Athletes have long sought ways to gain even a small edge that can make the difference between getting a medal and finishing in the middle of the pack, like altitude training or even performance-enhancing drugs.
Now British researchers are reporting that something completely legal and much less damaging to the body can dwarf the effects of drugs like EPO or testosterone. What really matters, they say, is whether the time of an event is in sync with an athlete’s body clock.
The most extreme example involves people who naturally go to bed late and wake up late. Even trying as hard as they can, they are as much as 26 percent slower when they sprint in the morning as in the evening. Individuals, like runners or cyclists, and people playing team sports, like soccer or football, would be affected.
“Quite a remarkable finding,” said Carlyle Smith, a circadian rhythm expert and emeritus professor at Trent University in Canada who was not involved in the research.
The results, published Thursday in the journal Current Biology, diverge sharply from those of earlier studies that found that performance peaks in the evening. The lead researcher, Roland Brandstaetter of the University of Birmingham, said the previous research had measured athletes together — those who woke early, those who woke late, and those in between. When Dr. Brandstaetter lumped his athletes together he, too, found that, as a group, they performed best in the evening. It was only when he divided the athletes into groups according to their circadian rhythms that profound differences emerged.
The study was small — the researchers tested 20 competitive field hockey players and 22 competitive squash players six times a day.
The early risers tended to wake up, on average, around 7 a.m. on weekdays and 7:30 on weekends; intermediate risers got up about 8 on weekdays and 9:10 on weekends; and the late risers awoke about 9:30 on weekdays and 11 on weekends. The researchers evaluated their performances with measures involving sprinting tests and, for the squash players, a test of concentration and alertness in which the athletes had to hit a ball into a small area.
The early risers had their peak performances at midday, the intermediate group did best in the afternoon and the late risers did best in the evening. Everyone did the worst at 7 a.m.
Dr. Brandstaetter said some earlier studies had examined as many as 20 athletes while others had as few as six to eight.
But researchers also said that the large differences in performance that the study found needed to be replicated. Dr. Levine said future studies should also involve larger groups of elite athletes and more rigorous performance tests that accurately reflect each athlete’s chosen sports.
Kenneth P. Wright Jr., the director of the sleep and chronobiology lab at the University of Colorado, Boulder, said the findings seemed consistent with what is known about biological clocks. Researchers have long known that an individual’s natural circadian rhythm controls body temperature, heart rate, reaction time and concentration, so it might be expected that individual biological clocks would affect athletic performance.
The good news for athletes is that circadian clocks can be tweaked. Dr. Brandstaetter says he deliberately alters his depending on what he plans to do, adjusting factors like light, activity and meal times. He normally does not get up early or late, but somewhere in between. But he makes himself an early riser for work and becomes a late riser when he is on vacation. He is now working with athletes, doing what he calls “circadian coaching.” The idea is to change the natural biological clocks of those who are naturally late risers when their sporting events — like marathons — start early in the day.
Of course, there is more to athletic performance than physiology, exercise researchers noted. “One of the biggest problems in athletic performance research is that we cannot replicate the highly motivated and competitive situations in the laboratory,” saidHirofumi Tanaka, an exercise researcher at the University of Texas in Austin.
Yet, he adds, “there is no question that circadian rhythms affect sports performance.” That is one reason athletes worry about jet lag, which can disrupt circadian rhythms “and become a performance killer.”
As for coaches and team owners, Dr. Smith said, “It would be handy to know the phenotype of all of your team members. You could predict who would be playing well at various times of day.”
The #1 Habit You Should Have to Lose Weight (It’s Not What You Think!)
A while back, a few of my colleagues and I decided to write down every single fat loss habit we have ever used ourselves or with our clients. In 4 days we had listed 167 of them. That’s a lot. Recently I asked those 50 coaches to look at the list again and pick the one habit you should have to lose fat easily.
And it wasn’t on the list.
To be fair, a habit is sort of nebulously defined. I think we can all agree that a habit is anything you do regularly, but according to the definition we use in psychology, a habit also needs to be done automatically—as in, without really thinking about it. Which is why identifying habits by yourself is so hard. How can you think about the stuff that you don’t have to think about?
Which is probably why we missed this habit. And it’s exactly why this habit is SO important for fat loss.
