Friday, March 30, 2012

Introducing Stephanie ...

I would like to formally introduce Stephanie, the new guest blogger for "Healthy Hair and Body".  You may have noticed her recent posts on Fitness and Healthy Eating that are featured every Monday/Tuesday.  She has degrees in Exercise Science and Biology in addition to heading her own blog entitled Infinite Life Fitness.  She is also an athlete of over 10 years with additional knowledge gained from several trainers and coaches.  Be sure to check her out in her corner of the World Wide Web (Infinite Life Fitnessand look forward to more weekly guest posts from her here at HHB.  Don't forget to "like" her fitness Facebook Page as well.

P.S.  If you have any questions for her or would like her to write a guest post on a particular subject, leave a comment below.

A Healthy You in 2012!
Valentine Day Treats … Lower in fat but still so YUMMY!
Reader's Question: How to Gain Weight
Simple, Healthy Recipes for a Busy Schedule
Foods to Fill You Up
Fitting Fitness Into Your Busy Life
Women's Fitness: What's True and What's False
Fitness Fashion 101

Thursday, March 29, 2012

Guest Commentary: Advocating on Capitol Hill

Jeffrey A. Nafash

Skepticism. Nervousness. Inferiority. These are all words that came to my mind when I prepared to venture to Washington, DC to advocate for an issue on Capitol Hill. Who am I? What do I know about issues? Why would my Senator or Representative want to hear what I have to say?

But, that is just it. I do have a voice. I do have an opinion. And, what I have to say matters.

During the weekend of March 9, I was fortunate enough to be an attendee at the Mid-East Regional Conference for the United Nations Association of the United States of America (UNA). UNA members from Pennsylvania and neighboring states came together and spent all weekend preparing for an advocacy visit on Capitol Hill and learning about the needed support for the United Nations. On Monday, teams of advocates marched to their Congressional representatives’ offices and made appeals for support of the United Nations.

The “ask” (what you are posing to your legislator to support) that we had on these particular Hill visits was for the United States Congress to have continued support for the United Nations and their efforts around the world, specifically to maintain funding for necessary programs, ratifying treaties, such as the Convention on the Law of the Sea. These are key issues that our leaders need to be made aware of!

As a Jefferson Master of Public Health Student, I was surprised at how well I was prepared to talk about Global Health issues as they pertain to the United Nations. Thanks to two classes I’m taking this semester – Public Health Policy and Advocacy, and Global Health – I knew the issues and felt prepared to share my stories. We live in a great nation, which has power on the international stage, and need to compel our leaders to ensure our stance in the future. For example, can you imagine a day where American support and funding to the United Nations is either shrunk or completely defunded? The implications would be dire; the United Nations is a great peacekeeping body on the Earth. The United States’ national security and influence in international issues would become a figment of the past.

To my classmates, friends, and the Jefferson community, I would suggest that you become an advocate. Whether you agree with my trip to Capitol Hill or not, pick what interests you and be a voice. Note that not all advocates are going to Capitol Hill and meeting with our Nation’s leaders. We live in a great city that is ripe with issues to be addressed by our local, city government, and at Jefferson we have the support and resources to make a difference.

Jeffrey A. Nafash is a student in the Master of Public Health Program at the Jefferson School of Population Health.

How I Avoid Type II Diabetes

From the CDC: "Type 2 diabetes accounts for 90%–95% of diabetes cases and is usually associated with older age, obesity and physical inactivity, family history of type 2 diabetes, or a personal history of gestational diabetes. ...  Type 2 diabetes can be prevented through healthy food choices, physical activity, and weight loss. ... . A person with diabetes has a shorter life expectancy and about twice the risk of dying on any given day as a person of similar age without diabetes." {Source}

Type II diabetes is a part of my family history.  My late maternal grandfather had it.  My older brother died from it.  My mother has it.  I want to avoid it.  Because of this reality, and because I generally want to remain healthy, my meals have the following guidelines:
  • eat a lot of fish, fresh vegetables, and whole grains (instead of processed grains).
  • only eat sweets (i.e., cakes, cookies, ice cream) once every couple of weeks or month. 
  • eat dried fruit to satisfy my sweet tooth.
  • rarely eat beef or other red meat.
  • refrain from sodas and juice cocktails.  
  • drink water and 100% cranberry juice.
  • only use extra virgin olive oil to cook.
If you have a family history of type II diabetes, then you may want to read the following links for how to avoid the disease:


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Twist Series: Strong vs. Weak Twists

Demonstration of a "weak" twist.

