Monday, January 31, 2011

Guest Commentary: Reflections on Community Service

Neil Goldfarb
Associate Dean for Research
Jefferson School of Population Health

On Sunday, January 30th, we held the mid-year retreat for the Greater Philadelphia Albert Schweitzer Fellowship Program at the Aletha R. Wright Center in Camden, NJ. As many of this blog’s readers already know, the Jefferson School of Population Health is the home of this regional chapter of the national Schweitzer Fellowship program. The Program provides opportunities for graduate students in a wide variety of health-related disciplines, from Universities throughout the Delaware Valley, to explore their interests in population health by conducting a year-long community service project, while pursuing their degrees.

The Aletha R. Wright Vision of Hope Center provides shelter and community-based assistance to adult homeless men. The Schweitzer Fellows spent the afternoon painting and sprucing up an exercise room, a media room being converted to a chapel, and a long hallway in need of some character. Afterwards, the Fellows shared their reflections on their projects, at this, the midway point to the academic year. I’d like to share with you a few of my own reflections on the day’s activities.

First, the Schweitzer Fellows are a truly inspirational group. They continually demonstrate passion for helping communities in need, and the program in turn is helping them to see past the “patient” to the “person.” The Fellows are a self-selected group who have applied for these positions through a competitive process. How do we broaden the opportunities for more students to share in this type of experience – especially in light of the constant challenge of securing funding, and resistance from academic program leaders who don’t encourage their students to apply?

Second, Nicole Moore, the Program Director, and I (faculty mentor), contacted many charitable organizations in the Delaware Valley looking for a site interested in having the assistance of 17 volunteers for a day, before Ms. Brown at the Wright Center welcomed us. Most of our calls and e-mails did not even receive a response. I was surprised and appalled, and wonder how often potential volunteers are turned away, or turned off, by non-response to their offers of help. Surely, our charities can do a better job of encouraging volunteerism.

Finally, for those of the Not-so-Great Society who think that we can’t afford the health insurance provisions of the Patient Protection and Affordable Care Act, I encourage you to go spend a day at the Aletha R. Wright Center talking to the residents. Then let’s talk about how we can eliminate all the waste in healthcare today, to pay for coverage for all.

Sunday, January 30, 2011

The China Study II: A look at mortality in the 35-69 and 70-79 age ranges

This post is based on an analysis of a subset of the China Study II data, using HealthCorrelator for Excel (HCE), which is publicly available for download and use on a free trial basis. You can access the original data on the HCE web site, under “Sample datasets”.

HCE was designed to be used with small and individual personal datasets, but it can also be used with larger datasets for multiple individuals.

This analysis focuses on two main variables from the China Study II data: mortality in the 35-69 age range, and mortality in the 70-79 range. The table below shows the coefficients of association calculated by HCE for those two variables. The original variable labels are shown.

One advantage of looking at mortality in these ranges is that they are more likely to reflect the impact of degenerative diseases. Infectious diseases likely killed a lot of children in China at the time the data was being collected. Heart disease, on the other hand, is likely to have killed more people in the 35-69 and 70-79 ranges.

It is also good to have data for both ranges, because factors that likely increased longevity were those that were associated with decreased mortality in both ranges. For example, a factor that was strongly associated with mortality in the 35-69 range, but not the 70-79 range, might simply be very deadly in the former range.

The mortalities in both ranges are strongly correlated with each other, which is to be expected. Next, at the very top for both ranges, is sex. Being female is by far the variable with the strongest, and negative, association with mortality.

While I would expect females to live longer, the strengths of the associations make me think that there is something else going on here. Possibly different dietary or behavioral patterns displayed by females. Maybe smoking cigarettes or alcohol abuse was a lot less prevalent among them.

Markedly different lifestyle patterns between males and females may be a major confounding variable in the China Study sample.

Some of the variables are redundant; meaning that they are highly correlated and seem to measure the same thing. This is clear when one looks at the other coefficients of association generated by HCE.

For example, plant food consumption is strongly and negatively correlated with animal food consumption; so strongly that you could use either one of these two variables to measure the other, after inverting the scale. The same is true for consumption of rice and white flour.

Plant food consumption is not strongly correlated with plant protein consumption; many plant foods have little protein in them. The ones that have high protein content are typically industrialized and seed-based. The type of food most strongly associated with plant protein consumption is white flour, by far. The correlation is .645.

The figure below is based on the table above. I opened a separate instance of Excel, and copied the coefficients generated by HCE into it. Then I built two bar charts with them. The variable labels were replaced with more suggestive names, and some redundant variables were removed. Only the top 7 variables are shown, ordered from left to right on the bar charts in order of strength of association. The ones above the horizontal axis possibly increase mortality in each age range, whereas the ones at the bottom possibly decrease it.

When you look at these results as a whole, a few things come to mind.

White flour consumption doesn’t seem to be making people live longer; nor does plant food consumption in general. For white flour, it is quite the opposite. Plant food consumption reflects white flour consumption to a certain extent, especially in counties where rice consumption is low. These conclusions are consistent with previous analyses using more complex statistics.

Total food is positively associated with mortality in the 35-69 range, but not the 70-79 range. This may reflect the fact that folks who reach the age of 70 tend to naturally eat in moderation, so you don’t see wide variations in food consumption among those folks.

Eating in moderation does not mean practicing severe calorie restriction. This post suggests that calorie restriction doesn't seem to be associated with increased longevity in this sample. Eating well, but not too much, is.

The bar for rice (consumption) on the left chart is likely a mirror reflection of the white flour consumption, so it may appear to be good in the 35-69 range simply because it reflects reduced white flour consumption in that range.

Green vegetables seem to be good when you consider the 35-69 range, but not the 70-79 range.

Neither rice nor green vegetables seem to be bad either. For overall longevity they may well be neutral, with the benefits likely coming from their replacement of white flour in the diet.

Dietary fat seems protective overall, particularly together with animal foods in the 70-79 range. This may simply reflect a delayed protective effect of animal fat and protein consumption.

The protective effect of dietary fat becomes clear when we look at the relationship between carbohydrate calories and fat calories. Their correlation is -.957, which essentially means that carbohydrate intake seriously displaces fat intake.

Carbohydrates themselves may not be the problem, even if coming from high glycemic foods (except wheat flour, apparently). This post shows that they are relatively benign if coming from high glycemic rice, even at high intakes of 206 to 412 g/day. The problem seems to be caused by carbohydrates displacing nutrient-dense animal foods.

Interestingly, rice does not displace animal foods or fat in the diet. It is positively correlated with them. Wheat flour, on the other hand, displaces those foods. Wheat flour is negatively and somewhat strongly correlated with consumption of animal foods, as well as with animal fat and protein.

