More Secrets To A Longer Life

A couple of related stories caught my attention recently. The impression I got from them is that people continue to look for easy answers, tips and secrets. With all the new technology and scientific breakthroughs, they tend to abandon common sense, expecting something better and easier. This attitude drives a lot of wasteful behavior indicative of a lack of discipline and critical thinking.

 

The first was from a website called Outside with the title: “8 Simple Tips to Live Longer and Healthier.” These tips, it explains, are easy and based on scientific time-tested methods. The tips are merely to develop healthy daily living habits. This idea has been around for ages and the evidence to support it “has mounted, even as more people try to find the elixir of youth.”  A 2016 British study “found a healthy lifestyle reduces one’s chance of all-cause mortality by a whopping 61 percent.”

 

To make such a list, as the line from Casablanca goes, “round up the usual suspects.” They are easy to understand, but not so easy to adopt.

1. Exercise is good for you.
2. Watch what you eat.
3. Socialize – loneliness has surprisingly bad effects.
4. Avoid nearly all supplements – “the vast majority don’t work and may even cause harm.”
5. Get enough sleep.
6. Get outside and enjoy nature.
7. Don’t smoke.
8. Drink alcohol in moderation.

This kind of information is republished frequently by the news media and in public service announcements. By now it’s not really news! Some might add a few more such as: sunscreen, brushing and flossing, drink when you are thirsty, wash your hands and get a flu shot.  But most of this is common knowledge.

 

The one about the supplements is certainly right but not often mentioned. For example, Harvard School of Health calls claims about antioxidants “mostly hype” adding, “mostly disappointing [study] results haven’t stopped food companies and supplement sellers from banking on antioxidants.” The American Council on Science and Health (ACSH) says, “Many studies have shown antioxidants do not add health benefits nor do they play a key role in preventing cancer or heart disease.” I have covered the dangers and waste associated with dietary supplements many times in the past.

 

The related idea of looking for the easy answer came from a story early in the pandemic. Americans were hoarding not only toilet paper but also another product that made little sense. Last May a Forbes article reported, “retail sales of orange juice increased 46% in the United States in a four-week period ending on April 11.” 

They apparently believed in the power of Vitamin C to cure colds and other viruses. That this is not true should also have been common knowledge. Back in 2006 NPR ran a story, “The Vitamin C Myth.” By then there had been “at least twenty well controlled studies on the use of mega doses of vitamin C in the prevention of colds, treating the duration of colds, and in treatment of the severity of colds;” none of them showed any evidence that “vitamin C in mega doses does anything.” 

 

This vitamin C myth is just another example of what I referred to recently in “Flashback – Fear of Power Lines” on September 11: when people get an idea stuck in their heads, it takes a great deal of persuasion to get them to change their minds, even if the science is definitive.

 

Problems in discipline cause us to ignore the simple but not easy-to-follow lifestyle instead hoping for a pill or magic medical device. Problems in critical thinking cause the brain latch on to one of those ideas and never again wonder if it’s accurate.

Black Raspberries

Without a doubt black raspberries are good for you. They contain more antioxidants than most other fruits along with anthocyanin, ellagic acid, Vitamin A, Vitamin C, Calcium and many other nutrients. But let’s not get carried away!

The subject came up in one of those health stories on the news last week. The big announcement was that a new study indicates that eating black raspberries might reduce inflammation associated with skin allergies.

The story went on to say that in a study done with mice at Ohio State University and recently published in Nutrients “found that a diet high in black raspberries reduced inflammation from contact hypersensitivity.” They fed one set of mice a normal diet while another set had the equivalent of a daily serving of black raspberries added to their diets. After three weeks the ears of all the mice were exposed to an irritant “that caused contact hypersensitivity. Then, they measured the reductions in swelling, comparing the ears of each mouse.” It turned out that the swelling went down more quickly in the group of black raspberry eaters.

This is interesting and promising, but why does it make the news? Mice are not the same as people, or else drug companies could save a lot of time on human trials. They plainly state, as do most initial studies that it was “an early indication that those benefits might exist” and “more work needs to be done.” 

The health benefits of black raspberries are well known. Other studies both at OSU and elsewhere have shown promise in reducing inflammation associated with some types of cancer. The National Institutes of Health (NIH) published this paper on the benefits of the anti-inflammatory properties of freeze dried black raspberries on ulcerative colitis, a disease that can dramatically increase the risk of colon cancers. Again, the studies were done with mice, not people.

From another OSU press release three years ago: “The researchers have demonstrated the remarkable ability of black raspberries to reduce the development of tumors in animal models of cancer, including the oral cavity, esophagus, and colon.” At that point they were ready to start some limited human trials and were soliciting smokers to test whether giving them regular doses of a black raspberry-rich drink could “protect [them] from oral disease and lower the risk of oral cancer.”

They are clear in their conclusions however. This does not necessarily mean that black raspberries prevent cancer.. “A definitive human study to answer that question would take decades and be cost prohibitive. Instead, researchers will continue to evaluate the influence of berries on biomarkers of cancer in both animal models and short-term clinical trials.”

Of course that sounds too much like science and doesn’t prevent this website from boldly proclaiming: “Black raspberries are a cancer-fighting superfood,” while pushing copies of his book.

This is so typical. News organizations release as health news a preliminary study done with mice, as they cover the TV screen with stock footage of berries at the grocery store. It's an easy job; they don't have to do any work to get the story. Meanwhile, limited studies and early indications are misrepresented as definitive results and to promote the superfood du jour. (A few years ago açaí berries were the new superfood.)

All this hype comes around regularly because Americans tend to ignore the details (critical thinking) and look for the easy answers in the form of supplements and superfoods (discipline). 

Flashback – Responsibility and Excuses

[How things have changed from when I originally titled this “Evidence Abounds” back in 2011. These days news is dominated by coronavirus and politics (or the mixture). What hasn’t changed is the tendency to use excuses in place of responsibility and the media’s willingness to encourage this behavior. First see the flashback comments.]

How hard is it to find evidence of problematic behavior in one or more of the five dimensions or of institutionalized support for these habits? – Surprisingly easy.  There are days when I have to pick and choose among available topics.

