems totally hopeless then you still have control over your attitude and can use such a situation to practice a virtue, resilience for example.

I hope that the above description has made you think about your own reactivity and whether you could take steps to improve this. Your mood is your responsibility. No one else can make you angry or upset, you make the choice. What’s more if someone is actually trying to upset you why give them the satisfaction by assuming that mood? By breaking out of the cycle of reactivity we give ourselves a huge advantage, we no longer are ruled by emotion, we have perspective which we can use to make better decisions and we always have positive options at our disposal. This is critical for a successful and fulfilling life.

If this area is of interest then there are several books which you can further your understanding and practice with. ‘The Chimp Paradox’ presents this idea in a unique model which is very easy to understand. ‘The Happiness Trap’ gives some great tips to give yourself perspective from your thoughts. For a more philosophical approach try ‘The Obstacle is the Way’ by Ryan Holiday or head straight to the source and look at ‘Meditations’ by Marcus Aurelius.

I’d love to hear your comments on this so please reply below or via social media.

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Controlling Decision Fatigue

1/9/2015

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At this time of year it is inevitable that many people are looking for resolutions to work on in 2015. I have previously covered several methods of goal setting in previous posts so I am looking at something different today. Personally I have several goals for the year, I am constantly refreshing my goal list so this doesn’t really count towards any resolutions as such. Instead I have been looking at new habits I could adopt that would have a broad effect on my success through the year.







I regularly listen to the Time Ferriss podcast and one topic he has covered with several of his guests is their morning routine. This may sound mundane but stick with me. It is quickly apparent from listening to successful people that a high percentage of them utilize a strict morning routine. The theory behind this is to avoid what is termed ‘decision fatigue’. The thinking goes that we only have a limited cognitive capacity for decision making each day, we certainly all know the exhaustion generated from a shopping trip. So if we waste some of this energy on mundane decisions it leaves us depleted for when we need to be firing on all cylinders later in the day, whether that be in the sporting arena or in the boardroom.


By essentially automating our morning routine we can save a heap of mental energy for use at the more important points in our day. What Tim Ferriss therefore suggests is ‘speccing out’ your first hour of each day. Write down your spec in great detail and give yourself a running order. It needs to be detailed to the level that you could give the notes to someone else and they could enact the routine identically.

So work out what you need to do each morning and think how you could streamline this process. A huge one for many people will be to pack their bag and arrange their outfit the night before. How long do you spend deciding what to wear each day? That is time and mental capacity being wasted! Have you noticed how so many really successful (and rich) people often dress very simply and plainly? This is a deliberate ploy, they don’t want to waste their effort on outfits when they have massive companies to manage.

Once you have gone through this process you may find that you have a lot more time each morning as you’ve cut the faffing out! You could choose to spend this extra time sleeping or you could look to increase the spec of your morning by adding in some extra activities such as meditation, mobility exercises, reading or a walk.

If you look at the photo above you will see that I have written down my routine. I have a more detailed version but this should give you an idea as to how it could look. I have also taken the decision to spec out the last hour of my day too. I feel this time directly contributes to my preparedness for the next day and also has a dramatic impact on my sleep quality so is important to consider. I also like the feeling of book ending my day so that no matter what chaos may unfold I always start and finish with control. I am confident that this simple process will help me to chase my goals this year. If you decide to follow suit then share your routines with your fellow Breeds either in the comments here or via social media.

(If anyone is wondering, ‘Tank’ is our incredibly spoilt house rabbit)


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New Year Fads

1/4/2015

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It seems the done thing nowadays to rubbish people’s efforts to make changes. Every year those seeking to use the New Year as an opportunity to make a fresh start are ridiculed by some with sarcastic memes and comments on social media. Now whilst I am sometimes skeptical about the sincerity of some people’s efforts I am not one to ridicule, I try to provide information through this blog to help people with their goals. However there are certain exceptions. Every year there are certain fads which people get fooled by and invest huge amounts of time, effort and money into. I hate to see people falling for these fads and I particularly hate to see the companies behind them profiting. So today I am attempting to provide direction for you #newyearnewme types with this list of the biggest fads to avoid.

  1. Detoxing

Detoxing is one of those words, alongside ‘toning’, which is guaranteed to get a snarl from me. The reason for this is that it is meaningless other than in the context of rehab from drug or alcohol dependence. I feel it is unlikely that you’re discussing your detoxing plan on Facebook as you are a recovering heroin addict so I am instead going to assume that you have no idea what you’re talking about and that you have bought into the fad either from a company or a friend selling you on it. If this statement has you feeling all defensive about your detox then please explain to me what it is exactly that you are trying to detoxify yourself from? Struggling? Thought so. You see we have some very clever organs, particularly your kidneys and liver, which are constantly working on ridding your body of any toxins. If these stopped working to the extent that toxins started to build up you wouldn’t need a juice cleanse, you’d need a hospital and fast. If you feel that a festive period full of alcohol has left you feeling horrible then you don’t need to book a colonic to detoxify yourself, just stop drinking and let your liver catch up.

