Monday, January 30, 2012

Arts Council funding, Clore Fellowships (Reprise), People's Health Trust and Poetry Please! (ohh, and the manifesto)

So, here's the last sample of people's comments on the m a n i f e s t o  for now. I hope you’ve enjoyed reading them, and that you know how to adjust your volume! Today see’s the thoughts of the President of the Society for Arts and Healthcare (SAH), Dr Gary Christenson, to whom, along with all those who've contributed, I’m incredibly grateful. Now it’s time to collate all the work together and publish part 2, which will be available far and wide.
People's Health Trust: Healthy Communities Small Grants Programme
This small grants programme makes awards of between £5,000 and £10,000 to local projects which help people live longer, healthier lives and address health inequalities. The Tust are particularly keen to support grassroots activities through their small grants programme, which is currently open in nine local society lottery areas. Funding will be available from other local society lotteries in the coming weeks and months, and local charities and community groups are urged to check the People's Health Trust's website for details. For more information, please visit www.peopleshealthtrust.org.uk


Arts Council England launches new fund
The Arts Council has launched a new £37 million fund to ensure more people living in places where levels of involvement are currently low, experience and are inspired by the arts. Over three years the fund will invest in around 15 programmes of activity that use radical new approaches to developing excellent, inspiring and sustainable arts experiences for communities not currently engaging with the arts.

The Arts Council has used the Active People survey to identify 71 areas of the country which fall into the lowest 20 per cent of arts engagement. Typically, grants of between £500,000 and £3 million will be invested in a number of these areas with the aim of increasing participation.

This programme is open to applications from any consortia that meet the eligibility criteria. All applications must be proposing work in one or more of the areas with the lowest 20 per cent of arts engagement as identified by the Arts Council.
There will be two funding rounds for applicants, with the first opening today. Interested consortia need to register their intention to apply with their regional office by 23 March 2012 with the closing date for the first round of applications 13 April 2012.

Excellence, both artistic and in engaging communities, will be at the heart of successful applications, with the Arts Council investing in programmes that encourage long term collaborations between local communities and arts organisations, museums, libraries and local authorities.

As well as increasing artistic participation in these areas, this investment will help the Arts Council learn about the impact of different approaches to increasing engagement. The knowledge gained from the programme will be made available to arts organisations, museums and libraries, local authorities and the wider cultural sector. Click on the logo below to get started!


Clore Fellowships
A reminder of the excellent opportunity of the Clore Fellowships...the clock’s against you, so don’t hesitate. Click on the money!




On the odd bit of poetry...
Why the pieces of poetry? In short, poetry wasn’t something that was part of my life as I was growing up, and over time (and out of the blue) it’s crept up on me, occasionally hitting me in the pit of the stomach, more often than not, explaining something I just haven’t quite understood. I think people reach out to it (or it to them) and find it more eloquent than they’d ever expect themselves to be, particularly at moments of heightened emotion; in times of love and death.


And if any of you want to share something, particularly if you’re from another country, with writers that I’ve never heard of, please feel free to email.
So here’s another Larkin; dark and from his later years. C.P.

Aubade

I work all day, and get half-drunk at night.
Waking at four to soundless dark, I stare.
In time the curtain-edges will grow light.
Till then I see what's really always there:
Unresting death, a whole day nearer now,
Making all thought impossible but how
And where and when I shall myself die.
Arid interrogation: yet the dread
Of dying, and being dead,
Flashes afresh to hold and horrify.
The mind blanks at the glare. Not in remorse
- The good not done, the love not given, time
Torn off unused - nor wretchedly because
An only life can take so long to climb
Clear of its wrong beginnings, and may never;
But at the total emptiness for ever,
The sure extinction that we travel to
And shall be lost in always. Not to be here,
Not to be anywhere,
And soon; nothing more terrible, nothing more true.

This is a special way of being afraid
No trick dispels. Religion used to try,
That vast, moth-eaten musical brocade
Created to pretend we never die,
And specious stuff that says No rational being
Can fear a thing it will not feel, not seeing
That this is what we fear - no sight, no sound,
No touch or taste or smell, nothing to think with,
Nothing to love or link with,
The anasthetic from which none come round.