There are certainly several delayed effects here, which may be distorting the results somewhat.  Degenerative diseases don’t develop fast and kill folks right away. They often require many years of eating and doing the wrong things to be fatal.

Tuesday, January 25, 2011

...towards a m a n i f e s t o

Some thoughts on happiness...

Hedonic well-being?
Let Sunshine Win the Day
or Cynicism: it’s healthy and it makes me happy

The North West m a n i f e s t o events came about as a response to societal changes and as a way of artists and health allies expressing their frustrations and articulating shared passion. As a piece of work, it’s less about strategising and more about connecting and moving forward, and very much in the tradition of artist’s manifestos: its about shouting from the roof-tops.

Last week’s event in Liverpool was planned to give voice to practitioners across Merseyside to come together and exchange ideas and vision to inform the manifesto and celebrate some of the unfolding activity across the area. So, as part of a series of events, exploring shared aspirations for the field, this was a bit of a hybrid event, and with over fifty people in the room was vocal, buoyant and inspiring.

I introduced the session by framing our practice in relation to wider national and regional activity and placing the arts at the heart of society, both in reflection and reaction.

Artistic Director of FACT, Mike Stubbs went on to give a Liverpool context, painting a picture of a thriving and engaged cultural sector and challenging us to think about how we evidence our impact.

Punctuated with artist’s interventions, the session drew some significant thoughts and insight from participants that can be found on the dedicated m a n i f e s t o /merseyside blog pages (only available to that sessions participants, but all the m a n i f e s t o sessions will be drawn together leading up to June 2011).

The only off-note, was in Nic Marks’ rounding-up of the morning. Marks, of the new economics foundation (nef), mistakenly forgot he was at an arts event and not a happiness forum, missing, as he did the cynicism, experience and discontent in the room, (and perhaps wider society).

Whilst many of the people in the session had eloquently described how the arts are, by their very nature political, and I’d opened the session by expressing frustration at societal acceptance of blame for government mismanagement and the crimes of the bankers, Marks focused on what he saw as ‘cheap shots’ at the happiness agenda.1

Now I may be mistaken, but at all the m a n i f e s t o events, I’m mindful of ensuring a couple of things; keeping what I say as consistent as possible, for parity’s sake across the region, and focusing on the long (and rather obvious) history of the arts being more than little baubles and trinkets to pacify people, but as exciting, provocative, subversive and again, political.

By suggesting that cynical politicians may just be hijacking the happiness agenda and arguing our work wasn’t just about making people happy, I apparently blinded Marks to why he was there: to look at the arts in relation to well-being.

And the Five Ways to Well-being by nef are pretty much accepted as good, common-sense ways of looking at day-to-day actions to promote well-being. By connecting with people: being active: taking notice of things beyond our day to day: keeping learning and giving. So no argument there, in fact this ‘latest scientific evidence’ is blindingly obvious.

That’s why we asked Marks to round things off; we thought that all these actions might in fact, contribute towards more fully engaged members of society who connect with others and actively debate and question the status quo: take more than a passing interest in the sound-bites of the popular press and see the potential of shared voices and practice as being part of something bigger: contributing to wider civic society.

Surely then, the result of being a fully engaged citizen might just lead to a more cynical and less superficially ‘happy’ society. Describing my comment about our work not just being about making people happy, as being a ‘cheap-shot’ typical of the media, and for a ‘quick laugh’ Marks risked skewing the whole flavour of the session and devaluing the contributions made.2

I doubt that anyone taking part in the session would question the impact of the arts on well-being, that’s why we’re all involved, we weren’t there to explore the damage we can inflict on each other with our practice.

The point is, that the arts offer so much more than hedonic gratification, and through participation give voice to frustration, anger and cynicism; in other words, art is more than the blind pursuit of happiness (whatever that is) that we’re all told we must aspire to.

Like flat-screen TVs, 4x4 cars or celebrity spray-on tan, it seems happiness is being peddled on the consumerist must-have shopping list. Well, with 2.5 million people unemployed and counting, it looks like the only quick-fire state route to happiness will be through prescription drugs, no doubt on offer through our local National Health Franchise.

Whilst we’re on our way to understanding well-being, (and I’d suggest that the arts and cultural engagement play a big part in that journey), I find it increasingly difficult to imagine how subjective happiness can be identified let alone measured.

And yet as far back as the 2006 Conservative Party Conference, David Cameron has muted the idea of a happiness index, commenting, ‘Let optimism beat pessimism, let sunshine win the day..." Five years later, the NHS, Education and Cultural sectors are undergoing fundamental changes and the banking crisis has thrown the global economy into turmoil. Under the instruction of Cameron, a happiness index is being prepared as I type.

Clive Parkinson
Blue Monday: January 24th 2011

1. In his summing up, Marks said that Cameron and the Government don’t talk about happiness, whereas in reality, there is a wealth of coalition rhetoric on the subject.
2. Rounding off the event and from the lectern, Nic Marks looked me squarely in the eyes and asked, ‘Isn’t happiness the most important thing for our children?’ (Like Ricky Gervais, but without the irony). I wanted to scream, ‘Of course it is, you twerp!’ but I applauded politely thinking, ‘I’d like my children to have a healthy degree of cynicism too; oh and food and shelter, oh and education and love...’

Monday, January 24, 2011

HealthCorrelator for Excel (HCE) is now publicly available for free trial

HealthCorrelator for Excel (HCE) is now publicly available for download and use on a free trial basis. For those users who decide to buy it after trying, licenses are available for individuals and organizations. If you are a gym member, consider asking your gym to buy an organizational site license; this would allow the gym to distribute individual licenses at no cost to you and your colleagues.

HCE is a user-friendly Excel-based software that unveils important associations among health variables at the click of a button. Here are some of its main features:

- Easy to use yet powerful health management software.

- Estimates associations among any number of health variables.

- Automatically orders associations by decreasing absolute strength.

- Graphs relationships between pairs of health variables, for all possible combinations.

The beta testing was successfully completed, with fairly positive results. (Thank you beta testers!) Among beta testers were Mac users. The main request from beta testers was for more illustrative material on how to use HCE for specific purposes, such as losing body fat or managing blood glucose levels. This will be coming in the future in the form of posts and linked material.

To download a free trial version, good for 30 use sessions (which is quite a lot!), please visit the web site. There you will also find the software’s User Manual and various links to demo YouTube videos. You can also download sample datasets to try the software’s main features.