Today I have an Associated Press article left over from 3 weeks ago presenting research that tells how hormones make it more difficult to keep weight off after dieting.  The headline begins, “Not your fault!”  This is right out of the poor discipline/poor responsibility playbook.  It gives people the excuse that they can’t stick to their diet because of their hormones.  Ironically the header above the article features six advertising links, five of which are for weight-loss products, programs or surgery – the easy answers that everyone looks for when faced with the hard work of getting back to and staying at the right weight.  This is practically the definition of discipline and responsibility failures that bubble up into many other societal issues and crises (budgeting, smoking, and alcohol abuse, to name a few).

How, in the first place, can any reputable scientist say that hormones are the problem?  Didn’t humans have the same hormones many years ago when the number of overweight Americans was less than half of what it is today?  It just doesn’t add up.

Second, how can the parent of a teenager use hormones as an excuse for regaining weight and not let that teenager use hormones as an excuse for any of their own destructive decisions?  This sounds like a can of worms ready to be opened.

I have sometimes jokingly said that if I ever got arrested for anything, I’d just tell the police that what I was doing was performance art and protected under the First Amendment.  Now, I guess, if that doesn’t fly, I have the excuse of hormones to fall back on.  

[Well, that was then, but in 2020, a NOVA episode was dedicated to blaming obesity mostly on genes using examples of rare cases. It's a little hard to believe that our genes are so much different from Americans living in the 1950s and 60s. Does evolution work that fast, or is it just another handy excuse?]

Flashback - Health Advice

[Here is a combination of a flashback and an example of how easy it is to predict future news. In November 2013 I wrote the below essay with the title "Secrets to Good Health." This month the BBC ran an article about a BMJ (British Medical Journal) report that men can live an extra 7 years, 10 years for women, of quality life by adopting five healthy habits: never smoking, healthy diet, exercise, body mass index (BMI) between 18.5 and 24.9 and moderate alcohol use. That's substantially what I told readers over 6 years ago in the following flashback.]

As I read this information from Johns Hopkins on how to maintain good eyesight, it occurred to me that products advertised as the secret to good health must be a scam.

This article from a group of medical experts tells that other than regular checkups, to maintain good eyesight “many lifestyle factors that protect our heart health may also help keep our eyes healthy, including being active; getting enough sleep; controlling blood pressure and diabetes; not smoking; maintaining a healthy weight; and eating a diet rich in fish and leafy, green vegetables like spinach and kale. Wow, that’s almost the same advice for every other health concern, not only heart health, but also improving the effects of arthritis, preventing chronic illness , promoting memory and general mental health.

The real secret to good health is that there is no secret.  Health authorities have not been trying to hide anything from us. There is no big secret "doctors don't want you to know."  In fact they have been shouting from the rooftops at every opportunity. We are told over and over on a number of issues that if we want to avoid problems and just generally feel better we should: get enough sleep, eat healthy, drink alcohol only in moderation, stop smoking, get plenty of exercise, drink enough liquids, use sunscreen, wear work gloves or protective eyewear as appropriate, learn relaxation techniques to reduce stress, brush and floss, wash your hands and get a flu shot. This should come as a surprise to no one. We have heard all this advice or subsets of it many times for many years.

The problem with advice like this is that no one wants to hear it. Americans are looking for the easy way, one that requires little discipline. So every time a new diet book is published or the doctors on TV tell us about a miracle cure or another health secret, people want to sign up for the program (and send in their money). They can’t hold an audience by saying the same things over and over, especially when we are so desperate for secrets, so the authors and television personalities must give us secrets.

The real secret is the boring truth – that there is no secret. Like every other endeavor in life, staying healthy requires a little luck and a lot of discipline to stick to the best course of action. The rest is distraction.

Buy Now, Pay (or regret) Later

Usually on Black Friday I write about perspective – that any deal on electronics is not worth the life of the person trampled in the stampede. Another aspect of perspective is appreciating what we have and not constantly yearning after more or bigger or newer. The problem is that understanding the difference between wants and needs is only a first step. It must be followed by the discipline not to ignore reality by buying something anyway, especially something you can’t afford.

What seems to be catching on today is a new gimmick called point-of-sale installment loans. “This holiday season, it's not enough to spot a great Black Friday deal on a big screen TV or a sweater. You need to consider whether you want to take out a loan at the checkout, too.” 

That’s right; shoppers no longer need to go to a bank for a loan to buy something they can’t pay for. An installment loan at checkout breaks the cash register receipt into a number of easy monthly payments. That service is now available at Wal-Mart and at many other retailers, both brick-and-mortar and on line. And installment loans are expected to be “hot this holiday season, as retailers attempt to drive sales and shoppers demand easy-to-understand credit.” Retailers are partnering with finance companies to give shoppers these loans, even to people who might not qualify for regular credit cards. Instead of paying at the time of purchase, shoppers can take the items home and pay in 3, 6 or 12 monthly payments.

This is not a new idea, but was usually limited to big-ticket items. Furniture stores have used it for years. The problem is that the eventual monthly payments add up to more than the original price – sometimes 20% or 30% more. 

Not paying cash at checkout is not new either. Credit cards made that possible years ago, and both arrangements involve interest. But shoppers generally ignore the interest in light of the convenience and recognize some advantages over credit cards. Installment loans have no late payment fees, which are a big revenue source for credit card companies, and people tend to like the idea of a predictable, fixed amount each month.

It really is the same idea as a mortgage or car payment, but now the idea is moving downstream to less expensive purchases. Another source says installment plans have a “wide appeal but resonates most strongly for debit users. Four-in-ten would consider using an installment plan for everyday purchases like groceries and household items.”

An American Banker article has another explanation for the trend; “many younger Americans are uncomfortable carrying credit card balances, partly because they saw their parents struggle with debt during the financial crisis and prefer the more certain repayment terms of installment loans.”

This brings up a few issues. First, the financial problems of the parents of younger Americans were not the fault of the credit card. They were problems of discipline and perspective. Going into debt in a different way is no guarantee of success. Since installment plans have no late fee, what do they do instead, send debt collectors or repossess the sweaters and Christmas toys? (This is not addressed in any of the stories.)

In effect, this is just another marketing ploy to get people to spend money they don’t have. The example in one of the articles was of a woman who bought tires from Wal-Mart. She was all right with paying the $644 in three monthly payments of $224, but she “doesn't remember the interest rate.” (It’s about 18% APR.) In this case, tires were probably a necessity, but sweaters, purses and toys?

