Tuesday, September 23, 2014

Sedentary Behaviour and Depression: Not just about less physical activity

In the world of sedentary behaviour research one question usually permeates any discussion among experts and non-experts alike.

It goes something like this: "So I see you've shown an association (causal or otherwise) between sedentary behaviour and health risk X. But isn't this really just about less physical activity?"

We all know that not getting enough physical activity means that there's a higher risk of being unhealthy, generally speaking. We now know, or at least have enough evidence to date to suggest, that excess sedentary behaviour is also associated with poorer health. Sedentary behaviour just refers to low-movement behaviours while in a sitting or reclined posture - in real world terms, this is just called sitting too much.

So I wasn't surprised to find yet another study on the ill-effects of sitting on our health. The authors pooled data from 13 cross-sectional studies and 11 longitudinal studies, or 193 166 people, which examined the association between sitting and the risk of being diagnosed with depression. The "main" finding was that individuals were 25% more likely to be diagnosed with depression if they were in the highest sitting group, as compared to the lowest sitting group. Of course, we don't know (and may never know) whether more sitting causes depression or depression causes more sitting. In my opinion, there seems to be evidence for both directions and the association may truly be bi-directional.

What's most interesting to me about this study - above and beyond the main finding - is a sub-analysis that they ran. The authors compared the effect of sitting on depression between studies that accounted for physical activity level, and those that did not. In the studies that did not account for physical activity, the likelihood was 34% [1.34 (1.22 to 1.48)], and for those that did account for physical activity, the likelihood was 12% [1.12 (1.06 to 1.18)]. This is to be expected, as physical activity is typically thought to be protective against depression, so adjusting for it should partition out some of the effect. However, even after adjusting for physical activity, there is still an association between sedentary behaviour and depression!

This underscores the importance of considering physical activity levels when examining the links between sedentary behaviour and health outcomes. Of course it's just good science, but even if only to silence the critics. I do believe that, conceptually speaking, physical activity and sedentary behaviour represent distinct and separate constructs. However, practically speaking these may be difficult to disentangle, especially with respect to the links with health and disease - it's just intuitive that a change in one necessitates an inverse change in the other. As researchers, we need to provide convincing evidence that this intuitive association between sedentary behaviour and physical activity does not necessarily exist.

Remember the conversation above? Some of the best evidence we have today would seem to suggest that the link between sedentary behaviour and depression is not just about less physical activity, but also about sitting too much. Practically speaking, the distinction is like splitting hairs, but conceptually speaking these two are "sitting" in quite different camps.

Monday, July 14, 2014

Do we need better health literacy, or better health journalism?

"Scientists have discovered a new miracle drug for breast cancer!"
"A new study suggests that chocolate is good for your heart!"
"Active video games offer promise in the fight against obesity!"

These are just a few of examples of news headlines that could be brought to you by your science/health journalism professionals. While I've just made these up on the spot, you've probably read or heard headlines similar to this (or exactly like this) before.

Today's post is brought to you in response to a terrific article by Adriana Barton in the Globe and Mail. In Health literacy 101: The science of how to read the science, Ms. Barton provides some useful information for those of us (which is most of us!) who are consumers of health-related media. In our information-age, tech-savvy world it is easier than ever to access information on the latest scientific studies. Journalists have taken advantage of this new-age of reporting and publish secondary articles on scientific reports daily, even hourly. The valid, and honest, interpretation of this scientific information varies tremendously. Enter the article mentioned above on health literacy, which in my view is really science literacy, something that we are struggling to uphold as the number of students eligible for, or obtaining, STEM degrees is low in Canada compared to our peer countries (a topic for another day...).

While I applaud Ms. Barton's efforts to provide some support for citizens consuming news about scientific studies, I think the article was brief to a fault. Coming from someone in the sciences, rather than a journalist, here are several other ways that you can improve your "health literacy".

1) Be skeptical: Ms. Barton noted that many media articles on scientific articles did not disclose any conflicts of interest. While a perceived conflict of interest does not imply any conflict of interest at all, it is a crucial piece of information that provides the reader with an additional lens to critique the article. Likewise, just because a study is funded by industry, that doesn't necessarily mean the article is garbage. There are plenty of scientific articles with no industry funding that are garbage too!

2) Read carefully.  Try to tease apart the numbers when journalists don't provide any. Often this can be a red flag that something is up, or that the writer is bending some findings to suit their purpose. In the article above, Ms. Barton quotes a JAMA Internal Medicine study, and writes: "Of 1,889 media reports on health research published from 2006 to 2013, Schwitzer and a team of 38 physicians and science writers found that half relied on a single source for the article, or failed to disclose the conflict of interest of sources." Now, read that again. Half of the media reports relied on a single source OR failed to disclose conflicts of interest. These are two different faux-pas with different meanings, and the author doesn't say how many of the reports fall into which category. This could mean than 49% used a single source while 1% failed to disclose, or it could be evenly split, or most articles committed both writing-offenses, while only a handful did either. It turns out that the original article doesn't differentiate between these two in their criteria, so this isn't Ms. Burton's fault at all, but this is a good example of how the numbers can be buried to make a point one way or another.

3) Greed is universal. Ms. Burton sheds light on an important aspect of publishing in the medical and scientific world. Publishing is academic currency - simply put, it's an efficient way for researchers to advance their careers. As with any field, greed can lead to people doing some strange things. In many ways, a lot of research is upheld to their researchers' own ethics...interpret this how you will, but this means is that there will always be variability in the integrity of published work. Most of the time the published work is probably good, but sometimes it's crap. What Ms. Burton didn't mention is that greed is universal. Journalists also live in a world governed by the publish or perish mantra and must publish their work to advance in their career. For those who have earned their way to full-time reporting positions, they are often required to publish every week, or even every day! There are countless examples of journalists twisting the words of researchers or mis-representing the findings of scientific articles- see this PLoSOne article on ADHD in the media (and the corresponding news article that goes with it). There's even a prize for being the best at it: the Orwellian Prize for Journalistic Misrepresentation. Now to be fair, it is a two-way street - the quality of a press release is related to the quality of a news report - it's just that on one side we have articles that are peer reviewed for their scientific rigor, and on other side we have articles that are peer reviewed for their "wow" factor, or their ability to enhance/maintain readership. I'll leave it up to you to decide which side to trust more.

4) Beware the percent! Simply put, try to read beyond articles which state findings in relative terms only. Ms. Burton did a great job above by telling us how many media reports there were in the study - kudos! As she alludes to in her article (credit where credit is due, I always say), a 50% reduction in risk means something very different for a risk of 1 out of 100 000 than it does for 1 out of 10. Be weary of articles that report only the relative terms, and in my view, especially those that convert absolute terms to relative terms.

Truth be told, I don't believe that all of the media spin put on scientific articles is accidental. I've seen absolute terms in a scientific article be translated into relative terms in a media article just to increase the "wow" factor. Errors in reporting may be due to external factors, such as incorrect findings in the first place (I've noticed a lot of John Ionannidis citations in researching this post) or selection bias in the types of articles that are passed along (such as those this elicit an emotional response). But in a field where 'spin' is not only acknowledged but actively used as a tactic, I just don't buy the picture of the accidentally misinformed reporter. This article in the CBC does a lot of externalizing in discussing inaccuracies in the media. Of course, there is blame all around - for everyone - although we can argue about who holds more of it.

