Friday, July 29, 2016

Lessons from Theranos: Why We Need Scientists and Skepticism

If you've been following the story of Theranos (as I have) you might find this "Viewpoint" piece by Dr. John Ioannidis interesting. It's published in this week's Journal of the American Medical Association and it's revealing. Here is my take: 


  • There were scientists and journalists who were wisely skeptical. They did their due diligence instead of leaping onto the runaway Theranos bandwagon. They raised red flags early on. However, few people picked up that part of the story.
  • Scientists are the ones who should be doing the science. Everybody loves a good "college dropout gets rich with big idea" story. But these folks are often entrepreneurs - like Steve Jobs, Bill Gates and of course, Elizabeth Holmes. Sadly, in Holmes' case, she and many of the people who flocked to her were not scientists. Her big idea of using a finger prick's worth of blood on which to run big bunches of lab tests needed scientists to develop and test the technology. Scientists need to go to school to learn to be scientists. And scientific data needs to be published in established medical journals and tested to see if it can be repeated. The process is slow and deliberate - not exactly the stuff of flashy, attention-grabbing headlines.
  • This is classic cart-before-the horse, sensationalized health reporting. It happens way too much and it needs to stop. The only people who can really stop it are good health and medical journalists who are able to combine healthy skepticism, the right sleuthing skills, and an understanding of how science works.
  • Dr. Ioannidis is an unsung hero in this story. His skeptical, sciency brain was able to quell the pull of the Silicon valley spotlight that hijacked so many journalists, politicians, and businessmen. He questions whether we even need more available testing when the bigger problem in medicine right now may be unnecessary testing.
But read the piece yourself - because it teaches us all something about to think. 

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Monday, July 25, 2016

Eat Vegetables, Be Happy?

A New Study Suggests a Link Between Increasing Fruits & Vegetables and Higher Life-Satisfaction Points 

A lower risk of heart disease or some types of cancer 20 years from now may not motivate you to eat more fruits and vegetables. Sure, improved health and a lower chance of getting a chronic disease should inspire us to eat healthy. But for most of us, they don’t. But what if eating more fruits and vegetables actually made you feel happier? Now, before you get too excited, the study I’m going to tell you about cannot show cause and effect. But, it does suggest that eating more fruits and vegetables could improve your life satisfaction.

Researchers in Australia analyzed the food records of over 12,000 adults in 2007, 2009, and 2013. They also measured their life satisfaction during those same years. People who increased their servings of fruits and vegetables from zero to eight a day reported higher life-satisfaction scores. The increase in their scores was equal to how you would feel if you found a new job. People who did not eat more fruits and vegetables reported a decrease in life satisfaction. The researchers controlled for the participants’ income levels and personal circumstances.

So will eating more fruits and vegetables make you happier?
·         This study cannot show that eating more fruits and vegetables actually makes you happier.
·         It does show that there could be some sort of link between the two. But remember, the people who increased happiness ate a lot more fruits and vegetables. It was a huge increase.
·         There could have been other things in their lives that explained their increased happiness.

But don’t let that stop you from eating more fruits and vegetables. It could be that as we start to take better care of ourselves, we improve our outlook on life! We definitely need more data on this topic. But don’t let that stop you from pursuing happiness and health through better eating!

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Source: 

Redzo Mujcic and Andrew J.Oswald.  Evolution of Well-Being and Happiness After Increases in Consumptionof Fruit and Vegetables. American Journal of Public Health: August 2016, Vol. 106, No. 8, pp. 1504-1510.doi: 10.2105/AJPH.2016.303260

Monday, July 11, 2016

Hyped Up Headlines: Eat Pasta! Lose Weight!

Here's what one of many headlines read last week: "Pasta Helps You Lose Weight, Study Reveals". I really want to love this headline. I really want to believe this headline. But this, and many, many other news outlets got this study so, so wrong. In full disclosure, I love pasta. I eat pasta - several times a week. I have an Italian-American mother and between her and my grandparents, we got fed a lot of pasta growing up. My grandfather used to say "A day without spaghetti is like a day without sunshine". 

But, as much as I want to, I can't love these headlines, because they have totally mangled the results of this study. The study is a "cross-sectional observational study". It used two different sets of data. In one study, researchers used a method called a "24-Hour Recall" to gather information about how people ate. This method sounds just like what it is: "What did you eat yesterday". So the researchers basically looked at how much pasta the study participants ate on one day and then looked at their body mass index (a measure of weight for height). Studies that asked people what they ate are prone to bad information because most of us aren't very good at remembering what and how much we ate. And one day of what you ate? Well, you can see how flawed that data is. 

And then we have the observational nature of the study. These types of studies are very limited in what they tell us. These studies cannot, I repeat CANNOT, show cause and effect. All they show is correlations or associations. Even if this data had been better, it still could not have shown that eating pasta caused lower body weights. Eating pasta could just be an innocent bystander and it was really something else that the pasta-eaters were doing that made their body weights lower. 