Twist Series: Growth & Length Retention IV

Micro twists (real hair)
  • I want to know how often should you moisturize in twists? I tend to do it everyday, and my hair ends up fuzzy!
I moisturize 1x a week, thus minimizing frizz, fuzz, and shrinkage.  I'm a big believer that if a moisturizer is doing what it's supposed to do, one wouldn't have to use it daily.  Try experimenting with other products if the one you are using just isn't keeping your hair moisturized.  Additionally, look into what you are using for your deep conditioner.  In my experience, a good deep condition and moisturizer on the day of twisting is key!  (Other than this method, you can plait your twists until they airdry to minimize the fuzz.)

  • at what length should you start wearing twists for length retention? i have about eight inches of hair all around and any time i try to do twists, it just looks ridiculous if i don't pin it up into a style. should i just refrain from doing twists until i get more length?

You can start wearing twists at any length that you are able to do so.  I will admit that when my hair was shorter, I felt ridiculous wearing twists to work.  However, after playing with them for some time, I was able to find a "suitable" style that was comfortable for me.  Eight inches is actually a good length for versatile twist styles.  In the next post, I'll include some pictures of style ideas for all lengths.  Stay tuned ...

Sunday, January 23, 2011

Population Health Colloquium--MARCH 2011

As the nation comes to grip with all the implications of Health Reform, and a renewed interest in work site wellness, prevention, care coordination and value based purchasing, the School of Population Health is presenting a forum to explore all of these issues. The Population Health Colloquium is a three day event co-located with two sister conferences on the Medical Home and Palliative Care set for March 13, 14, 15 and 16 in Philadelphia. Our School will also be conducting a pre conference work shop on the fundamentals of Population Health with lectures by four of our leading faculty members. Our special Sunday night March 13th "Book Event" is a great opportunity to meet more than half a dozen nationally prominent authors who will discuss their recent books, sign copies, and take questions from the audience about their work in health care. Our kick off speaker, Dr Nancy Snyderman, is the Chief Medical Correspondent for NBC National News and herself, an expert on care coordination, patient empowerment, and prevention. I am hoping to see scores of readers at our Colloquium and look forward to the ensuing dialogue. For more information go to See you then!!

Friday, January 21, 2011

Third Annual AMSA-IHI Patient Safety and Quality Leadership Institute

More than 50 students, from schools of medicine, pharmacy and nursing descended on the Jefferson School of Population Health for a weekend-long immersion in patient safety and quality movement.

Led by faculty from JSPH, and including leaders from Penn, Vanderbilt, Hofstra and the AAMC, these students were exposed to the latest thinking in curriculum design, experiential learning and safety simulation. The didactic presentations, facilitated workshops, and project presentations were all first rate.

Key themes emerged – insufficient faculty in the health sciences to teach the tenets of quality and safety, insufficient curriculum time devoted to these critical issues and, above all else, a lack of urgency in most schools responsible for career preparation for health professionals. This, despite the fact that 11 persons die every hour in our great nation from preventable medical errors!! That means nearly 300 persons perished during the formal part of our weekend-long teaching and learning event.

We ended the weekend with a checklist of ideas to implement "tomorrow" and a call for renewed energy for curricula and system reform.

For me, it was both an energizing experience to work with so many wonderful students from around the nation, and physically exhausting trying to keep up with their level of enthusiasm for all three days!! I am grateful for their total participation in this annual event and look forward to giving one of the three "Thought Leader" presentations at the 1,000-student strong AMSA Annual Convention on March 11, 2011 in Washington DC.

Are you learning about safety to save lives in your health system??

3in6 Challenge Rules

For the first post, read here.

To all the challengers (and interested readers), be sure to bookmark this post!

Purpose of this challenge: To retain 2-3 inches of growth in 6 months.

Challenge period: February 1 - August 1, 2011

1. Eat fresh vegetables or fruits with each meal.
2. Take a daily multivitamin.
3. Drink sufficient water.
(Amt of water in oz. = Your weight in lbs * 0.5)
4. Wear twists or braids 2-4 weeks at a time.
5. No direct heat.
6. Pre-poo with coconut oil for 20 minutes.
7. Absolutely no trimming.  (Start with a fresh cut now if need be.)

Each challenger is allowed two 1-week periods of styling her hair as she pleases (e.g., puff, rollerset, etc.).

For documentation of your length retention:
- Notebook/journal or camera
- Ruler/measuring tape

Tips on wearing twists/braids long term:
- Do not twist/braid too tightly
- Redo the perimeter weekly or biweekly.
- Deep condition & detangle thoroughly prior to twisting or braiding.
- For more tips, check out posts in the twist series

The Challenge begins February 1st!  Start preparing.

Everything Coconut Oil!

Thursday, January 20, 2011

Guest Commentary: Developing Improvement Leaders

Valerie Pracilio, MPH
Project Manager for Quality Improvement
Jefferson School of Population Health

There is a "gigantic challenge between the scale of the emergency and the scale of the response" said Bono at the National Prayer Breakfast in 2006. While he was referring to the AIDS epidemic, the same can be said for health care. This weekend, close to 50 students joined together on Jefferson's campus for the 3rd Annual Patient Safety and Quality Leadership Institute to learn how to be leaders in improving our healthcare system and address the emergency. In the time we spent talking about these issues this past weekend, nearly 300 lives were lost to medical errors (11lives/hour), as Dr. Nash mentioned in the previous post. How can this be acceptable in a system that is intended to help them?

Medical, nursing and pharmacy students came together this weekend, making the Institute interdisciplinary for the first time in its three-year history. This accomplishment was the result of collaboration between the program co-sponsors, the Jefferson School of Population Health (JSPH), the American Medical Student Association (AMSA) and the Institute for Healthcare Improvement (IHI). All three of these groups are working to improve the system, but we still have a long way to go.

As an IHI Open School Chapter leader, I hear about these challenges all the time, but we have to be sure to celebrate that there are a lot of great people working to fix the issues. Students have limited opportunities, at best, to learn about quality and safety in the classroom. Their voluntary participation this weekend is an indication that they already recognize safety and quality is part of their responsibility. As Donald Berwick, former CEO of the IHI, says, “the structure of the health-care system encourages good people to make harmful medical errors.”

The challenge facing the students was how to take what they learned back to their school/institution and educate others, in essence becoming advocates for improvement. We have a dual role as clinicians and leaders. The majority of current healthcare professionals don't understand this and future healthcare professionals need to be taught. The weekend started with a group of students interested in learning about quality and safety, but it concluded with a network of improvement leaders energized to create change. There is no doubt that the leaders developed this weekend will advance the improvement movement.