"Strong" twists frizz far less and last longer than "weak" twists. So what is a "strong" twist?  How do you make one? Naptural85 explains it in this video (starts at 1 minute 23 seconds):

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Tuesday, March 27, 2012

Fitness Fashion 101

By Stephanie of Infinite Life Fitness

One of the most important things that is most often overlooked when someone thinks about fitness and getting healthy is if they are actually wearing the right things to workout in!

There are some VERY important staple items that women (and men) need to have in order to be prepared for their rigorous workout routines.

1) Good, comfortable, appropriate shoe!
One of the most common mistakes that people make is that they start working out with just any average pair of shoes…or a pair of shoes they have tucked in the back of their closet.
It is optimal to find a shoe appropriate for the activities you plan to be doing.
If you do go out to find a new pair of shoes, running shoes are meant for running and walking shoes are meant for walking. These shoes are designed to help give you support in targeted areas. For those who will be jogging, walking, and spending time in the gym, cross-trainer shoes are a good suggestion. These shoes are usually light weight but also give you great support in all of the main areas. Most (if not all) major shoe stores have workers that are supposed to be educated on what type of shoe is best for certain activities. So if you are ever in doubt please be sure to ask!
Also your workout shoes should be used for one thing…to work out in! They should not be used for everyday common uses. Even if you need to break them in, break them in by working out in them. That is the best way to get the optimal use out of those shoes.


2) ATTENTION WOMEN: Are you working out with the right sports bra?
Yes sports bra…not a regular bra…but a bra made to support you during your workouts.
When looking for a GOOD sports bra, be prepared to spend a little money on one. But in the end it will be worth it! You want to find a bra that will house each breast in its own cup. This is the best to find because it can help reduce bouncing significantly compared to regular shelf bras and help support them. Look for “High Performance/High Impact” on the bra sale tag. This is a good indication that the bra is built to help support you through high intensity workouts. You also want to try to focus on bras that come in bra sizes and not the regular small, medium, or large. This is because the bras built to specific sizes are better engineered to fit your body type. Purchasing your bra from a “bra store” is also a good idea because the workers there can fit you into a bra that works best for you. Be sure to give the bra a test run when you try it on. Don’t be afraid to jump around and flop your arms (as if you are doing real exercise activities). This will allow you to know if the bra is comfortable to workout in. Also, you can check out this article for some great sport bra options.


3) Are you wearing the right clothes?
To be honest I like to wear old t-shirts and a pair of basketball shorts to workout in. The attire you wear it strictly up to what YOU like. Some people like to wear form fitting clothes and other like to wear baggy clothes. No matter what you wear, make sure you are comfortable in them and that they do not limit the activities you will be able to do during your workout. It is suggested that you remove your sweaty clothes as soon as possible after your workout. Those sweaty clothes house sweat, bacteria, and dirt/oils secreted from your body. Try to wash whatever clothes you wear according to the washing label. Washing clothes in the wrong temperature/condition can cause more wear and tear on the clothes and not allow them to last as long. Ladies, you may want to consider washing your bras and high elastic sports tops/bottoms in the gentle cycle to help preserve the elastic that is in the clothing. Try not to wear the same outfit several times in a row if you can avoid it (yes this includes socks). It has been suggested to let your workout clothes dry out instead of balling them up and throwing them in the hamper right after a workout. This will allow the sweat to dry out and limit the chance for more bacteria growth or the growth of mold/mildew.

I hope these few simple tips will help you when starting (or continuing) your workout routines. Some of the things listed will also help you prevent injuries with your workout (having the right pair of shoes is very important to help limit the chance of injury).

Please feel free to stop by my site for more fitness and health related topics.

Oldies, But Goodies

1. Oatmeal Facial for Oily & Acne-Prone Skin
2. Too Busy for Healthy Hair?
3. When You Get a Knot ...
4. Natural Skin Care - On a Budget
5. 100% Juice vs. 100% Vitamin C

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Sunday, March 25, 2012

Fur Coat and No Knickers, The BOMB, an International Arts and Health Conference and The Queen...

It's Olympic year, and as the UK gears up for the 'ultimate national well-being campaign' and we invest millions of pounds in sports and culture, we are constantly told that the arts are a force for good, nurturing civic pride and engendering happiness. But is the drive for happiness in danger of skewing our understanding of well-being, and whilst we lavish money on the Olympics in a time of global austerity, some of us question the prescription of culture for happiness - aren't the arts more than that? 