You see, all habits need a trigger—a little reminder that says, “Hey, you should do this action now.” They also need a reward—a little reminder that what you just did was a good thing. But these are really hard to identify by yourself because they happen below our level of consciousness. It’s really hard to remember new triggers, and it’s hard to remember to reward yourself. Habits are hard. But this is the one habit that makes all the other 167 habits on our list easy. As a result, we decided that The #1 Habit You Should Have to Lose Weight (™) is:
Finding people to share your journey.
Permanent lifestyle changes happen in relationships. Whether they take place with peers, a coach, family, friends, coworkers, the other anonymous people at the meetings, or the other new recruits who joined the Marine Corps with you, new habits happen when people get together and help each other out.
Finding your own triggers are hard. Seeing other people’s is easy. Remembering to tell yourself, “Great job!” is hard. Remembering to tell other people is easy. Figuring out how to work new foods, new activities, and new steps into your own life is hard. Watching and learning from a whole bunch of other people like you who are trying to get to the same place you are is just so much easier! Even my colleagues, habit experts all, needed each others’ help to figure this problem out.
I call this habit, this all-important, #1 habit, “Creating a community of consistency.” And it can be as big a commitment as hiring a coach, or as simple as telling a friend what you’re doing to lose weight or inviting them to join MyFitnessPal. Whatever you can do to share the load of learning, planning, remembering, and rewarding will be one less thing you have to worry about.
Oh, and it doesn’t have to be around a campfire singing kumbaya. Support doesn’t have to fluffy to be effective. In fact, my Marine Master Sergeant at the Berkeley Officer Selection Office taught me more than a thing or two about being consistent, and he sure as hell never sang kumbaya with me.
My legs hurt too. The following might help. from codyapp.com
Yoga Poses to Ease Post-Workout Muscle Soreness
So you killed leg day, but now you can’t even walk to the bathroom without being in pain. Post-workout muscle soreness is both a good thing and a bad thing. It’s a good thing because that indicates that you had a successful, muscle-building workout. Soreness is caused by the micro-tears in the muscles from working really hard. If you are sore, good job! You are building muscle.
Unfortunately, muscle soreness is can also be pretty uncomfortable- even painful- and also quite inconvenient in a lot of situations. If you work out a lot, you are going to be sore all the time, and that’s just no fun.
Here are yoga poses for post-workout muscle soreness. These poses will help ease muscle soreness, as well as increase your mobility & flexibility for your future workouts.
Yoga Poses for Post-Workout Muscle Soreness
Standing Forward Bend
Clasp your hands together behind your back, hinge forward at the hips, let your head hang, and bring your arms overhead. Sway slowly from side to side, letting the weight of your arms stretch your shoulders at different angles.
Standing Side Bend
Stand with your feet together and your arms overhead with your palms together. Keeping your arms straight- or close to straight- lean to the left and right, taking the time to feel your sides open.
Wide Legged Forward Bend Twist
Stand with your feet placed 3-4 feet apart, and hinge your torso forward at the hips. “Roll” your spine down and rest your hands on the floor, letting your neck & head relax. Bring one arm upwards and look up at it, feeling your spine twist and open. Switch arms and repeat.
Standing Forward Bend Stand with your feet together, and bend over, “rolling” your spine down as you reach towards the floor. Let your neck relax and your head hang.
Reclining Bound Angle Pose
Start in an upright (sitting) Bound Angle Pose (the “butterfly” stretch), then roll your spine back until your are laying down. This will stretch your hip flexors (and ladies take note, this pose is also great for relieving menstrual cramps).
Camel Pose (Ustrasana)
Begin on your knees, with your arms at your side, looking straight forward. Slowly draw your arms up over your head, then using one arm at a time, reach your hands behind you to grasp your heels. Make sure your hips are positioned over your knees, then relax your neck and shoulders so your head hangs back and your throat feels “open”.
Start in a high lunge, then slowly lower the back knee down to the floor. Keep your torso to an upright position, and make sure your front knee does not extend forward over your toes.
Lay with your back flat on the ground and legs fully extended. Bring both knees in towards your chest, clasp your hands around your legs, and round your back so your buttocks come slightly off the floor. Attempt to bring your forehead to your knees, then rock slowly from side to side to gently massage your spine.
Two Knee Spinal Twist
Lay with your back on the ground, and your knees bent. Let your knees fall to one side, and look in the opposite direction, with your arms extended to both sides.