Wednesday, January 19, 2011

Twist Series: Growth & Length Retention III

  • how can you protect your ends while in twists? 
First and foremost, wear a satin bonnet or scarf to bed.  Cotton pillowcases can make the ends of your twists dry and brittle.  Next, make sure your ends are sufficiently moisturized.  Lastly, if your twists brush your shoulders (or beyond), pin it up during the day.  This minimizes snagging and drying of the ends from contact with your clothes.

  • ... What products should you use? 
Use products that leave your twists sufficiently moisturized.  This includes a good deep conditioner and moisturizer on the day you twist.  Also use products that do not contain humectants (e.g., glycerin, propylene glycol) if you want to keep shrinkage at bay for as long as possible.  Other than these two conditions, use what works for you and what you like.  (I use LeKair Cholesterol for deep conditioning and a shea butter mix to seal after rinsing.)

  • ... and should end papers be used to protect ends? 
No, end papers are not necessary.

  • ... Also how long should you keep twists in for optimal growth? Should you keep a style in one, two or three weeks
For optimal growth, twists should be worn for as long as your hair can handle.  The less you manipulate your hair via styling, the less breakage, and the more length retention.  Ideally, twists should be worn for 2-5 weeks at a time with minimal washing (to prevent locking and meshing).  Find a duration that works best for your hair.  (I wear mine for 3-4 weeks at a time.)

Label of the Day: Breakage

{Image Source}
Here are some posts on "Breakage" in case you've missed them:

Tips for a Sensitive Hairline
Tips for Transitioning or Stretching Relaxers
Nape Breakage?
Micro Twist Takedown on CNapp Hair
Boar Brush = Damage to Your Edges?

For more breakage-related posts, click here.

Tuesday, January 18, 2011

3 inches in 6 months Challenge!

How do you readers feel about joining me in a length retention challenge?

Hair grows an average of 0.5in/month.  (Some people get less growth and others get more.)  For this challenge, we'll aim to retain 2-3 inches in 6 months.  Guidelines will be posted later this week to help you through the process.  Also, we'll be in touch on a monthly basis. If you are interested, please leave a comment below.

Challenge period: February 1 - August 1, 2011.

Healthy hair in 2011!

Saturday, January 15, 2011

Do you lose muscle if you lift weights after a 24-hour fast? Probably not if you do that regularly

Compensatory adaptation (CA) is an idea that is useful in the understanding of how the body reacts to inputs like dietary intake of macronutrients and exercise. CA is a complex process, because it involves feedback loops, but it leads to adaptations that are fairly general, applying to a large cross-section of the population.

A joke among software developers is that the computer does exactly what you tell it to do, but not necessarily what you want it to do. Similarly, through CA your body responds exactly to the inputs you give it, but not necessarily in the way you would like it to respond. For example, a moderate caloric deficit may lead to slow body fat loss, while a very high caloric deficit may bring body fat loss to a halt.

Strength training seems to lead to various adaptations, which can be understood through the lens provided by CA. One of them is a dramatic increase in the ability of the body to store glycogen, in both liver and muscle. Glycogen is the main fuel used by muscle during anaerobic exercise. Regular strength training causes, over time, glycogen stores to more than double. And about 2.6 the amount of glycogen is also stored as water.

When one looks bigger and becomes stronger as a result of strength training, that is in no small part due to increases in glycogen and water stored. More glycogen stored in muscle leads to more strength, which is essentially a measure of one’s ability to move a certain amount of weight around. More muscle protein is also associated with more strength.

Thinking in terms of CA, the increase in the body’s ability to store glycogen is to be expected, as long as glycogen stores are depleted and replenished on a regular basis. By doing strength training regularly, you are telling your body that you need a lot of glycogen on a regular basis, and the body responds. But if you do not replenish your glycogen stores on a regular basis, you are also sending your body a conflicting message, which is that dietary sources of the substances used to make glycogen are not readily available. Among the substances that are used to make glycogen, the best seems to be the combination of fructose and glucose that one finds in fruits.

Let us assume a 160-lbs untrained person, John, who stored about 100 g of glycogen in his liver, and about 500 g in his muscle cells, before starting a strength training program. Let us assume, conservatively, that after 6 months of training he increased the size of his liver glycogen tank to 150 g. Muscle glycogen storage was also increased, but that is less relevant for the discussion in this post.

Then John fasted for 24 hours before a strength training session, just to see what would happen. While fasting he went about his business, doing light activities, which led to a caloric expenditure of about 100 calories per hour (equivalent to 2400 per day). About 20 percent of that, or 20 calories per hour, came from a combination of blood glucose and ketones. Contrary to popular belief, ketones can always be found in circulation. If only glucose were used, 5 g of glucose per hour would be needed to supply those 20 calories.

During the fast, John’s glucose needs, driven primarily by his brain’s needs, were met by conversion of liver glycogen to blood glucose. His muscle glycogen was pretty much “locked” during the fast; because he was doing only light activities, which rely primarily on fat as fuel. Muscle glycogen is “unlocked” through anaerobic exercise, of which strength training is an instance.

One of the roles of ketones is to spare liver glycogen, delaying the use of muscle protein to make glucose down the road, so the percentage of ketones in circulation in John’s body increased in a way that was inversely proportional to stored liver glycogen. According to this study, after 72 hours fasting about 25 percent of the body’s glucose needs are met by ketones. (This may be an underestimation.)

If we assume a linear increase in ketone concentration, this leads to a 0.69 percent increase in circulating ketones for every 2-hour period. (This is a simplification, as the increase is very likely nonlinear.) So, when we look at John’s liver glycogen tank, it probably went down in a way similar to that depicted on the figure below. The blue bars show liver glycogen at the end of each 2-hour period. The red bars show the approximate amount of glucose consumed during each 2-hour period. Glucose consumed goes down as liver glycogen decreases, because of the increase in blood ketones.

As you can see, after a 24-hour fast, John had about 35 g of glycogen left, which is enough for a few extra hours of fasting. At the 24-hour mark the body had no need to be using muscle protein to generate glucose. Maybe some of that happened, but probably not much if John was relaxed during the fast. (If he was stressed out, stress hormones would have increased blood glucose release significantly.) From the body’s perspective, muscle is “expensive”, whereas body fat is “cheap”. And body fat, converted to free fatty acids, is what is used to produce ketones during a fast.

Blood ketone concentration does not go up dramatically during a 24-hour fast, but it does after a 48-hour fast, when it becomes about 10 times higher. This major increase occurs primarily to spare muscle, including heart muscle. If the increase is much smaller during a 24-hour fast, one can reasonably assume that the body is not going to be using muscle during the fast. It can still rely on liver glycogen, together with a relatively small amount of ketones.