And if they offer something more than a quick-hit, how is it that the quality of life of our older citizens is often institutionally neglected; worse still, those affected by dementia are relegated to 'warehouses of the dying'? This essay explores the relationship between art in the public realm and well-being. Clive Parkinson investigates public art's sometimes superficiality and its occasional potential to question societal norms, with blistering potency.
Read the paper by clicking on the image below:

Society for the Arts in Healthcare's
23rd Annual International Conference
Hosted by Children's Hospital of Michigan 
May 2-5, 2012 Detroit, Michigan, USA 
Experience the opportunity to immerse yourself in arts & health; best practices, model programs, and cutting-edge research. Click on image below.

Combining a poetic text and a bold, electrifying score for voice and sound, Autobiographer draws us into Flora’s slowly unravelling mind. In a tender and lyrical performance, fragments of stories and pulses of memory build layer upon layer into a curious, evocative portrait of a life refracted through the lens of dementia.

more details @  

As our Arts/Health agenda comes of age, our work is increasingly being seen as more than addressing morbidity in the individual. This is illustrated perfectly by the environmental, social and political health issues tackled by Tricycle Theatre in,  The Bomb, a partial history (in two parts)...

For those of you who missed the feverish bunting waving across Manchester on Friday, you may not have noticed we had a Queen in town. Not Russell Grant but Elizabeth herself, accompanied by the Duke of Edinburgh, when she opened Royal Manchester Children's Hospital, Manchester Royal Eye Hospital, Saint Mary's Hospital and a new wing at Manchester Royal Infirmary. The work of our colleagues at LIME featured heavily on this visit. The Queen unveiled the Lime commissioned glass designs by artist Martin Donlin.
Patients and staff at the Royal Manchester Children’s Hospital, musicians from the Royal Northern College of Music, (RNCM) Music for Health programme and artist Dawn Prescott from LIME also collaborated to create Diamonds, feathers and saxophones – from the Children’s Hospital, a new composition for The Queen.

Steven Jackson, who graduated from the RNCM last year, then incorporated the children’s rhythms, textures and shapes within the music he has written, and Dawn used their pictures and sculptures in the design of a book, containing the score and beautifully bound by Artisan Bookbinder Andrew Brown, which was presented to The Queen during her visit.  The final one-minute piece was performed to the monarch by the RNCM’s Absolution Saxophone Quartet: Anthony Brown, Jennifer Palfreyman, Spencer Moran and Fraser Johnstone.

Saturday, March 24, 2012

WHYY RADIO TIMES with Marty Moss-Coane

I’m very much looking forward to Wednesday, March 28th at 10am, when I will be a guest on the acclaimed NPR program Radio Times with Marty Moss-Coane. The show is timed to follow this week’s testimony in the US Supreme Court regarding the constitutionality of health reform (known as the Affordable Care Act), particularly the individual mandate to purchase health insurance. Joining me will be the constitutional scholar Professor Theodore Ruger from the University of Pennsylvania and one of the nation's top political reporters, Dick Polman.

Although I don’t have the expertise to comment as to the constitutionality of the individual mandate, without it we cannot cover an additional 32 million Americans who do not currently have health insurance – it is really that simple. Also, the conversation about the mandate just obfuscates the real issues – we need to rationalize the approach to medical care by paying for value, not volume, reduce medical error and coordinate care. Most importantly, we need to practice population health by engaging in more preventive care and create incentives to change unhealthy behaviors. It promises to be an interesting dialogue…I hope you will have an opportunity to listen, and perhaps call in to share your views.


Friday, March 23, 2012

Preserving Homemade Products: The Basics

"Preservation" is essential for many of those who mix their own homemade products.  It not only reduces the wasting of ingredients but it prolongs the shelf life of recipes.  Additionally, it saves time spent on concocting product after product for one-time use.  The following list consists of basic preservation methods that are imperative for any mixologist: 

Use refrigeration to preserve water-based products (e.g., spritzes) for a short period (a few days to a week or so).  The cold temperature of the fridge will delay growth of bacteria and fungi.

Use the freezer to preserve water-based products (e.g., deep conditioner mixes) for a longer period (few weeks to a month or so).  The even colder temperature of the freezer will delay growth of bacteria and fungi.  Place the product in the refrigerator to thaw on the night prior to using it.

Use clean utensils and containers:
Bathe utensils and containers in a solution of soap and hot water.  An alternative is to wipe down utensils and containers with alcohol.  The soap or alcohol will essentially kill any bacteria that would otherwise contaminate your mixture.

Add an essential oil (but pregnant women beware):
Essential oils can act as a slight preservative due to their antimicrobial properties. Tea tree, lavender, lemon, thyme, and rosemary are just a few essential oils known to have these properties.  Those who are pregnant or sensitive to essential oils should speak with their doctors before use.

Do not use fingers to obtain water-based product:
Our fingers contains tons of bacteria and can contaminate such products.


