Showing posts with label obesity. Show all posts
Showing posts with label obesity. Show all posts
Friday, August 14, 2009
Brown Fat: New Improved Single Factor Thinking
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Let me predict it here first, folks: Brown Fat will be the Next Big Thing in the Drive for a Single Factor Big Pill Solution to Obesity.
Put "brown fat" into google today and you'll see all sorts of clever people and magazines referencing this new study on how "brown fat" (used a lot for generating body heat in mamals and neonatals) can be used to help burn the evil "white fat" - our abundant adipose tissue.
Yes evil, says the article, in contrast to the "good fat" story from early last week i was telling. The article commences powerfully:
Electron micrographs of brown fat cells reveal one of their hallmarks: an extraordinary number of mitochondria, which, as described below, are involved in heat generation.
The mitochonria are typically round, with cristae across their entire width.
My favorite quote by one of the researchers from this story exemplifies single factor thinking:
Here, we have a head of a medical group, reminiscent of Barbie, saying gee, working out every day is hard; wouldn't it be great if i had a pill to lose weight for me?"
THis is the height of medical research? Wouldn't it be great to have a pill? Maybe that is the height of medical research: it's not about health, well being, quality of life, but about how far can we push this single thing for that effect.
If medicine were about well being perhaps the kinds of questions it would ask would be What are the issues around such weight gain? how does behaviour (neurology) interact with physical being (physiology)? what's the forensic differences between the Lean minority and the increasingly Fat majority? whether lean or fat what are the complex beneficial interactions of eating and movement and rest/sleep on a whole range of homeostatic factors that impact well being? do they have even greater impact on any level for those who are obese? doing things like improving insulin sensitivity, bone mineral density, cardio vascular fitness, ant-aging, balance, vision, awareness, focus? Knowing these complex interplays of systems to create a myriad of positive effects, is another drug or surgical intervention a good idea?
No? so what's on offer? A pill? and if not a pill how about an invasive procedure?
It's single factor thinking because it gets excited about saying "gee, if we could just tweak this one thing, wouldn't that be great if life were that simple...ok there may be side effects but look at that fat go...ok maybe nothing's happening with bone mineral density or strength, but look at that fat go." And some side effects like anti-anti-aging, are acknowledged:
Enthusiasm for the potential is unquenched. Here's another quote from the same article:
You know this may be exciting science and the source of many future publications and god knows how many dead rats in the process of Losing Weight, but it feels (a) arrogant and (b) taking the easy way out.
By analogy in Europe, there's laws against the sale of foods produced from GMO - genetically modified crops. Many farmers and People generally don't trust scientific manipulations in the food supply at such a vast level messing with what is perceived as Nature. There's concern that Something could go Horribly Wrong. To allude to another ancient trope for margarine commercials "It's not nice to fool Mother Nature"
Likewise the arrogance here is that we can find a Single Solution that will work in a Complex System (like us) and not think there'll be significant consequences. The taking the easy way out feels just ignorant. And in no small part disrespectful. We are complex organisms. Worse, we have psychologically reinforced habits wired up to physiological, homeostatically defined responses: we have behaviours wired into us for a non-fuel-abundant environment. And now we have abundant access to personal fuel. No wonder we're getting fatter.
Saying that, i'll say it again, it takes work and skills and practice and support to know how to change habits, to keep them changed and, initially, work against what are bodies are telling us to do: eat! The formula might be easy: eat less/move more, but the implementation is not simple, and sure as heck isn't saying gee let's just change this biological function. I bet that will be great! i won't have to work out. And we'll make lots of money to help other people not have to learn how to cook and move and learn habits of lean eating.
That sound cynical? Afterall these scientists are keen; they want to help solve an epidemic. And at least one of them is motivated to get off the eliptical. And i say Good For You - get off the elliptical and get something healthy like a kettlebell or a water rower.