All this is happening while U.S. household debt, according to Motely Fool, reached $13.54 trillion earlier this year, “an amount that has risen for 18 consecutive quarters.” 

Wake up America; debt is debt! Have a happy Black Friday, but don’t do anything foolish.

Internet Addiction

The subject of Internet addiction as a serious problem came to my attention earlier this month with the headline: “Lawmaker Aims To Curb Social Media Addiction With New Bill.” A US Senator from Missouri introduced a bill to ban addictive social media features. It would address such things as infinite scrolling, tracking of streaks, constant loading and auto-play on video sites, while requiring time limits on apps. He accuses the media companies of “using psychological tricks that make it difficult to look away.”

Many questions came to mind: What is the definition of Internet addiction?; Is it real?; and How big is the problem?

In another article NPR asks the question of whether it is real. One expert that they interviewed said, “Addiction begins with intermittent to recreational use, then progresses into daily use, and then progresses into consequential use, which in some cases will progress to life-threatening use," such as insomnia, dysfunctional relationships and absenteeism. It is the opinion of many experts that Internet addiction fits this pattern. NPR’s introductory story told how it led a young girl to experience depression, anxiety and suicidal thoughts. 

China and South Korea have recognized Internet addiction as a mental disorder, but that is not yet the case in the US. Despite many suggestions dating back to 1996, it has not been included in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), therefore, it is not officially a mental health disorder and mental health professionals don’t have a standard way to assess and diagnose it.

This answers my first two questions. Some experts in the US consider it real and a major problem, but it has not yet qualified as an official diagnosis. That leaves the definition open to individual interpretation. As a result the question of the size of the problem is fuzzy, at best.

This can be seen by the fact that one website from 2012 cites a survey putting the problem at between 1.5 and 8.2% of the population. Another source from last May says that the rate of addiction is estimated at 1.5 to 8%. That’s not much of a change in the seven years that have elapsed.

Other studies continue slicing and dicing the problem in various ways. By gender, 27% of women and 25% of men report being near-constant internet users with many more college than high school graduates (34% to 20%). Constant use also varies by income and race. Still, some people must be on the internet more than others just to be able to do their jobs properly. There is more to addiction than time on the computer.

This site provides links to 32 studies between 2008 and 2014 showing “Facts, Figures, & Numbers” from several countries. It’s been a very popular research subject, but has still failed to make the grade as a recognized disorder in the US.

Ultimately, it seems to be just another case of the government stepping in to solve a behavior problem. Every time Americans can’t exercise a little discipline, we lose our freedom to a well-meaning politician intent on solving our problems for us with another law. In this case it seems to be happening even before there is a clear definition of the problem or an understanding of its size.

Fortunately in this case, it doesn’t appear to stand a chance of passing, but it’s an excellent indicator of the general mindset. Whenever we fail in personal responsibility or discipline, help or “protection” comes in the form of regulations, restrictions and less freedom. And it takes only a small minority (8% or less, in this case) to get the ball rolling.

Save Your Vitamin Money

At least once a month we see reference to one or another survey or report about people being unable to afford retirement. They haven’t saved enough money, but may not be able to keep working either. But now just when it’s needed, along comes a reliable tip on how to save a little more: Don’t waste your money on vitamins. 

This is not the first time I have written about the waste and potential dangers of dietary supplements. The last entry on the subject of supplements in general was about two years ago where I quoted from the New York Times saying that annual spending in America averages about $100 per person. I focused on vitamin and mineral supplements as recently as last September. I was hoping after many attempts to have wrapped it up, but it’s good advice, so I will give it another shot based on some fresh headlines.

About two weeks ago researchers from West Virginia University School of Medicine published a study in the journal Annals of Internal Medicine showing “that although reduced salt intake and certain supplements may lower the risk of cardiovascular diseases, most nutritional supplements do not improve the risk for heart disease or death.”

An article reviewing that study quotes the lead researcher: “The reason we conducted this study was that millions of people in the United States and across the world consume supplements or follow certain dietary patterns, but there was no good-quality evidence to suggest that these interventions have any effect on cardiovascular protection." 

The study itself was not a clinical trial but a review of 277 other studies with a total of nearly one million subjects. It looked at the effectiveness of many popular nutritional supplements and 8 diets. “Findings show that of the 16 dietary supplements, only two showed beneficial effects on heart health, namely omega-3 long-chain fatty acids and folic acid….[whereas] selenium, vitamin B6, vitamin E, vitamin C, iron, and vitamin A, among others, show no significant effect on heart health.” 

Other important findings were that some supplements by themselves, not just the tainted ones that appear in the news from time to time, are potentially harmful. Another surprising finding was that “most diets, like modified fat intake, the Mediterranean diet, and reduced saturated fat intake, had no effect on the heart at all.”

Some other sources reporting on the same study had more watered down headlines. This one says, “For Heart Health, Some Popular Supplements Aren't as Helpful as We Thought.” But the sub-headline is more direct: “Consumers should ‘stop wasting their money on these products.’ ”

Another one is even more careful in its wording: “Nutritional supplements and diets not always protective, research suggests.” But they did provide a link to another study from 14 months ago that also came to the conclusion that “most commonly consumed vitamin and mineral supplements provide no consistent health benefit.”

The final conclusion as always is “only eating a healthy balanced diet is the key to overall health.” That shouldn’t come as a surprise to anyone who has been paying any attention to and looking into health news over the years. Once again, it’s looking for the easy, magical answers that cause us to waste time and money on pills and fad diets. Avoiding that mindset is, though, an easy way to come up with some extra money for that problematic retirement savings plan. 

Latest (?) Alzheimer’s News

Isn’t it interesting how the number of Alzheimer’s stories and articles picks up every July? Actually, it’s not a coincidence at all. The annual meeting of the Alzheimer’s Association International Conference® is scheduled for the middle of July. This year it ran from the 14^th to the 18^th in Los Angeles. Naturally, the news media eagerly awaits the latest studies coming out of the conference because the subject of Alzheimer’s Disease or dementia is an emotional draw for so much of their audience.

Since there is still no drug treatment to prevent or cure dementia, the emphasis lately has been on other prevention practices. Is there anything we can do? Yes, there is, and it’s announced as a new breakthrough regularly. But in reality, it differs from year to year by only a few minor tweaks and looks very much like other familiar health advice.

