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Tuesday, 22 December 2015

Healing Back Pain

I've put off writing this post for many years because I know it will be controversial. But we're a few days from Christmas, and I also know this post will be a wonderful gift for some people.

Chronic or intermittent pain, often located in the back, neck, and/or buttocks, is a major driver of personal suffering and reduced productivity in the US and other affluent nations. While pain can obviously have a variety of structural causes, such as sprained ankles or bruising, garden-variety back pain usually doesn't. I've come to believe that such pain is usually psychosomatic in nature-- in other words, caused by the brain but resulting in physical signs and symptoms in the body. It's widely accepted that a person's mental state can affect pain perception, but this idea goes further. Pain isn't just exacerbated by a person's mental state; it's often entirely caused by it.

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Thursday, 10 December 2015

New Evidence Strengthens the Link Between Hypothalamic Injury, Obesity, and Insulin Resistance

Obesity involves changes in the function of brain regions that regulate body fatness and blood glucose, particularly a region called the hypothalamus. My colleagues and I previously showed that obesity is associated with inflammation and injury of the hypothalamus in rodent models, and we also presented preliminary evidence that the same might be true in humans. In our latest paper, we confirm this association, and show that hypothalamic injury is also associated with a marker of insulin resistance, independently of BMI.

Introduction

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Sunday, 22 November 2015

Fat, Added Fat, and Obesity in America

In the last post, we saw that carbohydrate and particularly sugar intake have been declining in the US since 1999, even as our obesity rate has continued to climb.

In this post, let's look at another putative driver of obesity: our fat intake, and especially our intake of added fats like seed oils, butter, and olive oil. Like the graphs in the last post, the data underlying the following graphs come from USDA food disappearance records (not self-reported), and NHANES survey data (1, 2). Also like the last post, the graph of total fat intake is not adjusted for waste (non-eaten food), while the graph of added fat intake is*. As a consequence, the figures for total carbohydrate and total fat intake are higher than actual intakes, but still good for illustrating trends.

Here we go. First, total fat:
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Monday, 16 November 2015

Carbohydrate, Sugar, and Obesity in America

We like explanations that are simple, easy to understand, and explain everything. One example of this is the idea that eating carbohydrate, or sugar, is the primary cause of obesity. This lets us point our finger at something concrete and change our behavior accordingly. And it's true enough that it has practical value. But the world around us often turns out to be more complex than we'd like it to be.

The CDC recently released its latest data on the prevalence of obesity in the US, spanning the years 2013-2014 (1). These data come from its periodic National Health and Nutrition Examination Surveys (NHANES). Contrary to what many of us had hoped for after a slight decline in obesity in the last survey, the prevalence has once again increased. Today, roughly 38 percent of US adults have obesity. As a nation, we're continuing to gain fat, which is extremely concerning.

I decided to examine the relationship between obesity prevalence and our intake of carbohydrate and sugar over the years. The food intake data come from the USDA's Economic Research Service (2). For some reason, the data on carbohydrate don't extend beyond 2010. This probably relates to funding cuts at the USDA*.

Let's have a look at the data for carbohydrate:

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Friday, 30 October 2015

Food Reward Friday

This week's lucky "winner"... the Reese's PBC Burger!!
Image credit: The Works

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Monday, 26 October 2015

Do Processed and Red Meat Cause Cancer?

Today, the World Health Organization's International Agency for Research on Cancer published a statement in The Lancet detailing its position on the carcinogenicity of processed and red meat (1). The statement, resulting from a meeting of 22 scientists from 10 countries, concluded that processed meat is a group 1 carcinogen, meaning that it is "definitely carcinogenic to humans". They also judged that red meat is a group 2A carcinogen, meaning that it probably causes cancer but the evidence isn't as strong. They're mostly referring to the links between processed and red meat and digestive tract cancer, particularly cancers of the colon and rectum.

These statements were met with a media frenzy, and the expected furor from the meat industry. The most surprising thing, for me, is that anyone would be surprised by the IARC's statement.

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Friday, 16 October 2015

Why Do Girls and Boys Reach Puberty Younger Than They Used To?

Girls, and probably boys, are reaching puberty years younger than they did in our great-grandparents' generation. Why? There's no shortage of explanations, but the primary reason is probably quite simple.

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Thursday, 8 October 2015

Will You Fill Out This Paleo Diet Survey?