For the consumers of health media I wish you good luck in sifting through the good and the bad. Science isn't easy to understand, and science writing is hard enough to do, let alone read. The media offers an efficient medium to translate this information for you, but it is increasingly important to be critical of what you read in the age of post-print media.

My advice to those writing in health media is to describe the study in one easy to read sentence up front, containing all of the details needed to make sense of the finding. Use spin carefully - it is a powerful tool, and with great power comes great responsibility. Use absolute terms and provide numbers where possible. Do your homework and understand what these numbers mean - this is often troubling in media articles that present findings as likelihoods when the article uses odds ratios. And please, PLEASE, provide the link to the original article!

Monday, March 10, 2014

Google glass, household media plans, and competing with the screens

I empathize with parents today. Technology is omnipresent, appealing, and addictive. When challenged to get their children outside more, parents have asked me "sure, but how can I compete with the screens?".

There isn't an easy answer to this. To try to provide some answers, or at least generate discussion, my colleague and I Allana LeBlanc wrote an article for the Ottawa Parenting Times about healthy active living in a modern world. What follows here is an elaboration on the idea of competing with the screens.

I don't think that technology is going anywhere, anytime soon - and nor do I think it should. While screen-based technology has the potential to be harmful, especially to children, I also think that our technology is allowing us to communicate and interact as never before. That being said, the researcher in me is terrified of Google Glass. Considering how harmful we know screens are to children's health, if the idea of walking around with a screen 24/7 doesn't scare you, it sh
ould. (Can I say that on Blogger!?)

As with anything, it's the role of parents to teach their children moderation with screen-based media. Children today do spend too much time in front of screens, and credible organizations, such as the American Academy of Pediatrics, are recognizing this. When I was a child, I loved playing video games - still do, in fact. But screen time was something that was allowed on a rainy day or when there otherwise weren't opportunities for active play (such as long car rides). Of course, one size does not fit all, and parents should be encouraged to develop their own strategies using the evidence and guidelines, such as those from the AAP, to help them.

Regardless of the strategies that parents want to employ to reduce their kids' screen time, I think an integral part of any approach is to develop a household media plan. Parents will have different household rules regarding media and I think that's a good thing - it needs to be tailored to what you and your children want if it's to be sustainable while still being enjoyable. There is no one best strategy, or at least we haven't found it yet, but there are some general ideas that may help parents and families guide the development of their household media plan:

1) As far as screens go, less is better.

2) Rules around the timing of media use may be helpful, such as: no texting at the table, no phones in the bedroom overnight, and no television after 9:00. Again, these types of guides should be personalized to suit the needs of the family and the age of the child.

3) Using screen-based media after school is known to affect health. For instance, every 60 minutes that a 11-14 year old boy spends sedentary after 3:00pm is associated with 1.4 kg/m higher BMI and a 3.4 cm higher waist circumference (read the article here). I think that we could have a major impact on the health of children if every child was encouraged to play outdoors after school instead of using screen-based media. This is a critical area where parents can have a profound impact on the health of their children.

 CBC news' Pauline Dakin recently did a story on the effect of social media on teens. Social media is re-defining how children communicate with each other and with the world, and is largely becoming a new way of life. Now I wouldn't suggest that if you can't beat 'em, join 'em, but I do think that maintaining open lines of communication with children about screen-based media and social media is a good thing. Adults may be wise to educate themselves as to the purpose and uses of different social media apps, both to have intelligent conversations with their children when making household media plans, as well as to protect their children too. I'll spare you the Sun Tzu quotes, but I think a little "know thine enemy" may be in order.


Monday, March 3, 2014

Are today's playgrounds too safe?

I completed a survey today by Dr. Mariana Brussoni and Susan Herrington from the University of British Columbia, entitled: Are Today's Playgrounds too Safe? I would encourage you to respond to the survey here. It takes under 5 minutes to complete and it's actually quite fun to reminisce. Please note that I'm not involved with this project in any way and my opinions here may not be reflective of the opinions of the researchers above.

I want to comment on the notion of playground safety just briefly. I'll disclose my bias here - the playgrounds that I typically see in Ottawa do not appear to be any more, or less, safe than the ones I played on. Structurally or physically speaking they quite resemble the play structures that I played on a child. Slides, ladders, ropes, sand, etc. Maybe this isn't true for some (or most) playgrounds, but I'll be sure to keep a lookout around my neighborhood for anything that doesn't look 'normal' to me.

While I don't believe the playgrounds have changed too much (ok maybe a little - the rubber mats that have replaced sand are kind of silly), a lot of things around the playground have. For starters, parents' attitudes about playground safety have changed. On the survey above there is a term called "rough and tumble play" - I responded that, yes, I did do this as a child. I don't know many adults my age who would respond no to this. But I imagine that this is something that's a big no-no at the playground nowadays.

My favorite place to play as a child was the woods at the cottage (that's camp to my hometown residents of Northern Ontario!). Here, children of all ages from the neighboring cottages worked together to build multilevel forts. Big forts...forts you could live in - seriously, we had shingles on the roof. On most days we would kiss our moms goodbye and head into the woods with our tools just after breakfast and we usually needed to be reminded to eat sometime in the early afternoon, only to scarf down food as fast as we could to re-join our friends. We got cuts, scrapes, bruises (not just our egos when we weren't allowed to use the 'big' ax) and a occasionally someone cut their finger with a jack-knife (Ah-Hem...Sass). We actually nicknamed one of the trails 'the bloody foot trail'. But you know what? We had the best damn fort in the bay and we were proud of it.

As the oldest child in our small fort-building industry, it was often my job to delegate tasks to other children - after all, what's a construction site without a foreman around, right? Some of the jobs weren't so fun, and it was tough to delegate them to the other kids knowing this. I like to joke that everything I learned about leading a team I learned building forts in the woods of Horseshoe Bay, ON.

Back to the survey. Are playgrounds too safe? I don't really think so - perhaps marginally more safe than they already were, but it's not like there are any axes, jack-knives or bears hanging around playgrounds (usually, anyways). I think the problem is that kids might be spending too much time being supervised at the playground than building forts in the woods.

Tuesday, February 25, 2014

Dietary components, natural ingredients, and missing the forest for the trees.

First off, my apologies to the loyal Mikepedia followers for my absence - it was a busy few months, but my thesis is submitted at last!

I'd like to talk a little bit about food.

The food that we eat today is different than that of our primordial ancestors. It doesn't have to be, but in a Western diet it usually is. Food is different because we genetically modify it, mass produce it, endow it with supernatural-like shelf lives, and add chemicals to it. Chemicals likazodicarbonamide, for instance, which Subway has recently taken out of their bread largely due to an online protest by concerned consumers.

In the information age it's difficult to ignore how our food has changed. People are concerned, and rightfully so I say, about what's in their food - about what they're putting into their bodies and on their table for their families. It's easier than ever to critique what industry and food producers incorporate into their foods, and I think this is a good thing.

Where it gets murky for me is the concept of a 'natural' ingredient. Branding slogans like "all natural" or "no artificial ingredients" are misleading to people, and I believe they are self-serving. Often, ingredients are considered natural, or 'healthy' (please note the quotations!), if their name can be pronounced - we've no doubt heard this from some bread and cold cuts companies who claim that they "make their products with ingredients that you can actually pronounce". It's as if the difficulty in pronunciating an ingredient has anything to do with it's nutritional value, potential toxicity or association with disease risk.