Sit with your knees slightly apart and folded underneath your body, then lean forward to rest your forehead on the ground. Rest with your arms by your sides, or increase the stretch by reaching your arms forward.
From a sitting position, roll your spine backwards and down to the floor, and bring your knees into your chest. Place your hands on your lower back for support as you extend your legs upward towards the ceiling. Finally, lay your arms on the floor when you are stable, lower your legs down towards your face, and aim to touch your toes to the floor above your head.
Stand with your feet together, hinge forward at the hips, and bend your knees so that your palms are flat on the floor (if they aren’t already). Shift your weight so that your arms are supporting you as you hop or walk your legs back. Use your hands to push your body back towards your heels until you feel a stretch throughout your back and legs
Side Plank Pose
Starting from either Plank Pose or Downward Dog (whatever you are more comfortable with) shift your weight to one arm, and rotate your body to the side. Engage your core and lift your hips upwards, and extend your free arm overhead.
Lay on your stomach and place your elbows below your shoulders. Prop yourself up on your forearms, taking care to keep your shoulders down and away from your ears.
Lay on your stomach and place your hands flat on the floor beneath your shoulders. Slowly press up with your arms, straightening them only to the a point that is still comfortable for your back. Take care to keep your hips on the ground, and your shoulders away from your ears.
– See more at: http://blog.codyapp.com/yoga-poses-to-ease-post-workout-muscle-soreness/#sthash.sB08A5eQ.dpuf
Gallan told the newspaper that her “secret to a long life has been staying away from men. They’re just more trouble than they’re worth.” She noted that she also “made sure that I got plenty of exercise, eat a nice warm bowl of porridge every morning and have never gotten married.”
With the ever-growing cost of gasoline and groceries $13 bucks won’t buy you much these days. If you are a frequent consumer of the popular coffee houses like my fiancé is then you know that $13 bucks won’t buy you many frappe-latte-grande-triple shot-double the whipped cream- cherry on top coffees either. But, there is something that we can still get for $13 bucks that can carry great value toward the quality of our living. What I am suggesting is to get yourself a foam roller and start doing some self-myofascial release (SMR) as often as possible.
I must admit up until probably the last 18 months I can’t say that I was completely sold on the idea of SMR. I think I knew on some level that I should do it and I should have my athletes and clients do it but, deep down it wasn’t really that important to me. It wasn’t until I read some of the work of Eric Cressey and Mike Robertson and through my CSCS certification that I understood how and why it worked. During the time I spent earning my CSCS certification I learned about the Golgi Tendon Organ (GTO) and the term autogenic inhibition. It wasn’t until after reading the work of Mike Roberts that I understood how these terms and foam rolling was so closely linked. Without getting too scientific, the GTO is located at the muscle-tendon junction and it is responsible for relaying the level of tension in the muscle-tendon pairing. When the tension in a muscle reaches the point in which an injury may occur such as that in a tendon rupture, the GTO steps in and tells some muscle spindles to relax the muscle with tension. This process of reflex relaxation is autogenic inhibition at its finest. When using a foam roller you can simulate muscle tension and in return causes the GTO to relax the muscle.
Regardless of the routine rigors that you put your body through (athletics, bodybuilding, general fitness activities, etc) muscles need to have a balance of strength, resiliency, and pliability. Whereas conventional stretching can help with the length of a muscle, foam rolling and other soft tissue work will address tissue density and the pliability component. With foam rolling we can actually get both some length work (flexibility) through the increased range of motion using the GTO and autogenic inhibition property while simultaneously helping to rid the body of adhesions in the fascial system.
Hands on body work will and always will be a better form of addressing the density of muscle tissue. Unfortunately, from a finances standpoint having actual hands on type of work such as massage, active release therapy (ART), Rolfing, etc can prove to be a very costly amenity. Using a foam roller can prove to be effective both from a biological and financial standpoint when it comes to soft-tissue concerns.
What You Can Expect From SMR -
You can expect to question if you are doing it correct.
You can expect to wonder if others are thinking the same thing.
You can expect it to be uncomfortable.
You can expect an improvement in mobility and range of motion.
You can expect reduction of scar tissue and fascial adhesions.
You can expect decreased tone of overactive muscles.
You can expect an improved quality of movement.
Reasons That You Might Not Use SMR –
You might not use SMR on areas that have recently suffered an injury.
You might not use SMR if you have circulatory problems.
