Thursday, April 30, 2009

"...Ultimately goals can't protect us from ourselves."

I'm from the school of thought that finds goals essential to life. From everyday to-do lists to Five Year Plans, I've always considered goal setting to be a crucial piece of success. If you're not working towards something, then what's the point?

I came across Ready aim... fail: Why setting goals can backfire while perusing the Boston Globe website, or Boston.com. The Ideas section of the Sunday Globe always has some really interesting pieces, but I thought it best to cancel my subscription a few months ago because the mere existence of newspaper in my apartment was a major point of contention for my roommate. Oh well.

Anyway--goals. This article explores the idea that goals are not always the profound agents of motivation and productivity that they are always purported to be. In fact, some goals are very destructive and bad.

For example, take the "notoriously combustible" Ford Pinto. Stop laughing, this is serious!
In the late 1960s, Ford CEO Lee Iacocca, determined to take back the market share the company was losing to smaller imports, announced a crash program to create a new car that would be under 2,000 pounds, under $2,000, and would go on sale in 1970. Desperate to meet the conditions and the deadline, company executives ignored and then played down questions about the safety of the car's design. As a result, the Pinto, with a fuel tank just behind the rear axle, was uniquely prone to igniting upon impact, and 53 people died in such fires.
Clearly, putting a fuel tank in the rear of a car is hardly a good idea considering the high number of rear end collisions that occur EVERYDAY. Cars are not supposed to immediately ignite upon impact, unless you live in the movie Speed, or some equally explosive action film.

But who in the Ford corp voice their concern? Who halted production? Apparently, nobody. Executives at Ford were so goal-crazed that they opted to forgo reinforcing the rear end (at a cost of $121 million) because the projected payout to victims was less ($50 million). See The Ford Pinto Case: A Study in Applied Ethics, Business and Technology if you want to get the full story.

The Pinto catastrophe is a super extreme example of goals gone awry and exemplifies the evil-ish nature that lurks beneath the corporate surface of such things as "cost analyses" and other business tools I only vaguely understand. Now, how does this model of corporate greed relate to individual goal setting?

A professor at the University of Toronto is quoted as saying, "You know how Shakespeare wrote that the fault is not in our stars but in ourselves? Well, the fault is not in our goals but in our values."

Hmm... looking at goals as a reflection of our values, eh? That is an interesting way of thinking about it. This is probably an exercise that few people consciously engage in, but seems like a good way to check in with yourself and make sure you don't value Greed, Gluttony or any of the other Deadly Sins. Here is a possible dialogue to get started:

"Hey self! How u been?"
"Oh not too bad. And you?"
"Well thanks for asking! I've been alright, although that blueberry muffin I ate yesterday was sort of nasty. I might be off muffins for awhile."
"Really? I didn't think it was too bad. Maybe below-average for a muffin, but still edible."
"Yeah, well maybe you should raise your muffin standards. Hey, by the way, what are my goals?"
"Oh you know...." *Thoughtful consideration of various goals*
"Great! Now what things do I value that made me select these goals?"
"Wow, that's a toughie! I'd say..." *Thoughtful consideration of values*

End.

The Globe article doesn't go into the details of personal goal setting too much, but I think the lesson learned from Ford, Enron and possibly our entire banking system is this: Set goals, but be sure to re-evaluate them from time to time to make sure your efforts are going towards a reasonable, worthy cause. It seems like the re-evaluation part becomes increasingly important as you work to attain "life goals".

But really, what do I know? I wouldn't consider myself the poster child for goal setting in any capacity. My latest goal (which was conceived this morning) is to write a screenplay for the Juno-ish version of this movie, which frankly, looks awful but is a good concept. I expect Fox Searchlight will buy it for $5 million, at which point I will quit my temp job and move to Mexico (post-Swine Flu). At quarterly intervals, I will fly my friends and family down to visit me so they can learn Spanish, eat the most delicious food in existence, and get sunburned.

Huh. It sounds like it has Pinto potential. Maybe I'll only ask for $1.5 million, so I have to stay domestic. We'll see.

Thursday, April 23, 2009

NY Times Reporter's File on Obesity: Could you BE more pessimistic?!

Dear Laura,

I received your email re: NYTimes.com: Reporter's File: Obesity. Per your comments concerning the content of said "file", I have responded below in an itemized fashion.

(I would like to note that I am NOT a medical professional, nor a professional of any kind (besides being on the Board of the North American Jackass Association, NAJA). Therefore, my comments are purely my own opinion and do not reflect the established opinion of the Western medical community. However, I would like to note that I have read widely on the subject of obesity in the United States because it is a curious problem and besides, everyone and their mom seems to have their own idea about why the U.S. is so fat, so why shouldn't I?!)