Add vitamin E oil or rosemary extract oil:
These oils can slow the oxidation of products containing oils, such as avocado, evening primrose, flax, hemp, or sweet almond oil. Vitamin E and rosemary extract are antioxidants, not preservatives.  Thus, they will not prolong the shelf life a product prone to bacteria and mold growth.

Other tips:
Seal containers airtight
Store non-refrigerated products in dark, cool areas


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Thursday, March 22, 2012

"Hidden" Sources of Breakage

Breakage, breakage, breakage.  When we experience breakage, our first inclination is to presume dryness, over manipulation, or heat usage as the source.  However, sometimes the actual culprit may run a little deeper.  Here are some "hidden" sources of hair breakage:

1) Overstretching the hair: Do you stretch your hair prior to styling? If so, be sure you are using one of these least harmful methods: twists or loose braids. Banding is another option as well, depending on the tension.  On the other hand, tight banding or tight braiding can overstretch the hair and lead to weakened strands. Also, be sure you are stretching on damp hair instead of wet hair.  Wet hair will be more susceptible to breakage under tension. Lastly, refrain from using rubber bands or any other harmful hair tie (e.g., cotton) during the drying process.

2) Styling on wet or drenched hair: Hair is most fragile when wet or drenched with water.  Styling the hair in this state may lead to mechanical breakage.  Depending on the manipulation required for the desired style, it may be better to wait until the hair is damp or damp-dry.

3) Diet low in protein: Hair largely consists of protein (i.e., keratin) which is built from amino acids extracted from foods we put into our body.  A diet low in protein can translate into weaker, thinner hair strands (and thus breakage) or even hair loss.  Mitigate this issue by incorporating more nuts, chicken, fish, and beans into your diet.

4) Diet low in zinc, iron, and/or Vitamin B-12: A deficiency in any of these nutrients can result in weaker strands (and thus breakage) or even hair loss.  Taking a good multivitamin on a daily basis can ensure that you are receiving a sufficient amount of these nutrients. If you are severely deficient in zinc or iron (e.g., anemia), I highly recommend that you see a doctor.

5) Use of sulfate shampoos: Certain sulfate shampoos (e.g., shampoos containing SLS and ALS) can be harsh on the hair thus weakening the strands. Switching to a more gentle sulfate shampoo or a natural shampoo can mitigate this issue.

6) Overexposure to sun: Hair that was overexposed during the summer months can be showing signs of weakness and breakage in the fall/winter months. Depending on the extent of weakening, mitigation can range from regular deep conditioning the hair with protein to trimming for a fresh start.

7) Use of an improper comb: Thin-tooth combs or combs with seams can tug on the hair and yield mechanical breakage.  Stick to seamless, wide tooth combs.

8) Hair that used to be heat styled: Even if one has not used heat in a while, heat usage from months or even a year prior can be haunting the person now. Mid-shaft splits can be opening and yielding breakage. There is also the issue of split ends widening.  Trims are the best way to mitigate this problem.

9) Sleeping on a cotton pillowcase: Cotton can be both drying and abrasive to the hair.  Sleep on a satin/silk pillowcase or use a satin/silk bonnet to put a stop to this breakage source.

10) Hair that has been colored: Dyeing can weaken the hair shaft by lifting the cuticles. Depending on the extent of weakening, mitigation can range from regular deep conditioning with protein to trimming for a fresh start.

11) Protein-moisture imbalance: Hair can either become brittle or stretchy and thus break due to a protein-moisture imbalance.  Read this post for more information.

As always, please speak with your doctor before adjusting your diet or lifestyle.

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Oldies, But Goodies

1. Tips for a Sensitive Hairline
2. Soy Smoothie Meets Green Smoothie
3. Healthy Ice Cream Alternative
4. Antibacterial Soap Debate
5. Natural Nail Polishes
6. Homemade Shampoo Recipes

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Monday, March 19, 2012

Women’s Fitness: What’s True and What’s False

By Stephanie of Infinite Life Fitness

When it comes to health and fitness, there are tons of advice and tips that have been shared. The problem is not all of those are true! Today, I would like to go over the true and false facts when it comes to fitness.

Women think that if they train with weights, this will cause them to look muscular and bulk up like men

FALSE: It is very unlikely that you will bulk up to gain muscles like those of body builders. It is almost impossible for the average woman to look like that with a light weight routine added to their fitness routine. Yes some women may bulk up a little more than others, but not to the extent of someone who looks like a body builder. Lifting weights helps you to get a well-defined, toned, fit looking body. Women who do have masculine type muscles most likely take anabolic steroids (a synthetic type of testosterone) along with other drugs in order to achieve the intense muscularity they show off in fitness competitions. Weight lifting has been proven to help you lose weight faster and to help you keep it off in the long run.