You might not use SMR if you have chronic pain conditions (e.g, fibromyalgia, etc)
You might not use SMR on bony prominences/joints.
What we must understand about SMR is that it should be used like any other type of training. There must be a level of appropriate and accurate progression and regression for using SMR. The most common variables to manipulate for SMR are pressure and density. Examples of increasing the mass of an object would be going from a lighter foam roller to a heavier one, or going from a tennis ball to a lacrosse ball. The size hasn’t changed but the mass certainly has. Examples of changing pressure would be going from if you have two legs on the roller to taking one leg off. You could also stack the legs on top of each other to increase pressure or if you are using your hands and feet for balance and stability work to get them off the ground forcing more of your bodyweight onto the roller. As a general rule of thumb it will usually be much easier to decrease the surface area of an object (going from a roller to a tennis ball) than it is to apply more pressure.
Most common areas in need ofSMR:
Plantar Fascia (common issue is Plantar Fasciitis) – will typically need to be performed with tennis ball or some similar object rolled on the bottom of the feet.
Tensor Fascia Latae (TFL) and Illiotibial Band (IT Band)
(increasing the pressure by stacking the legs)
Tibialis Anterior (Shin)
Thoracic Extensors, Middle and Lower Trapezius, Rhomboids
Latissmus Dorsi and Teres Major
How to SMR
This does not need to be an entire workout in itself. This should account for a very small fraction of the actual workout. Find the desired areas and make usually 10-15 passes back and forth or up and down the muscle. When you find a spot that seems to be more sensitive than others hold the roller in place on that one particular spot these will sometimes be referred to as “hot spots.” Usually the pain from these “hot spots” will start to subside after 30-45 seconds and then you would continue to move amongst the targeted area. This does not have to be a very complex chain of events, you will need practice at it and resist the urge to discredit it after the first “failed” attempt at it. You will get better at it and you will be thankful that you stuck with it.
The first thing that you need to do is get your hands on a foam roller. I’ve used many foam rollers over the last 18 months and can say that you’re going to get the best ones from Perform Better, sure Academy and those places have them but they are cheap and don’t seem to last long with routine usage. The ones at Perform Better the quality is high and the price is low. HERE is a link that will take you directly to what I’m talking about, there is no need to get fancy with all of the new “state of the art rollers” that are on the market just start with a basic one. If your gym or the place that you workout at offers foam rollers, great….that was easy then. I would still suggest that you have one at the house and use it as often as possible given the returns that you will get in return. I can assure you that you will not regret having a foam roller around the house. If the financial resources allow you I would actually suggest that you get a full 3’ roller and a 1’ roller to carry with you on trips or long car rides or to work. The 1′ roller actually tends to be a little easier to use in some places and also lends itself to useage against a wall if you prefer to roll some areas while standing.
Suggestions on what density roller to start with is somewhat of a guess really. I can say that I have had success with this approach: match the density of the person to the roller. If you are older or you are working with an older individual or anyone else that possesses less densities of muscle tissue then start with a softer roller (white roller will be lightest). If you are dealing with athletes or individuals that are more fit and have denser muscle tissues then you can get away with using more firm objects (black roller or other types).
So….get started! You will not regret it, it is worth the investment in time and very little money.
Sitting at work is bad, but is standing actually better?
PAT GREENHOUSE/GLOBE STAFF
HubSpot employees work at their standing desks in Cambridge.
If too much sitting is the modern health equivalent of smoking and more people are spending longer hours sitting in front of their office computers, are standing desks the solution to rising rates of diabetes, heart disease, and obesity? Or does simply replacing sitting all day with standing all day miss the mark?
The makers of standing desks — which cost a few hundred to several thousand dollars — have sold many consumers and companies on the notion that their products will reverse “sitting disease” and the health ills caused by spending an average of nine of our 14 waking hours in an office chair or on the couch.
More than a dozen studies conducted over the past decade suggest that too much sitting leads to more disability as we age, doubles the risk of diabetes and heart disease, and could even shorten our lifespan. For example, Harvard researchers found in a February study involving more than 92,000 women that the more time participants spent sitting at work, driving, or watching TV, the greater their risk of dying from heart disease, cancer, or strokes.
Such news may have contributed to a 50 percent rise in the sales of standing desks over the past year as more companies invest in them for their employees.