You know what else is 'natural', and easy to pronounce? Arsenic. Or how about lead? There are some other compounds that are natural and not very easy to pronounce, like epibatidine which is secreted by an Ecuadorian poison dart frog, which is also highly toxic.

If you have concerns about the food that you eat, then good for you. I'd fight for your right to know what's in the food you're eating any day. But if you're truly interested for the sake of your own health, not just to participate in an anti-industry, anti-synthetic compound crusade, the article above suggests starting with reducing 3 of the compounds in your diet that are associated with the highest chronic disease risk of all: sodium, fat and sugar. These are the leading 3 dietary components independently associated with chronic disease risk. So let's refocus our lens from a micro- to macro- level, and let's not miss the forest for the trees for disease risk.

Monday, October 14, 2013

Quantum Mechanics and Dietary Intake - The Role of the Observer

Many of us this time of year are preparing for Canadian Thanksgiving - a holiday that's about giving thanks, family, friends, and of course...the food.

Ah yes, the turkey, the gravy, the stuffing and who could forget the pumpkin pie? As an aspiring obesity researcher I can't help but be fascinated by food intake patterns on holidays such as thanksgiving. These holidays are a good example of how people's dietary patterns are more closely related to the patterns of others than they are to the individual - the thanksgiving feast is common to millions, but it's not everyday we sit down and stuff ourselves full of turkey.

My fascination with food and holidays extends to our ability to measure peoples' food intake patterns - something this field is not terribly good at. In fact, a study just published in the Public Library of Science journal, PLOS One, by Edward Archer has identified some major flaws in the reporting of dietary intake in the US' National Health and Nutrition Examination Survey (NHANES)- the largest survey of the dietary habits of Americans. They reported that throughout the 39-year history of the NHANES the majority of respondents reported physiologically implausible dietary intakes - essentially, they were under-reporting how many calories they ate compared to how many they burn. Their conclusion? "The ability to estimate population trends in caloric intake and generate empirically supported public policy relevant to diet-health relationships from U.S. nutritional surveillance is extremely limited." It's thought that this effect is largely due to measurement error (the tools aren't good enough) and response bias - people who know they're being observed will change their behavior (see Hawthorne effect), or in this case, misreport their behavior.

While I may be disappointed with our measurement techniques for food intake I take solace in the fact that other researchers have it worse than I - namely the quantum physicists. Observer effects exist everywhere in science - altering the path of an electron by measuring it with a photon, the measurement of the momentum or position of a particle where improvement in one leads to reductions the other, and of course the observer-expectancy effects in clinical trials. Even when measuring the air pressure in a tire, some of the air must be let out by the observer! The quantum physicists, however, have to put with a nasty concept called the wave function collapse - this is where, simply put, the type of measurement being used on a particular system affects the outcome or end state of the system. Consider the quantum Zeno effect, where the very existence of a system relies upon it's being measured (or else otherwise decaying).

There just doesn't seem to be a good way around the overall systematic bias of measuring food intake - just like the physicists measuring the momentum and position of a particle, there are trade-offs in the different measurements of food intake. I'm not sure that we'll ever obtain a true record of the diet of a population (prospective or retrospective), and we may be forced to reduce measurement bias wherever possible, but ultimately accept its existence and its effect on our outcomes of interest. Research in this area may forever be required to add the phrase 'interpret with caution' to every paper or book published. I should note that some advancements have been made - recent tools involve taking pictures of food, sometimes with a smart phone, for assessment of serving size and composition. These tools have a long way to go, and they may introduce other forms of bias, but they seem promising for energy balance research.

However, even if measurement error is reduced to null, or an acceptably low level, there will always be physiological differences in the food we consume, digest, and store. Rob Dunn notes several of these in his recent article (Scientific American, September issue, 'Everything you know about calories is wrong'), including variation in: the 'appetites' of gut bacteria, rates of absorption of different foods and alteration in these rates due to co-consumption of other foods (think interaction effects), and proportion of digestion of many foods (nuts and legumes in particular). There are other factors that influence the number of calories we consume and store as well, such as the preparation of food which can partially digest some compounds making it easier for the body to digest them (and thus requiring less energy from the body to do so), and the immune response that some foods prompt in the body - something that has not been considered from an energy balance perspective.

I suppose all scientists - be they measuring the particles of the universe or those in a slice of a pizza - have to put up with observer effects. For many of us, learning to live and work with these effects is difficult to swallow - but alas the observer effects are here to stay, giving us something to chew on over the holidays.

Thursday, July 11, 2013

Childhood Obesity and Active Video Games- part of the problem or the solution?

This post is in response to an excellent round table discussion put together by the journal Games for Health, entitled: "Gaming, Adiposity, and Obesogenic Behaviors Among Children".

The experts at the round table did an excellent job discussing the relevant literature surrounding active video games (AVGs). I had a few concerns while reading the article that centre around the idea that we should use AVGs to reduce the prevalence of childhood obesity.

Some concerns/points of discussion:

1) There is much talk about getting children to play AVGs, although as Kristi Adamo points out, we don't understand why children play these games, let alone why they would replace other sedentary behaviors with them. The premise that the reasons for playing non-AVGs are the same as those for playing AVGs is flawed- I suspect that research will soon show that children play non-AVGs and AVGs for different reasons, and that it may be unreasonable to expect a direct replacement of non-AVGs for AVGs. Also, children who play non-AVGs may not be interested in playing AVGs - again, if they're playing them for different reasons. Monique Simons says this very well “To be effective at preventing overweight, children must enjoy playing active games and be willing to replace the non-active games with active ones.” Ralph Maddison suggests that non-AVGs could mistakenly be replaced with other sedentary behaviors (such as TV watching). While this is possible, it is also likely that children will simply add this type of video gaming to their repertoire of sedentary behaviors- leading to an additive effect, and thus more screen time.

2) The idea of inducing automatic shut-offs or other time-based controls on AVGs is interesting- for example, a child can only play the game for one hour at a time before the game shuts off for 12 hours, or a child must maintain a pre-determined activity level (assessed by heart rate or accelerometry) or the game will shut off. If we program AVGs with an automatic shut-off, or limited amount of time that the game can be played, there is the possibility that children will then turn to the seated video games. Further, if a child doesn't meet the activity intensity threshold required to keep an AVG running, this could have negative consequences. Such negative reinforcement may frustrate children and they may stop playing. Why not switch to the seated video game, where you can play for hours without being interrupted or by having to move around at a given intensity. After all, I'm playing video games, not exercising :) (my own personal jab at the AVG people - not reflective of the article)

3) By enhancing AVGs through deeper narratives and character development we would be encouraging children to spend more time indoors (active or otherwise). I suspect that games meant to simulate authentic activities will not lead to the same energy expenditure as the authentic activity itself - although I'm not aware of any study comparing energy expenditure between these two. Further, with deeper narratives and character development, as well as more detailed story line and plot, there may be less of a social aspect to these games. If the goal is to capitalize on what makes seated games so appealing (again, detailed story lines, narratives and character development) I think we can expect these games to become less, not more, social in nature. The benefit of this is that children are likely to play them longer by themselves (assuming point #2 is not an issue) and each individual child playing may achieve higher energy expenditure alone than in a group – each child would be playing instead of one playing and 3 sitting watching on the couch, as is the current model. The drawback of this is obviously the lack of social interaction with peers – video games can be a dangerous path to social isolation, and I for one don’t think that children need any more enticing to go down this path than they currently have.