In 2017 a new study, “published in The Lancet and conducted by the first Lancet Commission on Dementia Prevention and Care, brought together 24 international experts to review existing dementia research and provide recommendations for treating and preventing the devastating condition.” They concluded that a third of dementia cases “worldwide could potentially be prevented through better management of lifestyle factors such as smoking, hypertension, depression, and hearing loss over the course of a lifetime.” It was presented as a new report. Although the report was new, these recommendations look very familiar. 

For example, in 2015 World Dementia Council (WDC) asked the Alzheimer's Association to evaluate and report on modifiable risk factors, that is, possible prevention steps for cognitive decline and dementia. They concluded that there was “sufficiently strong evidence” that “regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension)” along with “a healthy diet and lifelong learning/cognitive training" could have a positive effect.

 And last July similar news came out of their annual meeting, which was held in Chicago. One of the experts announced the results of a large multi-year study: “Lowering blood pressure more than usually recommended not only helps prevent heart problems, it also cuts the risk of mental decline that often leads to Alzheimer's disease.” Getting the top number down to around 120 was shown to lower risk of mild cognitive impairment by 19 percent. (That’s three references to hypertension in four years.)

At that time they reminded readers that the American Heart Association recommends the following lifestyle changes to help manage high blood pressure: balanced diet, alcohol in moderation, regular exercise, weight and stress management, no smoking and taking medications as directed. (It all sounds familiar.)

Not to be deterred by the fact that this is getting a bit repetitious, last week the BBC (and many others) reported on the latest findings revealed at this year's conference with the headline: “Dementia: Lifestyle changes that could lower your risk.” The report outlined the factors associated with a healthy lifestyle: no smoking, eating a healthy diet, getting regular exercise and drinking only in moderation.

I didn’t investigate these studies to mock the findings. I agree with the findings. In fact, it is totally aligned with something I published over 5 years ago, pointing out that there are really no secrets to good health, just the same old advice.

 Rather my intention was to show how the media repeat news stories, rarely questioning whether or not it’s really new. I also discovered, without a hint of surprise, that they will adjust any news story to fit their agenda. In this case as reported by Kaiser Health News (KHN), the Washington Post reported that the study advised, “Ditch the red meat,” and KHN wrote, “Give up red meat.” When I looked at the study details and dug into the (footnote) source they used to define a healthy diet, the wording was “fewer red meats,” not to ditch it or give it up.

That leaves us again with a need for discipline to stick to that common-sense healthy lifestyle and critical thinking to take the news with a large helping of skepticism.

Walk Faster, Live Longer?

A very interesting article in JAMA a number of years ago requires the application of critical thinking to avoid making a misinterpretation.

 A team of scientists put together a summary of nine studies over the years totaling almost 35,000 subjects over the age of 65, residents of various nursing facilities . Each study was trying to find out whether measuring a person’s walking speed could help predict how much longer they would live.

The data came from the various researchers measuring how fast people walked over a short measured course, between 8 and 20 feet long, using a stopwatch and converting the speed to feet or meters per second. They then followed up years later to see how well the measured speed at the time of the test correlated with how much longer the individuals lived. (The authors refer to it as “gait speed.”)

The published conclusion, when they put the information from all the studies together: “In this pooled analysis of individual data from 9 selected cohorts, gait speed was associated with survival in older adults.” The graphs accompanying the article show this quite clearly, and the findings held true for both men and women and for people of different races. The top group walked the course at 1.6 meters per second, which converts to about 3.6 miles per hour. (For a longer distance this would mean a pace at which someone could walk a mile in about 17 minutes.)

How is this useful? “First, gait speed might help identify older adults with a high probability of living for 5 or 10 more years, who may be appropriate targets for preventive interventions that require years for benefit.” It could help assess whether a particular medical procedure would be worth the risk – there is always a risk, especially for older people. “Second, gait speed might be used to identify older adults with increased risk of early mortality, perhaps those with gait speeds slower than 0.6 m/s.” It is a simple and informative way for “assessing expected survival to contribute to tailoring goals of care in older adults.” Furthermore, it is a simple measurement that can be easily done in a nursing home corridor by non-professionals.

How is this not useful? Correlation is not causation. Someone seeing this article and not using critical thinking might conclude that beginning to walk faster was a way to guarantee longer life. After all, the graphs on the page clearly show that those who walked faster lived longer. Except for the fact that exercise is good for anyone, this conclusion is not necessarily so; it’s not what the analysis shows.

The authors theorize that the correlation exists because, walking “requires energy, movement control, and support and places demands on multiple organ systems, including the heart, lungs, circulatory, nervous, and musculoskeletal systems.” A slower walking speed could indicate some damage or a larger than normal energy requirement for other reasons. Both could be a general indicator of lessened vitality. It makes sense that those who were going to live longer were just capable of walking faster, and did so.

Unfortunately, scientists did not prove that increasing our walking speed will increase our life expectancy. (In fact, people walking faster while texting could easily decrease their life expectancies.) Getting more exercise, including walking, and generally taking care of ourselves will. There is rarely one easy answer. The real secret to good health appeared in this space over five years ago and, unfortunately requires some degree of discipline.

Weight Loss and Diets

In America the news media tell us that we are in the midst of an obesity epidemic. This is clearly a discipline issue. As in most cases about the dimension of discipline, the answer is simple to understand and hard to do. Apparently though, and typically, a great number or people think there is some easy path to weight loss.

That’s why Americans buy about 5 million diet books every year. Millions are looking for that magic answer and presumably going back to buy a second and third book as each particular formula invariably fails them. Hundreds of different diet books are listed on Amazon, many labeled as best sellers. I found from another source a list of the ten best books on the Ketogenic diet. How many books do we need on a diet described as an “extreme form of low-carbohydrate diet” originally used to treat epilepsy in children a century ago. But today, by way of “celebrity endorsement it has become a popular weight-loss fad diet, but there is no evidence of any distinctive benefit for this purpose, and it risks causing a number of side effects.The British Dietetic Association named it one of the ‘top 5 worst celeb diets to avoid in 2018’.” 

This article in the Guardian from earlier in the year challenges these diet programs with all their accompanying hype by presenting five myths about weight loss. The thrust of the argument is that people tend to misjudge the dangers of their condition as well as their personal progress toward their goals.