But that's not what this anti exercise head of a diabetes research group is thinking - at least not as portrayed in this article. He thinks swap activity for pill. One Single Thing (workout: hard) for some Other Single Thing (pill: easy).
But we know that exercise is not a Single Thing - depending on how hard, how long, how frequently etc etc there are all sorts of effects going on inside that are good for us, hitting an abundance of systems: visual, vestibular, proprioceptive, mechanical, chemical, biological.
By comparison what does taking a pill do? We go from rich multi-factor interactions when we move to a far narrower set of internal interactions in ingesting a pill. And this from someone who should Know Better, don't you think?
-------
Thanks to Xafier for pointing out this article to me,
and let me cite Eric Cobb again for framing the notion of single factor thinking, covered in the 9S:sustenance cert. Tweet Follow @begin2dig
Put "brown fat" into google today and you'll see all sorts of clever people and magazines referencing this new study on how "brown fat" (used a lot for generating body heat in mamals and neonatals) can be used to help burn the evil "white fat" - our abundant adipose tissue.
Yes evil, says the article, in contrast to the "good fat" story from early last week i was telling. The article commences powerfully:
IN THE war on our waistlines, fat is the enemy. It is fat, or adipose tissue, that gives us our beer bellies and our love handles, our man boobs and our muffin tops. And when plastic surgeons sculpt people into slenderness, it is fat tissue they suck up and throw out with the clinical waste.
Electron micrographs of brown fat cells reveal one of their hallmarks: an extraordinary number of mitochondria, which, as described below, are involved in heat generation.The mitochonria are typically round, with cristae across their entire width.
"I exercise on an elliptical trainer and it's pretty hard for me to burn up 500 calories," says Ronald Kahn, head of obesity research at Harvard Medical School's Joslin Diabetes Center. "If I could do it without working and do it every day, it would be pretty great."Wow, where to begin here? Nigh on 20 years back there was a furor that was kicked off with Matel's "Math is hard" Barbie. What that was saying to kids - young girls especially?
Here, we have a head of a medical group, reminiscent of Barbie, saying gee, working out every day is hard; wouldn't it be great if i had a pill to lose weight for me?"
THis is the height of medical research? Wouldn't it be great to have a pill? Maybe that is the height of medical research: it's not about health, well being, quality of life, but about how far can we push this single thing for that effect.
If medicine were about well being perhaps the kinds of questions it would ask would be What are the issues around such weight gain? how does behaviour (neurology) interact with physical being (physiology)? what's the forensic differences between the Lean minority and the increasingly Fat majority? whether lean or fat what are the complex beneficial interactions of eating and movement and rest/sleep on a whole range of homeostatic factors that impact well being? do they have even greater impact on any level for those who are obese? doing things like improving insulin sensitivity, bone mineral density, cardio vascular fitness, ant-aging, balance, vision, awareness, focus? Knowing these complex interplays of systems to create a myriad of positive effects, is another drug or surgical intervention a good idea?
No? so what's on offer? A pill? and if not a pill how about an invasive procedure?
Researchers are experimenting with various ways to increase the amount or activity of our brown fat, either pharmaceutically or even surgically, by extracting ordinary white fat through liposuction, transforming it into brown fat and re-implanting it. A mere 50 grams of brown fat - well within the range of what some of us already have - could dissipate around 500 calories a dayand why is this single factor thinking?
It's single factor thinking because it gets excited about saying "gee, if we could just tweak this one thing, wouldn't that be great if life were that simple...ok there may be side effects but look at that fat go...ok maybe nothing's happening with bone mineral density or strength, but look at that fat go." And some side effects like anti-anti-aging, are acknowledged:
Manipulating brown fat, whether by drugs or surgery, may not be risk-free, however. By increasing energy expenditure you generate a high-flux metabolic state, points out Celi. This could increase our exposure to potentially harmful free radicals generated by the metabolism, which could conceivably cause cancer or even hasten ageing.But what if there's a reason that we have fewer brown fat cells as we age; maybe it helps us age better?