4) The round table experts begin talking about the 'energy in' component of video games – in fact, some suggest that the link between video games and childhood obesity may have more to do with energy in (eating food) than energy out (exercise/activity). However, the majority of the solutions or areas for future direction for AVGs revolve around energy expenditure, save for a few examples of what might work for reducing food intake. If, as Amanda Staiano suggests, the driving factor for the link between video games and childhood obesity is increased caloric intake instead of the displacement of physical activity, why is there so much emphasis on making games more active? To the outsider, it would make more sense to do one of two things: the first would be to design games that promote less food intake (ie/ with less food advertisements)- however, there are still factors such as distraction mechanisms, habituation to food cues through non-food stimuli, associated learning to eat when gaming, increased stress response which may lead to over consumption and caloric compensation throughout the rest of the day. Suffice it say, this option doesn't seem realistic. In my opinion the best option to minimize the effect of screen time on childhood obesity is to reduce the amount of time kids spend in front of screens – period. TV, video games, computers, smart phones, tablets, etc. Kristi Adamo states an excellent point in her premise “if video games are a non-negotiable priority for children, [then] the ‘active’ gaming direction is logical”. Video games are not non-negotiable – like any behavior, moderation is key, and parents have a major role in demonstrating (through word and action) to their children that alternatives to screen time are feasible, enjoyable and salubrious.

So what then of AVGs? By using AVGs to reduce the prevalence of childhood obesity we may be missing the forest for the trees - video games, and screen-based sedentary behaviors in general, primarily through their associations with increased caloric intake, are a part of the obesogenic environment and thus play a role in the development of obesity. Using screens to reduce the prevalence of childhood obesity from a population perspective is not a viable or sustainable approach, no matter how "active" these screens are.

Sunday, May 26, 2013

Timely and accessible publication of research - is it too much to ask?

Recently, I was made aware of some the questionable tactics employed by the OMICS group, an open access publisher of over 200 journals which uses an 'author-pays' model. Traditional print journals rely on funding from subscriptions from individuals and institutions to support their publishing of scientific literature; publishing companies such as OMICS rely on authors' payments to publish their work. They claim to publish content within 21 days (as opposed to 6 months to 1 year, like most print journals).

The article which discusses this in much more detail is available to you if you have access to The Chronicle of Higher Education through your institution or professional association, or if you would like to subscribe to the journal for one ($76.00) or two ($132.00) years:

Stratford M (2012). 'Predadotry' Online Journals Lure Scholars who are Eager to Publish. The Chronicle of Higher Education, 3/9/2012 58(27): A1-A8. 

The article does raise some serious concerns about some open access publishing companies, and while I fully  support the publishing of scientific content in reputable, honestly peer-reviewed journals, there are some serious drawbacks to which I can understand as a young, budding researcher.

Step back for a second and ask yourself why these journals exist.

1) The publish or perish model of academic/scientific success does promote the advancement of science through competition; however, as with all competition, there are those who will look to 'cheat' to get ahead. 50 years ago, in the journal Science, Bernard Forscher from the Mayo Clinic in Rochester, Minnesota, published a story entitled Chaos in the Brickyard. This story describes the consequences of a publish or perish model of success in academia - with peer-reviewed publication as the currency of academia (the more you publish, the 'richer' you are), the emergence of author-pays model of publication should come as no surprise. By placing such an emphasis on competition, we have enabled the creation of the many bricks, not to mention brick-making factories.

2) The timeliness of scientific publication is of utmost importance, especially in my field of research (bio-medical sciences and population health). New research functions to inform clinicians and policy makers whose primary goal is to improve the health of millions of people. The amount of time required to publish in traditional journals can be down-right disappointing - I personally find it difficult reading 'new' papers with primary analyses, published say last week, where the data was collected anywhere from 1-3 years ago. In a field that is growing and expanding more rapidly than ever, this is unacceptable. I can empathize with scientists who are enticed by the quick turn around time of open access online journals, especially when operating in the publish or perish model.

3) Access - as I mentioned above, you will not be able to access the article that I am referring to without an individual or institutional subscription - frustrating, isn't it? The goal of scientific research should be to advance scientific knowledge and understanding, and while for the most part this is true, historically this did not refer solely to a select few in society with the right connections or available finances. The owner of OMICS group,
Mr. Srinu Babu Gedela started his open-access publishing company because he had difficulty getting access to academic literature when he was a Ph.D. student at Andhra University in India (Stratford, 2012).

If this timely and accessible method of publishing promotes the dilution of scientific integrity, then we are to blame. If this new world of open access, online publishing is the monster that it is often made out to be, then we are the ones who have created it. We have no one to blame but ourselves for creating an academic competition, timeliness and accessibility void - in a free market society, the void will always be filled.

Researchers absolutely need to be made aware of the publishing tactics and strategies, unethical or otherwise, of many of the new online journals - and I would applaud Mr. Stratford for bravely doing so. However, instead of trying to police journals and point fingers, I would suggest that we (the scientific community as whole) need to learn a few lessons from this. The reputable, peer-reviewed journals in which most researchers desire to publish should aim to become more timely and accessible in their publishing of scientific content. All the while, we as researchers should begin to move away from the publish or perish model of academic success, and towards one which values the impact and originality of publications, the quality of peer review, and the building of edifices instead of bricks.

Please feel free to discuss in the comments box- this is science, after all!

Sunday, April 21, 2013

Endocrinological Hypothesis and Obesity: Cause or Mechanism?

I wanted to comment on a well-written essay recently published in the British Medical Journal by Gary Taubes, entitled:

The science of obesity: what do we really know about what makes us fat?

From the essay: The history of obesity research is a history of two competing hypotheses. Gary Taubes argues that the wrong hypothesis won out and that it is this hypothesis, along with substandard science, that has exacerbated the obesity crisis and the related chronic diseases. If we are to make any progress, he says, we have to look again at what really makes us fat

This essay, in my view, has two components - the first is the comment on the competing hypotheses for the cause of obesity, while the second concerns the 'sub-standard' research that has been undertaken throughout the past half-century in obesity research, regardless of the hypothesis.

1) I feel as though Taubes presents a straw-man of the energy balance hypothesis of weight gain. While it may be true that die-hard supporters will cite the 1st Law of Thermodynamics until they are blue in the face, I expect that most of the researchers, clinicians and academics who spend their lives trying to better understand obesity also understand that this Law its limits with respect to weight gain. Clearly, an individual who lives with a chronic, mild negative energy balance will not waste away until they disappear. There are metabolic compensation mechanisms to prevent this from happening (reduction in basal metabolism). Finally, the circular logic presented by Taubes that weight gain is caused by overeating, and that we can tell if an individual is overeating if they have weight gain, does not refute this hypothesis - it only supports it.

2) Taubes refers to the endocrinological hypothesis of obesity - although this hypothesis is never explicitly stated. It goes like this: due to intrinsic physiological abnormalities (say, altered insulin response) a positive energy balance is the result, rather than a cause of the condition of obesity. Sure, so weight gain is the result of aberrant physiological processes. This seems to substitute one mystery for another - what causes these aberrations in physiology? I think that Taubes is confusing this endocrinological hypothesis for a cause, when it is actually a mechanism of the cause. The cause of obesity is now believed to be an obesogenic environment, one that promotes abnormalities in a number of physiological processes associated with weight gain. But these processes are not the cause of weight gain, they are the mechanism through which weight gain results.