People can hugely misjudge their calorie intake, and overweight people have a strong tendency to grossly underestimate the calorie content of their food (by about 47%). Those who believe they are fat but healthy, according to the writer, are deluding themselves. Being overweight is inherently unhealthy. “Their risk of becoming ill was eight times higher than that of the healthy group with normal weight. The risks include, but are not limited to: diabetes, cardiovascular disease, cancer, sleep apnea, arthritis/joint problems, fertility problems, asthma, back pain, incontinence, gout and stroke.”

The BBC reinforces the seriousness by proclaiming in this headline “Obesity-related cancers rise for younger US generations, study says.”

The other side of the problem has to do with the fact that people also misjudge other factors including: how many calories they burn through exercise, how overweight they are, that the extra weight doesn’t slow them down or that they can blame it on genetic differences. (See last Friday’s comments.) 

The most reliable advice comes from people not trying to sell books or diet programs, for example, advice from the book, The Cure for Everything, which I also referred to last Friday. Exercise is necessary and healthy, but it does little toward weight loss without a change in eating habits. (This is backed up by over 60 independent studies.) It’s not about a diet, in the popular sense of the word, but in a lifestyle choice. To make good choices the author recommends paying close attention to what you eat, either by calorie counting or any other method. This “forced self-monitoring…causes you to eat less, which is the only way to lose weight” (p. 54). The tendency to give yourself special treats for being successful or to treat the whole exercise as a temporary “diet” yields only temporary results – an outcome familiar to so many. It’s all about portion size.

This certainly seems Spartan and the opposite of fun, but simple-to-understand-and-hard-to-do is the hallmark of discipline. Unfortunately, the search for magic answers continues; but doing the same thing repeatedly and expecting a different outcome is the mark of insanity. Quoting from the book one more time: “If you see the word detoxify, cleanse, supplement or metabolism associated with a product or process, be suspicious. Someone is trying to sell you something that likely does not work and, in fact might be harmful” (p. 92). (I would add celebrity endorsements to the list of warning signs.)

Responsibility Explained

I recently ran across an interview on LinkedIn with a business author promoting her latest book. The book is What Awesome Looks Like: How to Excel in Business and In Life, by Amy Rees-Anderson. The author’s background is that she started a software business and later sold it for $400 million. The book is listed elsewhere as “a guide for entrepreneurs, executives and employees with the desire to understand how they can excel in business, balance work and family life and find a purpose beyond the bottom line on the way to becoming successful leaders and business owners.”

A guide to entrepreneurship seems a far cry from the idea of behavior having consequences. It didn’t catch my attention for that purpose. In fact the title was the first thing I noticed. It was a turn-off for two reasons. First it looks like just another book full of magic answers – excel in business and life? Otherwise, it could be good advice disguised and presented as magic answers, in which case people will find the path is easy to understand but the execution is hard, just as dieting and achieving financial security require discipline and responsibility. So there might be the link to behavior after all.

The second negative is just a personal pet peeve. "Awesome" is possibly the most overused word in the English language today. It is supposed to be an adjective, but adjectives are used to describe. In current usage, the description has become so watered down that it carries only some vague positive connotation. It has lost any specificity. It tells me that a person feels good about something, but hasn’t the energy or imagination to describe the feeling in more detail. With any luck it will go the way of groovy, a similar adjective/interjection, popular in the 1960s. But I digress.

Pertaining to the subject of behavior in the five key dimensions, the interview commented on the number of apologies in recent news from politicians and celebrities for various missteps. Some have been strong and some weak; some are almost non-apologies. They sounded good, but said nothing.

An important point is that everyone makes mistakes and the interview presented a good outline for making a good apology. Any apology should contain some commitment not to make the mistake again. The author presents the outline as a memory device calling it the, “Six A’s of a Proper Apology: 

1) Admit – I made a mistake
2) Apologize – I am sorry for making the mistake.
3) Acknowledge – I recognize where I went wrong that caused the mistake.
4) Attest – I plan to do the following to fix the mistake, on this specific timeline.
5) Assure – I will put the following protections in place to ensure that I do not make the same mistake again.
6) Abstain – Never repeat the same mistake.”

Underlying this process is the idea of strong behavior in the dimension of responsibility, taking ownership of your error and problems and making a sincere attempt to improve. How different this is from the current trend of playing the victim, blaming circumstances or someone else, or seeming to apologize only for getting caught.

This is a good guide for responsible behavior and also reinforces the point I have made often. Many books, articles and blogs explore portions of the solution contained in the five key behavioral dimensions, but only this one pulls them all together.

The Miracle (?) of Homeopathy

One week ago I compared adults’ belief in psychic abilities to children’s belief in the Easter Bunny. But that is not the extent of these false notions. Another subject that adults love to believe in is miracle cures. It reflects a problem in the areas of discipline, not wanting to do the hard work or stick to a routine, and critical thinking, not wanting to accept evidence over stories. A good example of this is homeopathic medicines.

The theory dates back to the 1700s and is based on the idea that the body can be stimulated to cure itself by means of a like-cures-like reaction. In other words, substances that cause an adverse reaction in a healthy person can (supposedly) cause the body of a sick person to fight against the same condition.

Here is how WebMD explains it. “Red onion makes your eyes water. That’s why it’s used in homeopathic remedies for allergies.” Similarly, they may use poison ivy, white arsenic, crushed whole bees, and various herbs to evoke a beneficial effect.

“Homeopathic doctors weaken these ingredients by adding water or alcohol. Then they shake the mixture as part of a process called ‘potentization.’ They believe this step transfers the healing essence [from the ingredient to the liquid]. Homeopaths also believe that the lower the dose, the more powerful the medicine. In fact, many of these remedies [are so diluted that they] no longer contain any molecules of the original substance.”

The theory sounds a little like vaccinations where a small number of living or dead cells are injected to fire up the body’s immune system, but it’s not the same. Vaccines have something in them. Homeopathic medicines are diluted to the point where they contain only water, plus any contaminants the water carries. Therein lies the problem.

Last summer the FDA released a warning about one particular manufacturer saying, “Consumers and pets who use these products could have an increased risk of serious infection, that could require medical attention, due to the high levels of microbial contamination.” They warned three other companies for violations of (1) inadequate investigation of test results that found high levels of microorganisms, (2) lack of quality oversight of ingredients with potentially toxic effects, including snake venom, and (3) having insects in their ingredients.