Doing only crunches (or an abs machine) will help you gain that 6-pack you always dreamed of

FALSE: There is no such thing as target training. You cannot just do one thing and expect it to magically work in that area. In order to achieve your desired fitness goals you have to have a well-rounded workout. You have to target the main areas as well as have a cardio workout. To get rid of belly fat you have to slim down by losing those extra calories.

Drinking water will help you lose weight

TRUE: There are many different articles (such as this one) that support evidence of drinking more water to aid you in shedding those unwanted calories. Drinking water is a great substitute to other drinks you have during the day. It will help you cut down on calories as well as keep your body hydrated.

If you are not sweating you are not working hard enough

FALSE: When you sweat that is your body’s way of trying to cool you down. Everyone’s body is different! If you may notice some people sweat way more than others and in some cases some people do not sweat very much at all. It is possible to have a great workout without your body pouring out with sweat.

Running on a treadmill (or other machine) puts less stress on your knees than running on asphalt or pavement

FALSE: Any type of fitness routine that involves running will bear on your knees and other joints. It does not matter what type of surface, but overall it will still have the same end result….sore knees. The best way to help limit this is to vary your workout. Trying doing several different types of cardio routines that you can switch between. This can be done by using other machines in the gym or using a bike.

Stretching before a workout can help you prevent injuries

TRUE: It is actually suggested that you stretch before and after your workout to help your muscles. There have been dozens of studies done to help prove this to be true. Stretching your major muscle groups for about 30 seconds each before and after your workout is something you should incorporate into your fitness routine.

Sports bras are only good for helping prevent your boobs from painfully bouncing all over the place

TRUE AND FALSE: Yes sports bras help to prevent your boobs from bouncing out of control during your workouts, but it has also been proven to help prevent your breast from sagging. Yes it is a known fact that gravity and time are attributed to the cause of sagging, but is has also been shown that high intensity activities loosen the connective tissues that keep your breast firm. So be sure you have the right type of bra when you are working out. And it is also suggested that you get your bras replaced once a year.

Carbs are bad for you

FALSE: There are some diets out there that suggest that you should stay away from carbs if you want to achieve your desired results. Well that is not all true. It is never good to cut out one whole food group from your diet (no matter what type of diet suggests it)! You need carbs to fuel your body! The main idea should be to lower your intake on carbs (not cut them out of your diet completely). You should learn what good carbs are and what bad carbs are so you can make sure you are consuming the best nutrients for your body.

I hope that I have helped clarify some popular fitness myths.

Please check out my personal health and fitness blog that shares more recipes, workouts, and other health tips!

Mixology || Herbal Soap Recipe

Do commercial soaps irritate your skin?  Does the call for "lye" in homemade soap recipes scare you?  Well here is a simple recipe for an all-natural exfoliating soap with no direct use of lye.

1 lg Block olive or veg soap
25 g Loosely chopped herbs
3 dr Essential oil - thyme, rosemary, horse chestnut
1 tb Oatmeal, finely ground

Grate the soap into a basin and add the remaining ingredients. Heat gently in a bain-marie until it melts and mix well. Line an egg box with waxed paper and pour the soap into each section.

FOR MORE RECIPES: 250 Bath Body Recipes

The 2012 red meat-mortality study (Arch Intern Med): The data suggests that red meat is protective

I am not a big fan of using arguments such as “food questionnaires are unreliable” and “observational studies are worthless” to completely dismiss a study. There are many reasons for this. One of them is that, when people misreport certain diet and lifestyle patterns, but do that consistently (i.e., everybody underreports food intake), the biasing effect on coefficients of association is minor. Measurement errors may remain for this or other reasons, but regression methods (linear and nonlinear) assume the existence of such errors, and are designed to yield robust coefficients in their presence. Besides, for me to use these types of arguments would be hypocritical, since I myself have done several analyses on the China Study data (), and built what I think are valid arguments based on those analyses.

My approach is: Let us look at the data, any data, carefully, using appropriate analysis tools, and see what it tells us; maybe we will find evidence of measurement errors distorting the results and leading to mistaken conclusions, or maybe not. With this in mind, let us take a look at the top part of Table 3 of the most recent (published online in March 2012) study looking at the relationship between red meat consumption and mortality, authored by Pan et al. (Frank B. Hu is the senior author) and published in the prestigious Archives of Internal Medicine (). This is a prominent journal, with an average of over 270 citations per article according to Google Scholar. The study has received much media attention recently.