3) Taubes also compares smoking and lung cancer with eating and obesity. As previously mentioned on my blog (Obesity Prevention: applying lessons from anti-tobacco campaigns), eating is compulsory, often beneficial, and complex, while tobacco is optional, not beneficial, and simple. A poor comparison, and one that obesity researchers, clinicians and academics alike should discontinue using, especially in published literature.

4) Kudos to Taubes for pointing out that the majority of the research used to inform policy and public health messages is not exactly top-notch. He is correct to suggest that we absolutely need better quality research - that we need to go beyond associations to assess causation. However, there are many ethical considerations that cannot be avoided in this type of research. Also, I would personally agree with Taubes that the money we will save in health care expenditures and personal health (and productivity, quality of life, etc) will outweigh the amount of money that we put in to research obesity, should we conduct the required studies. Convincing the powers that be of this long-term financial benefit is another matter.

Overall, an interesting piece. I don't expect people to abandon the energy balance hypothesis just yet. We do need better quality research - more longitudinal studies and intervention studies - and I think the field is headed in the right direction here, albeit slowly. Do we have to "look again at what really makes us fat", as Taubes suggests? I don't believe so...but have a look and decide for yourself :)


Thursday, February 21, 2013

Bisphenol A and Childhood Obesity - Evidence for Reverse Causality?

The paper: Association between Urinary Bisphenol A Concentration and Obesity Prevalence in Children and Adolescents
View the abstract
The author:  Leonardo Trasande
The Journal: Journal of the American Medical Association 2012

Bisphenol A

This is bisphenol A (BPA), a chemical that's been used the in manufacturing sector for about 50 years in United States to make everything from CDs to car parts (1). Recently, BPA has received a lot of exposure (pun intended) in the media because it is found in the linings of aluminum cans, and other food products.

In the US, 92.7% of people aged 6 and above have detectable levels of BPA in their urine (1); similar numbers can be seen here in Canada from the Canadian Health Measures Survey (2). The human health effects of BPA at low, environmentally relevant doses (meaning, what we would typically be exposed to in our environment) are currently unknown. Of course, giving mice an incredibly high dose acutely can cause the mice to develop health consequences...but this can be said about almost anything at a high enough dose (See Toxicology 101: the dose makes the poison).

Finally, the primary route of exposure to BPA is oral (by mouth), and the primary source of exposure is through food containing BPA (1). The half-life is estimated to be 4-43 hours, with 24 hours being the average for most people.

Absorption: Readily absorbed orally (primary route of exposure)
DistributionThere is little free BPA in blood, and there may be some storage in adipose tissue
Metabolism: It is rapidly metabolized by the liver (glucuronidation)
Excretion: Rapidly excreted through the urine

The paper:

This paper uses data from a sub-sample of  the 2003-2008 National Health and Nutrition Examination Survey (NHANES), including 2838 participants aged 6-19. They first looked at correlations between BPA and weight status (overweight/obese). Then they used multivariate logistic regression to predict the odds of being obese if you are in the 1st, 2nd, 3rd, or 4th quartile of BPA concentration (so, if you're in the highest category of BPA concentration, are you at an increased risk of being obese?). They also measured three other chemically similar, but non-food related phenols as an analysis of specificity - perhaps it's just phenols in general, or perhaps there is something specific about BPA. Despite being cross-sectional, the paper is written implying forward causality (referring to the mechanisms by which BPA can modify adipose tissues, examining BPA by quartile, not BMI...etc). It's not until the end of the discussion that there is a small paragraph explaining that reverse causality may play a role too.

The study measured BPA using a one-spot urine sample. The within-day and between-day variation of urinary BPA concentration is quite large, and it would have been ideal to collect more than one sample. Seasonality might even come into play here as well - do people eat higher amounts of BPA-containing foods at different times of the year (ie/ Christmas, summertime, etc). One randomized cross-over study showed that serving people canned soup for 5 days led to a 1221% increase in urinary BPA, as compared to soup prepared without canned ingredients (3). Needless to say, multiple measurements are absolutely needed.

In lieu of multiple measurements, the authors controlled for urinary creatinine, which sort allows them to control for a dilution factor - there are two parts to a concentration measurement, the solute and and solvent, or in this case BPA and water. If you drank more water that day your BPA concentration would be lower, but this is not related to the dose, but instead to the dilution. Good on em'.

Other covariates include:
-24 hour dietary recall - they were not able to control for physical activity levels of children, so they assumed everyone to have a high physical activity level for the evaluation of caloric intake as being 'normal' or 'excessive' - a more conservative approach on their part.
-daily hours of television watching (a known correlate of obesity in children)
-serum cotinine (a metabolite of cigarette smoke) - not sure how many 6 years olds are smoking, but fair enough.
-race/ethnicity, and
-socio-economic status (education level and income)

However, they did not control for frequency of consumption of BPA-containing foods. This is a very important consideration that I'll get into later.

Essentially, they found that you are more likely to be obese if you are in the 2nd, 3rd, or 4th quartile of urinary BPA concentration, as compared to the 1st quartile, in both unadjusted and fully adjusted models (see paper for logistic regression analysis). Also the prevalence of obesity increased with the increasing quartiles. It's not exactly linear (the 2nd and 3rd groups are switched), but the authors themselves suggest that this is because of the large variation in using a one-spot urine sample.

Finally, the other three chemically similar and non-food related phenols were not associated with obesity, and did not perturb the models when they were added as covariates, both individually and together.

Up to now, it's a pretty good study. Some things they probably should have controlled for, maybe taken a few more measurements, but overall it's not bad. The interpretation is where it gets weird...

From these results the authors suggest that there is something specific about BPA that is causing it to be related to obesity. Something that other chemically similar non-food related phenols do not have.

Essentially, this is the model that the authors have come up with. BPA is related to obesity, with increased urinary BPA probably causing obesity more than obesity is causing the increase in urinary BPA. Again, it isn't until the end of the discussion that the authors finally suggest the little arrow in this relationship, saying there is a chance that this could be reverse causal as well.

So, I took some of the premises that the authors used and came up with an alternate interpretation.

Let's assume that:
1) The primary source of BPA exposure is through food, as the authors claim in the introduction. This is supported by the literature.
2) Other chemically similar, but non-food related phenols are not related to obesity.

So what we're looking for are commonly consumed foods that contain high amounts of BPA. Low and behold, an analysis using 2005-2006 NHANES data (very similar to the data that the authors here are using) suggested that “Consumption of soda is significantly associated with higher urinary BPA” (4). There is much evidence to suggest that one of the primary sources of BPA exposure in children is sugar-sweetened beverages.

Making the assumption that increases urinary BPA are not causing children to consume more sugar-sweetened beverages, if we modify the model, we get this:

The question is, are sugar-sweetened beverages associated with childhood obesity? Here, the evidence has mounted over the past several decades. Sugar-sweetened beverage consumption patterns have paralleled the rise in obesity in the United States (5), and the results  from a large meta-analysis published in the British Medical Journal in 2013 suggest that sugar-sweetened beverage consumption (along with other free sugars) is a determinant of body weight (6). It's understood in the literature that this relationship is bi-directional. If you consumer more sugar-sweetened beverages, you're more likely to be obese, and obese children tend to consume more sugar-sweetened beverages. I would argue that it's most likely the former, and that the latter is the result of behavioral patterns that the formed during the process of the former...but I'll leave this for another post.