The usual disclaimer applies to all these remedies: "Products labeled as homeopathic have not been approved by the FDA for any use and may not meet modern standards for safety, effectiveness and quality." 

It strains credibility that medicine containing not a single molecule of the active ingredient would be effective. The doctor who runs this site calls homeopathy “the ultimate fake,” giving a thorough explanation of his position. So if it does actually work, it must be a miracle. But what does the evidence show?

Here is a headline from Science Direct a few months ago: “A randomized, blinded, placebo-controlled trial comparing antibody responses to homeopathic and conventional vaccines in university students.” Their conclusions from this well designed experiment were four-fold: 

• Homeopathic vaccines failed to elicit an antibody response.
• The antibody response to homeopathic vaccines was similar to placebo.
• In contrast, conventional vaccines showed a robust response.
• These findings suggest homeopathic vaccines should not be licensed.

How does a half-billion-dollar industry react to these facts? They continue to promote their products as “a safe, gentle, and natural system of healing that works with your body to relieve symptoms, restore itself, and improve your overall health. It is extremely safe to use, even with very small children and pets, has none of the side effects of many traditional medications, is very affordable, is made from natural substances, and is FDA regulated.”

Add "holistic" and "alternative" to that sales pitch and people will ignore facts and fall all over themselves trying to obtain some magical relief! Of course, with nothing in it, it is safe and has  no side effects, except possibly from contamination the manufacturer has overlooked. Here’s an idea: skip the trip to the health food store and feed your children and pets tap water. It’s basically the same thing, but even safer. 

Irresponsibility: Finding Excuses

Last time I was very pleased to find an example of strong behavior in the dimension of responsibility. The woman attacked by the jaguar at the zoo admitted her part in the incident and hoped that others would learn from her mistake. 

When someone is in the wrong, the common reaction seems to be denial or making excuses. The news lately is filled with celebrities, politicians and their defenders quick to deny a charge, downplay the seriousness of a charge or call attention to all the celebrities or politicians in the past who did the same or worse without ramifications. So it’s OK?

Making excuses covers a multitude of sins, and it serves as a convenient, and often accepted, way  if covering up for behavioral slip-ups in any of the five key dimensions.

One area where this comes into play is when weak behavior in the area of discipline leads to unwanted consequences, for example, lung cancer from smoking, retirement insecurity from failure to save during the working years or obesity.

Along the lines of the latter I found this article on line: “10 Reasons Why Obesity Is NOT About Gluttony and Sloth.” First, the author obviously used the most provocative words possible to describe a situation characterized by a simple lack of discipline, too little exercise or too large portion sizes. Use of the terms gluttony and sloth, boarders on name-calling; they arouse a sense of resentment to prepare the reader to be receptive to a litany of ready-made excuses.

And here they come, all the reasons an unmotivated person can fall back on:

• Obesogenic Environment: where living in an area without sidewalks or safe walking routes coupled with a lack of accessibility to fresh fruits and vegetables along with other environmental factors may add challenges. (People would be thin as rails if only they had sidewalks.)
• Culture of Beauty: drives people toward an unattainable standard, encouraging “self-starvation, exercise abuse, and other eating disorders. It really only serves those who make money off of it.” (This stems from a perspective problem, being manipulated by external values.)
• Mental Health problems “from depression and anxiety to chronic stress and past trauma” can become an issue. “Weight gain can be the result of emotional eating as a way to cope or a result of medications.” (See addiction below for the same excuse in different words.)
• Genetics: While genetics does not predict obesity, over time the combination with other factors may predispose individuals to have obesity issues (though that doesn’t explain why it would suddenly become a factor in the last 50 years.)
• Social Networks: Social influences “play a role in our health behaviors including eating, exercise, weight loss or gain.” (Blame it on your friends.)
• Food Addiction: works like other addictions as “a way to cope with uncomfortable feelings and situations in life.” (Is it realistic to expect life to be comfortable all the time? How easy to forget that life in this century is more comfortable than at any other time in history.)
• Lack of Awareness: too many confusing “messages about what to eat, how to exercise, and ways to lose fat” leave “most of us…scratching our heads.” (But most of these confusing messages come from the purveyors of easy solutions, miracle diet plans and magic answers or from scientists trying to secure funding.)
• Family Income: “Soda is less expensive than water…” (Last I checked water is so inexpensive that I take a shower in it! It falls from the sky! Unless you live in a place like Flint, MI, this argument is as bogus as they come! See here for more about the expensive healthy food myth.)
• Environmental Chemicals in lab experiments alter the metabolism and increasing “the size and number of fat cells in animal exposed to chemicals.” (Blame it on the chemicals, while ignoring the difference between lab experiments and reality.)
• Fat Shame: causes the internalization of society’s fat phobia…creating the most harm. (But change is hard; it doesn’t happen without some discomfort as a motivation. If anything, society has become overly sensitive to the idea of fat shaming and many other attitudes labeled as intolerant.)

So there they are, ready-made excuses to maintain an unhealthy lifestyle. Just spouting off one or two of these (and ignoring the comments in parentheses) is a lot easier than taking responsibility for lapses in discipline.

Lower Tax Refunds, Not Bad News

Despite what CBS and others tell us, the report from the IRS that “tax refunds are about $170 lower than last year” is not bad news. The fact that “the average refund so far this year is $1,865, down from $2,035 in 2018” is only a timing issue. People who think otherwise are forgetting how income taxes work.

Employers are required to withhold taxes from each paycheck. These are sent to the federal and state governments. It is better to have them withhold a little more to avoid being hit with penalties and interest for not paying enough up front. But traditionally, taxpayers have jacked up their withholding on each paycheck to ensure a large refund. It makes up for lacking the discipline to voluntarily put aside a little each pay period. 

At the beginning of each year they experience what seems to be a windfall. But it’s not some gift from Uncle Sam; it’s really just a matter of getting their own money back after it has been withheld from them throughout the year. Withholding and the refund are not separate, unrelated pieces. They are each part of the whole. Changes in one lead to changes in the other, but the total paid in taxes is exactly the same whether you get it today or next March.