HubSpot, an inbound marketing software company in Cambridge, purchased sit/stand desks that raise and lower with the push of a button for all 650 employees this year after staffers started asking for them.
But occupational health specialists worry that office workers may have gotten the wrong message that standing in one place, rather than sitting at their desk, will help them shed extra pounds, improve their hearts, or stave off other negative effects of too much sitting.
“Standing all day isn’t the answer,” said Alan Hedge, a design and ergonomics professor at Cornell University. “That’s where we were 100 years ago, and we needed to develop chairs to prevent curvature of the spine, backaches, and varicose veins.”
While standing still burns a few more calories as our hearts work harder to circulate blood upward, it also puts more strain on our veins, backs, and joints, especially if we’re overweight.
“Studies haven’t yet determined how much standing helps healthwise,” said Dr. I-Min Lee, an associate epidemiologist at Brigham and Women’s Hospital who has studied the risks of sedentary behavior. In population studies, researchers haven’t been able to determine whether the health benefits of reduced sitting time stem from moving around more or from standing still. And results on whether exercise reduces the health risks of sitting are conflicting.
A May study of nearly 17,000 Canadian adults found that those who reported the most time standing had a 33 percent lower risk of dying from any cause over 12 years compared to those who stood the least. But those who exercised at least two hours each week — even if they sat the rest of the time — enjoyed the same life-extending benefits as those who stood the most. The Harvard researchers, on the other hand, found in their study that regular exercise didn’t erase the increased death risk associated with prolonged sitting.
In terms of calorie burn and physical exertion, standing in one place is equivalent to 1.3 MET (a physiological measure expressing the energy cost of physical activities) compared to 1 MET for sitting. Walking at a 3 mile-per-hour pace is a 3.3 MET activity, while jogging is a 7 MET, which means it burns 7 times the energy than the body at rest.
MATTHEW J. LEE/GLOBE STAFF
Luke Leafgren and his portable computer stand invention at Harvard.
“The calorie burn difference between standing and sitting is so small, it probably won’t make much difference in terms of weight loss,” Lee said.
But some obesity experts argue that standing at a workstation encourages us to move around more and, hence, burn significantly more calories.
In a June study, 28 office workers who were given a sit/stand desk for a month reduced their time spent in a sedentary position by 38 minutes a day compared to when they used a traditional desk. They also reported a mood boost, increased energy, and reduced fatigue.
“I think it’s correct to say we’re in the middle of a ‘stand up movement,’ but the emphasis needs to be on movement,” said the study author Dr. James Levine, director of the Mayo Clinic/Arizona State University Obesity Solutions Initiative. “I don’t want people to think that they should stand up like still soldiers. That is not a good idea.”
Kerem Shuval, a senior research specialist at the American Cancer Society who uses a standing desk, agrees. “I find when I stand, I’m more likely to walk out of my office to talk to a colleague than call or e-mail.”
Animal studies suggest that levels of a fat-burning enzyme called lipoprotein lipase rise not from standing but when muscles get activated by moving around. “That’s why non-exercise activity is so important throughout the day,” Shuval said. Keeping the body in a fat-burning metabolic mode also helps improve cholesterol, blood sugar, and high blood pressure.
Levine’s ability to do this without suffering an ankle sprain or pulled muscle, however, may not be typical. Many people may find it too difficult to write computer code or edit copy while walking on a moving conveyer belt.
“Sure, you’ll burn more calories, but it will likely slow down your typing and increase the errors you’ll make,” Hedge said. “A treadmill desk is fine for making phone calls, reading, or dictating e-mails, but I don’t recommend one for keyboard work.”
Luke Leafgren, a Harvard resident dean and Arabic language instructor, occasionally uses a treadmill desk while composing e-mails, but not for his dissertation. “It took so much mental energy to write that I couldn’t get distracted by the physical exertion.”
Leafgren recently invented a portable computer stand, called StandStand, that fits flatly into his backpack and which he uses to prop his laptop on a library desk or dining hall table. (StandStand will be sold online for $70 next year.)
Higher priced sit/stand desks that can be easily adjusted or using a standing desk with a high-rise chair makes the most sense to provide comfort and prevent back and joint problems. Alison Elworthy, vice president of operations at HubSpot who is seven months pregnant, adjusts her desk height from sitting to standing a few times an hour throughout the day. “Staying in one position for a long period of time isn’t comfortable,” she said.
