Team McCallum

R&D for Lifetime of Life

Udiet: the battlefield.

2010 was stuffed with debate over the reasons why people in developed countries are getting heavier.

 The most simplistic explanations focussed on overeating, or inactivity, or both. HFCS (high fructose corn syrup) also came in for a beating. The problem with this is that Europe imports very little HFCS, but countries in Europe are reporting more and more problems associated with obesity.

 www.obesitymyths.com comes up with a much larger range of interesting possibilities. But in 2005, the New York Times linked this site to sponsorship from fast food producers such as Coca-Cola and McDonald’s, in this article.

Two reputable groups of scientists published work where they found that the mantra of ‘eat less and exercise more’ doesn’t cover all of the potential reasons.

 A government group in the UK called Foresight was asked to predict what will happen there over time, based on best evidence, and building in realistic assumptions. In order to do so, they had to scour published research to identify the drivers of obesity and build a very detailed model of which drivers are most important. Written in simple English, this is probably the best explanation there is of the obesity epidemic.

The full report is available as a free PDF download here. However, at over 160 pages, it won’t be everyone’s cup of tea.

The second group of scientists published a summary of obesity drivers in November 2009. Again, this is available free using this link.

Their findings outline the battlefield for the Udiet.

1. Overeating, particularly re heavily marketed energy dense foods.

2. Underactivity, again with an organisation driver behind it.

3. Infection caused by bacteria and viruses.

4. Epigenetics, whereby prenatal and early postnatal exposure to the environment alters how genes are expressed without changing the genes. For example, babies born very underweight at birth who are incubated and fed rich diets to catch up weight have a higher risk of obesity and associated issues later in life.

5. Increasing maternal age. Animal studies have shown that babies born to older mothers are fatter than those born to younger mothers.

6. BMI breeding effect. Studies have found that those with a body mass index somewhat above average are producing slightly more children, on average, than the rest of the population, causing the population BMI to increase over time.

7. Assortitative mating is taking place. This hypothesis is that those with higher BMI prefer partners of similar kind, and due to the genetic effect, this leads to even heavier children. A wide range of population studies support this idea.

8. Sleep debt is happening, and leads to increased eating, increased fat deposition and lowered activity. Research shows metabolic changes occur to support this, and also leads to higher risk of diabetes and heart disease. For example, one study shows that getting one and a half hours less sleep than ideal over a two week period results in a diabetic-like profile for glucose and insulin.

9. Endocrine disruptors interfere with estrogen and androgen signalling, and have been building up in the human environment for some time.  These have been found to be involved in obesity in animals and in humans.

10. Commonly used medicines are known to contribute to weight gain. These include medicines for diabetes, high blood pressure, steroids, contraceptives, and anti-histamines.

11. Artificial ambient temperature. The hotter your environment, the less energy you burn keeping warm. The UK home went from 13 centigrade in 1970 to 18 centigrade by 2000. US homes went from 18 centigrade in 1923 to nearly 25 centigrade in 1986.

12. Mothers input. The state of the mother’s glucose and insulin handling systems directly affect the number of fat cells and the fat cell content of the baby.

13. Reduction in smoking rate. The scientists considered this so well documented they excluded it from their list.

14. Altered US demographics. A 2006 article along the same lines had found that alterations in the US population were increasing the races which tend toward higher BMI, therefore  increasing the average BMI of the nation.

The aim of the scientists’ report was not to remove the first two reasons from focus, but to show that the battlefield is considerably more complex than simply food and exercise.

These 14 points are not comprehensive. For example, other researchers have found that altering the circadian rhythm, by staying up late in artificial light and not synchronising your body clock to early morning light, is also a risk factor for weight gain. Also, breastfeeding v formula milk wasn’t mentioned, although formula milk is associated with higher risk of obesity.

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January 9, 2011 Posted by | Activity, BMI - body mass index, Breastfeeding, Child Health, CVD - cardiovascular disease, Diabetes, Environment, Epigenetics, Exercise, HFCS - high-fructose corn syrup, High blood pressure, Obesity, Pregnancy, Pregnancy, Success, Thermogenesis, UK, United States, Weight management | Leave a comment

Preventing newborn flu.