Thus, we have the following (note the reversed arrows in the box):

Where the unidirectional association between urinary BPA and sugar-sweetened beverages, along with the bidirectional association between sugar-sweetened beverages and obesity in children, combined with the finding that other chemically similar non-food related phenols are not associated with obesity, provides evidence to suggest that the relationship between BPA and obesity may be more about reverse causality than about forward causality.

BPA and Obesity:

Forward causality?

Reverse causality?

Or both?

What do you think?

Saturday, February 16, 2013


Thank you everyone for all of the wonderful comments. I'm glad you're enjoying the content.

To answer some questions, no I did not make this myself- I use Blogger, which is an open source tool for publishing blogs.

I didn't design it myself either...I'm using one of the many templates provided by Blogger.

Hope this answers your questions.


Wednesday, January 9, 2013

Rebuttle to Health at Every Size: Life expectancy is not the only measure of health

In the December 2012 issue of Discover, Dr. Linda Bacon provides a commentary which supports the HAES approach to healthy active living. Dr. Bacon cites data from the CDC (published in the Journal of the American Medical Association in 2005 and an independent report in 2011 - not referenced) which shows that people classified as overweight live longer than normal weight people, and that despite the increases in obesity in the US between 1970 and 2007,  life expectancy has increased from 70.8 to 77.9 years.

The claims that overweight people live longer than normal weight people, and that life expectancy has increased alongside obesity are important to recognize - indeed, overweight is associated with longevity in many other species in the animal kingdom, and there are metabolically healthy obese individuals.

While all of this true, Dr. Bacon does not mention the effects of overweight and obesity on morbidity or quality of life. A paper published by the American Journal of Preventative Medicine in 2010 suggests that quality-adjusted life years lost due to obesity doubled from 1993 to 2008. Overweight and mildly obese people may be expected to live longer than their normal weight counterparts, but time and time again the research literature has shown that obesity is associated with a number of chronic diseases. Chronic diseases have a tendency to reduce an individual's quality of life. 

A meta-analysis published last week in the Journal of the American Medical Association provides a similar conclusion- while grades 2 and 3 obesity (BMI= 35-40, and 40+) are associated with an increase in all-cause mortality (basically, death from everything), grade 1 obesity (BMI=30-35) was no different than normal weight, and overweight (BMI= 25-30) was associated with lower all-cause mortality. The authors note in their discussion a major limitation of this meta-analysis - not evaluating weight status according to a measure of morbidity.

As we continue to conduct research in this area it is important to remember that life expectancy is not the only measure of health. There is much more to both health, and obesity, than meets the eye.

Please comment!

Health at Every Size - a brief comment

Let's face facts. We've lost the war on obesity - Health at Every Size community (http://www.haescommunity.org/)

The health at every size (HAES) approach to healthy active living is gaining steam. Indeed, there has been collateral damage in the war against obesity, such as food and weight preoccupation, eating disorders, stress, weight bias, etc. However, to say that we've lost the war on obesity is too simplistic. Firstly, the 'war' on obesity is not really a war at all. For instance, we can have a war on tobacco, which is a much simpler concept (see previous post on XX). But our stance against obesity is more of a conquest...a life-long struggle to gain minor but significant advancements against a multi-facted disease which affects millions of people. And to say that we've lost it? Look around you...as our environment becomes more and more obesogenic, it seems as if the 'war' has barely begun.

Indeed, one could make the argument that we have lost the war on obesity treatment:

1) lifestyle interventions may not be successful (weight regain and the associated effects of this cycle)
2) drugs don't work so well - the only approved pharmaceutical drug for weight lost in Canada (Orlistat) can provide very modest weight lost- about 3kgs on average (Lancet, 2007: http://www.ncbi.nlm.nih.gov/pubmed/17208644)
3) bariatric surgeries, while to-date the most effective method of inducing weight loss in an individual, are costly and frequently include side effects and weight re-gain (again, as well as the associated effects).

But surely not the war on obesity prevention.

Prevention of obesity through lifestyle modification is arguably the most effective way to reduce chronic disease risk, both at the individual and population levels- we must not forget this.

It is said, albeit refutable, that the current generation of children may have a lower life expectancy that that of their parents, for reasons such as our increasingly obesogenic environment. We have an opportunity with our current generation of children to change things for them - to provide them with an environment that promotes health (yes, in all shapes and sizes). 

We may not finish this conquest, but if we don't, it's up to them.

The message that we've lost the war is not productive. The last thing we need people to do is give up on preventing obesity. While I appreciate many of the other messages from the HAES movement, the notion that we've lost the war on obesity needs to go.

Feel free to refute in the comments section!

Saturday, November 3, 2012

Obesity Prevention: applying lessons from anti-tobacco campaigns

The recent OMA policy paper on the prevention of obesity has referred to obesity as health challenge which requires immediate and aggressive action.

The OMA has released several recommendations on how to reduce the incidence of obesity in Ontario by considering some of the strategies that were effective in reducing rates of tobacco use. A summary of the recommendations can be found here from the October issue of the Ontario Medical Review:


While I personally agree with these recommendations, barring some debate about definitions, such as "low nutritious foods", the connection to the anti-tobacco campaign of recent decades is an awkward one, at best.

It is correctly stated that "tobacco and food products are different in many ways, and unlike food, tobacco products have no safe level of use". Indeed, tobacco and food products are very different in and of themselves, in relation to human health and disease, and, as I will argue, in their simplicity when aspiring to decrease the incidence of a chronic disease.

Point #1: Tobacco is optional, food is compulsory.
The paper states that tobacco products do not have a safe level of use, but that food products do. Not only do food products have a safe level of use, but they are required for sustaining life.

Point #2: Tobacco is not beneficial, foods are often beneficial
Tobacco products do not promote physiological function or well-being of humans in any way - rather they are associated with physiological dysfunction and disease. On the contrary, many foods promote health and well-being.

Points #3: Tobacco is simple, food is complex
Tobacco is a consumer product available for purchase if one so chooses. Food is not simply one product on the shelf...there are myriad types of foods available on the market...some good, some bad. Further to this, obesity, the ultimate goal of these changes in food policy, is a result of many factors at various levels of the socio-ecological model.

The OMA policy paper is a major step in the right direction towards altering the obesogenic environment, and ultimately to reducing the incidence of obesity in children and in adults. Despite only addressing one side of the energy equation, their recommendations could have large impacts on the prevention and reduction of obesity. There are indeed several lessons learned from the campaign against tobacco that can be applied to obesity, and I commend the OMA for these recommendations  However, I fear that comparing tobacco with obesity - by suggesting that "we reduced smoking levels, so we can therefore reduce obesity levels" - does a disfavor to the fight against obesity.

Tobacco is optional, it is easy to convince people that it is bad because it has no health benefits, and it is simple in that it is one consumer product. Food is compulsory, it is much more difficult to navigate the good food/bad food environment for consumers, and food is complex - it is not just a product on the shelf. Further to this, obesity is far much more than just food - it is the result of an imbalance in the energy equation, but is promoted by numerous factors in the obesogenic environment.

In comparison, reducing smoking rates was easy. Reducing obesity is a whole different box of french fries.

Monday, October 29, 2012

Get off the couch to turn down the heat.

A recent Scientific American article (sorry, I can't provide the link without a subscription, and I don't want to plagiarize it - you'll have to trust me!), suggested that an effective way to make it easier for people to turn down their thermostats in the winter would be to use remote controls to do this. The main idea is that people would be able to use their smartphones, or other devices, to turn down their thermostat during the day, and turn it back on just before they're coming home, thus saving energy.