Take a look at the area highlighted in red, focusing on data from the Health Professionals sample. That is the multivariate-adjusted cardiovascular mortality rate, listed as a normalized percentage, in the highest quintile (Q5) of red meat consumption from the Health Professionals sample. The non-adjusted percentages are 1.4  percent mortality in Q5 and 1.13 in Q1 (from Table 1 of the same article); so the multivariate adjustment-normalization changed the values of the percentages somewhat, but not much. The highlighted 1.35 number suggests that for each group of 100 people who consumed a lot of red meat (Q5), when compared with a group of 100 people who consumed little red meat (Q1), there were on average 0.35  more deaths over the same period of time (more than 20 years).

The heavy red meat eaters in Q5 consumed 972.37 percent more red meat than those in Q1. This is calculated with data from Table 1 of the same article, as: (2.36-0.22)/0.22. In Q5, the 2.36 number refers to the number of servings of red meat per day, with each serving being approximately 84 g. So the heavy red meat eaters ate approximately 198 g per day (a bit less than 0.5 lb), while the light red meat eaters ate about 18 g per day. In other words, the heavy red meat eaters ate 9.7237 times more, or 972.37 percent more, red meat.

So, just to be clear, even though the folks in Q5 consumed 972.37 percent more red meat than the folks in Q1, in each matched group of 100 you would not find a single additional death over the same time period. If you looked at matched groups of 1,000 individuals, you would find 3 more deaths among the heavy red meat eaters. The same general pattern, of a minute difference, repeats itself throughout Table 3. As you can see, all of the reported mortality ratios are 1-point-something. In fact, this same pattern repeats itself in all mortality tables (all-cause, cardiovascular, cancer). This is all based on a multivariate analysis that according to the authors controlled for a large number of variables, including baseline history of diabetes.

Interestingly, looking at data from the same sample (Health Professionals), the incidence of diabetes is 75 percent higher in Q5 than in Q1. The same is true for the second sample (Nurses Health), where the Q5-Q1 difference in incidence of diabetes is even greater - 81 percent. This caught my eye, being diabetes such a prototypical “disease of affluence”. So I entered the whole data reported in the article into HCE () and WarpPLS (), and conducted some analyses. The graphs below are from HCE. The data includes both samples – Health Professionals and Nurses Health.

HCE calculates bivariate correlations, and so does WarpPLS. But WarpPLS stores numbers with a higher level of precision, so I used WarpPLS for calculating coefficients of association, including correlations. I also double-checked the numbers with other software, just in case (e.g., SPSS and MATLAB). Here are the correlations calculated by WarpPLS, which refer to the graphs above: 0.030 for red meat intake and mortality; 0.607 for diabetes and mortality; and 0.910 for food intake and diabetes. Yes, you read it right, the correlation between red meat intake and mortality is a very low and non-significant 0.030 in this dataset. Not a big surprise when you look at the related HCE graph, with the line going up and down almost at random. Note that I included the quintiles data from both the Health Professionals and Nurses Health samples in one dataset.

Those folks in Q5 had a much higher incidence of diabetes, and yet the increase in mortality for them was significantly lower, in percentage terms. A key difference between Q5 and Q1 being what? The Q5 folks ate a lot more red meat. This looks suspiciously suggestive of a finding that I came across before, based on an analysis of the China Study II data (). The finding was that animal food consumption (and red meat is an animal food) was protective, actually reducing the negative effect of wheat flour consumption on mortality. That analysis actually suggested that wheat flour consumption may not be so bad if you eat 221 g or more of animal food daily.

So, I built the model below in WarpPLS, where red meat intake (RedMeat) is hypothesized to moderate the relationship between diabetes incidence (Diabetes) and mortality (Mort). Below I am also including the graphs for the direct and moderating effects; the data is standardized, which reduces estimation error, particularly in moderating effects estimation. I used a standard linear algorithm for the calculation of the path coefficients (betas next to the arrows) and jackknifing for the calculation of the P values (confidence = 1 – P value). Jackknifing is a resampling technique that does not require multivariate normality and that tends to work well with small samples; as is the case with nonparametric techniques in general.

The direct effect of diabetes on mortality is positive (0.68) and almost statistically significant at the P < 0.05 level (confidence of 94 percent), which is noteworthy because the sample size here is so small – only 10 data points, 5 quintiles from the Health Professionals sample and 5 from the Nurses Health sample. The moderating effect is negative (-0.11), but not statistically significant (confidence of 61 percent). In the moderating effect graphs (shown side-by-side), this negative moderation is indicated by a slightly less steep inclination of the regression line for the graph on the right, which refers to high red meat intake. A less steep inclination means a less strong relationship between diabetes and mortality – among the folks who ate the most red meat.