1. Let's start at the beginning, shall we? On the issue of genetics, Reporter's File says:
Diet and exercise do matter, they now know, but these environmental influences alone do not determine an individual’s weight. Body composition also is dictated by DNA and monitored by the brain. Bypassing these physical systems is not just a matter of willpower.
You already knew this. People look different and have different body types and are able to consume different foods to different effects. Some people are going to have an easier time gaining weight that losing it just as others will stay thin forever.

Is this an excuse for obese people? Should we all just get over the fatness because it's genetic?! It might sound like that at first, but I don't think it is. There are several factors at play here, and none of them reign supreme in determining weight. Genes, diet, exercise and willpower are all important parts of the equation here. They are clearly not EQUAL parts of the equation, but they are contributing factors nonetheless.

The article also completely seems to miss the influence of other factors like stress and sleep deprivation, not to mention the higher prevalence of obesity among people with low SES. Maybe those things are considered "weaker" or maybe just more boring. It's hard to say.

2. On the issue of diet, Reporter's File says:
The nation’s poor diet has long been the scapegoat... The recent rise in obesity may have more to do with our increasingly sedentary lifestyles than with the quality of our diets.
It seems there is evidence that we Americans have been eating a lot of crap for quite awhile now, but I would argue that the definition of "crap" has deteriorated to an even lower level of crappiness.

Case in point: The article points to the fact that in 1966, McDonald's had already sold about 2 billion hamburgers. What they don't say is that in 1966, people were washing down those hamburgers with a 10 ounce can of Coke, or more likely, a 6.5 ounce bottle. Today, it's more likely that people are eating Big Macs (not introduced until 1968) which weigh in at 540 calories, a large fries (500 calories) and drinking a 32 ounce Coke (310 calories). Can you do that math? It's 1350 calories. I SERIOUSLY doubt that a meal at McDonald's in 1966 was 1350 calories. Yes, we sit around on our asses a lot more, but there is no doubt in my mind that we are consuming a lot more calories to go along with it.

(Which is to offer no explicit comment on the increasing size of individual soda quantities. A year ago, a Pepsi spokesperson explained the reasoning behind the introduction of 26- and 16-oz bottles into convenience stores: "[It] is about giving consumers more choices, and if that leads to more frequent transactions and greater volume, it's also a win for our customers, our bottlers and us.")

3. On the issue of exercise, Reporter's File says:
The leisurely after-dinner walk may be pleasant, and it may be better than another night parked in front of the television. But modest exercise of this sort may not do much to reduce weight, evidence suggests.
The key word here is "modest." A meandering 20 minute walk will hardly get your heart pumping. Unless, of course, you are extremely overweight and you just ate the McDonald's Big Mac, fries and Coke for dinner and also the walk is uphill. This sort of modest exercise *might* help you maintain your weight so you don't gain any more, but it's not going to reduce weight.

The Reporter's File fails to mention exactly what type of exercise can aid weight loss, so it seems like exercise is worthless. Obviously that is not the case. Have you seen The Biggest Loser? Have you noted how hard they work out? So hard! And how long? Hours! A huge amount of effort is expended to lose all of that weight. And once they get to their "goal weight", whatever that may be, it's going to be more hard work to maintain that weight. This effort does not fall under the "modest" exercise category. It's hard f-ing work, but exercise can help.

However, for the average person, I think that if you only exercise to lose weight, you are going to be disappointed. It takes more than 30 minutes of cardio twice a week to see significant weight loss. Fortunately, the benefits of exercise are far-reaching! Exercising affects your muscles and bones--from your legs and arms to your heart and lungs--is incredibly important to your physical and mental health. The Reporter's File mentions nothing about this (since it has nothing to do with obesity) but it's useful to note that exercising isn't just about weight loss.

4. On the issue of the body's/brain's determination, Reporter File says:
Scientists now believe that each individual has a genetically determined weight range spanning perhaps 30 pounds.
I really don't know anything about this. It's the genetic thing again. Obviously, this 30 pound span is not a hard and fast rule. If that's true, then how does a person grow to be 40, 60, 100 pounds overweight?

I don't want to get touchy-feely, but if this "30ish pound span" idea is correct, there is clearly a pretty big disconnect between what we think our bodies want and what they actually need. People must be seriously ignoring the subtle signs they receive from their body in order to gain so much weight. Does your body really want a Big Mac or is your brain just mesmerized by the fluffy bun, the sizzling patty and the glistening cheese? (Yes, sometimes cheese glistens with delicious cheese sweat.)