While I appreciate the importance of saving energy, and would advocate for trying to be energy conscious wherever possible, it is likewise important to consider the consequences of implementing such suggestions. I fear that people would not only use this while away from the home, but also at home.

In our eat more, move less, sleep less world, the last thing we need is yet another excuse not to get off of the couch.


Mike Borg

Friday, March 16, 2012

An open letter to the APA and their referencing style

Dear American Psychological Association,

I am writing you today to ask why you invented your referencing style. I understand that in our simple world things can be a bit...well...simple, and although some people may be tempted to add a bit of complexity here and there (and about 3 dozen obscure, arbitrary rules while they're at it), I feel as if the APA style of referencing is taking this idea a bit too far.

Sure, it could be simple and easy to reference a paper by, say, using numbers to identify a particular  reference, but gosh darnit people are just writing too many papers nowadays! If we don't figure out a way to waste everyone's time when they're writing papers the world would be just be a sea of literature. Can you imagine such a place? - the trees that would be lost...the labor force needed to edit and grade papers...the never-ending reading! By God, without any structure to the universe, we might as well all build a tree fort and befriend a leaf named Jose!

Whew, glad that'll never happen...because we have APA style-referencing. Structure, order, and whole potpourri  basket of frustration, agony, and teardrops on computer keyboards...

Thursday, October 27, 2011

Recent Press: Remove the Occupy Protesters

Last night, CBC Radio One ran a story highlighting the desire of some (or arguably, most) people to have the Occupy protesters removed from their encampments indefinitely. The story was part of the The Current hosted by Anna Maria Tremonti. Guests on the show included:
  • Ric McIver- an entrepreneur and former alderman in Calgary who believes the protesters have worn out their welcome,
  • Ralph Young- the President and CEO of Melcor Developments Ltd. - a real estate development company that owns the land where the Occupy Edmonton group has set up camp, and
  • Dean Douglas Stoute- the Dean of St. James Anglican Cathedral in Toronto. Occupy Toronto has set up in a park that's jointly owned by the church and the city.
In Edmonton, the protesters are camping out on private land, and the owner is asking them to leave the premises at night (from 11:00pm to 6:00am), just as they would be required to do if this were municipally owned land. There has been little or no compliance with this request.

What I found most interesting was a quote by a young Occupy protester in Edmonton- the young man claims that his grandfather fought in the Canadian military for his right to protest, and that he does not believe that he should have to leave the premises at night.

I saluted Ric McIver who suggested that this young man's grandfather also fought for the Rule of Law here in Canada, and that his grandfather would likely not be pleased by his grandson's blatant disobedience. In Canada, I believe we have a responsibility to respect both public and private property. The issue isn't protesting...I'll be the first person to stand up for this young man's right to protest...but my support will end where this protesting is affecting the livelihood of others.

Another quote by a young female organizer of the Edmonton Occupy movement suggested that it would be too much of an inconvenience to dismantle and re-assessmble all of their tents, equipment, etc. I was once again impressed by the response, this time by Ralph Young, that this young lady does not wish to be inconvienced in her protests, but has not given consideration to the feelings of others and her potential inconvience in their lives.

I think that these two quotes embody more than just the feelings of two individuals. I believe that this speaks to the underlying societal pathologies of entitlement (quote #1) and selfishness (quote #2) displayed by many young people, and perhaps the Occupy movement at large.

On a side note, the protesters are likely not going to leave on their own. But this is Canada, and next week marks the beginning of the glorious month of November, where temperatures can drop significantly below 0 overnight.

Give it time in Canada...the occupy movement will likely be 'frozen' in its' tracks...

Sunday, October 23, 2011

The 99% movement vs the 53% movement

By now I'm sure that everyone with access to television/radio/Internet (or in today's world perhaps Twitter and facebook) has heard of the 99% movement, which is protesting corporate greed on Wall St, and in government, more or less. The idea is that the 99% of people are fed up with the 1% of people who control a significant amount if wealth.

Recent polls suggest that the majority if Americans support the movement (unfortunately, I am without solid Canadian data, please comment if you know of any).

Well there is a new movement coming from the conservative American right- they call themselves the 53%. The idea is that these are the 53% of people who pay income tax, work hard, and who don't expect things to be handed to them. A common theme of social or financial hardship, any ultimately overcoming said hardships, characterizes the lives of members of the 53%.

The 53% are quite critical of the 99% (sorry about the numbers...)- they understand that there are major critiques of both Wall st and government, but they suggest that "what the 99% are missing is the critical element of individual responsibility for their own lives and futures."

Clearly, more that 53% of people in the United States pay income tax...but that's not really the point of the movement.

I live in a cohort of young people (say 18-25), that are overwhelmingly self-entitled and lazy, and who expect handouts at every turn. Unfortunately, although there are young people who do not live up (or live down, rather) to this stereotype, I would consider them to be the minority. The 99% (most of whom are young people) aren't wrong, they're just misguided...

The issue lies in how young people in my cohort were raised- they were raised to believe that they were 'special'. Indeed, children should be special in the eyes of their parents and families, as this promotes a culture of love and care. Where this is a disfavor to children (and now, to young adults) is when children learn that they do not have to work hard for what they receive because of the very fact that they are special. This is fine when Johnny wants a pack of gum at the corner store- surely, it would ridiculous to suggest that Johnny ought to start working at the age of 5 to earn this pack of gum- but when this behavior (and I'm talking about the behavior of parents here, not children) continues on into adolescence and teenage hood, it can completely distort how young people view work, reward, success, and others around them.

Being 'special' at a young age is a good thing, until a child reaches an age where they are out on their own in the real world and suddenly have to cope with the fact that the rest of the world no longer sees them as being special. Young people who were raised like this may still believe that they do not have to work for that 'pack or gum', the only difference in that the treat at the candy store is now college tuition (yes, lower tuition people, I'm talking to you), employment, or housing.

I have much respect for young people who were raised in such a way and actually accept that they are no longer special, and realize that people in the world do not exist to serve them, and that they are going to have to work for what they receive. Many will not accept, or realize, this, and can likely be found at protests such as Occupy Wall St, still demanding something for nothing, and still believing that they are special.

Obviously, the lesson here isn't to teach your kids that they're just like everyone else...children's individual talents and skills should be nurtured and praised. But it is important that in our world today children learn the basic values that families are meant to teach: the value of a dollar, the importance of good work ethic, the fulfillment of working hard, and the reason why we should all work hard- because you're not special in the eyes of the world, and the world is not going to hand you everything in life.

I was raised to believe that I was special in the eyes of my family- that they would love me no matter what. But I was also raised to understand that I must work for what I receive, and to understand why it is important to work hard. I am proud to say that I was raised this way, and indeed, these are some of the values that I would like to pass on to my children one day.


Saturday, October 22, 2011

Time-orientation, the effects of video gaming on education, and the role of the family

RSA Animate has created a wonderful visual aid to Professor Philip Zimbardo's lecture on The Secret Powers of Time (link below). 
I'll discuss the following idea from the video:

The notion of time-orientation, and video games' effect on education in North American youth (primarily males).

Zimbardo lectures on the concept of 'time-orientation', and explains that one's cultural and social interpretations of time have profound impacts on everyday life. He explains that there are 6 'time-zones', or time-orientations that people live in: 2 for the past, 2 for the present, and 2 for the future.

