Focusing on the global burden of risk factors, not diseases

In Vietnam, the switch from bicycles to motorbikes as the primary means of transportation has reduced physical activity and, in turn, contributed to rising rates of chronic diseases.

In Vietnam, the switch from bicycles to motorbikes as the primary means of transportation has reduced physical activity and, in turn, contributed to rising rates of chronic diseases.

During his TED talk in 2006, Hans Rosling describes how he informally tested his class of Swedish undergraduate students at the start of the term.

He asked his students: “Which country has the highest child mortality of these five pairs?”

— Sri Lanka or Turkey
— Poland or South Korea
— Malaysia or Russia
— Pakistan or Vietnam
— Thailand or South Africa

Rosling chose each pair so that one country had twice the child mortality rate of the other country in the pair.

He discovered that his students, for the most part, were unable to select which country—out of the five pairs—had the highest child mortality rate.  Continue reading

Confused? This probably has something to do with it.

An eye-opening (to say the least) infographic on the accelerating pace of scientific publishing and the rise of open access.

— A list of papers published in 1880 would fill about 100 pages.

— Today, we’re looking at a page published every 45 minutes.

How many of these papers discuss “new” or “breakthrough” findings in health, nutrition, causes of morbidity and mortality, and so on? My guess: more than we could read in multiple lifetimes.

Yes, no wonder so many of us are confused.


Tyranny of the chain restaurants: A decision tree for damage control (plus: beware of the “health halo”)

Chain restaurants and global bloat.

Chain restaurants and global bloat.

The map above depicts the distribution of McDonald’s outlets worldwide in 2004. Out of approximately 30,500 McDonald’s outlets, 45 percent were located within the U.S.—that’s 47 outlets per million people in the U.S. compared to 5 outlets per million people worldwide. Hence, the bloated distortion.

Sometimes, you have no other alternative but to eat junk. It’s a familiar situation—you’re on a road trip, at the airport, or pressed for time. Your choices may be 1) eat junk, or 2) go hungry. Option #1 is no more attractive in absolute terms than it is at any other point in time, but relative to option #2, it wins. And, thus, you succumb to the ubiquity of the chain restaurants that surround you. We all do.  Continue reading

Ramping Up Your Physical Activity (and sticking with it)

Why it’s unnecessary to fully commit to a commitment device: Lessons learned from my superficial experiment with tracking my activity in real time

A commitment device is a means to lock yourself into a course of action that you might not otherwise choose, but that produces a desired result. Examples of commitment devices on the health improvement and weight loss fronts are numerous, ranging from a device as innocuous as a gym membership to a device as drastic as bariatric surgery.

Since last summer, I’ve been recovering from an injury to the soft tissue behind my left knee (more on this later). Prior to the injury, I ran four to five miles, three times a week—on a treadmill and with incline intervals. This was my routine for years.

Below are two examples of what my typical treadmill run looked like at the time (please excuse the slight blur of the photos—I took them while walking slowly on the treadmill during my cool-down):

Treadmill run on 6/15/2013:


Treadmill run on 6/18/2013:


I didn’t realize it then, but I was using the image on the treadmill console as a commitment device. Continue reading

Making Sense Out of Sugar Intake Recommendations

Sugar: you're probably consuming more than you think.

Sugar: you’re probably consuming more than you think.

What’s the Sugar Problem?

Most of us know the problem. Excess sugar consumption is implicated in all manner of poor health outcomes, including excess weight gain, obesity, non-communicable chronic diseases (e.g., heart disease, diabetes, cancer, etc.), and dental caries.

Despite the recent spate of news stories on the FDA’s proposal to add a line for “added sugars” to the Nutrition Facts label and the World Health Organization’s announcement that it will be releasing new sugar intake guidelines, I find myself as perplexed as ever regarding the amount of sugar that’s considered compatible with good health.

Wait a second, how much sugar is considered too much sugar? How many grams? Or, should I be focusing on calories from sugar?

The fact of the matter is that the decision-making bodies that issue recommendations on sugar intake refer to the amount of sugar in different units—grams, teaspoons, calories, and proportion of daily calories. When nutrition recommendations are spoken in different languages like this, I’m less inclined to pay attention. I’ll go out on a limb and guess that I’m not the only one who feels this way.