Hedge said changing positions regularly is a good idea for all office workers.
What’s best for your muscle and joints and your mind’s productivity? Sit for no more than 20 minutes at a time, Hedge recommended, and stand in one position for no more than 8 minutes. You should also take a two-minute moving break at least twice an hour to stretch or walk around.
Fruit Juice Vs. Soda? Both Beverages Pack In Sugar, Health Risks
Better for you than soda? With 49 grams of fructose per liter, not much.
When it comes to choosing between sodas and juices in the beverage aisle, the juice industry has long benefited from a health halo.
We know that juice comes from fruit, while soda is artificial. In particular, the sugars in juice seem more “natural” than high fructose corn syrup — the main sweetener in so many sodas. After all, we’ve gotten rid of most of the soda we used to offer kids at school, but we still serve them lots of juice.
But a study published online in June in the journal Nutrition shows that on average, fruit juice has a fructose concentration of about 45.5 grams per liter, only a bit less than the average of 50 grams per liter for sodas. The sneakiest — and sweetest — juice is Minute Maid 100 percent apple, with nearly 66 grams of fructose per liter. That’s more than the 62.5 grams per liter in Coca-Cola and the 61 grams per liter in Dr Pepper.
Michael Goran, the director of the Childhood Obesity Research Center at the University of Southern California, led the study. He says he decided to measure the fructose, specifically, in juices and sodas because of a growing body of evidence suggesting fructose is a riskier substance than glucose.
“The human body isn’t designed to process this form of sugar at such high levels,” Goran said in a statement. “Unlike glucose, which serves as fuel for the body, fructose is processed almost entirely in the liver where it is converted to fat, which increases risk for diabetes, cardiovascular disease and liver disease.”
Goran’s assertion is not universally accepted. Other health researchers, like Fred Brouns at Maastricht University in the Netherlands, say sugar is basically sugar. He has argued that we should spend less time fixating on fructose and its role in the emerging chronic disease epidemics and more time looking at sugar and overconsumption overall.
Goran says that while high fructose corn syrup in soda and food has become a focal point for researchers and public health advocates in recent years, there’s been less attention on the link between fruit juice and obesity and diabetes.
“But it’s hard to imagine why any there’s reason why juices wouldn’t be as harmful as sodas if they’re delivering the same amount of sugar,” he tells us.
One of the biggest problems, Goran notes, is that nutrition labels only tell us the total grams of sugar — so it’s hard to know how much fructose is in any product. (The term “sugars” on the label can include sucrose, which is a combination of glucose and fructose; lactose and other variations.)
But, Goran adds, if we’re getting fructose from whole fruit, that’s a different story. The fructose in whole fruit comes with fiber, which slows down and reduces the absorption of the sugar in the body, “serving as a sort of antidote to the negative effects of fructose metabolism.”
Barry Popkin, a leading obesity researcher and professor of nutrition at the University of North Carolina, Chapel Hill, agrees that fruit juice consumption is associated with health risks because of the high sugar content.
“Yes, from our long-term, huge studies in Singapore, Australia, the U.S. and Europe, I think 100 percent fruit juice is as bad as sugar-sweetened beverages for its effects on our health,” he tells us. And, Popkin adds, every long-term study on the effects of 100 percent fruit juice intake on diabetes risk shows a very significant risk, too.
Popkin notes that only about nine countries have banned fruit juices from schools. “However, all countries now say a maximum 4 ounces of fruit juice whereas 20 years ago we said unlimited,” he adds.
So what’s a juice lover to do with so many supersweet products on the market? Aswe’ve reported, some beverage makers are now starting to cut the sugar. Goran recommends diluting juice you buy at the store with 50 percent water.
“From a public health perspective, we’re going to need to change the cultural norms about how sweet things like juice really need to be,” he says.
Few phrases turn me off as quickly as networking lunch. That’s only possibly outdone by networking foodless event. So it was strange that Tuesday morning as the networking lunch grew closer, and I had no exit strategy, I felt fine. I wasn’t thinking of phone calls I could make (or “phone calls” I could “make”), or stairwells that looked like neat places to eat. I was actually a little excited.