5. On the issue of maternal diet and pregnancy, Reporter's File says:
According to several animal studies, conditions during pregnancy, including the mother’s diet, may determine how fat the offspring are as adults. Human studies have shown that women who eat little in pregnancy, surprisingly, more often have children who grow into fat adults. More than a dozen studies have found that children are more likely to be fat if their mothers smoke during pregnancy.
I believe this. This research is fairly new it seems, but it's pretty compelling and scary as hell. The Reporter's File was updated August 2007, and already there have been some new updates in the role of the maternal diet. In January, researchers found that a high-fat diet can lead to fatty liver disease in newborns, which sounds like a fantastic way to start a new life.

Overall, on the first read the Reporter's File comes across as hopelessly pessimistic. But after I read it a second, third, fourth time, there really isn't any content that you haven't heard before. The difference is that you usually hear bits of this information accompanied by tips and tactics to combat the somewhat depressing information. But the File lays the bad news on thick and without relief.

But that's the point. The title is "For the Overweight, Bad Advice by the Spoonful," not "I'm Going to Tell You a lot of Bad News, and Then Make You Feel Better About It." The facts are that it's hard to lose weight and there are a lot of factors stacked against the obese.

A little awhile ago I posted a quote from an editorial in the American Journal of Public Health. Essentially, people are starting to recognize that the epidemic of obesity (and yes, I'd call it an epidemic if 66% of Americans are overweight or obese, according to the File) is not just a personal problem shared by of millions of individuals. It's systemic. The way We eat, the way We teach our children, the way We do business, etc. is quickly becoming one giant, intertwined mess of misinformation.

The File makes it seem like there is no hope for the obese Individual, and maybe there isn't a lot. But I think there is hope for the obese Society, if we start making some difficult changes in the way we live our lives.

Love,
Chloe

Monday, April 13, 2009

Divine Digesting of the Blogs, V. 2

A couple things from the All Mighty Reader...
Chapter I. Religious folks and saving lives;
Chapter II. A sports career in retrospect;
Chapter III. Running in (pretty much) my parents' backyard!

I. Religious folks and saving lives
Toni at EverythingHealth noted an interesting study in the New York Times a couple weeks ago. Terminally ill cancer patients who were very religious (specifically Christians in the U.S.) were more likely to request intensive life-saving procedures in the last week of life than other people. These other people included Christians who were not quite so religious and people who chose other coping mechanisms altogether. You can find the abstract here.

The lead author, Dr. Holly G. Prigerson offered her explanation of this curious finding in the Times article: “To religious people, life is sacred and sanctified and there’s a sense they feel it’s their duty and obligation to stay alive as long as possible.”

While that may be the case, the procedures used to squeeze out every last drop of life are the most costly. The Times estimates that Medicare spends about 1/3 of it's budget on people in their last year of life, and most of it at the very end. I suppose that statistic isn't really as outrageous as it sounds though--obviously most people want to do whatever they can to hold onto someone a bit longer, regardless of cost.

Invasive procedures performed at the end of life can also be emotionally taxing. The article suggested that prolonging life for these terminally ill cancer patients created more physical pain for the patient and emotional pain for loved ones.

So, is this another reason to chastise evangelical Christians, or is their fight a good one?

II. A sports career in retrospect
Completely changing gears-- Megan at ...Because I Played Sports posted about her experience at the 2009 WNBA Draft, along with a little background as to why this event was so special. I really appreciated reading the back story to the development of her blog and everything that has followed. It's always great to hear Plan B success stories! (And no, that was not a birth control reference.)

My back story is probably not as interesting or as poignant (since I'm not writing this from my ESPN dressing room or whatever), but in the last two years since I haven't been playing softball, spring season is bittersweet. I too started playing softball when I was a little girl, and I loved it right from the beginning. I don't hesitate to say I still love it to this day, but my career was so full of highs and lows and insecurities and frustrations that it's extremely difficult to look back on it with any detail and not cringe in agony. Why didn't I try out for that team? Why wasn't I more confident? HOW DID I MISS THAT BALL?!

As a whole, I loved and continue to love it. I have no doubts that playing the game for so many years has had a direct effect on the person I am today. But at times I have to wonder--Why put myself through it? There wasn't a season I didn't cry or complain or threaten to quit, up until the very end (when I probably should have thrown in the towel). There were times I could have strangled my coach or my teammates or my "captains."

But despite all the headaches and knee aches and stomachaches... maybe it's all about the struggle. Without it, what's the point? It makes life thoroughly interesting and without it, I would (well, we ALL would) just be a puddle of goo in a LaZ Boy. Which is not to say that sometimes that doesn't sound awesome...

III. Running in (pretty much) my parents' backyard!
Quickly--Watch this video that was posted at Women Like Sports.

Watch until Marni Renison starts talking to you. Now hit Pause. This is Tualatin Hills Park and Rec complex and it's like a 3 minutes walk from where I grew up. That big white building over Marni's right shoulder? That's where I played basketball most of my life. And the path right behind her? It goes down the hill and off to the left, past the soccer fields and TO MY HOUSE. Oh Oregon, how I miss thee.

