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?]

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.)

To Breakfast or Not To Breakfast?

That continues to be the question.  When I was growing up many years ago, we were told that breakfast was your most important meal.  The government still subscribes to this as many communities provide breakfast as well as lunch to qualifying students, subsidized with federal funds through the USDA’s School Breakfast Program (SBP).

It wasn’t too long ago that the news took the opposite view of breakfast.  Only 16 months ago I published the original To Breakfast or Not To Breakfast telling how breakfast had been declared optional based on a paper in the American Journal of Clinical Nutrition.  This opinion was backed up by an earlier (Summer 2014) study reported by the Huffington Post and USA Today.

The emphasis was on whether people who were skipping breakfast to lose weight were making a good decision.  They surmised that from a standpoint of weight loss, skipping might hold a slight benefit.  If you are hungrier at lunch and eat a little more, it will usually not be enough to offset all the calories missed from skipping breakfast.  So the net intake would be favorable.

But that stance was so 2017! The latest study is in and we are back to eating breakfast as a better solution.  (I originally saw the story on a TV health segment but these two sources are available on line here and here).

Researchers at the Mayo Clinic divided 347 healthy adults into three groups, those who never ate breakfast, those who ate infrequently (one to four times a week), and those who regularly ate breakfast (five to seven days a week).  Then they followed them for 12 years and found that the breakfast eaters ended up with “smaller waistlines and were less likely to be obese.”

But the really scary part of the report came next. The “people who ate breakfast regularly only gained about three pounds over the past year. People who ate breakfast occasionally put on five pounds, while people who skipped a morning meal entirely gained eight pounds and developed dangerous belly fat.”  (Since this was a 12-year study, it is unclear why they only reported on weight gain over the past year.)  In any case, notice that the breakfast eaters did better, but on average no single group lost weight!  Isn’t it interesting that success is now defined not as losing weight, but as not gaining as much as the other guy.

After reporting on the study, each of the news sources turned to their expert who dazzled readers with such earth-shattering observations as:  people should “stick to healthier foods in the morning [and]…avoid high density, sugar-filled foods.” They should also “consider how many nutritionally empty foods they eat during the day – and then cut those out.” (Not earth-shattering after all - just common sense.) This sounds more like the dimension of discipline than any magical link between breakfast and weight loss.

This whole breakfast question, like so many others in the health-research category, is like being on an amusement park ride with abrupt corners, twists and turns only to end up in the same place we started.  Of course, no one can explain why there would be a link between eating breakfast and weight loss, so the issue is still up in the air until the next study is published. 

Easy Resolutions

It’s the end of another year; time to consider a few resolutions.  The trouble with resolutions is they take will power.  The dimension of discipline comes into play.  Why can’t there be some easy resolutions that are more about not doing something than about working hard.  That should make things considerably easier, and more rewarding in terms of that feeling of success.

A Christmas visitor directed me to this website.  The title of the article is “7 bad science and health ideas that should die with 2016.”  The authors write about how some wrong ideas just seem to stick around.  Friends tell friends.  Ideas become ingrained, and despite all the good science to the contrary, they just won’t go away.  According to the article, this particularly applies to seven myths “that were decisively debunked this year” or possibly debunked again in one more attempt to make them go away. 

This is one of my personal favorite subjects; the things people continue to believe and refuse to change their opinion despite overwhelming contrary evidence.  Instead they look to social media friends or their favorite echo-chamber news source for reassurance.  Throughout the last five and a half years I have brought up many of these subjects.  (For a few of my examples, just look to the history over the last six months where the title begins, “One More Time.”)

In this case though, since these are bad ideas, shown to be decisively incorrect, a good and easy New Year’s resolution would be simply to stop believing them.

The first myth – Exercise will help you lose weight.  Many studies show that “the extra calories you burn only account for a small part of your total energy expenditure, and that cutting your food intake is a much more efficient way to lose weight.”  

The actual myth should read "increasing exercise alone would lead to significant and lasting weight loss."  Exercise is really good.  It gets the blood pumping, which is good for the heart, and good for the bones and good for the brain.  It even helps reduce the chance of getting certain diseases.  But no one can increase exercise while maintaining the same diet and lose much weight.  Unfortunately, it doesn’t work that way.  Programs led by the NFL and the First Lady are not going to impact the childhood obesity epidemic unless diets change also.  We could all start running marathons and it wouldn’t help.

The second myth – There’s been no global warming since 1998.  They present several charts and graphs to point out that the temperature has increased over that period.  There have been ups and downs – not unusual for a small data set, in this case less than 20 annual observations.  These ups and downs have led some to doubt whether the warming has persisted.  But the temperature has been increasing for the last 400 years, so the fact that we have not had a dramatic flattening or change of direction should surprise no one.

This myth misses the key questions about climate change.  Warming is not the issue.  The major questions are: first, whether actions prescribed will have any measurable effect on the warming, and second, whether the change in climate will be catastrophic.  The assumed answer to both these questions is yes.  But the large consensus about warming does not extend to these assumptions.  The danger is that if the answer to either is no, we have wasted a lot of resources, resources that will be needed to adapt to a catastrophic change if it comes or resources that will be completely wasted.  In the latter case we will have sacrificed some our standard of living and deprived third-world countries of the ability to improve theirs significantly for nothing.  Of course none of that matters because debate is closed.