Advice on both sides of the Atlantic is that pregnant mothers are an at-risk group that should get the flu vaccine. Now a second study has confirmed that mums-to-be who get the jab pass on the benefits to a second key group. where neither the US or the UK recommends vaccination. New-borns under 6 months have 90% less chance of catching flu if mum had the jab when pregnant.

Dr Marietta Vazquez looked at hospital admissions for flu in babies under 12 months old, from the period 200 to 2009, in Yale-New Haven hospital in north east US. These were each matched carefully with two controls who did not catch influenza.

On this comparison, where mother got inoculated against influenza while pregnant, baby had a 92% less risk of being admitted to hospital with flu. This protection only showed up in those under 6 months.

This finding is in line with an earlier study on the subject. Then, testing babies’ blood for antibodies showed better levels for those whose mother was vaccinated, at birth and at 3 months, while at 6 months the levels were similar to babies of non-inoculated mothers.

The US recommends inoculation of babies from the age of 6 months on. The UK does not.

December 21, 2010 Posted by | Influenza, Pregnancy, Success, UK, United States, Vaccine | Leave a comment

Drugs v society.

Prof David Nutt has published a report in the Lancet that looks at the top 20 drugs (legal and illegal) and ranks them on the basis of the harm they cause in the UK on a society wide basis. Using this approach, and given that alcohol is legal and widely consumed, alcohol is rated the most damaging, more so than any illegal drug, including heroin, crack and crystal meth. On this basis, tobacco does not make it into the top 5.

Prof Nutt was head of the Advisory Council on the Misuse of Drugs, a statutory body required by law to provide scientific evidence to the government about the dangers posed by drugs, in order that they can be classified into category A (the most harmful) to category C (the least harmful). Prof Nutt was fired from this position by the Home Secretary after making comments deemed to be political rather than scientific. At this time Prof Nutt established the Independent Scientific Committee on Drugs (ISCD), to continue the work without government interference.

The paper in the Lancet was published on behalf of the ISCD and appears today on the same date as a one-day international conference on the topic of drugs classifications, run jointly by the Lancet and the ISCD.

The ISCD and external experts used the government’s 16 current criteria (9 personal, 7 re impact on society) and ran these through a scoring exercise for the top 20 drugs. What they found was this produces classifications out of step with the category A to C rankings for many of these drugs.

The totals for a given drug considering both personal and society impact could hit a maximum of 100.

On personal harm the top 3 were crack (37), heroin (34) and crystal meth (32). On harm to society the top 3 were alcohol (46), heroin (21) and crack (17). On the combined score (out of 100), the worst 3 were alcohol (72), heroin (55) and crack (54).

The total for tobacco was 27, just one short of cocaine and lagging crystal meth (33).

These totals apply to how the drugs are used in the UK, not elsewhere.  However, the point of the paper was to try to come up with a classification that is evidence-based re whole society impact.

Today’s joint Lancet/ICSD international conference has speakers from the EU, the Netherlands, Portugal and the UK. Having decided alcohol is the worst drug in use in the UK, the conference ends with a drinks reception from 5pm to 7pm for “drinks and canapes”.

November 1, 2010 Posted by | Alcohol, David Nutt, News, Politics, Science, Smoking, UK | Leave a comment

Parents v kids’ grades.

Prof Gianni de Fraja’s work on the role of parents, schools and kids’ academic success has received widespread coverage in the media, with different sources selecting vastly different spins to put on the research.

To understand it clearly, you need to know that the team tested a model of the parent-child-school interaction as something called a Nash equilibrium. Many important real-life situations are analysed this way.

Simplifying greatly, a Nash equilibrium assumes that each party knows the strategy of the others, and with this knowledge in mind puts in place a strategy to get the best for himself/herself. It does not guarantee the best for the players as a whole. It is more like “if you are going to do that, then I going to do this, because that’s best for me in this situation”.

The team compared the effort put in by each of the three parties and looked at the impact the had on the school exams they passed, at standard UK levels (GCE and A level).

They found that, if the difference made by a child exerting more effort alone (with no change from the other two) was counted as 1, then the school (acting alone) was more important at a score of 1.5. However, by far and away, it was the parents who put in effort that made the biggest difference, at a whopping 6 times more than the kids alone.

Part of this impact was directly on the child, through activities such as reading to the child and helping them with their homework. Part of this impact was on the school, by getting involved in things like parents evenings and influencing school policies to getter better teaching.