This week, I received an e-mail from a graduate student at Humboldt State University named May Pati�o.  She asked me to share her online research survey targeted to Paleo dieters.  Here are the goals of her research, in her words:
The main objective of my study is exploring how the Paleo diet is being implemented in practice.  I would like to assess the health outcomes of these practices, as well evaluate how closely they conform to, or deviate from ways this diet is being described in theoretical literature, and implemented in controlled diet trials. I also want to be able to use the data collected to help explain what is driving the popularity of the ancestral health movement. Ultimately, I would like this information to be used to better inform protocols for controlled diet trails.
The survey took me about 40 minutes to complete.  You're welcome to participate whether or not you're on the Paleo diet.  Please consider taking the survey, for the love of science!

Research Survey: The Paleo Diet in the US
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Monday, 5 October 2015

That Time I Ate Most of a Large Pizza in One Sitting

Two weeks ago, I had a brush with Extreme Eating. My experience illustrates some important principles of how the brain regulates appetite and body fatness-- and how it reacts to calorie-dense, highly rewarding foods.


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Tuesday, 15 September 2015

Out for Two Weeks

I'll be out of town with limited internet until September 27th.  Feel free to leave comments, but I won't be able to moderate them until I return.  Sorry for the inconvenience!
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Friday, 11 September 2015

The Global Finance University: The Future of the End?

As a member of the UC Investment Advisory Group for the last several years, I have tried to push for socially responsible investing and have had little luck, but September 9th marked a new day.  Out of nowhere, the Chief Investment Officer mentioned that the university was no longer invested in coal and guns.  After I pushed him on what this meant, one of the other members seemed quite bothered, and he wanted to be assured that the university is making investment decisions based on economics and not morality.  The CIO assured him that the move away from coal and guns made economic sense, but still the university was now pursuing a sustainable investment strategy.

Some have called Harvard a Hedge Fund with a school attached, because it has over $36 billion in its endowment, but the UC holds over $100 billion in its retirement funds, endowments, and working capital funds.  This large amount of money can be used for good, or it can be used for darker purposes, but one thing for sure, it makes the university an important global finance player.  Of course, we should all ask what it means when a public university enters global finance.

On my pessimistic days, I remember being lectured by fellow members about the need to focus on returns and not trying to make any social statements by our investment choices.  The argument here appears to be that capitalism is essentially amoral, and so we must think and act in an amoral way.  When you extend this logic to the university itself, a public institution with a public mission is driven by an anti-public ideology.  Moreover, as finance has become globalized and its power and valuations exceed the traditional productive and consumer economies, we must realize that we have entered a new stage of capitalism and social organization.  In this era of multinational corporations and central banks circulating trillions of dollars of credit, we have to understand that the old world of democratic institutions and nation-states is being eclipsed. 

A glimmer of hope emerged for me at the last investment meeting because the CIO was making the argument that we can earn a high rate of return and do good at the same time.  Of course, this combination of profit and moral advancement can be a smokescreen to hide naked greed, but it is possible for people to take advantage of this new rhetoric of socially responsible investing.  In other words, as our economies become globalized and integrated into a financialized market, we can steer the circulation of capital in a positive direction. 

In perhaps one of the most surprising conversations I have ever heard at a UC investment meeting, Regent Makarechian started to drill the CIO about the relation between investing and human rights.  I believe the regent even asked if we are investing in companies with good labor conditions. It was clear that the group was pretty uncomfortable with the discussion, but I see this moment as an opportunity. 

Clearly, individual nations cannot deal with global climate change, tax evasion, international labor standards, migration, or terrorism on their own.  Moreover, our democratic institutions are being transcended by multinational corporations, global elites, undemocratic central banks, and the World Trade Organization.  Is it possible that our only hope is a shareholders revolution where huge pension and sovereign wealth funds transform amoral capitalism into socially responsible investing?

  



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Wednesday, 2 September 2015

Myths about College Degrees and the Job Economy

John Cassidy�s New Yorker article �The College Calculus: What�s the real value of a collegeeducation� does a good job at revealing many of the popular myths currently circulating around the country concerning college degrees, jobs, and inequality. Drawing from Claudia Goldin and Lawrence Katz 2008 book The Race Between Education and Technology, he examines the logic behind the idea that we are failing to produce enough high-skilled workers with college degrees to keep up with technological progress.  As Goldin and Katz have argued: �Not so long ago, the American economy grew rapidly and wages grew in tandem, with education playing a large, positive role in both. The challenge now is to revitalize education-based mobility.� The problem with this theory linking education to technology and social mobility is that it is false and misleading.

