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Sunday Smorgasbord

Posted Jan 31 2010 5:11pm
It's that time of the week again! Yet another random sampling of the latest ED news and research, gathered by me for all of your enjoyment. As always, I welcome your thoughts and comments.

Whole Foods says to employees "Weigh Less, Pay Less"

Jezebel broke the story that employees of Whole Foods Market who meet certain health biomarkers (blood pressure, cholesterol levels, and BMI) will receive at 10% discount on the cost of their health insurance.
Whole Foods CEO John Mackey explains the program in a letter, reproduced below. Apparently it's part of an initiative to reduce health care costs, which is interesting since Mackey is against the health care reforms that would actually reduce costs for all people.

Note that Mackey knows BMI isn’t a perfect measure of health, but at least it’s cheap! Even more fun, though, is the poster for the new Healthy Discount program, breaking down exactly what BMI range his minions need in order to get various discounts on his Tofu Pups.

If your BMI is above 30, you’ll get to keep the original 20% employee discount, but you’ll paying more than your thinner co-workers, who can knock as much as 30% off. Because if public health research has taught us anything, it’s that reducing people’s buying power totally makes them healthier. Stay classy, Whole Foods.
For some great analysis, check out Rachel's great coverage at The F Word and an interesting discussion by the parents of Around the Dinner Table, started by the ever feisty IrishUp.

Biological tests for mental illness

News that a research study had established a biological-based diagnosis for PTSD was covered by numerous news outlets last week. Scientific American had a decent summary here:
Diagnosing PTSD is not necessarily simple. Psychological evaluations for PTSD cannot always easily distinguish it from other mental illnesses, such as depression, or determine if a patient is over- or underreporting the symptoms. Now, a brain- scanning technique called magnetoencephelography (or MEG) could offer the first biological test to help specifically diagnose and treat those with PTSD. In a study published January 20 in Journal of Neural Engineering, MEG correctly identified 97 percent of patients that psychologists previously determined were suffering from PTSD.

...For 72 of the 74 patients previously diagnosed with PTSD, MEG scans detected a pattern of neural communications that was different from the healthy participants, but shared among the PTSD group. On the flip side, 31 of the 250 healthy patients had abnormal scan results.
As many of my readers can guess, I love the idea of a biologically-based diagnosis for what is, essentially, a biologically-based illness. But the blog Mind Hacks raised some very interesting problems with this study that wasn't covered by the mainstream media.
The study used a form of brain scan called MEG, essentially a high-tech form of EEG that picks up magnetic fluctuations from the brain's electrical activity rather than the electrical signals themselves, and found that the coherence of signals across the resting brain was reliably different in vets diagnosed with PTSD by interview, compared to healthy people without mental illness.

Crucially, the scan didn't pick out cases of PTSD among people with a range of mental illnesses, it just found a difference between people with PTSD and healthy people. But this is not a diagnosis, it's just a difference.

If you're not clear on this distinction, imagine that I claimed I found a new way of diagnosing malaria in under 2 seconds - I just measure body temperature and if the person has a fever, I decide they have malaria.

I hope you would point out that this is ridiculous, because people with flu can have fever, as can people with typhoid, mumps, dengue and so on.

My test would genuinely distinguish between people with malaria and healthy people, but in no way is it a diagnosis.
It's important to know both the advantages to these brain-based diagnoses and also their limitations. Certainly, this study represents an advancement in PTSD diagnosis, but how much of an advancement remains to be seen.

Forget Jenny Craig. Hit the Drive-Thru.

Abby Ellin's new article in the New York Times covers the ever-evolving diet trends. No need for gritty shakes or pre-packaged meals; the newest diet trend is fast food.
Christine Dougherty, a 27-year-old business consultant in Pensacola, Fla., thinks so. “I don’t like to cook, and I wanted to be realistic without changing my lifestyle too much,” Ms. Dougherty said. She began replacing her usual fast-food lunch or dinner with meals from the Fresco menu at Taco Bell, which consists of seven items — including burritos and tacos — each with less than 9 grams of fat, compared with, say, 30 grams of fat in the Stuft beef burrito on the regular menu.

Ms. Dougherty said that she ate there five to eight times a week, exercised more and — over two years — lost 54 pounds. By December 2009, she was the spokeswoman for Taco Bell’s new Drive-Thru Diet advertising campaign for the Fresco menu, which features Ms. Dougherty’s story in TV and print advertisements, and online. The company recently began offering the menu in its drive-through kiosks, and not just inside the restaurants.

...Some nutritionists suggest that consumers be careful of anything the fast-food business has to say about reduced-calorie, or healthy, options. “Even if they’re offering healthy fare, go into it with a wary eye — more likely they’re tricking you,” said Elizabeth Somer, the author of “Eat Your Way to Happiness,” and a registered dietitian in Salem, Ore. “The fast-food restaurants have not led the troops in healthy eating yet, so there’s no reason to believe they’re going to change their colors now.”
It seems to me that this is just another "Lose Weight Quick!" scheme. I could eat two Big Macs every day and lose weight, if that was the only thing I ate. It's not some sort of food magic, it's just a way to reduce your caloric intake. It's not been studied, it's not a long-term solution, it's just another trend. Frankly, the thought of eating Taco Bell several times each week makes me gag. I have never liked "Taco Hell" and it has nothing to do with the fat and calories of the options. It's just...ick.

Michelle Obama's anti-obesity initiative

In yet another short-sighted attempt to stem the "epidemic" of childhood obesity, Michelle Obama is promoting an initiative with a nice-sounding goal: "To put in place common-sense initiatives and solutions that empower families and communities to make healthy decisions for their kids."

Says Obama in an interview with USA Today:
Obama acknowledged the difficulties parents face. "It wasn't that long ago that I was juggling a full-time job with the round-the-clock role of being a mom," she said. "And there were plenty of times when after a long day at work, when the fridge was empty and the kids were hungry, that I just ordered that pizza, because it was easier. Or we went to the drive-through for burgers, because it was cheap and quick. And I wasn't always aware of how all the calories and fat in some of the processed foods I was buying were adding up.

"It got to the point where our pediatrician had to tap me on the shoulder and say, 'You know, you might want to consider making some changes in your family's diet.'

Because we all know that diets are really effective and have phenomenal long-term success rates. And it gets better:

Tackling the problem has been gaining momentum recently. On Monday, an expert panel recommended that physicians and other medical professionals screen children ages 6 and older for obesity and refer obese children to comprehensive weight-management programs.

Right now, there aren't enough weight-management programs for children, and those programs aren't covered by most insurance plans, experts say. The new recommendation may help change that.

Will they also cover the treatment of the eating disorders that are triggered by these health classes and anti-obesity hype? Even the president himself isn't immune to the fitness hysteria:

U.S. president Barack Obama has also in the past publicly voiced concerns about the habits of their children, saying that Malia had become 'a little chubby'.
Way to make your kid really freaking paranoid, Mr. President. Many kids put on weight right before puberty as their bodies' gear up for a growth spurt. It's neither problematic nor pathological, until we've made it that way.
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