Then John did his strength training, after the 24-hour fast. When he did that, the muscles he used in the exercise session converted locally stored glycogen into lactate. A flood of lactate was secreted into the bloodstream, which was used by his liver to produce glucose and also to replenish liver glycogen a bit. Again, at this stage there was no need for John’s body to use muscle protein to generate glucose.

Counterintuitive as this may sound, the more different muscles John used, the more lactate was made available. If John did 20 sets of isolated bicep curls, for example, his body would not have released enough lactate to meet its glucose needs or replenish liver glycogen. As a result, stress hormones would go up a lot, and his body would send him some alarm signals. One of those signals is a feeling of “pins and needles”, which is sometimes confused with the symptoms of a heart attack.

John worked out various muscle groups for 30 minutes or so, and he did not even feel fatigued. He felt energetic, in part because his blood glucose went up a lot, peaking at 150 mg/dl, to meet muscle needs. This elevated blood glucose was caused by his liver producing blood glucose based on lactate and releasing it into his blood. Muscle glycogen was depleted as a result of that.

Do you lose any muscle if you lift weights after a 24-hour fast?

I don’t think so, if you deplete your glycogen stores by doing strength training on a regular basis, and also replenish them on a regular basis. In fact, your liver glycogen tank will increase in size, and you may find yourself being able to fast for many hours without feeling hungry.

You will feel hungry after the strength training session following the fast though; probably ravenous.


Brooks, G.A., Fahey, T.D., & Baldwin, K.M. (2005). Exercise physiology: Human bioenergetics and its applications. Boston, MA: McGraw-Hill.

Wilmore, J.H., Costill, D.L., & Kenney, W.L. (2007). Physiology of sport and exercise. Champaign, IL: Human Kinetics.

Friday, January 14, 2011

Guest Commentary: The Role of Outliers in Determining Hospital Quality

Robert Lieberthal
Jefferson School of Population Health

One of the exciting new opportunities in healthcare quality and safety is the potential to use large datasets to help us identify high quality hospitals. However, this task is daunting, because we are still figuring out how to extract useful information from all that data. I am currently writing a grant on validating the PRIDIT method for aggregating Hospital Compare data.

Richard Derrig, one of the researchers responsible for developing the model, described PRIDIT as '...a relatively new and versatile technique for producing a rank ordered score for the intensity of a latent variable [hospital quality in this case], given a set of predictor variables that are related to the variable in a monotone way [hospital process measures in this case].’ The work is an extension of two of my papers: “Hospital quality—A PRIDIT approach” and “Grouping hospitals by quality—a PRIDIT approach with bootstrapping. The following is an excerpt from my grant application:

In prior work, we demonstrated how to create bootstrapped standard errors for the PRIDIT scores. We found that the size of standard errors for the overall quality score varies with the level of quality in a u-shaped pattern. Standard errors are small for average quality hospitals and larger for low quality and high quality hospitals. Our conjecture was that, because we classified most hospitals as being of average quality, our confidence in the quality of these hospitals is much higher than “outlier hospitals” of high or low quality.

The u-shaped pattern comes from the following graph in my paper, “Grouping hospitals by quality—a PRIDIT approach with bootstrapping” published in the 2008 Proceedings of the Joint Statistical Meeting. The x-axis shows the percentile of hospital quality, and the y-axis shows the standard deviation of quality scores for a hospital at a certain percentile of the quality distribution. Standard deviations for outliers are almost four times as high as for average hospitals:

I think that this result is instructive as I reflect on the debate over health reform, as well as in our future efforts at quality improvement. When President Obama lauded the Cleveland Clinic as being a high quality, low cost hospital, one rejoinder was that the Cleveland Clinic is indeed special, drawing wealthy patients from around the world, and thus is not a model for most community hospitals (WSJ).

On the other hand, when Martin Luther King Jr.-Harbor Hospital in Los Angeles County was shut down by federal regulators, there was a ripple effect on nearby community hospitals which may have negatively affected population health (NY Times), pointing out the sad truth that sometimes the hospital a community has is better than none at all.

My takeaway is that, while more data is better, we will have to employ a mix of statistical and cultural techniques when evaluating hospital quality in the context of overall population health. The growing power of computers, the gigabytes of new data, and the flood of bright new researchers we are attracting to the study of healthcare quality and safety will help us answer many of the open questions in the academic literature.

However, I think that we should be skeptical about the real world meaning of our results, and focus on research settings most likely to lead to generalizable outcomes. I am hopeful that we can find ways to improve quality at all types of hospitals, but especially those serving the most vulnerable populations.

Youtube: HEALTHY Food Recipe for the Professional

Check out the following informative video from one my favorite youtubers.  I've been making my own ground turkey tacos for some time and love to see when others are taking the healthier route as well.   She (Afrostory) does a thorough job of explaining alternatives to ground beef, cheese, salsa, and iceberg lettuce.  She also gives insight into the effects of high sodium, processed salt, lactose intolerance, etc.  

If you're on a budget, check out the following DIY healthy smoothie recipes in place of Odwalla:

Soy Smoothie Meets Green Smoothie
Cranberry Smoothie

Again, healthy hair and body start from within!

Chapt.II: Precautions When Highlighting

Last week, I talked about factors to consider BEFORE chemically highlighting your natural hair.  Please read that post before delving into to this one.

This week, I'll discuss some precautions one should take when highlighting natural hair at home.  If you choose to have the process done professionally, be sure that your colorist knows how to color natural hair and not just hair in general.  I had a friend walk into an Aveda salon and walk out with beautiful color but loosened texture and dry hair.  Don't let that be you.

PRECAUTIONS when highlighting at home:

1. Use a commercial kit.  Commercial highlighting kits are designed to yield minimal mistakes.  I have used (in the past) and recommend African Pride HiLites.  L'Oreal Colour Rays (used this time) is also good but TOO strong for relaxed tresses.  Though a few people have had success with hydrogen perioxide as a highlighting technique, I do NOT recommend it (from my own past experience); by the time it lifts the color to a desirable shade, damage is done to the strands.

2. FOLLOW THE DIRECTIONS provided in the kit.  This is the number one precaution one must take above all others.  Many highlight jobs go wrong when instructions are not followed properly.  I've had the experience of my whole hair break off when I left a dye on for 5 minutes longer than stated in the directions.

3. Pre-treat with coconut oil for 20 minutes before highlighting.  I don't know whether this method is effective against chemical damage or merely psychological, but I felt better knowing that my hair was strengthened going into the dye job.  The oil did not interfere with the intensity of the color in my experience.

4. Don't leave the dye on your head longer than instructed.  Actually, it is ideal to leave it on for less time. If the kit says 25 minutes, leave it on for 20 minutes.  If you want optimal color, leave it on for the full 25 minutes but no longer than that.