Enthusiasm for the potential is unquenched. Here's another quote from the same article:
Right, well is that statement true? Increasingly, most obesity appears now in kids. The rate is growing almost exponentially, right? (remember the piece a few weeks about about resistance workouts and obese kids - and how they lost no adipose tissue?) and kids apparently have way more brown fat cells than middle age folks apparently. So, maybe obesity isn't age related, or about just brown fat cell ratios.Nedergaard believes the focus should be on preventing the decline in brown fat as people get older. "Most obesity appears in middle age and onwards, and this is when it seems brown fat activity starts to disappear," he says. It might be possible to identify the cause of this decline and then reverse it, perhaps by replacing a lost hormone. What this hormone might be, though, remains a mystery.
You know this may be exciting science and the source of many future publications and god knows how many dead rats in the process of Losing Weight, but it feels (a) arrogant and (b) taking the easy way out.
By analogy in Europe, there's laws against the sale of foods produced from GMO - genetically modified crops. Many farmers and People generally don't trust scientific manipulations in the food supply at such a vast level messing with what is perceived as Nature. There's concern that Something could go Horribly Wrong. To allude to another ancient trope for margarine commercials "It's not nice to fool Mother Nature"
Likewise the arrogance here is that we can find a Single Solution that will work in a Complex System (like us) and not think there'll be significant consequences. The taking the easy way out feels just ignorant. And in no small part disrespectful. We are complex organisms. Worse, we have psychologically reinforced habits wired up to physiological, homeostatically defined responses: we have behaviours wired into us for a non-fuel-abundant environment. And now we have abundant access to personal fuel. No wonder we're getting fatter.
Saying that, i'll say it again, it takes work and skills and practice and support to know how to change habits, to keep them changed and, initially, work against what are bodies are telling us to do: eat! The formula might be easy: eat less/move more, but the implementation is not simple, and sure as heck isn't saying gee let's just change this biological function. I bet that will be great! i won't have to work out. And we'll make lots of money to help other people not have to learn how to cook and move and learn habits of lean eating.
That sound cynical? Afterall these scientists are keen; they want to help solve an epidemic. And at least one of them is motivated to get off the eliptical. And i say Good For You - get off the elliptical and get something healthy like a kettlebell or a water rower.
But that's not what this anti exercise head of a diabetes research group is thinking - at least not as portrayed in this article. He thinks swap activity for pill. One Single Thing (workout: hard) for some Other Single Thing (pill: easy).
But we know that exercise is not a Single Thing - depending on how hard, how long, how frequently etc etc there are all sorts of effects going on inside that are good for us, hitting an abundance of systems: visual, vestibular, proprioceptive, mechanical, chemical, biological.
By comparison what does taking a pill do? We go from rich multi-factor interactions when we move to a far narrower set of internal interactions in ingesting a pill. And this from someone who should Know Better, don't you think?
-------
Thanks to Xafier for pointing out this article to me,
and let me cite Eric Cobb again for framing the notion of single factor thinking, covered in the 9S:sustenance cert. Tweet Follow @begin2dig
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Tuesday, July 28, 2009
More on Exercise without Diet doesn't produce Weight Loss and the Ethics of Research
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Despite the promising title, Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese, the results don't offer what one might expect from it.
Most of us would say "body comp" means weight, girth measures, bmi changes. But no. It doesn't. In this case, it seems to mean fat kids who worked out got stronger, added lean mass, but didn't lose weight or overall fat. This is consistent with other studies of working out without diet to go with it:
First off, the main goal of the study was to explore resistance training rather than aerobic intervals training for obese kids. As far as i can tell, they are simply hypothesizing that some kids who are obese may prefer lifting to running type activities, and if that's the case, let's see what that does. That's not much of an hypothesis to test in a research environment is it?
Not surprisingly, since other research has shown this too, obese kids in an 8 week program make super strength and power gains too. Just like non-obese kids. And like adults of all ages who are new to lifting. Neural adaptations are taking place, and new tissue is being laid down.