What a nice, end of the work day surprise!

Wednesday, April 8, 2009

The (Un)Fair Copyright in Research Works Act

The National Institutes of Health (NIH) is an agency of the US Department of Health and Human Services, and is primarily responsible for doling out funds for biomedical and health-related research. The recipients of this funding include it's own organizations that put the plural in Institutes (for a total of 20 institutes and 12 centers) and everyone else outside the NIH umbrella. But you probably knew all that already.

According to the NIH's Research Portfolio Online Reporting Tool, in 2008, NIH handed out 45,887 research grants to 2,538 institutions for a total of over $20 billion of government (i.e. taxpayer) funds. The total awards, which include training and construction grants, fellowships, etc., are upwards of $21 billion.

I know that the recent bailing out of several of our nation's major banking institutions makes $20 billion seem like chump change, but let's pretend like we don't have anything to compare it to. That is A LOT of money. And we're handing out to people who are doing really fantastic and cutting-edge research that will benefit all of mankind in the long run (hopefully). However, a bill introduced by US Rep. John Conyers, D-Mich, threatens to limit public access to the findings from all that research, unless you pay a fee.

HR 801, also known as The Fair Copyright in Research Works Act, would prohibit the government from requiring scholarly journals to make federally funded studies accessible to the public. Supporters of the bill include 5 cosponsors and obviously, the guys set to lose money, the publishers. Currently, the NIH has an "open access" policy for all manuscripts to be made available via PubMed Central.

The concept of open access seems obvious, but it's not. The NIH's policy was just put in place a mere 12 months ago! Seriously. Already people have been excited and the content on PubMed has increased substantially, according to this great article at Science Progress.

The NIH's open access policy is a good start, but it's not amazing. First, the policy states that manuscripts have to be submitted to PubMed no more than 12 months after being accepted for publication. Which means there will be a delay for many studies to be made available. Second, the nature of scientific study is such that only studies that get positive results are published. If some people do a study thinking they're going to find something fantastic, and then they get nothing or something very small, they're not required to make that public knowledge. I'm sure they report it to the NIH (all funds come with many strings attached), but since their non-results won't get published in a peer reviewed journal, we'll never find out about it. Maybe this isn't a huge deal, but I just hope someone somewhere is keeping track of money the NIH has spent on "statistically insignificant" research, aka crap.

But wait a second, you say. Maybe I don't care to know about current research, because I'm not a student. Maybe I prefer to get my scientific information from the local news at 11 and, I don't know, MY DOCTOR!

Well sure, your primary care physician is probably a great source of information. However, due to the VAST and VARIED amounts of research being conducted, it is virtually impossible for any one person (MD or not) to be 100% up to date on the latest and greatest research. Especially if your doctor is seeing upwards of 20 patients a day. When do you think he/she has time to peruse the last 10 studies regarding your weird foot fungus? And that is even assuming that he/she cares enough to do so. Ideally, doctors and specialists stay up to date with new findings, but they're only human and they only have 24 hours in the day, like the rest of us slackers.

So, you think this "Fair Copyright" Bill is BS too? What is one to do? There are several options.
  1. Follow the progress of the bill here.
  2. Check out the Alliance for Taxpayer Access here.
  3. Look at this huge list for ways to promote open access for faculty, universities, foundations, journals, etc.
In any case, it's somewhat mind-boggling that open access is just now being achieved to some extent. The need for transparency and accountability in our nation's research centers should not be underestimated, as well as other areas of government. Clearly, we don't want people wasting time studying, oh I don't know, Moon Robots or something. Let's just leave that one to Japan.

Resources:
Research copyright bill would end access to free health info(3/5/09)
Open Access News blog
Open Access Overview by Peter Suber
Open Access Directory

Sunday, April 5, 2009

The odds are against you

"Governments and public health researchers who are serious about tackling obesity must consider the toxic environment that has led to the current epidemic. Proposals for reform that focus solely on individuals--be it on their knowledge, willpower or decision-making ability--will not be successful in reversing our society's body weight trajectory.

We need measures aimed at changing the context, not the individual.


Rather than simply encouraging consumers to make healthier choices, we must recast the environment so that healthy options are far more accessible, available, and desirable than unhealthy alternatives. A fruitful area for further exploration is corporate practice, because it is so influential in shaping consumption patterns and because it must be carefully regulated in new ways if we are to achieve any change in the epidemiology of obesity.
"

From the editorial "Why Education and Choice Won't Solve the Obesity Problem" in American Journal of Public Health, April 2009.