Getting a smaller refund leads some to believe that the tax cut was not real. (See the CBS piece for examples.) But they have only themselves to blame. “According to payroll processing firm ADP, only a small fraction of workers bothered to change their withholding” as the IRS urged them to do after their employers adjusted their withholding. They were happy to get more in their paychecks, but want to complain later about a smaller refund.

If they looked at total taxes paid, it would be obvious. When someone else files the tax forms and people only sign at the bottom, it’s so easy to ignore the total tax and only care about the size of the refund check. 

Then the news media stir things up by airing the complaints and making a big deal of it while only explaining the details in the last part of the report (if at all). And Bloomberg predicts that Democrats will intentionally promote this misunderstanding to their political advantage. 

As one expert told CBS, "I think taxpayers generally will try to avoid thinking about taxes, even after a major overhaul." The story is the same with taxes, tax refunds and other related issues, such as Social Security and Medicare. Many Americans don’t want to take the time to understand the details. They just want to complain. The frightening part about democracy is that someone who doesn't pay attention has the same number of votes as someone who does.

Government Shutdown Hardships

A week ago CBS reported on IRS workers' problems that came from the shutdown. “After a month with no pay, real hardship does exist for IRS employees including not having the money needed to get back and forth to work or to pay for the child care necessary to return to work right now.” Even some cities have been struggling as spending and the related sales tax revenues decreased. There were many other reports from around the country about similar hardships: food, utility bills, transportation, credit card payments, rent, etc.

It’s sad to see about 800,000 Federal workers furloughed with no pay. Many were required to continue coming to work not knowing when they would next be paid. They would struggle until the dispute was settled and back pay arrived. I have no solution to propose to avoid shutdowns, but I know what should happen immediately upon the workers' return. All government workers should be given a class in personal finance.

Suze Orman is not the only one who has been advocating for many years that everyone have an emergency fund, but she gives familiar advice. Here from a 2015 article is a typical example. “Your long-term goal is to have eight months of living expenses set aside in your emergency fund. I know that’s a lot, but I want you and your loved ones to be okay if you were ever laid off, or sick for an extended period of time.” Other experts are more conservative, recommending 3 to 6 months. But still, that’s more than a few weeks.

Of course, no one has been listening. Unfortunately, government workers thrown into a panic, resorting to food banks after missing a single paycheck does not strike the public as unusual. An emergency fund of only $1000 would be a good start, but a Bankrate survey from 2018 showed “only 39 percent of survey respondents said they would be able to cover a $1,000 setback using their savings.” That leaves 61 percent of the entire population out in the cold – or going to a food bank – soon after losing a job.

Admittedly, losing their job is not usually on the minds of government workers. Their job security is enviable. However, there have been four shutdowns in the last six years, each with the potential to cause similar problems. Between that and the same chances of personal emergencies that they share with the rest of the population – auto accidents, illnesses, personal injuries, etc. – their lives overall are not that much different or more secure than the rest of us.

Critical thinking dictates a need to build an emergency fund. Discipline is required to stop living paycheck to paycheck in order to do that. Responsibility implies that hardships after only a month without pay gives them no right to play the victim. That status, however, is too convenient for politicians trying to shame the other side, trying to shift the focus away from their own inability to act like competent leaders or even like adults.

This is yet another crisis that can be laid at the feet of individual behavior. The news media has this same information, but don't expect them to report it that way. They are too busy pushing sob stories and manipulating our emotions to keep the ratings up, to ask what personal choices could have allowed those crises to be averted.

Dangers of Detox Plans

It began with the headline: “The Soy Sauce Colon Cleanse That Left a Woman Brain Dead Shows How Dangerous Viral Internet Trends Can Be.” Looking up “Soy Detox Hoax,” I found an interesting mix of news stories about this tragic event and other sites promoting the practice. On one hand there were serious warnings, but every other entry linked to what appeared to be “How To” information.

The Explore Health site called the practice an “extremely dangerous fad.” A 39-year-old woman tried the soy sauce cleanse and went into cardiac arrest on the way to the hospital. She was revived, but drifted in and out of consciousness for several days. She woke up with severe nerve damage, unable to move, swallow, or speak.

According to Fox News, who gave a similar description of the situation, tests showed extremely high levels of salt in her blood, which can draw water away from the brain.

This was not an isolated incident of a soy sauce overdose. Back in 2013, a 19-year-old man drank a quart of soy sauce on a dare. He began twitching and having seizures, then went into a coma and nearly died from an excess of salt in his body. Too much soy sauce is dangerous; a soy sauce cleanse is a bad idea.

But the problem is not limited to soy sauce. Another search, this time for “Dangers of Detox” yielded numerous articles in the mainstream press and on medical and health-oriented websites warning of the practice in general. They date back more than ten years. The danger is not really news!

Most begin by pointing out that the detox fads come and go, usually driven by one or another Hollywood personality. Here is just a sampling of reliable advice.

NBC News had a story back in May 2007, “Experts Warn of Detox Diet Dangers.” Their expert, a gastroenterologist, concludes: “Your body does a perfectly good job of getting rid of toxins on its own…There’s no evidence that these types of diets are necessary or helpful.” Another expert adds that any attempt to flush the bad stuff from your body, the so-called toxins, also flushes out “good bacteria that keep the intestines healthy.”

 From Live Science in November 2014: “There's no scientific evidence that juice cleanses are a sensible approach to better health.”

 In September 2013 a piece about hidden dangers of detox lists as possible side effects: vitamin deficiency, muscle deterioration, heart palpitations, hair loss, depression, abdominal and digestive pain, reduced immune system, skin problems, anemia, and gallstones. 

Harvard Health discussed it in May 2008. “We tend to forget that the body is equipped with a detoxification system of its own” and “can defend itself very well against most environmental insults and the effects of occasional indulgence.” If you're generally healthy, there is no need. If you are experiencing health problems, “visit your doctor instead of a detox spa.”

Journal of Family Practice in August 2011 published a rather technical document for its members about the dangers of colon cleansing. “Patients may look to colon cleansing as a way to ‘enhance their well-being,’ but in reality they may be doing themselves harm.” They emphasized that there are no proven benefits.

There you have it. Many sources tell the straight facts. Under normal circumstances, bodies are built to detox themselves. Colon cleansing or other detox programs or diets are not beneficial with a high probability of causing serious harm. Your body is not full of toxins. Your colon does not need to be periodically cleansed, and doing so does not support, strengthen or promote any natural processes.