This post should help clear things up by providing a better sense of what the recommendations, as a whole, mean for you.

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FDA’s New Proposed Nutrition Facts Label: Go Big or Go Home

How quickly can the FDA pull this off?

How quickly can the FDA pull this off?

It was hard to miss the news last week: The U.S. Food and Drug Administration (FDA) is proposing updates to the Nutrition Facts label on food packages to “reflect the latest scientific information, including the link between diet and chronic diseases such as obesity and heart disease.”

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A Friendly Reminder from Your Personal Health Coach, the World Health Organization

Or, Today’s Physical Activity Primer and Encouragement in Tweets


Good Intentions, Unintended Consequences

Read carefully. And then read it again.

Read carefully. And then read it again.

How Scientific Research and Personal Health Journalism Bred a Weight-Loss Myth that Persists Despite Evidence to the Contrary

This is a story that begins in 1959.

It’s a true story about how scientific research and personal health journalism interact in unintentional ways that may discourage, rather than encourage, the public from pursuing better health.

In 1959, a physician in Pennsylvania and a researcher in New York co-authored a study published in the Archives of Internal Medicine entitled, “The Results of Treatment for Obesity.”

The authors of the study, Albert Stunkard and Mavis McLaren-Hume, set out to determine whether treating obesity—as part of the routine practice of the New York Hospital’s nutrition clinic—would result in measurable and permanent weight loss among obese patients referred to the clinic.

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Part 2 of 2: The Essential Twitter Guide for Health Enthusiasts


In part one of this two-part post, I attempted to dispel misperceptions that may be holding you back from experimenting with Twitter as your tool of choice for gathering the most relevant public health and personal health information.

More generally, I tried convincing you (and I hope I succeeded) that Twitter is, in fact, a flexible tool for meeting your non-E  Tonight and non-TMZ information needs. Twitter has plenty to offer those who couldn’t care less about which troubled celebrities went to the club last night.

In this current post (part 2), I’ll provide a quick-start guide for those who are interested in using Twitter for building a personalized stream of health-related news, research, and resources.

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Part 1 of 2: The Essential Twitter Guide for Health Enthusiasts


How to Set Up Your Twitter Account in Less than 11 Minutes and What You Need to Know to Make the Most of Your First 48 Hours

Preface: A Personal ConfessionI have a confession: Up until this week, I was a…how do I put this? A complete and utter stranger to Twitter.

Go ahead…laugh. Get it out of your system. Jack Dorsey, Twitter’s co-founder, published his first tweet in March, 2006. It’s now January, 2014. What took me so long? And, could you be holding out for the same reasons?

To be fair, the latest data indicate that you and I are not alone. According to the Pew Research Center’s Internet Project, only about 18 percent of online adults in 2013 reported using Twitter—a small jump from just 16 percent in 2012. Mathematically speaking, this means that the overall percentage of adults using Twitter is much, much lower. It turns out that you’re not nearly as late to the game as you suspect.

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What happens when philosophy meets public health?


No, not Aristotle. It wasn’t until I was a graduate student in public health and health policy that I became aware of the biologist, Edward Wilson, and his much-debated thesis on the unity of knowledge. I was sitting in an introductory course on environmental health. The professor flashed the indented quote below on a PowerPoint slide, read the quote, re-iterated in his own words the importance of synthesizing knowledge as it relates to human health, and moved on with his lecture.

Edward O. Wilson, on the synthesis of knowledge:

We are drowning in information, while starving for wisdom. The world henceforth will be run by synthesizers, people able to put together the right information at the right time, think critically about it, and make important choices wisely.

In other words, as the title of his book suggests, Wilson’s vision is one of consilience—he advocates for a world that forms linkages between the sciences and the humanities, a “jumping together of knowledge by the linking of facts and fact-based theory across disciplines to create a common groundwork of explanation.”

The appeal of this pursuit, Wilson emphasizes, is “the value of understanding the human condition with a higher degree of certainty.”

At the time, I was sitting in one of four required courses that comprise the core curriculum of most (if not all) U.S. schools of public health: environmental health, epidemiology, global health, and the behavioral and social sciences in public health.

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