And so it stays just on the edge of vision,
A small, unfocused blur, a standing chill
That slows each impulse down to indecision.
Most things may never happen: this one will,
And realisation of it rages out
In furnace-fear when we are caught without
People or drink. Courage is no good:
It means not scaring others. Being brave
Lets no one off the grave.
Death is no different whined at than withstood.

Slowly light strengthens, and the room takes shape.
It stands plain as a wardrobe, what we know,
Have always known, know that we can't escape,
Yet can't accept. One side will have to go.
Meanwhile telephones crouch, getting ready to ring
In locked-up offices, and all the uncaring
Intricate rented world begins to rouse.
The sky is white as clay, with no sun.
Work has to be done.
Postmen like doctors go from house to house.





Kleiber's law and its possible implications for obesity

Kleiber's law () is one of those “laws” of nature that is both derived from, and seems to fit quite well with, empirical data. It applies to most animals, including humans. The law is roughly summarized through the equation below, where E = energy expenditure at rest per day, and M = body weight in kilograms.


Because of various assumptions made in the original formulation of the law, the values of E do not translate very well to calories as measured today. What is important is the exponent, and what it means in terms of relative increases in weight. Since the exponent in the equation is 3/4, which is lower than 1, the law essentially states that as body weight increases animals become more efficient from an energy expenditure perspective. For example, the energy expenditure at rest of an elephant, per unit of body weight, is significantly lower than that of a mouse.

The difference in weight does not have to be as large as that between an elephant and a mouse for a clear difference in energy expenditure to be noticed. Moreover, the increase in energy efficiency predicted by the law is independent of what makes up the weight; whether it is more or less lean body mass, for example. And the law is very generic, also applying to different animals of the same species, and even the same animal at different developmental stages.

Extrapolating the law to humans is quite interesting. Let us consider a person weighing 68 kg (about 150 lbs). According to Kleiber's law, and using a constant multiplied to M to make it consistent with current calorie measurement assumptions (see Notes at the end of this post), this person’s energy expenditure at rest per day would be about 1,847 calories.

A person weighing 95 kg (about 210 lbs) would spend 2,374 calories at rest per day according to Kleiber's law. However, if we were to assume a linear increase based on the daily calorie expenditure at a weight of 68 kg, this person weighing 95 kg would spend 2,508 calories per day at rest. The difference of approximately 206 calories per day is a reflection of Kleiber's law.

This difference of 206 calories per day would translate into about 23 g of extra body fat being stored per day. Per month this would be about 688 g, a little more than 1.5 lbs. Not a negligible amount. So, as you become obese, your body becomes even more efficient on a weight-adjusted basis, from an energy expenditure perspective.

One more roadblock to go from obese to lean.

Now, here is the interesting part. It is unreasonable to assume that the extra mass itself has a significantly lower metabolic rate, with this fully accounting for the relative increase in efficiency. It makes more sense to think that the extra mass leads to systemic adaptations, which in turn lead to whole-body economies of scale (). In existing bodies, these adaptations should happen over time, as long-term compensatory adaptations ().

The implications are fascinating. One implication is that, if the compensatory adaptations that lead to a lower metabolic rate are long term, they should also take some time to undo. This is what some call having a “broken metabolism”; which may turn out not to be “broken”, but having some inertia to overcome before it comes back to a former state. Thus, lower metabolic rates should generally be observed in the formerly obese, with reductions compatible with Kleiber's law. Those reductions themselves should be positively correlated with the ratio of time spent in the obese and lean states.

Someone who was obese at 95 kg should have a metabolic rate approximately 5.6 percent lower than a never obese person, soon after reaching a weight of 68 kg (5.6 percent = [2,508 – 2,374] / 2,374). If the compensatory adaptation can be reversed, as I believe it can, we should see slightly lower percentage reductions in studies including formerly obese participants who had been lean for a while. This expectation is consistent with empirical evidence. For example, a study by Astrup and colleagues () concluded that: “Formerly obese subjects had a 3–5% lower mean relative RMR than control subjects”.

Another implication, which is related to the one above, is that someone who becomes obese and goes right back to lean should not see that kind of inertia. That is, that person should go right back to his or her lean resting metabolic rate. Perhaps Drew Manning’s Fit-2-Fat-2-Fit experiment () will shed some light on this possible implication.