With over 10 years of evidence, warnings and examples of cleansing gone wrong, why would anyone try it? One reason is that it appeals to those low on disciple and critical thinking, looking for easy answers and not necessarily fond of science. They trust Hollywood endorsements more than medical professionals.

Unfortunately, the ads and promotions are so easy to find. Mixed in with the numerous links to stories of the brain-dead woman were such headlines as “Best Colon Cleanses for 2018” and “Best Non-GMO Colon Cleanse,” which has a laughable account of a man who lived for over 150 years and fills the rest of the page with endorsements from satisfied customers.

Living Longer (continued) – Same Old Boring Advice

For the last two weeks, we have been looking at commonly mistaken solutions in the search for a longer life. There is no shortage of unverified exercises, tricks, potions and diets claiming to help us live longer. Many years ago a TV commercial featured some very wrinkled people living in the remote Russian steppes whose secret to a longer life was eating yogurt. These days everyone eats yogurt, and the more exotic the better, with little to show for it.

Sadly the trick to living longer is not yogurt or supplements or more vacations. It’s not being lazy to save your energy as this piece argues. Instead about every few months, like clockwork, the health-news segments present a new study or often the same old studies with the same old boring advice.

One that resurfaces every few years is a Harvard study revealing the five things anyone could do to raise the chances of living longer. (More details about the study came out in MarketWatch just last July.)

It was also published by the Harvard Gazette back in April with the headline: “Five healthy habits to live by,” and told of the five habits, if adopted in adulthood, that could add approximately 14 years to women’s life expectancy and 12 years to men’s. 

The five so-called secrets uncovered by this study were (drumroll, please) “eating a healthy diet, exercising regularly, keeping a healthy body weight, not drinking too much alcohol, and not smoking.” I hope no one paid a lot of money for a study basically telling us what everyone already knew (but most didn’t want to hear). 

But in May 2016 a source called the Thrillist reviewed a different Harvard study on the same subject. “For 75 years (and counting), researchers have been following the same 600+ people to determine what makes a long, healthy, and happy life.” This longitudinal study, following the same subjects over an extended period, came up with seven secrets. Of course there is considerable overlap: keep learning, don’t smoke, don’t abuse alcohol, exercise, maintain a healthy weight, adapt well to setbacks, and have positive relationships.

Actually, the study reported in 2016 was a combination of two simultaneous studies, one with 263 participants and the other with over 300. The first of these was reported on in the Huffington Post in August 2013 with the headline: "The 75-Year Study That Found The Secrets To A Fulfilling Life.” This one was based on an interview with the author of a 2004 book on the subject. The main differences between the studies, the focus on relationships and coping, are explained by the fact that this study was as concerned with happiness as with longevity.

So the secret to a longer life is not a secret at all. It has been publicized for well over a decade with the common-sense equivalent going back many years before. As I explained two Fridays ago, it just takes some combination of critical thinking and common sense, perspective, economic understanding - not throwing away good money on junk science - and discipline to stick to a sensible routine.

Of course, if none of that common sense advice appeals to you because it lacks tricks and secrets and requires discipline, follow the latest advice for living longer from this New York Times article, based on yet another study – play more tennis!

Living Longer – The Secret To A Long Life

Everyone wants to know the secret to living longer, and many, many answers to that question are tossed around in the news media and on social media every day.  This is an important issue to most Americans. It is a matter for critical thinking, making sure the proposals pass the test of common sense, for perspective, making sure the potential gain is worth the investment, for economic understanding, knowing that a dollar spent on this pursuit cannot be spent elsewhere, and for discipline, having the ability to stick to a plan for the long term. (Note: any secret to longevity that has no long-term component doesn’t pass the critical thinking test.)

The next three or four installments of this page will cover an investigation of a few of these secrets to longevity. So where shall we start – how about with taking more vacations?

A news article about a study in Finland that, curiously enough, got to Yahoo News by way of India, tells us that men who take vacations live longer. Specifically, “compared with those who took more than three weeks, men who took three weeks or less annual leave from their regular work schedule were found to be 37 per cent more likely to die early.”

The study included 1,222 middle-aged executives, who were randomly assigned to a test group or a control group. Every four months they gave the test group advice on healthy living, including subjects like diet, exercise and not smoking. The control group was left alone. “Shorter vacations were associated with excess deaths in the [test] group,” but made no difference in the control group. They concluded: “stress reduction is an essential part of programmes aimed at reducing the risk of cardiovascular diseases.” 

Wow, where do I start? To be fair, I couldn’t find a link to the paper presented, so have no idea about how long the study lasted – hopefully, it was more than a few years, or how they defined excess deaths. But there are other flaws in the reasoning.

First, the sample was a decent size, but they cut it in half for no apparent reason. They assigned men randomly to each group. Randomization is a good course of action when you have no idea about the background of the subjects, but with more information it is preferable to assign similar people to each group to try to balance out what researchers call confounding factors. Some of those factors may have been family or work situations that could make taking vacation more stressful or impossible, such as divorce or personal/corporate bankruptcy. So randomizing into two groups is puzzling.

Then I wonder if vacation time was the only variable they tested for – that would seem odd given that they also provided healthy living information to only one group. Otherwise they may have been testing for a number of variables and found an “association” only with vacations. I have written elsewhere about how this practice can lead to some unreliable, even crazy results.

And who funded the study? Was it the Finnish tourism industry?

 Finally, the conclusions they reached cannot be applied to any large population – of Finland or anywhere else. They tested only male executives. It is comparable to a college professor testing a group of undergraduates, called a sample of convenience, and publishing the results as if they applied to ordinary citizens across the country. No can do! Do male Finnish executives have anything in common with female Detroit autoworkers? In fact, the conclusions did not even apply to their own so-called control group. How does not receiving healthy living information affect how stress-reducing a vacation is? Half their experiment backed their findings and the other half didn't!

I’m sure it made the news because everyone would like to exercise a little confirmation bias and latch on to a scientific study telling them what they want to hear: that not taking a three-week vacation can be a health hazard. Unfortunately, it’s not that simple.

So, if we want to live longer, we must look elsewhere, like to those magic pills, foods or beverages packed with vitamins and minerals – right? Not so fast! A word or two about that next time.