5. Rinse and wash your hair and scalp thoroughly after the process.

6. After using the conditioner/conditioning shampoo from the kit, follow up with your usual deep conditioner.  This step will ensure that moisture and strength is restored to your strands.  In my recent highlighting experience, I immediately followed up with a 20-minute deep treatment using Lekair Cholesterol mixed with olive oil.

7. Wait about 4-6 months to highlight after a henna treatment.  (See this link.)  After highlighting, wait another 4-6 months before hennaing again.  Some individuals may highlight/henna sooner, but this precaution is just to be on the safe side.


Wednesday, January 12, 2011

Bits and Bats…an Arts and Health Networking Miscellany
27th January, 6:00 – 8:00
Venue at MMU: Details will be emailed to you at least 48 hours in advance

Just to remind you that at this networking evening, I’ll be sharing some very quirky films from the early days of the NHS, purely for our fun and conversation. They are wonderful. If you have any film/new media at all that you’d like to share, please let me know in advance.

m a n i f e s t o update…
For those of you who have been involved in these events to date, a big THANK YOU. There’s another event at the Bluecoat Gallery on the 19th.

Its part m a n i f e s t o and part celebration of work underway in Merseyside and if you want to attend, please get in touch with Polly Moseley at  

Following the first stage m a n i f e s t o work which has seen a gathering of passion, vision and aspiration of those involved, I’ll be drawing all the strands together for a second stage of activity which will see us coming together and refining what it is, where it goes and what we do with it. By June 2011 we’ll have something very public to share.

The North West Arts and Health Network is past 1500 members…but what does it all mean?

In reality, our reach is potentially far wider than this, as a number of you email this to your networks on my behalf (thank you)!

Remembering that this network is informal and free…what is it that you’d like to see happening? How can we support each other and what would be useful to have online…most anything is possible.

It would be easy for me to put a survey out and ask you all the obvious questions; but what would the point be? Because if I’m asking the questions, I’m steering things just a bit too much.

So what might be a good starting point is if you email me thoughts, ideas and aspirations and I’ll put some of those questions on the BLOG, anonymously, but so others can see the sorts of things people are talking about. So feel free to email me at and we can beef up our network in ways that are useful to you.

News in from Jeremy Hunt...

… ‘Culture and sport support a range of policy priorities including, but not limited to, economic growth, health and wellbeing, and safer and stronger communities’.

Thanks for that one Jeremy.

See his letter to local authorities below.

29 December 2010

Dear Councillor

We are writing to you about our shared goal of getting better local services for people and to update you on some practical measures to help local authorities delivering cultural and sporting services when the government's overriding priority is deficit reduction, as reflected in the local government finance settlement.

We would like to highlight some of the many examples of improvement and modernisation across local cultural and sporting services. Culture and sport support a range of policy priorities including, but not limited to, economic growth, health and wellbeing, and safer and stronger communities. It is for these reasons that culture and sport are so important to communities and tend to attract significant local interest. Councils across the country have also learned that it is important to prepare for changes with evidence that can be defended.

Through the Future Libraries Programme (FLP) the Local Government Group and Museums, Libraries & Archives Council (MLA) are supporting 36 councils to find new ways to deliver library services without cutting the front line. We thought it would be helpful, ahead of the formal publication of findings from the programme, to share with you examples of the leading savings options that are emerging and our newsletter gives you more information. The MLA and Local Government Group can help if you want to find out more and are available to assist you in looking at a wider range of options and ideas for your library services that could help you save money while minimising the need for cuts to front line services.

Library authorities outside the programme are also developing innovative approaches to providing services:

* Essex County Council will be helping to improve Slough Borough Council's library service and reduce its administration costs from 1 January 2011;
* Investment by Aviva has contributed towards the transformation of York Central Library with more books, the latest technologies and new services;
* In North Yorkshire volunteers at Grassington Hub are at the heart of service delivery.

We are convinced that innovation, led by the energy and experience of councils themselves, is also going to provide the best recipes for modernising cultural services generally in a tougher financial climate.

There are also lots of examples of councils developing different approaches to providing local cultural and sporting services and responding to the economic situation by being innovative:

Many councils are successfully commissioning their cultural services to deliver more efficiently other key service priorities such as adult social care, health, better outcomes for children and young people and economic development;

* Manchester City Council has focused its culture and sport services as major drivers of economic growth, inward investment, and job creation and training;
* Leicester Comedy Festival has developed relationships with communities and the health service to respond to issues such as men's health, teenage pregnancy and healthy eating amongst children and young people;
* Suffolk Artlink manages a series of projects aimed at improving the lives of vulnerable people in Suffolk including older people and their carers;
* In Kirklees a partnership between creative arts organisations offer a range of services for people as part of their mental health and wellbeing care planning services.

There are a number of different ways by which examples such as these are shared widely across the local government sector, including:

LGID's website brings together in one place the learning that is coming out of the "Passion for Excellence" improvement work in partnership with DCMS and key public bodies.

The Living Places website is a suite of online resources developed by DCMS and key public bodies to support the contribution of culture and sport to planning http://living  

LGID has also launched two new publications outlining ways the sector can improve its efficiency through new ways of working and making better use of assets and sources of further help.  

Help and advice is available and it could assist you in providing the culture and sport local people will be looking for while making the savings that are needed.

Secretary of State for Culture, Olympics, Media and Sport

Chair, LG Group Culture, Tourism

Tuesday, January 11, 2011

Chocolate Conditioner Recipes!

I LOVE chocolate (in moderation) but who would've thought it could be used to condition the hair!?!  Chocolate is high in fat and has a bit of protein - a great combination for a conditioner worth trying.  (This sweet also has a small amount of caffeine, which studies have suggested may stimulate hair growth in those suffering from balding.[1])  I smell a recipe review coming around Valentine's Day?  If you can't wait until then, feel free to experiment with the concoctions below:

- dark chocolate bar
- yogurt
- honey
Recipe and Instructions

- overripe banana (be sure to sieve)
- honey
- dark chocolate
Recipe and Instructions

CHOCOLATE HAIR MASK - For the Mixologist!
- honey
- overripe banana
- coconut milk
- coconut oil
- pure cocoa butter
- jojoba oil (or olive oil)
- pure cacao (cocoa) powder
Recipe and Instructions


Twist Series: Growth & Length Retention II

  • While maintaining twists, how can you prevent the ends from getting tangly (scraggly)? 
  • i second the question on how to prevent tangly ends while in twists. they feel detangled before i twist them, but when i take them down i sometimes feel the tangles.
I first make sure to twist on damp/dry, stretched hair.  (Shrunken ends are more inclined to tangle than stretched ends.)  To prevent tangling after twisting, I keep moisturizing and washing to a minimum - about weekly or biweekly.  By the end of week #2, my ends are pretty shrunken and this would be a perfect time to redo my twists.  However, I tend to keep twists in for 3-4 weeks at a time.  Slightly tangled ends at this point are almost inevitable, but shea butter or some water + conditioner help the strands separate fairly easily.  (If the ends are really tangled, that may indicate that you're in need of a trim.)