A person becoming obese and going right back to lean is not a very common occurrence. Sometimes this is done on purpose, for professional reasons, such as before and after photos for diet products. Believed it or not, there is a market for this!

Notes

- Calorie expenditure estimation varies a lot depending on the equation used. The multiplier used here was 78,  based on Cunningham’s equation, and assuming 10 percent body fat. The calorie expenditure for the same 68 kg person using Katch-McArdle’s equation, also assuming 10 percent body fat, would be about 1,692 calories. That would lead to a different multiplier.

- The really important thing to keep in mind, for the purposes of the discussion presented here, is the relative decrease in energy expenditure at rest, per unit of weight, as weight goes up. So we stuck with the 78 multiplier for illustration purposes.

- There is a lot of variation across individuals in energy expenditure at rest due to other factors such as nonexercise activity thermogenesis ().

Monday, January 23, 2012

All diets succeed at first, and eventually fail

It is not very hard to find studies supporting one diet or another. Gardner and colleagues, for example, conducted a study in which the Atkins diet came out on top when compared with the Zone, Ornish, and LEARN diets (). In Dansinger and colleagues’ study (), on the other hand, following the Atkins diet led to relatively poor results compared with the Ornish, Weight Watchers, and Zone diets.

Often the diets compared have different macronutrient ratios, which end up becoming the focus of the comparison. Many consider Sacks and colleagues’ conclusion, based on yet another diet comparison study (), to be the most consistent with the body of evidence as a whole: “Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize”.

I think there is a different conclusion that is even more consistent with the body of evidence out there. This conclusion is highlighted by the findings of almost all diet studies where participants were followed for more than 1 year. But the relevant findings are typically buried in the papers that summarize the studies, and are almost never mentioned in the abstracts. Take for example the study by Toubro and Astrup (); Figure 3 below is used by the authors to highlight the study’s main reported finding: “Ad lib, low fat, high carbohydrate diet was superior to fixed energy intake for maintaining weight after a major weight loss”.


But what does the figure above really tell us? It tells us, quite simply, that both diets succeeded at first, and then eventually failed. One failed slightly less miserably than the other, in this study. The percentage of subjects that maintained a weight loss above 25 kg (about 55 lbs) approached zero after 12 months, in both diets. This leads us to the conclusion below, which is always missing in diet studies even when the evidence is staring back at us. This is arguably the conclusion that is the most consistent with the body of evidence out there.

All diets succeed at first, and eventually fail.

In using the terms “succeed” and “fail” I am referring to the diets’ effects on the majority of the participants. This is in fact better demonstrated by the figure below, from the same study by Toubro and Astrup; it is labeled as Figure 2 there. Most of the participants at a certain weight, lose a lot of weight within a period of 1 year or so, and after 2 years (see the two points at the far right) are at the same original weight again. What is the average time to regain back the weight? From what I’ve seen in the literature, all the weight and some tends to be regained after 2-3 years.


The regained weight is not at all lean body mass. It is primarily, if not entirely, body fat. In fact, many studies suggest that those who diet tend to have a higher percentage of body fat when they regain their original weight; proportionally to how fast they regain the weight lost. Since the extra body fat tends to cause additional problems, which are compounded by the dieting process’ toll on the body, those dieters would have been slightly better off not having dieted in the first place.

Guyenet and Schwartz have recently authored an article that summarizes quite nicely what tends to happen with both obese and lean dieters (). Take a look at Figure 2 of the article below. The obese need to lose body fat to improve health markers, and avoid a number of downstream complications, such as type 2 diabetes and cancer (). Yet, with very few exceptions, the obese (and even the overweight) remain obese (or overweight) after dieting; regardless of the diet.


So what about those exceptions, what do they do to lose significant amounts of body fat and keep it off? Well, I rarely use myself as an example for anything in this blog, but this is something with which I unfortunately/fortunately have personal experience. I was obese, lost about 60 lbs of weight, and kept it off for quite a while already (). Like most of the formerly obese, I can very easily gain body fat back.

But I don’t seem to be gaining back the formerly lost body fat, and the reason is consistent with some of the studies based on data from the National Weight Control Registry, which stores information about adults who lost 30 lbs or more of weight and kept it off for at least 1 year (). I systematically measure my weight, body fat percentage, and a number of other variables; probably even more than the average National Weight Control Registry member. Based on those measurements, I try to understand how my body responds in the short and long term to stimuli such as different exercise, types of food, calorie restriction, sleep patterns etc.