Not too surprisingly, at least to me, the results above suggest that red meat per se may well be protective. Although we should consider a least two other possibilities. One is that red meat intake is a marker for consumption of some other things, possibly present in animal foods, that are protective - e.g., choline and vitamin K2. The other possibility is that red meat is protective in part by displacing other less healthy foods. Perhaps what we are seeing here is a combination of these.

Whatever the reason may be, red meat consumption seems to actually lessen the effect of diabetes on mortality in this sample. That is, according to this data, the more red meat is consumed, the fewer people die from diabetes. The protective effect might have been stronger if the participants had eaten more red meat, or more animal foods containing the protective factors; recall that the threshold for protection in the China Study II data was consumption of 221 g or more of animal food daily (). Having said that, it is also important to note that, if you eat excess calories to the point of becoming obese, from red meat or any other sources, your risk of developing diabetes will go up – as the earlier HCE graph relating food intake and diabetes implies.

Please keep in mind that this post is the result of a quick analysis of secondary data reported in a journal article, and its conclusions may be wrong, even though I did my best not to make any mistake (e.g., mistyping data from the article). The authors likely spent months, if not more, in their study; and have the support of one of the premier research universities in the world. Still, this post raises serious questions. I say this respectfully, as the authors did seem to try their best to control for all possible confounders.

I should also say that the moderating effect I uncovered is admittedly a fairly weak effect on this small sample and not statistically significant. But its magnitude is apparently greater than the reported effects of red meat on mortality, which are not only minute but may well be statistical artifacts. The Cox proportional hazards analysis employed in the study, which is commonly used in epidemiology, is nothing more than a sophisticated ANCOVA; it is a semi-parametric version of a special case of the broader analysis method automated by WarpPLS.

Finally, I could not control for confounders because, given the small sample, inclusion of confounders (e.g., smoking) leads to massive collinearity. WarpPLS calculates collinearity estimates automatically, and is particularly thorough at doing that (calculating them at multiple levels), so there is no way to ignore them. Collinearity can severely distort results, as pointed out in a YouTube video on WarpPLS (). Collinearity can even lead to changes in the signs of coefficients of association, in the context of multivariate analyses - e.g., a positive association appears to be negative. The authors have the original data – a much, much larger sample - which makes it much easier to deal with collinearity.

Moderating effects analyses () – we need more of that in epidemiological research eh?

Sunday, March 18, 2012

Women's Health Choices, Loneliness, Binge Drinking, 2 Dance Opportunities and more...

Thinking about the reach of the arts on public health, often results in ‘nanny state’ productions that often leave the target audience feeling either patronised, or humiliated. Popular culture however, has the power to engage with hot political issues and reach huge numbers of people. Amid heated debate about pre-termination ultrasound laws in the USA, cartoonist, Garry Trudeau has decided to take on the abortion wars head-on in his cartoon strip Doonesbury, which, because of its contentious subject matter for Americans in election year, has been pulled from several newspapers. In an interview with the Washington Post, Trudeau commented:
‘I chose the topic of compulsory sonograms because it was in the news and because of its relevance to the broader battle over women's health currently being waged in several states. For some reason, the GOP has chosen 2012 to re-litigate reproductive freedom, an issue that was resolved decades ago. Why [Rick] Santorum, [Rush] Limbaugh et al. thought this would be a good time to declare war on half the electorate, I cannot say. But to ignore it would have been comedy malpractice.’
To read more of this interview with Trudeau, click on the cartoon below. To see some of the  cartoon strips, click on the cartoon above!

Loneliness is as big a killer as smoking, obesity and alcohol, campaigners warned as they held the first major summit on loneliness last week.

Care Services Minister Paul Burstow announced that councils, responsible for public health from April 2013, will be urged to conduct an audit of health and care services and identify how they can help reduce levels of isolation. Mr Burstow said: 

"Loneliness is the great unspoken public health issue. Research suggests it is more harmful to health than obesity and that there is a 50 per cent reduction in mortality if you have a strong social network. Research has shown that loneliness can be as harmful to your health as alcohol and tobacco, but we also know that people who have day- to-day contact live longer and healthier lives. The Government is working with the Campaign to End Loneliness to raise awareness about just how important even a simple phone call or visit can be to someone's health." Read the full article here.
Research published in 2006 from the American Sociological Review and based on surveys of 1,531 people in 1985 and 1,467 in 2004 show that in 1985, the average American had three people to whom they could confide matters that were important to them, but in 2004, that number dropped to two, and one in four had no close confidants at all. The same research illustrated the percentage of people who confide only in family increased from 57% to 80%, and the number of people who depend exclusively on a spouse is up from 5% to 9%. (Thanks CMG)

‘Americans have a third fewer close friends and confidants than just two decades ago — a sign that people may be living lonelier, more isolated lives than in the past.’'