Earlier I’d watched the sun rise over Oakland, a mix of nerves and East Coast brain scheduling having landed me in a suit writing notes to my near-future self by 4:30 AM. I was to speak at a meeting of the Institute of Medicine (IOM) on the role of media in obesity. The reputation of the IOM doesn’t extend far beyond health professionals, but it’s an independent nonprofit that “works outside of government to provide unbiased and authoritative advice to decision makers and the public.” And often what the IOM says clearly changes the direction of medical culture. But apart from issuing its definitive reports, the institute hosts intimate roundtables on specific pressing issues. They are essentially brainstorming gatherings, of the sort that bring together academia, government, industry, and advocacy. This week the IOM’s roundtable on “obesity solutions” gathered in the California Endowment high rise, shades mostly drawn in homage to PowerPoint, to dig into questions ranging from the future of soda taxes and colonizing food deserts to roles of school recess, childhood poverty, and family dynamics in weight gain.
“Did you know that chewing gum could increase a person’s metabolic rate by as much as 20 percent?” offered a seasoned ex-government official, as a curiosity, from behind a podium in the corner of the small conference room. Many in the audience, seated actually at multiple round tables, chuckled. Others jotted down a note. Some of them chuckled but also secretly jotted down a note. I’m not supposed to say who did what. Most of what happened in the meeting, I was directed, is not intended for public consumption at this point.
As attention to obesity has increased, soaring national obesity rates seem to be leveling off. In certain places, and among certain age groups, obesity seems even to be on the decline. But it is still a major health issue of our time, involving a third of Americans directly and costing billions of dollars, despite the fact that by some expert accounts, if everyone took in around 30 fewer calories per day, the national obesity rate would be back down to where it was in the 1970s. Why, then, has progress been meager?
Much of it has to do with public perceptions of obesity: either as a purely biological disease of metabolic imbalances and inefficiencies, or, oppositely, as a failing of character. The IOM is increasingly embracing media as a way of conveying an answer to what obesity is, and how it’s really best understood as neither. It is a confluence of the biological, the psychological, and perhaps most importantly, the social.
But I can say that the group was important and eclectic. There was the national health officer from the YMCA, a CDC program chief, the director of the childhood obesity team at Robert Wood Johnson Foundation, the vice president of the NAACP, executive director of the Congressional Hunger Center, the global director of health and nutrition at Mars (yes, Mars, proprietor of Combos, has a director of health and nutrition), a professor of global health from Duke University, a distinguished professor from University of California at San Diego, and on and on. It was all headed up by the attorney and former mayor of Nashville, Bill Purcell. There was no audience, no corporate sponsorship, and no grandstanding; it was just a lively meeting where people came to ostensibly solve obesity.
After the gum-chewing provocation, the speaker dove briefly into the under-appreciated concept of non-exercise activity thermogenesis: burning calories through basic daily activities. Is there a way to make a person into a fidgeter? He said yes, possibly. And that everyone should always give standing ovations for speakers—which everyone duly did, for every speaker, throughout the day. All of this built to the more salient overarching point that, by various metabolic calculations, as he put it, “The notion that people with obesity have decreased energy requirements is untrue.”
I wanted to ask if kids should be allowed (encouraged?) to chew gum in schools. I didn’t interrupt, though I wouldn’t have been alone if I had. When the speaker was midway through talking about the role of adverse childhood experiences like abuse, poverty, and family dysfunction, in determining body weight later in life—a concept well described by Vincent Felitti in 1998 but only now gaining wide attention—a government official stood, reading from a Blackberry, to tell everyone that the department of health and human services had just approved a significant investment in research into the obesity-inducing effects of adverse childhood experiences. Much of the room sighed approvingly.
In another well-received monologue a private-sector executive explained that he had aggregated the insights from a swath of different obesity-prevention programs across the country. Some of the most salient findings involved the “school sector” and the proven importance of integrating physical activity in the school day, improving cafeteria food environments—particularly by limiting junk-food vending machines in schools—and nutrition education, and investing in school gardens.
“Thank you for that!” said a representative of school administrators. “Do you have a copy in writing of everything you just said?”
This was a room where, before anyone stood to talk, it was already well-understood that blaming obesity on poor personal decisions is an extremely reductionist approach. It’s at many levels misleading and has proven time and again to be ineffective if not counterproductive. Yet still, according to a presentation by Berkeley researchers, the most common “solution” that most people propose for obesity is personal behavior change.