As Lawrence Mishel has stressed, since the mid-1970s, we have seen a constant separation between wages and productivity.  The following graph shows that as workers using new technologies produce more goods and profits, their wages have remained relatively flat:

(click on image to enlarge)

Thus as education levels and technological advances have increased since 1970, the profits generated from these activities have not been shared with the average worker.  The problem then is not a question of education or skills or even technology, the issue is how profits are distributed. 

In an act of great ideological deception, business leaders and politicians have been able to turn our attention to higher education as the solution to wage stabnation because they do not want us to look at some of the real causes, like profit hording, de-unionization, financial speculation, executive pay, regressive taxation, and outsourcing.  Cassidy points out that in place of dealing with these real economic issues, we are told that America has a fair meritocracy, and the key to economic advancement for individuals and the country as a whole is to produce more people with college degrees.

The myth of the meritocracy is an effective ideological tool because it tells us that if someone does not have a good job, it is their own fault.  After all, we have a fair system of equal opportunity, which provides everyone the chance for social mobility.  The reality of the situation is that our economic system is enhancing inequality and higher education is making things worse.  Looking at the relation between family income and college attainment since 1970, we see that people in the top quartile income bracket who enter college have increased their degree attainment from 55% to 99%, while people from the bottom bracket have moved from 22% to 21% during the same forty-three-year period: 

Therefore after trillions of dollars spent on financial aid and student loans, the people in the bottom 50% have seen virtually no gain in degree attainment, while the people at the top have experienced a massive growing advantage.

One reason why our meritocracy does not work in higher education is that many admissions decisions are based on SAT scores, and SAT scores are highly correlated with wealth.  The following chart reveals this tight connection between parental income and SAT scores:

Since many college ranking systems like The US News & World Report rely heavily on SAT scores, universities and colleges who want to move up the ladder or maintain their high position have a huge incentive to only accept high scoring students, and this means for the most part, wealthy students.  In fact, in order to both enhance their revenue and increase their status, these institutions, including selective public universities, have increasingly replaced need-based aid with merit aid, and once again merit is often defined by SAT scores:
Public universities are therefore competing with each other for wealthy students by replacing low-income students who need financial aid with wealthy students who do not need aid but get it anyway.  

As higher education continues to reward wealthy students with admissions to selective institutions, low-income students are mostly attending low-funded community colleges with low graduation rates.  This system turns the meritocracy back into an aristocracy as the wealthy are able to use higher education as a way of further enhancing their positions of social power.  Meanwhile, lower- and middle class families are putting themselves into debt in order to compete in a rigged game.  In fact, the following chart shows that lower-income students are holding most of the student debt:
According to this chart, 58% of all student debt is owned by people whose household net worth is in the bottom 25%, and we should remember that this is also the same group with the lowest graduation rates and the lowest prospects of gaining a high-paying job.

Promoters of higher education as the solution to our economic inequality argue that it is still worth it for everyone to go to college because on average, people with a college degree make so much more money than people without a degree.  To examine this claim, we can look at the following graph:

Since 1980, the gap between people with bachelor degrees and people without these degrees has gone up, but 65% of the difference is due to the decreased in median wages for people without college degrees.  The real reason for most of the college wage premium can thus be explained by outsourcing, globalization, automation, and de-unionization; in short, there are very few middle-class jobs available to someone without a college degree, but this has little to do with education; rather, in the global race to the bottom, employers have simply sought to increase profits by decreasing labor costs. 

Returning to Cassidy�s New Yorker article, what is so striking is that he continues to argue that we really do not know why workers are not making more or why college is not leading to higher wages:  If higher education serves primarily as a sorting mechanism, that might help explain another disturbing development: the tendency of many college graduates to take jobs that don�t require college degrees. Practically everyone seems to know a well-educated young person who is working in a bar or a mundane clerical job, because he or she can�t find anything better. Doubtless, the Great Recession and its aftermath are partly to blame. But something deeper, and more lasting, also seems to be happening.� Although Cassidy makes it seem like it is a giant mystery why there are not enough well-paying jobs for college graduates, we know the answer concerns a set of governmental policies and employer practices that drive down wages and benefits for everyone but the people at the top.