For those of involved in the arts/health field, we know just how true this is and that engagement with culture and the arts can have a profound impact on anyone who is socially isolated. Of course the pleasure of friendship and solidarity is wonderful, but so to is the challenge and stimulation that the participatory arts offer. We mustn’t lose sight of the ever-changing political and social climate that we currently inhabit and if politicians are identifying the burgeoning issues associated with isolation, particularly amongst our older citizens, it’s an area we should be clear to assert both our role, and our potency.

And if you missed this in the weekend papers, there's an interesting piece of research that points to the 'dark side' of Facebook linking it and other social media platforms to socially aggressive narcissism, obsession with self-image and shallow friendships. Read it and weep, or laugh maniacally. (Thanks Dr S)

This week, the comment on manifesto part one, and the power of the arts for giving voice, comes from a friend and colleague in Kabul, artist Shamsia Hassani.
‘There are some unknown words in my mind: some unclear feeling in my heart which is removing me to an unknown world, the world that everyone is writing with their own inside alphabet. I call this world ART.’

Ommolbanin - Shamsia Hassani, Artist

To find out more about Ommolbanin and Freedom to Create, click on the image above.

Fri, 23 Mar 2012
12.00 PM - 3.00 PM
Dance Conversations presents a free opportunity for Merseyside Dance artists and companies working in the field of dance and health and professionals from the health and social care to network and share ideas and practice and information on existing or future projects and research.

This is an amazing opportunity for 12 North West Graduates and Artists.
Auditions for the FIRST EVER North West Graduate Dance Company

INFO - Supported by Arts Council England, NWGDC will create original and exciting work to tour the region and will offer training in Teaching and Learning as well as develop Business and Entrepreneurial skills to support a career in dance.

AUDITION DATES - Auditions are Saturday 14 April 2012 at Edge Hill University, Ormskirk and Sunday 15 April at The Lowry, Salford Quays.
Applicants will be required from 10.00am until 6.00pm DEVISING - Based at Edge Hill University, the first devising process to create new work with  Alesandra Seutin begins  Monday 28 May until Sunday 10 June  2012.  The second devising with Gary Clarke and Antonia Grove begins Monday 20 August until Saturday 25 August 2012. 

TOURING - Rehearsals and tour begin September 2012 and run until beginning of December  2012. Please note that successful applicants will be required for additional rehearsal dates which will be confirmed before the audition.

INTERNSHIPS - Internships are scheduled for Spring 2013. These will provide company members with work based learning opportunities.

WHO CAN APPLY? - Anyone who has graduated since 2007 with a degree in Dance
or an appropriate degree in Performing Arts .   All applicants must live in
the North West of England. All applicants MUST be available during the above periods for devising, touring and internships.

DEADLINE - Deadline for applications is 12.00 mid-day, Friday 23 March 2012

WHAT TO DO NEXT - For more information and an application pack please contact Gil Wilson-Graystone, Project Manager at 

VOCAB dance video  


Did stone age cave women and men talk to each other in symbols? This is a fascinating article bringing together research around the symbols that adorn many cave paintings. Click on the image for more. Beautiful and resonating across time.

An excellent article by Alice Jones in the Independent exploring alcohol in contemporary culture, and how two theatre companies have used the arts to tell an all to familiar story.
‘Last summer, the performance artist Bryony Kimmings locked herself in a warehouse in Bethnal Green, east London and got drunk for a week. Not for fun, you understand, but in the name of art: her aim was to explore the links between intoxication and creativity, or to find out whether she was a better artist when she was drunk.’ (7 Day Drunk)
‘The Paper Birds trawled the pubs and clubs of London and Leeds to find the raw material for their latest show, Thirsty. They set up a hotline, printed up business cards with the words "Are you drunk? Call this number" and used the voicemails they received as the inspiration for their play about young women and binge drinking, performed to a shouty soundtrack of karaoke classics on a set made out of toilet cubicles.’ (Thirsty)

'Thirsty', touring to 2 April (; '7 Day Drunk', to 31 March, Soho Theatre, London, then touring to 26 May (

...and finally, in a spirit of high self-esteem and Facebook-induced, deluded, dance-flavoured blogging, here is Gene Kelly tap dancing on roller-skates. What better start to our week? Life is good...C.P.