So, here's my take on pasta. If you eat too much pasta, it could pack on some pounds. If you eat pasta within the number of calories you need, you probably won't gain weight. Maybe there is something about pasta that helps keep weight lower. But this study does not tell us that. 

And yes, that is Audrey Hepburn eating pasta. 

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham 

Friday, May 20, 2016

What's Wrong with this New York Times Headline?

I recently came across this headline from an article published in the health section of the New York Times a few months ago: Which Type of Exercise Is Best for the Brain? My interest was piqued. Below the headline there were pictures of people lifting weights and sprinting. "Oh goody! I'm going to find out where I should be focusing my workouts so I will maintain my brain power" I thought. But the first sentence dashed my hopes into a million little neurons:  "Some forms of exercise may be much more effective than others at bulking up the brain, according to a remarkable new study in rats."  In rats belonged in the headline, although, at least it was in the first sentence. Many journalists don't reveal that the study they're dazzling their readers with was with animals until several paragraphs in. This article belonged in the science section, not the health section.

So, let's review why animal studies often don't translate to humans: Humans aren't giant rodents! The journalist did describe, in excellent detail, how the researchers attempted to mimic human activity in the study: little rodents climbed walls with teeny tiny weights attached to their tails or trotted on miniature treadmills. So maybe the next time I go to the gym, I should attempt the climbing wall that terrifies me with a weight attached to my yoga pants? Luckily for me, the moderate running on the treadmill turned out to be best for increasing the number of brain cells (in rats). But did the rats remember where they put their car keys?

The journalist does clearly point all of this out towards the end of the article but by that time you're ready to give up your weight training to run like a rat on the treadmill.

Could this study eventually be confirmed in humans? Sure. And I hope it is. But for now, I'm not giving up my weight training or my running - but I am staying away from the climbing wall. 

Beth Kitchin, PhD, RDN
Assistant Professor of Nutrition Sciences
University of Alabama at Birmingham




Monday, January 4, 2016

8 Reasons Your Resolutions Are Doomed to Fail

Resolutions are really nothing more than goals. And the way you set your goals can have a big effect on whether or not you achieve them. At this time of year, many people set health goals like losing weight or exercising. But I’m guessing no one ever taught you how to set goals the right way, so your resolutions will likely fail. Here’s why:

1.    You didn’t make your resolutions actions/behavior oriented. If weight loss was your “goal”, then you are doomed to fail. “I will lose weight” or “I will lose 20 pounds” are not actions. You can’t “do” an outcome – you can “do” behaviors. Setting behavioral goals such as “I will switch to diet soda or water instead of drinking regular sodas” or “I will keep a food record and track my calories” are behaviors that will lead to weight loss. Don’t resolve to “lose weight” but resolve to cut back on snacks, eat more fruits and vegetables, eat breakfast, reduce portion sizes. Or, sign up for an exercise or weight loss class.  These actions will help you achieve the outcome – weight loss – that you want.
2.    You Set the Bar Way Too High. Not being realistic about your resolution sets you up for failure. Don’t resolve to run 5 miles every day, 7 days a week. Set goals that you really, honestly feel you can achieve. It can be as small as walking 5 minutes a day or adding in one extra piece of fruit every day. After you achieve that goal, set newer, higher goals. Take baby steps so that you can feel good about your achievements and stay motivated.
3.    You didn’t make a plan and write it down. If you don’t put it on paper (or an app) you’re less likely to follow through. Charting your progress on your plan will help you stay on track.
4.    You Weren’t Specific Enough.  “I will exercise more” sounds great but what does it mean? The more specific you are, the more likely you are to follow through. “I am going to walk for 20 minutes after work on Tuesday, Thursday and Saturday morning” is much more specific and tells you exactly what you are going to do.
5.    You Weren’t Flexible. What if rains and you can’t walk after work on Tuesday? Will you go to the gym? Do you have a workout DVD that you can use inside? Having a backup plan makes is a key to resolution success.
6.    You didn’t reward yourself. No, just the joy of achieving your goal is not enough. We are humans and humans like stuff.  You need to reward yourself with something meaningful. It may be as simple as a bubble bath, binge watching Downton Abbey, or a lunch date with a special friend.
7.    You Didn’t Ask for Help. For some of us, going it alone goes just fine. But sometimes, you need to recruit some help. Chances are you’ve got friends and family members who have the same goals you do. For instance, make walking dates with friends. There is strength – and support – in numbers. You may need to seek professional help – especially if you are trying to quit smoking or lower your cholesterol. Seek the right professional to help you.
8.    You’re Unforgiving. If you are too hard on yourself when you don’t reach your goal, your motivation will bottom out. You should constantly reevaluate and re-set your goals and keep at it.