  • How often should you trim while wearing twists? 
Trim as often as needed rather than on a set schedule.  (See this post.)  Trimming on a set schedule reduces length retention in my opinion and experience.

  • When is the best time to start pinning them up? I'm noticing that I'm losing some length due to damage at the ends, though I've been wearing my hair in twists as a protective style for the past few months.
Ideally, you want to start pinning up twists when they are long enough such that the style is effortless and does not cause much tension on the scalp or ends.  For me, that "comfortable" length was APL stretched.  Damage at the ends can result from a number of sources: pinning up the twists too early, leaving the twists in for too long, impatience during the twist takedown, improperly taking the twists down (i.e., pulling them apart from root to tip = bad), dryness, etc.

Monday, January 10, 2011

How come evolution hasn’t made us immortal? Death, like sex, helps animal populations avoid extinction

Genes do not evolve, nor do traits that are coded for our genes. We say that they evolve to facilitate discourse, which is alright. Populations evolve. A new genotype appears in a population and then either spreads or disappears. If it spreads, then the population is said to be evolving with respect to that genotype. A genotype may spread to an entire population; in population genetics, this is called “fixation”.

(Human chromosomes capped by telomeres, the white areas at the ends. Telomere shortening is caused by oxidative stress, and seems to be associated with death of cells and organisms. Source: Wikipedia.)

Asexual reproduction is very uncommon among animals. The most accepted theory to explain this is that animal populations live in environments that change very quickly, and thus need a great deal of genetic diversity within them to cope with the change. Otherwise they disappear, and so do their genes. Asexual reproduction leads to dramatically less genetic diversity in populations than sexual reproduction.

Asexual reproduction is similar to cloning. Each new individual looks a lot like its single parent. This does not work well in populations where individuals live relatively long lives. And even 1 year may be too long in this respect. It is just too much time to wait for a possible new mutation that will bring in some genetic diversity. To complicate matters, genetic mutation does not occur very often, and most genetic mutations are neutral with respect to the phenotype (i.e., they don’t code for any trait).

This is not so much of a problem for species whose members reproduce extremely fast; e.g., produce a new generation in less than 1 hour. A fast-reproducing species usually has a short lifespan as well. Accordingly, asexual reproduction is common among short-lived and fast-reproducing unicellular organisms and pathogens that have no cell structure like viruses.

Bacteria and viruses, in particular, form a part of the environment in which animals live that require animal populations to have a large amount of genetic diversity. Animal populations with low genetic diversity are unlikely to be able to cope with the barrage of diseases caused by these fast-mutating parasites.

We make sex chiefly because of the parasites.

And what about death? What does it bring to the table for a population?

Let us look at the other extreme – immortality. Immortality is very problematic in evolutionary terms because a population of immortal individuals would quickly outgrow its resources. That would happen too fast for the population to evolve enough intelligence to be able to use resources beyond those that were locally available.

In this post I assume that immortality is not the same as indestructibility. Here immortality is equated to the absence of aging as we know it. In this sense, immortals can still die by accident or due to disease. They simply do not age. For immortals, susceptibility to disease does not go up with age.

One could argue that a population of immortal individuals who did not reproduce would have done just fine. But that is not correct, because in this case immortality would be akin to cloning, but worse. Genetic diversity would not grow, as no mutations would occur. The fixed population of immortals would be unable to cope with fast-mutating parasites.

There is so much selection pressure against immortality in nature that it is no surprise that animals of very few species live more than 60 years on average. Humans are at the high end of the longevity scale. They are there for a few reasons. One is that our ancestors had offspring that required extra care, which led to an increase in the parents’ longevity. The offspring required extra care chiefly because of their large brains.

That increase in longevity was likely due to genetic mutations that helped our ancestors extend a lifespan that was programmed to be relatively short. Immortality is not a sound strategy for population survival, and thus there are probably many mechanisms through which it is prevented.

Death is evolution’s main ally. Sex is a very good helper. Both increase genetic diversity in populations.

We can use our knowledge of evolution to live better today. The aging clock can be slowed significantly via evolutionarily sound diet and lifestyle changes, essentially because some of our modern diet and lifestyle choices accelerate aging a lot. But diet and lifestyle changes probably will not make people live to 150.

If we want to become immortal, as we understand it in our current human form, ultimately we may want to beat evolution. In this sense, only very intelligent beings can become immortal.

Maybe we can achieve that by changing our genes, or by learning how to transfer our consciousness “software” into robots. In doing so, however, we may become something different; something that is not human and thus doesn’t see things in the same way as a human does. A conscious robot, without the hormones that so heavily influence human behavior, may find that being alive is pointless.

There is another problem. What if the only natural way to achieve some form of immortality is through organic death, but in a way that we don’t understand? This is not a matter of faith or religion. There are many things that we don’t know for sure. This is probably the biggest mystery of all; one that we cannot unravel in our current human state.

Friday, January 7, 2011

Healthy Skin Tips for 2011

{Image Source}
Do you want healthy skin in 2011?  Start with these tips:

1a. Eat healthily
The number one key to healthy skin is to eat healthy.  Great food choices include carrots (high in Vitamin A), green vegetables, oranges, etc.  If you are not getting sufficient nutrients from your meals, invest in a good multivitamin.  An antioxidant supplement couldn't hurt either.  (For more info: antioxidants and aging.)

1b. Eat less sweets
Research has shown that sweets (eg., chocolate, candy, cake, etc.) may contribute to acne.  From my own personal experience, I have seen this to be true with my skin.  For the new year, replace sweets with granola bars, peanut butter on wheat sandwiches, and fruits.  (For more info: sugar and acne, article on sugar and acne.)

2. Drink sufficient water
Water helps to move nutrients throughout the body.

3a. Adhere to a skin care regimen
A skin care regimen is also essential for achieving healthy skin.  Wash daily and nightly.  Exfoliate regularly.  Invest in a good cleanser, moisturizer, and sunscreen.  (For more info: basic skin care regimen.)

3b. Wear sunscreen
Even though "black don't crack", it eventually will and will do so at a faster pace without UV protection.  Wear sunscreen containing a minimum SPF of 15.  (For more info: black skin and sunscreen.)