Some economists argue that companies simply have to decrease wages and employment opportunities in order to survive in an increasingly competitive global market.  However, we also know that US companies are currently sitting on trillions of dollars of reserves, and they are using hundreds of billions of dollars of profits each year to buy back their own stocks in order drive up their company valuations and increase executive bonuses:
This practice of hording profits and then using it to increase executive compensation has helped to drive the stock market up as most workers see little if any wage gains.  Once again, having more people with a college degree will not change this situation.

As many of us now know, 10% of Americans hold over 50% of the wealth, but what most people do not know is that up to 80% of all wealth is either directly or indirectly due to inheritance.  As Thomas Piketty has argued, one reason then for the lack of social mobility and the increase in inequality is the way we allow the wealthiest families to retain and enhance their advantages.  To highlight this issue, we can look at the top tax rates since 1913 and compare it to income inequality during the same time period:
Clearly, we can associate high levels of taxation for top earners with increased inome equality, and so tax policy, and not higher education, plays a huge role in increasing social mobility and decreasing inequality.

Of course, the wealthy have used their financial advantages to not only game higher education but also the political system, which helps to enhance wealth through tax policies and anti-labor practices.  Yet, even with all of the ample evidence that most of the wealth and wage inequality is being driven by corporate hording and governmental policies favoring the super-rich, Cassidy continues to argue that we really do not know what is going on: �Why is this happening? The short answer is that nobody knows for sure. One theory is that corporate cost-cutting, having thinned the ranks of workers on the factory floor and in routine office jobs, is now targeting supervisors, managers, and other highly educated people. Another theory is that technological progress, after favoring highly educated workers for a long time, is now turning on them.� Here we see how the focus on technology and education blinds us from seeing how human greed is driving the exploitation of labor, and without any counter-force, like strong unions, governmental regulations, and progressive tax policies, there is nothing to stop the concentration of wealth at the top.  


Instead of hoping that higher education should be the solution to all of our economic problems, we should follow Cassidy�s advice and return to the notion that college is a public good and an end in itself: �Being more realistic about the role that college degrees play would help families and politicians make better choices. It could also help us appreciate the actual merits of a traditional broad-based education, often called a liberal-arts education, rather than trying to reduce everything to an economic cost-benefit analysis.� If we focus on making higher education more accessible and affordable as we enhance its quality, we can at least make sure that it does not enhance inequality and decrease social mobility.  The first step is to stop believing that college degrees produce good jobs. 
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Wednesday, 26 August 2015

How Much Does Sugar Contribute to Obesity?

Last week, the British Medical Journal published a review article titled "Dietary Sugars and Body Weight", concluding that "free sugars" and sugar-sweetened beverages contribute to weight gain. But what are "free sugars", and why does the scientific literature suggest that the relationship between sugar intake and body weight isn't as straightforward as it may initially appear?




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Tuesday, 18 August 2015

More Thoughts on the Recent Low-fat vs. Low-carb Metabolic Ward Study

The recent low-carb vs. low-fat study has provoked criticism from parts of the diet-health community. Let's examine these objections and see how they hold up to scientific scrutiny.
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Thursday, 13 August 2015

A New Human Trial Undermines the Carbohydrate-insulin Hypothesis of Obesity, Again

The carbohydrate-insulin hypothesis of obesity states that carbohydrates (particularly refined carbohydrates and sugar) are the primary cause of obesity due to their ability to increase circulating insulin, and that the solution to obesity is to restrict carbohydrate intake. Numerous studies have tested this hypothesis, more or less directly, in animals and humans. Despite the fact that many of these studies undermine the hypothesis, it remains extremely popular, both in the popular media and to a lesser extent among researchers. A new human trial by Kevin Hall's research team at the US National Institutes of Health offers very strong evidence that the carbohydrate-insulin hypothesis of obesity is incorrect. At the same time, it offers surprising and provocative results that challenge prevailing ideas about diet and weight loss.



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Saturday, 25 July 2015

Refined Sugar Worsens Blood Lipid Markers of Cardiovascular Disease

Blood lipids such as LDL and HDL cholesterol are markers of the biological processes that impact cardiovascular disease, and they are commonly measured to assess cardiovascular risk. When we think about the impact of food on blood lipids, dietary fat typically comes to mind. Yet a new study shows that dietary carbohydrate, specifically high-fructose corn syrup, can have a large impact on blood lipid markers of cardiovascular disease risk.