Middle class parents were much more likely to get involved in this manner than lower class parents. The media angles on this are pure speculation either on their own part or based on the comments of members of the research team, but it was made clear the research team does not have a solid explanation for this. For example, it may be that the lower class are less educated themselves and so less able to carry out those activities that make a difference.

Remember, the basic premise in a Nash equilibrium is that each party is trying to do what is best for them, given the way the others are doing things.

So while schools should be trying to make an effort, as it is more important than just encouraging the kid to try hard, the best route is for parents to get involved a lot, with both the child’s schoolwork and with the school. It’s the parents who have the most influence.

If you want your kid to get good grades, get involved!

October 29, 2010 Posted by | Learning, News, Relationships, Success, UK | Leave a comment

Sugared drinks v diabetes.

Dr Frank B Hu and 5 colleagues in N America have found that sugar-sweetened drinks, even at a low level, are linked to an increased risk of type 2 diabetes and metabolic syndrome. This effect is independent of any impact the sweetened drinks have on weight or on total calorie consumption. Further, it kicks in at levels as low as 1 to 2 standard size drinks per day.

The research team combed medical literature for good quality studies, in order to combine them. They found 8 studies of sugar-sweetened drinks and type 2 diabetes, covering 311,000 people, and 3 studies for metabolic syndrome, covering nearly 20,000 people.

From these they calculated that 1 to 2 sweet drinks per day, compared to less than 1 per month, raised the risk of type 2 diabetes by 26% and metabolic syndrome by 20%. One drink was a standard 12 oz size in the US, which is slightly larger than the 330 ml size in Europe. They found the result was dose-dependent, so more soft drinks increased both risks.

They concluded “In addition to weight gain, higher consumption of sugar-sweetened beverages is associated with development of metabolic syndrome and type 2 diabetes.” 

The full research paper shows that the sweetening component has quite different effects depending on whether it is fructose, glucose or an artificial sweetener. However, in the form of an added sweetener at this magnitude all have undesirable health effects.

The paper also references other research to show that the preferred US sweetener, HFCS (high fructose corn syrup, a 55/45 mix of fructose and glucose) and the standard European sweetener (sucrose, a 50/50 mix of fructose to glucose) both increase the risk of metabolic syndrome and type 2 diabetes through not only weight gain but through other paths. These extra paths include increased dietary glycemic load leading to insulin resistance, beta-cell disruption and inflammation. Further problems are hypertension and an increase in visceral fat (bad fat).

These findings dovetail neatly with recent research that there are good carbs and bad carbs.That report is here.

As soft drinks increase visceral fat, and both increase the risk of type 2 diabetes, this may explain why US adults have larger waist sizes than their UK equivalents, and also twice the rate of diabetes. That report is here.

October 28, 2010 Posted by | Diabetes, Diet, Frank B Hu, Glycemic index, Health, HFCS - high-fructose corn syrup, Metabolic syndrome, Obesity, Soft drinks, Success, Sugar, UK, United States, Waist circumference, Weight management | Leave a comment

Diabetes – US v UK.

Dr James Banks has found that the much higher rate of diabetes in US adults, compared to the UK,  is mainly due to a larger waist circumference for any given body mass index (BMI).

The team examined results from one study of 6,900 adults in England and a second study of 4,600 US adults of European descent.

Conventional risk factors for diabetes differed little between the two groups, yet rates of diabetes are nearly twice as high in the US.

While obesity was higher in US men (32% v 27% of English males), the BMI profile was very similar in women across the 2 nationalities, so BMI alone could not account for the difference.

When BMI was taken out of the equation by comparing people of the same BMI in both nationalities, it was found that the major risk factor was waist circumference, so larger US waists meant more US citizens at risk at each level.

The team used 3 sizes to grade as low risk (94 cm for men, 80 cm for women) medium risk, (up to 101 cm /88 cm respectively) and high risk (above these sizes).

Abdominal fat cells produce more triglycerides and proinflammatory markers than fat cells deposited elsewhere, contributing to higher insulin resistance and diabetes.

The researchers found waist circumference explained around three quarters of the country difference in diabetes rates for women and around 40% of the difference for men.

Even at the normal weight range, 41% of US women had a waist circumference in the high risk range, compared to 9% of English women.

October 10, 2010 Posted by | Diabetes, Gender, Health, Obesity, Success, UK, United States, Weight management | 1 Comment

US health lags further.