Now the authors claim that their findings are great. They say
It's really great to see BMC going up too - that's something to keep for life.
But where does this take us? IF absolute fat doesn't go down, weight goes up, how does bf% go down? There's more new lean mass. as opposed to more (or less) fat. That's kinda fudging, isn't it?
These results (gaining lean mass; not losing weight overall) are consistent with both non-obese kids and adults. It tells us that muscle building mechanisms for the first 8 weeks of a program have an impact. That's good. What about the next 8 weeks and then the next 48 weeks?
When we work with adults who are overweight, we know that after 8-12 weeks, if their girth, weight, and fat - nothing on these measures seems to change - they are not feeling a whole lot of love and success or seeing it in their mirrors.
We know that the study reports here that eating habits didn't change throughout the study. They weren't logged too religiously, though, and unless an observer is making those logs, we know from other work that we ALL misreport food logs.
We know that folks may feel zippier from working out - and that's fabulous - but we also know with obese adults that without nutrition, all the jumping and pumping in the world will not shed the excess weight which is having the biggest negative impact on overall health.
What's the Point? In fairness, one might say, this study was *just* looking at effects of resistance training over 8weeks on obese kids. Is that good enough? These are real kids with real problems. Is this fair to them or the best we can do?
Consider this: the study doesn't explicitly state an hypothesis, eg: we postulate that fat kids who do resistance will have the same benefits as non-fat kids who start resistance.
Hypothesis Testing
Is that poor science not to have an explicit hypothesis? Generally speaking, in most fields, yes.
Because you have to defend why you hypothesize your position and show value of the study: why on earth would you think you'd need to see if fat kids respond to resistance training differently than skinny kids? When that's said outloud, kinda makes one go "hmm" no?
Without that rationale for the study being clear, what's the point of the work? It's rather gratuitous. The authors as said only suggest that some fat kids might not like aerobics or intervals so they need alternatives. Right! so the next point would be again to say, we have lots of results to show the benefits of resistance training for kids. What's the special thing you think you need to test in this population not covered by these other studies?
Well, these kids are obese.
Ok, so what? are you asserting that because of that, the effects of a resistance program may be different? if so why? what's the basis for that assertion and how will you test it? Are there special fat kid risk factors to test that one might think fat kids shouldn't do resistance? No? So what's the point?
The authors just show what we already know from a zillion ways past sunday: resistance training builds lean muscle. And even if absolute fat doesn't go down, because lean muscle goes up, the bf% ratio changes. And as we see in the charts, kids did gain weight - from the lean muscle.
That's why these kind of studies seem gratuitous to me. And heh, not every paper an academic writes is earth shattering. But something leaves me edgy here. Obesity is a real problem. This study is dealing with clinically overweight and obese kids (over 23-43% body fat in the study).
So we've confirmed that yet one more population benefits from resistance training. Was there any doubt, however, that that would be the case? Any hypothesis to test? No? then what's the study contributed, really? For 8 weeks kids got no nutritional counseling when the authors KNOW that obesity programs combine nutrition and exercise. "It is clear that, along with nutrition and lifestyle, exercise plays a significant role in overcoming obesity in children."
But if the authors had provided that counseling, that would have screwed up their results: they wouldn't know what was down to resistance vs what was down to diet.
Now ethically, we can say the children weren't harmed; in fact they are healthier than when they started. And still obese. And if they stick with their current training and their current activity they'll still be obese a year from now.
What's actually been proven here? hypothesis testing two. In the realm of statistics, one can simply set an alpha or confidence level - a percentage - by which if the results fall within that percentage, the results happened because of the intervention, not by chance. The way the authors set up this study, their signficance values don't claim that the body comp change is significant, but that the reason for the change is down to the intervention. That's right. Just that what change occurred is not because of chance but because of the progam. In other words they have an above 95% certainty that that body comp change is because of the training. Shocking.