So whether it is a tea, a pill, a shake, a juice diet or a pipe to insert somewhere unspeakable if it is marketed as detoxifying it is essentially bollocks. Don’t be tempted by the advertising, you will only be wasting your money.

The alternative: Eat real food. Cut out processed junk, eat meat and veggies, some high fat dairy and some potatoes and you will be amazed at how much better you feel. No need to pretend to your friends that you actually really like the taste of a detox kale smoothie.

If you’d like to read more ranting on this check out: http://www.theguardian.com/lifeandstyle/2014/dec/05/detox-myth-health-diet-science-ignorance

 
  1. Commercial Weight Loss Plans

Whether it’s Weightwatchers, Slimming World, Cambridge or any other plan you care to mention, you will not convince me that it is a worthwhile use of your time and money. The reason for this is simple; I understand how every program they offer works. They are all based on the concept of enforced calorie restriction. Now whilst this method certainly can work to produce weight loss this is always in the short term and is virtually impossible to maintain. When calories are initially cut below maintenance, weight loss will occur, however the point that these plans fail to take into account is that our bodies are adaptive organisms focused on only one thing. Survival. Now in this context do you see how daft it is to assume that our bodies will happily let us shed weight continuously? Our body may allow the initial weight loss but then it will see this as a survival threat and do whatever it can to prevent more weight loss. This means that your metabolism will slow down so that not only will your weight loss slow but you will also be in a perfect metabolic state for storing fat. That means that when your plan ends you will quickly surpass your initial starting weight.

I spent 2 years working in an NHS service for the morbidly obese (Our BMI entry criteria was >45). 90% of our clients had used at least one commercial weight loss company. They all described the same pattern of losing initial weight, falling off the wagon, gaining beyond their original starting weight and then repeating the process. As the cycles mount up so does the metabolic damage until weight loss is painfully difficult. Having seen how these people had been conned by these companies up to the point where their lives were at stake I now have very strong feelings on the subject. Don’t be fooled by the marketing. Stay away from commercial weight loss solutions. Their goal is profit and isn’t your weight loss.

The alternative: If weight loss is your goal then cut out processed rubbish and focus instead on real food. Take carbs out of your morning and start to limit your sedentary time, walking whenever possible. You’ll be amazed at how easy it is to lose weight this way and it’s free!

  1. Juicing

Now I know that the Nutribullet you got for Christmas was really expensive and that you just have to use it but I am still going to burst your bubble I’m afraid. Now a good rule for juicing is to lay out the ingredients you are about to liquefy on a plate. Would you consider eating them all as they are? Could you even manage that? If it is a no then that is a pretty good indication that you shouldn’t be ingesting them in liquid form. Whilst it is possible to make a case for juices of just vegetables, I’d rather you just eat them and so would your stomach. However such juices aren’t my target, the reason being that 99% of juicy types aren’t blending veg only smoothies, mainly because they taste heinous. My target is instead the fruit filled smoothies. Now whilst you may believe that a juice of 15 different fruits is health in a glass you have sadly been misinformed. Whilst fruit does contain some useful vitamins and minerals it also contains fructose, which makes it sweet and is therefore why you’re willing to drink them. When you blend many fruits together into a liquid you make them very easy to digest and therefore release a lot of sugar into your bloodstream. Fructose is processed slightly differently to glucose as it is first dealt with by the liver. Initially it is processed for fuel however this processing capacity is very quickly overwhelmed and the excess is stored as fat, on your liver, to be dealt with later. Safe to say that having a fatty liver isn’t desirable. This rapid release of sugars into the blood has other unhelpful effects, particularly with hunger regulation. If you are planning on surviving on a couple of shakes a day with an evening meal then prepare for a miserable time of hunger pangs and food cravings.

The alternative: If you like juicing for the convenience then consider swapping your juice for a coffee and cream. The latter will give you stable energy and be helpful for your body composition. If you juice as you don’t like vegetables then try covering leafy greens with butter or chucking a load into a rich stew. Or just grow up?

 

There are some other culprits to add to this list but hopefully you have the idea by now. If you are searching for a healthier you in 2015 ignore the Herbalife and juice plus adverts, save yourself the money and just focus on the basics; eating real food. Happy New Year!

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