Label of the Day: Moisture

Here are some posts on "Moisture" in case you've missed them:

1. Winterize Your Washes!
2. Winterize Your Conditioner!
3. Retaining The Hair You Grow: Chapter 6
4. Reader's Question: More on Moisture ... Dry Ends
5. Oils, Aloe Vera, and Whipped Butter
6. Whipped Hair Butter Recipes Galore!
7. Retaining the Hair You Grow: Chapter 7
8. Grapeseed Oil, Linoleic Acid, & Body Butter Mix
9. Reader's Question: When Shea Butter Doesn't Work
10. Moisturizing Spritz Recipes

Thursday, January 6, 2011

Does strength exercise increase nitrogen balance?

This previous post looks at the amounts of protein needed to maintain a nitrogen balance of zero. It builds on data about individuals doing endurance exercise, which increases the estimates a bit. The post also examines the issue of what happens when more protein than is needed in consumed; including by people doing strength exercise.

What that post does not look into is whether strength exercise, performed at the anaerobic range, increases nitrogen balance. If it did, it may lead to a counterintuitive effect: strength exercise, when practiced at a certain level of intensity, might enable individuals in calorie deficit to retain their muscle, and lose primarily body fat. That is, strength exercise might push the body into burning more body fat and less muscle than it would normally do under calorie deficit conditions.

(Strength exercise combined with a small calorie deficit may be one of the best approaches for body fat loss in women. Photo source:

Under calorie deficit people normally lose both body fat and muscle to meet caloric needs. About 25 percent of lean body mass is lost in sedentary individuals, and 33 percent or more in individuals performing endurance exercise. I suspect that strength exercise has the potential to either bring this percentage down to zero, or to even lead to muscle gain if the calorie deficit is very small. One of the reasons is the data summarized on this post.

Two other reasons are related to what happens with children, and the variation in spontaneous hunger up-regulation in response to various types of exercise. The first reason can be summarized as this: it is very rare for children to be in negative nitrogen balance (Brooks et al., 2005); even when they are under some, not extreme, calorie deficit. It is rare for children to be in negative nitrogen balance even when their daily consumption of protein is below 0.5 g per kg of body weight.

This suggests that, when children are in calorie deficit, they tend to hold on to protein stores (which are critical for growth), and shift their energy consumption to fat more easily than adults. The reason is that developmental growth powerfully stimulates protein synthesis. This leads to a hormonal mix that causes the body to be in anabolic state, even when other forces (e.g., calorie deficit, low protein intake) are pushing it into a catabolic state. In a sense, the tissues of children are always hungry for their building blocks, and they do not let go of them very easily.

The second reason is an interesting variation in the patterns of spontaneous hunger up-regulation in various athletes. The increase in hunger is generally lower for strength than endurance activities. The spontaneous increase for bodybuilders is among the lowest. Since being in a catabolic state tends to have a strong effect on hunger, increasing it significantly, these patterns suggest that strength exercise may actually contribute to placing one in an anabolic state. The duration of this effect is approximately 48 h. Some increase in hunger is expected, because of the increased calorie expenditure during and after strength exercise, but that is counterbalanced somewhat by the start of an anabolic state.

What is going on, and what does this mean for you?

One way to understand what is happening here is to think in terms of compensatory adaptation. Strength exercise, if done properly, tells the body that it needs more muscle protein. Calorie deficit, as long as it is short-term, tells the body that food supply is limited. The body’s short-term response is to keep muscle as much as possible, and use body fat to the largest extent possible to supply the body’s energy needs.

If the right stimuli are supplied in a cyclical manner, no long-term adaptations (e.g., lowered metabolism) will be “perceived” as necessary by the body. Let us consider a 2-day cycle where one does strength exercise on the first day, and rests on the second. A surplus of protein and calories on the first day would lead to both muscle and body fat gain. A deficit on the second day would lead to body fat loss, but not to muscle loss, as long as the deficit is not too extreme. Since only body fat is being lost, more is lost on the second day than on the first.

In this way, one can gain muscle and lose body fat at the same time, which is what seems to have happened with the participants of the Ballor et al. (1996) study. Or, one can keep muscle (not gaining any) and lose more body fat, with a slightly higher calorie deficit. If the calorie deficit is too high, one will enter negative nitrogen balance and lose both muscle and body fat, as often happens with natural bodybuilders in the pre-tournament “cutting” phase.

In a sense, the increase in protein synthesis stimulated by strength exercise is analogous to, although much less strong than, the increase in protein synthesis stimulated by the growth process in children.


Ballor, D.L., Harvey-Berino, J.R., Ades, P.A., Cryan, J., & Calles-Escandon, J. (1996). Contrasting effects of resistance and aerobic training on body composition and metabolism after diet-induced weight loss. Metabolism, 45(2), 179-183.

Brooks, G.A., Fahey, T.D., & Baldwin, K.M. (2005). Exercise physiology: Human bioenergetics and its applications. Boston, MA: McGraw-Hill.

Wednesday, January 5, 2011

Chemically Highlight Natural Hair?

{Jordin Sparks}
In late November, I chemically highlighted my hair for the first time since going natural.  After approximately seven weeks, my hair is doing just fine.  How do you know if chemical highlighting is for you?  Well, for one, I DO NOT recommend it unless you have thoroughly contemplated and researched the process, alternatives, and consequences.  Here are some questions worth considering before taking the plunge:

Read this previous post on the chemical process and potential damage from misuse.  Do your own research as well.

Why do you want chemical highlights?  Can the color you are seeking be achieved by healthier, more natural means (e.g., henna, honey, cinnamon)? What about temporary alternatives (e.g., color extensions)?

If your hair is damaged and weak, I recommend staying away from chemical highlights.  If your hair is healthy, are you willing to suffer any setbacks or consequences that may come with highlighting?  Split ends? Increased porosity?

Do you plan to henna after highlighting? Have you hennaed and now plan to chemically highlight?  If so, there are some factors (e.g., length of time between dye job and henna treatment, quality of henna used, etc.) you should consider.  Read this link and do further research.

Stay tuned for a post on PRECAUTIONS, MAINTENANCE, ETC.
{Highlights achieved with a semi-permanent commercial dye.}
WHY I DID IT: I'm an artist at heart, and one of the ways I express myself is through my hair.  I was an avid highlighter before going natural but played it safe after the big chop through now in order to achieve certain health and length goals.  Now that I'm at a comfortable length, I am willing to take a risk and return to highlighting.  The color I chose is a dramatic, loud red versus the subtle, deep red that henna produces.