Past oriented people are either:
Past-Positive, where they focus on all of the good things that have happened in their lives- the awards, successes, etc- these are the types of people who maintain photo albums or diaries
Past-Negative, where people tend to focus on their regrets, or failures- these are the people who blame their present, and any relative lack of perceived success, on their past, or past decisions

Present oriented people are either:
Present-Hedonistic, where they continually seek pleasure and avoid pain, probably the most basic of the time-orientations
Present-Fated, where people believe that they had might as well live in the present, because the decisions do not affect their future because it is fated- either fated because of their religion, poverty, or culture. The most obvious example here, being someone whose religion restricts them from participating fully in society.

Future-oriented people are either:
Future-Planning (my own term for what Zimbardo describes) where people learn to work rather than play, and plan for the future appropriately.
Future-Other (? Zimbardo doesn't actually finish this concretely), where people believe that life begins after the death of the mortal body. My sense is that this is similar to the present-fated orientation of time.
Zimbardo suggests that video games instil a sense of control in young people (young boys, specifically). They are able to control their virtual environment and can build entire worlds to their liking, thus they become programmed to learn in dynamic, digital environments that they alone have sole control over. He then suggests that this is the reason that boys tend to have increasing difficulty in traditional schools- schools are 'analog', they are static with one individual speaking about one topic for prolonged periods of time. Boys perceive this type of learning to be boring as it is passive, rather than active, and they have relatively little control over this environment.

Zimbardo's suggestion to resolving the issue of boys' inattentiveness and lack of motivation, as if solely due to video gaming, is to make schooling more interactive and dynamic to better serve an evolving audience of multi-tasking and control-obsessed young boys.

This could not be farther from the appropriate solution to the issue.  Re-creating the traditional learning environment in such a way that makes it more dynamic and attractive to these individuals would result in drastically reducing these young people's ability to focus their attention on specific learning objectives. Turning classrooms into gigantic iPads will enable children and youth to learn in a more comfortable environment in the short-term. However, when they become adults they may not be able to properly interpret static information, and create new ideas for themselves and for their generation.

The solution is not to change the school, it is change the video gaming.

I think Zimbardo needs to understand video gaming a little better. Video games today are designed to act as alternative parental figures for children:
  • They provide children with an immediate sense of gratification through immediate-to-short-term goal completion, thus providing children with the positive reinforcement of goal completion that should ultimately be coming from their parents,
  • They attempt to foster emotional relationships with characters/figures in the game in place of real-world emotional relationships, such as with family or parents,
  • They are designed to be addictive by allowing children to exercise a much more efficient method of self-gratification- what I mean by this, is that as a character in a video game, one can experience a life-time's worth of accomplishments in mere hours.
The point is that video games teach children and youth to be lazy. This is because video games offer an avenue of goal accomplishment, self-gratification, reinforcement, and praise that is much, much more efficient and easy than in the real world. This makes real-world tasks seem, by comparison, arduous, inefficient, and boring.

This may be a little politically incorrect, but the reason why some young video game-obsessed boys may not be doing well in school is not that they have learned to learn in a different way, and therefore we should cater to this newfound, and supposedly equivalent, method of learning. Rather, it is that children and youth who continually play video games are being programmed towards an over-arching culture of laziness.

We can make classrooms as dynamic and interactive as we want...but it will not inspire these video game-obsessed children to excel because the underlying fundamental philosophy of education is the acceptance of delayed gratification. These children are learning that gratification does not have to be delayed, because through video games it can occur as quickly as 5 minutes ago.

We are all born present-hedonists. Zimbardo argues that the purpose of schools, and education for that matter, it to transform present-oriented children and youth into future-oriented adults (depending on the culture). If schools are supposed to transform children and youth into future-oriented adults, who favour work over play, and who accept delayed gratification as a part of life, then they are going to need help.

It is time to get back to a culture focused on family values, where children are taught how to be ethical, upstanding, successful citizens in the home. This cannot happen if children are spending more time playing video games, than simply talking to their parents.  

Friday, September 16, 2011


Just publishing some of the stats from the blog...

Countries where people have read Mikepedia:
United States 
United Kingdom
Hong Kong 
South Korea

Browsers with which people view Mikepedia:
Chrome  (45%)
Firefox  (25%)
Internet Explorer  (25%)
Safari (3%)

Operating Systems of people who view Mikepedia:
Windows (82%)
Linux  (9%)
Macintosh (6%)
hp-tablet  (1%)

I think the percentaged are all rounded wrong...but its the trend that's important.

Tuesday, September 13, 2011

The Grand Design: On the Existance of a Luminiferous Ether

"The most incomprehnsible thing about the universe is that it is comprehensible"- Albert Einstein

To my faithful blog followers- I apologize for my leave of absence. A grueling summer filled with too much fun, a trip to Canada's Atlantic provinces, and a medical school application later...I am back.

Aristotle imagined a universe where there existed a 'luminiferous ether', or just 'ether' for short (1). The term is of course spelled with the Latin dipthong "ash" replacing the first letter 'e' (Æther), but I will use the modern English spelling as my keyboard does not contain Latin characters :)

This ether, considered a 'classical element', refers to the material which fills all of the universe outside of the terrestrial sphere. This material was believed to be the 'messenger' of all forces in the universe - basically, imagine a continuous series of invisible tubes connecting each and every object, like a GMAT permutation question gone mad. When an object moves, it pushes on the ether, which pushes on another object. This is how the universe was thought to operate. Of course, with no good scientific method to prove this concept right or wrong, it remained a prominent, though rarely discussed, idea for quite some time

Countless experiments were carried out in search of a method to study the ether, as well as to prove its' very existence. James Clerk Maxwell carried out one such experiment near the late 1860's- altogether, a fairly well thought-out study. He proposed that: if the Earth moves through the ether, and since the Earth moves in different directions at different parts of the year, then the speed of light must vary, even if only slightly, at different times of the year. This experiment is a good example of those which attempt to either study, or prove the existence of, the ether, because it very clearly outlines the dominant assumption in these experiments: there can be an absolute observation of physical laws, due to the absolute nature of ether- in essence, the ether is the absolute reference with which to compare an observation.

We now know that there is no 'ether'. There is not a mysterious, immeasurable material filling the voids of space with which matter does not reside. This concept of an ether died with the assumption that the laws of physics, including the speed of light, will remain constant with uniformly moving observers- an assumption made by Einstein in his theory of special relativity, where he showed that observations are dependent upon the observer. By assuming that the speed of light is the same in all frames of reference, there will be variation in time- in other words, time is not absolute. This notion, combined with Maxwell's theories of electricity and magnetism, dictates that time cannot be considered separate from the three physical dimensions; otherwise known as the concept of 'space-time'.

Space-time is not flat- it is curved and distorted by the masses and energies within it. In a hypothetical universe without mass or energy (hypothetical, because without mass and energy it could not possibly be observed) there would be no 'time' component of space-time; it would simply be a three-dimensional flat space.

Objects move within space-time, and bend and warp the fabric like a bowling ball on a mattress. It is the essence that 'fills' the universe...


Luminferous Ether...

I ask, given the scientific capabilities of his day, the limitations of previous discoveries, and lack of what we would today call the 'scientific method'...I ask, was Aristotle really all that wrong?

It has been said that Aristotle discovered and/or explained everything, and that everything since then is just a footnote...


1) Stephen Hawking & Leonard Mlodinow. The Grand Design. 2010. Random House Inc, New York, New York, United States.