Well-constructed goals can stack the odds in favor of actually achieving your New Year’s resolution. So go forth and set some realistic, flexible behavioral goals and make it happen!

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham
Follow me on Twitter: @DrBethK

Tuesday, November 24, 2015

The Best Cranberry Recipe Ever!

Welcome to the greatest cranberry recipe ever. I made this for my family last Christmas and everybody loved it - even my 7 year old nephew. I've been making it for my own Thanksgiving dinners for years. One of the things I love most about it is how easy and "unmessy" it is. The most work-intensive part is chopping up the pears. I also love that you don't put the cranberries through a food mill - so it stays chunky and you keep the skins - where a lot of the nutrition lies. I love to eat this leftover for days after Thanksgiving. I treat it like dessert since I am not a fan of pumpkin pie. I cut the sugar to about 3/4 cup - a whole cup is a little too sweet for me. But if you like it sweeter, keep it in. Don't try to cut the sugar too much. Cranberries are very bitter on their own and need a lot of sugar! I skip the last two steps - the canning part - and just put it in the fridge and eat it for many days after the holiday meal!

Pear Cranberry Compote


Recipe type: PreservesSource: Allrecipes.com
Author: Marisa 
Prep time: 20 mins
Cook time: 1 hour 30 mins
Total time: 1 hour 50 mins
Serves/Yield: 2 pints

If you're planning your Thanksgiving menu already, this pear cranberry compote would complement the turkey quite nicely. Just skip the canning process and store jars in the refrigerator for up to ten days.
Ingredients
  • 3 pounds thin-skinned pears
  • 1 pint cranberries (approximately 8 ounces)
  • 1/4 cup orange juice
  • 1 cup sugar
  • 1 teaspoon cinnamon
  • 1/4 teaspoon freshly grated nutmeg
Instructions
  1. Chop pears into small pieces. Place in a heavy-bottomed, non-reactive pot. Add cranberries and orange juice.
  2. Put a lid on the pot and place it over low heat. Cook until the pears are very, very soft and the cranberries have popped, about 1 hour.
  3. When the pears are soft, use a potato masher to break the fruit. Add the sugar, cinnamon and nutmeg and stir to combine.
  4. Raise temperature to medium-high heat and simmer, stirring constantly for 5-7 minutes, to help evaporate the liquid in the compote. When it has darkened in color and no longer looks watery, it is done.
  5. Funnel compote into prepared pint jars and process in a boiling water for 20 minutes. Be sure to read our post on Canning Basics if you have any questions.
  6. When time is up, place jars on a folded kitchen towel to cool. Once jars are cool, check seals and store in a cool, dark place.




 Enjoy the cranberries and have a Happy Thanksgiving! 


Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham

Monday, May 25, 2015

New Study: Nutrition Therapy Can Lower Your Chances of Getting Type 2 Diabetes! Are You at Risk?


Get out your pencil and a piece of paper for the Diabetes Risk Test! Why? A new study shows that people who are at risk for type 2 diabetes can lower that risk by getting medical nutrition therapy from a registered dietitian. The researchers looked randomly put 76 overweight or obese adults with moderately high blood sugar in the “usual care” group or in the nutrition therapy group. The usual care group was told to exercise and eat healthy. The nutrition therapy group got one-on-one nutrition counseling. After 12 weeks, the usual care group’s blood sugar went up. The group who got nutrition counseling saw their blood sugar go down.
Why is this study important? Your insurance may not cover a meeting with a dietitian until you actually get diabetes. Studies like this show the importance of medical nutrition therapy before you get diabetes - at the pre-diabetic stage. 

So, how to you know you are at risk? Take this test on www.diabetes.org


Know Your Risk: 


How old are you?

Less than 40 years (0 points)
40—49 years (1 point)
50—59 years (2 points)
60 years or older (3 points)

Are you a man or a woman?

Man (1 point) Woman (0 points)

If you are a woman, have you ever been diagnosed with gestational diabetes?
Yes (1 point) No (0 points)

Do you have a mother, father, sister, or
brother with diabetes?
Yes (1 point) No (0 points)

Have you ever been diagnosed with high blood pressure?
Yes (1 point) No (0 points)

Are you physically active?
Yes (0 points) No (1 point)

What is your weight status? (Use this Table)















































As you can see, being overweight, having a family history, not being physically active, and having high blood pressure are all things that can increase your chances of getting diabetes.

If you scored a 5 or higher, you should talk to your doctor about getting a blood sugar test to see if you have pre-diabetes or diabetes. Your doctor can refer you to a registered dietitian! You can also find a dietitian in your area at eatright.org.

Beth Kitchin, PhD, RDN
Assistant Professor, Nutrition Sciences
University of Alabama at Birmingham


Reference: Parker A, et al. Abstract #1209. Presented at: Presented at: AACE 24th Annual Scientific & Clinical Congress; May 13-17, 2015; Nashville, Tenn.