Introduction

Dietary fats have well-established impacts on blood lipids. For example, in short-term feeding trials, saturated fat tends to increase total cholesterol, increase LDL ("bad") cholesterol, and increase HDL ("good") cholesterol, while the omega-6 polyunsaturated fat linoleic acid decreases total cholesterol and decreases LDL cholesterol. For this reason, dietary advice to reduce cardiovascular risk tends to focus on dietary fat.

The hypothesis that refined dietary sugar is harmful to the cardiovascular system isn't new. In 1972, British physiologist and nutrition researcher John Yudkin published a classic book called Pure, White, and Deadly, which argued, among other things, that refined sugar is harmful to the cardiovascular system. Yet at the time, the supporting data were weak, and the hypothesis was never taken very seriously by the scientific community.

Peter Havel and his group at UC Davis have begun to breathe new life into this hypothesis with their rigorous work on the cardiovascular effects of dietary sugars.
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Thursday, 9 July 2015

A University Divided: Separate and Unequal

Although we do not have information on how many students have accepted UC offers of admissions for 2015-16, we do know that there has been another large increase (2,453) in non-resident student acceptances and a decrease in students from California (down 1,039).  We also know that extra tuition for non-resident students will go up 5% to $24,700 per student, while in-state tuition will remain at $12,192.  This increased incentive to enroll non-resident students has resulted in the following admissions figures: 45 percent of offers at UC Berkeley went to out-of-state and internationalstudents; the figure was 42 percent at UCLA, 39 percent at UC San Diego and 35percent at UC Davis.� In other words, these campuses stand to take in a huge amount of extra funds.  For instance, if a campus enrolls 1,000 non-resident students for four years, the increased funding is $100 million.  It is no wonder that UC has rejected the legislature�s offer of $25 million if the entire UC system increases enrollments for Californian students by 5,000.  Instead of getting an extra $5,000 per resident student, the UC can get an extra $24,700 per non-resident student. 

Of course this whole logic means that money has become the main value, and many students from California will end up paying more to go to public schools in other states or to expensive private universities.  Moreover, the rush for non-resident student revenue will enhance the inequity of the system so that the campuses with the highest number of underrepresented students (UCR, Merced, UCSB, UCSC) will continue to receive the lowest level of revenue, and the campuses with the highest number of wealthy students will receive the most funding.  As I have previously reported, last year�s admissions enhanced the inequity among the campuses:


This chart tells us that campuses that received higher funding in the past (see the last column) built up their reputations and now can cash in on non-resident student revenue (NRT) (the second column). Moreover, the extra NRT funds on one campus do not help the students on other campuses, and the amount of financial aid for non-resident students ($32 million last year) is almost as much as the total amount of rebenching ($37 million last year). 

As the state auditor pointed out in 2011, the campuses receiving the lowest level of per student funding were also the campuses with the highest number of underrepresented minority students.  The chart below lists the percentage of undergraduate underrepresented minority students and Pell grant students for each campus in 2014-15:

                           Underrepresented           Pell
UCB
16
27
UCD
19
37
UCI
22
48
UCLA
21
31
UCR
41
56
UCSD
17
30
UCSB
27
41
UCSC
30
51
Merced
47
63
















Thus, while 16% of undergrads at Berkeley were underrepresented minority students this year, Riverside had 41%, and while Berkeley took in over $40 million in extra non-resident student tuition revenue, Riverside only brought in $7.5 million.  Furthermore, 31% of undergrads at UCLA are Pell grant eligible, but 51% at UCSC fall into this low-income category, and yet UCLA brought in an additional $41 million in non-resident student tuition, while UCSC brought in $19 million.  These statistics clearly show that UC has a separate and unequal funding model based on race and class, and this situation only promises to get worse next year. 

When the state auditor pointed out the racial component of the campus funding imbalance in 2011, President Yudof wrote that, �There is absolutely no basis � statistically, historically, or ethically � for drawing such a connection. Furthermore, the BSA makes no investigation into or observation of disproportionate or inequitable treatment or outcomes for students at different campuses� (p. 81).  However, after making this statement, the UC then later admitted that the correlation between funding and race may have been the unintended result of an ad hoc funding process, and yet, nothing has changed and things are only getting worse.  The UC can no longer plead ignorance and must find a way to share NRT revenue among the campuses. 

  


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