Ok, that's not shocking but it means the title is: Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese. All that can be claimed, surely, is that we know within the realm of probability, literally, that resistance training has an effect at changing body comp. To say a "significant" effect - again means kinda weasel words. In stats, significance just means there's a treatment effect. To normal human beings significant means "wow that was a big deal."
So the authors are being technically accurate, but less clear that perhaps saying "Resistance training does induce body comp changes in fat kids in 8 week protocol, really really"
So, bottom line, did we learn anything new from this study that we didn't know before? Are the results surprising in any way? Was a bold hypothesis demonstrated? Did researchers who know that nutrition and lifestyle along with exercise is a big part of dealing with obesity provide that information to their participants' families as part of the study or just say good bye to the participants at the end of the 8-weeks?
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Most of us would say "body comp" means weight, girth measures, bmi changes. But no. It doesn't. In this case, it seems to mean fat kids who worked out got stronger, added lean mass, but didn't lose weight or overall fat. This is consistent with other studies of working out without diet to go with it:
McGuigan, MR, Tatasciore, M, Newton, RU, and Pettigrew, S. Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese. J Strength Cond Res 23(1): 80-85, 2009-Update: as R.M. Koske rightly points out in the comments below, body comp is technically changes in fat/muscle/bone ratios. And it's not entirely fair to conflate a scientific definition of a concept used in a research journal with popular understanding. But i DO take issue with the term SIGNIFICANT body comp alteration. more on that below.
The purpose of this study was to investigate the effect of an 8-week resistance training program on children who were overweight or obese. Forty-eight children (n = 26 girls and 22 boys; mean age = 9.7 years) participated in an 8-week undulating periodized resistance training program for 3 d[middle dot]wk-1. Measures of body composition via dual-energy X-ray absorptiometry, anthropometry, strength, and power were made before and after the training intervention. There was a significant decrease in absolute percent body fat of 2.6% (p = 0.003) and a significant increase in lean body mass of 5.3% (p = 0.07). There were no significant changes in height, weight, body mass index, total fat mass, or bone mineral content. There were significant increases in 1-repetition maximum squat (74%), number of push-ups (85%), countermovement jump height (8%), static jump height (4%), and power (16%). These results demonstrate that the resistance training program implemented produces significant changes in body composition and strength and power measures, as well as being well tolerated by the participants. An undulating periodized program provides variation and significantly increases lean body mass, decreases percent body fat, and increases strength and power in children who are overweight and obese.
First off, the main goal of the study was to explore resistance training rather than aerobic intervals training for obese kids. As far as i can tell, they are simply hypothesizing that some kids who are obese may prefer lifting to running type activities, and if that's the case, let's see what that does. That's not much of an hypothesis to test in a research environment is it?
Not surprisingly, since other research has shown this too, obese kids in an 8 week program make super strength and power gains too. Just like non-obese kids. And like adults of all ages who are new to lifting. Neural adaptations are taking place, and new tissue is being laid down.
Now the authors claim that their findings are great. They say
An undulating periodized program provides variation and results in significant increases in lean body mass, decreased percent body fat, and increased strength and power.
It's really great to see BMC going up too - that's something to keep for life.
But where does this take us? IF absolute fat doesn't go down, weight goes up, how does bf% go down? There's more new lean mass. as opposed to more (or less) fat. That's kinda fudging, isn't it?
These results (gaining lean mass; not losing weight overall) are consistent with both non-obese kids and adults. It tells us that muscle building mechanisms for the first 8 weeks of a program have an impact. That's good. What about the next 8 weeks and then the next 48 weeks?
When we work with adults who are overweight, we know that after 8-12 weeks, if their girth, weight, and fat - nothing on these measures seems to change - they are not feeling a whole lot of love and success or seeing it in their mirrors.
We know that the study reports here that eating habits didn't change throughout the study. They weren't logged too religiously, though, and unless an observer is making those logs, we know from other work that we ALL misreport food logs.