Between 1975 and 2005, US spending on health per person per year increased dramatically, producing improvements in the chances of living for a further 15 years for a higher percentage of the population. But other comparable countries of the world increased spending per person less than the US, while at the same time producing bigger gains in health, leaving the US lagging even farther behind.

Professors Peter A Muennig and Sherry A Glied compared the US to 12 other countries and rejected possible reasons for this, including smoking, obesity, traffic fatalities, firearm deaths and racial mix, one by one.

For example, Australia has a very similar smoking and obesity profile. In 1975 Australian spend per person was close to the US spend, whereas in 2005, it was only about half of the US spend. Yet Australia produced much bigger gains and Australians have a much better chance of surviving the next 15 years than US citizens.

The 12 comparison countries were picked on the basis that they were reasonably large and had a national income per person of at 60% of that in the US. The 12 were Australia, Austria, Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland and the UK.

The authors concluded “We speculate that the nature of our health care system—specifically, its reliance on unregulated fee-for-service and specialty care—may explain both the increased spending and the relative deterioration in survival that we observed. If so, meaningful reform may not only save money over the long term, it may also save lives.”

October 8, 2010 Posted by | Aging, Australia, Canada, Germany, Health, Japan, Success, The Netherlands, UK, United States | Leave a comment

The Mediterranean Diet.

The EPIC-PANACEA team has reported that high adherence to a Mediterranean diet helps prevent weight gain and protect against obesity.

EPIC-PANACEA covers 10 European countries (Denmark, France, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden and the United Kingdom) and the study looked at over 370,000 individuals, following them for around 5 years.

A score of 0 to 18 on the Mediterranean diet was calculated based on food consumption at the start of the study, and compared with weight change between start and end.

Those in the 11-18 showed a small average weight loss and were 10% less likely to become overweight or obese than those with low adherence, in the 0-6 range.

The team found that ” The low meat content of the Mediterranean diet seemed to account for most of its positive effect against weight gain.” This is in line with their finding reported earlier this year that high meat consumption  predicted weight gain over the same period.

September 21, 2010 Posted by | Diet, Germany, Mediterranean diet, Obesity, Success, The Netherlands, UK, Weight management | Leave a comment

Scots universally unhealthy.

The link between individual health risk factors and socioeconomic status has been reported before. But Dr David I Conway and team examined the link between multiple risk factors and socioeconomic status, using the 2003 Scottish Health Survey.

The 5 major health risk factors were
– current smokers (cigarettes, cigars, pipe)
– heavy alcohol consumers (over 21 units/week for men, over 14 units/week for women)
– poor diet (less than 5 portions of fruit and vegetables per day)
– overweight/obese (BMI over 25)
– physically inactive (below recommended level of 30 minutes of mederate exercise 5 times per week).

Only 1 person in 40 had a clean sheet – none of the risk factors.

55% had 3 or more risk factors.

The most important determinants for falling into the 20% of people who had 4 or 5 risk factors were low education and living in the most deprived communities.

The Scottish results are similar to those found in a recent survey of England, though there are differences. Alcohol-related deaths in men are about twice as high in Scotland as England.

June 11, 2010 Posted by | Activity, Alcohol, BMI - body mass index, David I Conway, Diet, Exercise, Health, Obesity, Smoking, Success, UK | Leave a comment

Conspiracy theory: Vancouver Heathrow.

After deciding to make changes in the risk of how dangerous the ash from Icelandic volcanos really is, all UK airports were cleared to open roughly one and a half hours ago, at 22:00 local time.

Or were they?

The first flight to land in the UK, a little before the 22:00 clearance, was BA84 from Vancouver to London Heathrow.

How do you get from Canada to London BEFORE the ban gets lifted?

According to our research, the flight time from Vancouver is 9-11 hours. Best estimate 9 hrs 25 min. Plus check in!

So the Canadians knew 10-11-12 hours before we did that the flight ban would be lifted. Wow!

BA84? Could that be British Airways flight 84? Surely not the UK government deciding private enterprise knows best weeks away from an election?

All we can say for sure is – UK airports were opened up for flights from 22:00 – BA84 from Vancouver, Canada, managed to land shortly before the airports were opened.

UPDATE: Please see comment by David, passenger on BA84, who knows the real story!

April 20, 2010 Posted by | Politics, UK | 1 Comment