The third myth - Antibiotics cure colds.  This is simple.  Antibiotics kill bacteria.  Viruses cause colds.  Bacteria and viruses are not the same.  But people take antibiotics and the cold goes away.  People also take vitamin C, Echinacea, zinc and other products and the cold goes away.  Then they all swear by the effectiveness of whatever they tried.  Of course, some people take nothing and the cold goes away.

The particular danger with antibiotics is that “the more we take antibiotics – particularly when they're not necessary – the more we increase the chances of helping develop antibiotic-resistant bacteria.”  A second concern is that they can wipe out good bacteria in our guts.  A third problem is that it’s a waste of money.

Some good, easy resolutions would be to drop the idea that exercise alone will be an effective weight loss program, to admit the earth is warming but not to panic over every dismal prediction, knowing that dismal predictions drive so much funding, and to lay off the antibiotics unless prescribed for a bacterial infection.

Come back Monday for a few more easy resolutions.

Know What You Are Buying

I have warned about herbal supplements in the past, but in light of this revelation from CBS news, perhaps it’s time to renew that warning.

The article highlights an ongoing study of supplements.  “The investigation, led by New York Attorney General Eric Schneiderman, focused on a variety of herbal supplements from four major retailers: GNC, Target, Walmart and Walgreen Co. Lab tests determined that only 21 percent of the products actually had DNA from the plants advertised on the labels.”  Does that mean that in 78 percent of the bottles they could not detect any trace of the ingredients listed?  That’s exactly what it means.  Three out of four people who buy these supplements are actually getting something else.

And people do buy them.  “A 2013 study from the Canadian Institutes of Health Research estimated there are about 65,000 dietary supplements on the market consumed by more than 150 million Americans.”  That’s almost half the population.

Supplements are supervised by the FDA, but under a different program than prescription medicine.  The companies are required to verify safety and proper labeling, but they are rarely checked.  They work more on the honor system.  When they are tested, this is often the outcome – tests find little or none of the labeled ingredients and in rare cases some contamination. 

So what’s a consumer to do?  You could rely on expert opinion, but that can also be problematic.  This website describes a recent $9 million fine issued by the Federal Trade Commission against a purveyor of Green Coffee Bean Extract (GCBE), who used an appearance on the Dr. OZ television show to launch sales of his product.  The FTC charged that he and his companies made deceptive claims that their supplement could cause consumers to lose 17 pounds and 16 percent of their body fat in just 12 weeks without diet or exercise, and that the claim was backed up by a clinical study.  None of this, of course was true.  Soon after he agreed to appear on the show, presenting himself as an independent expert on GCBE, his company began selling it on the Internet.  He used the on-air appearance to direct viewers to these websites.  After his appearance “his companies sold tens of millions of dollars' worth” to people who sadly, continue to believe in weight-loss magic without diet or exercise.

These examples reinforce the need for critical thinking, the kind of skepticism that identifies what’s too good to be true and steers clear.  When buying supplements, understand that they are not necessarily vigorously tested, may not even contain what is on the label, and won’t usually deliver the results advertised or promised in those stories from Facebook friends.  Likewise, those selling weight loss without diet and exercise are selling “snake oil” no matter how much you might want to trust the source referring them.

The Real Diet Busters

Each year, Frances M. Berg, M.S. of the Healthy Weight Network presents to promoters of weight-loss products the "Slim Chance Awards" in four categories:  worst claim, worst product, worst gimmick and most outrageous.  I came across a list of those awards for past 24 years on the diet scam website.  That’s nearly 100 products or advice sold to people to help them lose weight that mostly just helped them lose money. 

How desperate do you have to be to believe some of this stuff?  Examples include miracle potions and cleansing products that guarantee healthy weight loss.  Use a plastic bracelet that gives off vibes to stimulate weight loss and good health (2011).  “FDA cited 69 weight loss ‘supplements’ containing hidden, potentially harmful drugs or toxic substances, most imported from China, and says there may be hundreds more” (2009).  Slimming Slippers supposedly use reflexology, magnets, and the laws of gravity to increase metabolism by activating nerves in your foot to control digestion and eating habits (2000).  They have promoted belts, patches, jeans, body wraps, and even ear staples (2006).  Scientifically speaking, this is pure hogwash.

Several of descriptions of the “award-winning” products and claims mention government action (Food and Drug Administration or Federal Trade Commission) or class action lawsuits that were in progress at the time to protect us from dangers, to reimburse defrauded customers or to stop false advertising.

Losing weight is a classic example of behavior requiring discipline.  The process is easy to understand, eat less and exercise more, but carrying through on that program is very difficult.  We are naturally drawn to promises of an easy way out.  Beyond all those products and gimmicks, Amazon lists 39,472 paperback books and 19,375 hardcover books on the subject.  These, sometimes dangerous, guarantees of instant success are the real diet busters because there is no silver bullet, no easy way out or magic solution.  Everyone knows this, but the temptation to deny it in favor of a miracle cure is often too great.