We know that folks may feel zippier from working out - and that's fabulous - but we also know with obese adults that without nutrition, all the jumping and pumping in the world will not shed the excess weight which is having the biggest negative impact on overall health.
What's the Point? In fairness, one might say, this study was *just* looking at effects of resistance training over 8weeks on obese kids. Is that good enough? These are real kids with real problems. Is this fair to them or the best we can do?
Consider this: the study doesn't explicitly state an hypothesis, eg: we postulate that fat kids who do resistance will have the same benefits as non-fat kids who start resistance.
Hypothesis Testing
Is that poor science not to have an explicit hypothesis? Generally speaking, in most fields, yes.
Because you have to defend why you hypothesize your position and show value of the study: why on earth would you think you'd need to see if fat kids respond to resistance training differently than skinny kids? When that's said outloud, kinda makes one go "hmm" no?
Without that rationale for the study being clear, what's the point of the work? It's rather gratuitous. The authors as said only suggest that some fat kids might not like aerobics or intervals so they need alternatives. Right! so the next point would be again to say, we have lots of results to show the benefits of resistance training for kids. What's the special thing you think you need to test in this population not covered by these other studies?
Well, these kids are obese.
Ok, so what? are you asserting that because of that, the effects of a resistance program may be different? if so why? what's the basis for that assertion and how will you test it? Are there special fat kid risk factors to test that one might think fat kids shouldn't do resistance? No? So what's the point?
The authors just show what we already know from a zillion ways past sunday: resistance training builds lean muscle. And even if absolute fat doesn't go down, because lean muscle goes up, the bf% ratio changes. And as we see in the charts, kids did gain weight - from the lean muscle.
That's why these kind of studies seem gratuitous to me. And heh, not every paper an academic writes is earth shattering. But something leaves me edgy here. Obesity is a real problem. This study is dealing with clinically overweight and obese kids (over 23-43% body fat in the study).
So we've confirmed that yet one more population benefits from resistance training. Was there any doubt, however, that that would be the case? Any hypothesis to test? No? then what's the study contributed, really? For 8 weeks kids got no nutritional counseling when the authors KNOW that obesity programs combine nutrition and exercise. "It is clear that, along with nutrition and lifestyle, exercise plays a significant role in overcoming obesity in children."
But if the authors had provided that counseling, that would have screwed up their results: they wouldn't know what was down to resistance vs what was down to diet.
Now ethically, we can say the children weren't harmed; in fact they are healthier than when they started. And still obese. And if they stick with their current training and their current activity they'll still be obese a year from now.
What's actually been proven here? hypothesis testing two. In the realm of statistics, one can simply set an alpha or confidence level - a percentage - by which if the results fall within that percentage, the results happened because of the intervention, not by chance. The way the authors set up this study, their signficance values don't claim that the body comp change is significant, but that the reason for the change is down to the intervention. That's right. Just that what change occurred is not because of chance but because of the progam. In other words they have an above 95% certainty that that body comp change is because of the training. Shocking.
Ok, that's not shocking but it means the title is: Eight weeks of resistance training can significantly alter body composition in children who are overweight or obese. All that can be claimed, surely, is that we know within the realm of probability, literally, that resistance training has an effect at changing body comp. To say a "significant" effect - again means kinda weasel words. In stats, significance just means there's a treatment effect. To normal human beings significant means "wow that was a big deal."
So the authors are being technically accurate, but less clear that perhaps saying "Resistance training does induce body comp changes in fat kids in 8 week protocol, really really"
So, bottom line, did we learn anything new from this study that we didn't know before? Are the results surprising in any way? Was a bold hypothesis demonstrated? Did researchers who know that nutrition and lifestyle along with exercise is a big part of dealing with obesity provide that information to their participants' families as part of the study or just say good bye to the participants at the end of the 8-weeks?
Tweet Follow @begin2dig
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