Three years ago, an IOM report concluded that the obesity “epidemic”—a touchy and divisive word among this crowd, in part because it technically refers to the spread of a contagious disease, which may or may not be a good way to think about obesity (“crisis” is safer)—has been fueled by an extremely complex and dynamic set of circumstances, in schools and offices, in community planning, in media and technology, in food development, packaging, and marketing. And these factors can’t be divorced from the individual choices they inform, consciously and otherwise.
Still, only 18 percent of Americans identify external factors (like the ubiquity of junk food, lack of opportunities and places for kids to play, et cetera) as the primary causes of childhood obesity. Most people, Colleen Barry and colleagues reported recently in the New England Journal of Medicine, blame things like “overeating,” “lack of exercise,” and “watching too much television.”
Blaming those things is not wholly wrong, just indicative of an incomplete understanding of the problem. These things are better regarded as symptoms than causes. The differences in public understanding of the causes of obesity hew eerily to political ideologies, in ways that, a decade ago, they did not. A breakdown here from Barry, Jeff Niederdeppe, and Sarah Gollust, who also spoke at this week’s IOM meeting:
Who Is Responsible for Childhood Obesity?
Gollust made the point that most people agree the national problem of obesity is a serious one. But while 87 percent of people who identify as Democrats believe the federal government should intervene to address the issue, only 27 percent of Republicans do.
That was doubly clear when, over drinks after the meeting, one member who has been involved with Michelle Obama’s “Let’s Move” campaign explained to me how cleanly divided the public is over it. Only about half of Americans support the initiative, even though it is almost as simple and irrefutably positive in concept and implementation as any health initiative could be. Kids: move more.It’s not that people really oppose the idea, the official explained. It’s that theyoppose Michelle.
In 1972, economic theorist Anthony Downs described a life cycle for social problems, and it’s one to which obesity seems susceptible. Initially people care a lot, but the sense of urgency fades when the need for public sacrifice and displacement of powerful societal interests becomes evident. (“I strongly agree that you should feed your kids less and exercise them more, but I also strongly disagree that I should pay to build public parks and create safer neighborhoods, or compromise my access to giant, giant sodas.”) Prolonged exposure to the idea leads to politicization and polarization that compound inaction.
In its report three years ago, the IOM called for public awareness to catalyze change, through communication campaigns, grassroots community mobilization, cross-sector advocacy, and political champions. This week the vibe was much the same. These are spaces where doctors are not trained to perform, but where doctors can do a world of good.
Almost inevitably when I tell people that I’m no longer practicing radiology, they say something about what a big decision it must have been to “leave medicine.” But no one at this meeting said that. Of course what I do now is in no way intended to replace any traditional medical structure, the importance of a personal relationship with a physician, but I feel increasingly less like it’s accurate to say I left medicine. Daily inroads are small, but in sum, messages from the media are critical. Do we in media depict obesity as a personal affliction, a moral failing, or a social disease? And how do those depictions change the way people feel about governmental policies? The current consensus seems to be that obesity can accurately be regarded as a disease, but as a biopsychosocial one.
When the networking lunch finally came, it did go fine, I thought. But that’s not to say it was without confrontation. Near the end, a man in a blue blazer kneeled down beside my chair and asked me, with some urgency, why media outlets insist on publishing undignified images of fat people.
“Why do you cut off their heads?” he asked, referring to a trend that’s been called out on various blogs, termed “Headless Fatties.” It’s where, in a story about obesity, an article will include a photo of an overweight person devoid of head. Typically the person is in an unflattering position, incompletely clothed or in clothes that are too small, and often doing something unhealthy. An optimistic explanation might be that outlets are trying to illustrate obesity using stock photos without identifying a single person—it’s not an overt attempt to dehumanize, though it does come off that way. But Yale University’s Rudd Center for Food Policy and Obesity recently found that 72 percent of news stories on the websites of CBS, ABC, MSNBC, FOX, and CNN depicted overweight people in a “negative and stigmatizing manner.”
“There are better ways to illustrate obesity,” the concerned man said, still concerned. It’s these subtle messages that slowly build a public perception that influence policy. The Rudd Center, among others, has an open-access database of photos of overweight and obese people intended to minimize stigma. The images show people not languishing on couches, but out walking in parks and at grocery stores choosing judiciously among the produce. The people look happy and real, as people are. They are neither victims nor offenders. They make good decisions and bad, as all people do, in every case inseparable from the context in which those decisions are made.
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