And I act accordingly to keep any body fat gain from happening; by, for example, varying calorie intake, increasing exercise intensity, varying the types of food I eat etc. With a few exceptions (e.g., avoiding industrial seed oils), there is no generic formula. Customization based on individual responses and cyclical patterns seems to be a must.

Looking back, it was relatively easy for me to lose all that fat. This is consistent with the studies summarized in this post; all diets that rely on caloric reduction work marvelously at first for most people. The really difficult part is to keep the body fat off. I believe that this is especially true as the initial years go by, and becomes easier after that. This has something to do with initial inertia, which I will discuss soon in a post on metabolic rates and their relationship with overall body mass.

For people living in the wild, I can see one thing working in their favor. And that is not regular starvation; sapiens is too smart for that. It is laziness. Hunger has to reach a certain threshold for people to want to do some work to get their food; this acts as a natural body composition regulator, something that I intend to discuss in one of my next posts. It seems that people almost never become obese in the wild, without access to industrial foods.

As for living in the wild, in spite of the romantic portrayals of it, the experience is not as appealing after you really try it. The book Yanomamo: The Fierce People () is a solid, if not somewhat shocking, reminder of that. I had the opportunity to meet and talk at length with its author, the great anthropologist Nap Chagnon, at one of the Human Behavior and Evolution Society conferences. The man is a real-life Indiana Jones ().

In the formerly obese, the body seems to resort to “guerrilla warfare”, employing all kinds of physiological and psychological mechanisms, some more subtle than others, to make sure that the lost fat is recovered. Why? I have some ideas, which I have discussed indirectly in posts throughout this blog, but I still need to understand the whole process a bit better. My ideas build on the notion of compensatory adaptation ().

You might have heard some very smart people say that you do not need to measure anything to lose body fat and keep it off. Many of those people have never been obese. Those who have been obese often had not cleared the 2-3 year “danger zone” by the time they made those statements.

There are many obese or overweight public figures (TV show hosts, actors, even health bloggers) who embark on a diet and lose a dramatic amount of body fat. They talk and/or write for a year or so about their success, and then either “disappear” or start complaining about health issues. Those health issues are often part of the “guerrilla warfare” I mentioned above.

A few persistent public figures will gain the fat back, in part or fully, and do the process all over again. It makes for interesting drama, and at least keeps those folks in the limelight.

新年快乐, Lord Howarth on m a n i f e s t o, Manuwangku, Clore Leadership and a National Summit on Participatory Arts

新年快乐       恭喜发财       新年如意

In this week’s m a n i f e s t o responses, we have some poignant political commentary from amongst others Lord Howarth and Mike White. Next week will see the last of these short films of reflective responses, and include comments form the President of the Society for the Arts in Healthcare. After this I will begin to draw together the salient themes for our second manifesto installment, which will be published in hard copy as an advocacy ‘tool’. Thank you for your inspiration. C.P

Music by Kronos Quartet, playing Bella by Barlight by John Lurie
MANUWANGKU - UNDER THE NUCLEAR CLOUD
As debate continues to rage (albeit quietly) about the risks of nuclear power, in light of Fukushima and Chernobyl, and in my own part of the world discussions to extend the Lake District National Park’s role as a global nuclear rubbish tip look even more likely, let’s look to a community whose voice has been routinely suppressed over the last 200 years. Yet another reminder, that if we are thinking about this arts/health agenda, we need to be more expansive. 
Jagath Dheerasekara
Muckaty is situated on Warlmanpa country, 120 km north of Tennant Creek in the Northern Territory of Australia. Traditional Owners call the area “Manuwangku”. Nomination of their traditional land as a domestic nuclear waste dump site in 2007, coupled with proposals for Australia to “lease” uranium and take back radioactive waste from overseas nuclear power operations, have generated justifiable fear and concern amongst the Aboriginal communities in and around Muckaty (Manuwangku).
The exhibition, “Manuwangku, Under the nuclear cloud” is focused on this community under threat. Photographs by Jagath Dheerasekara, Curated by Sandy Edwards are online @ http://jd.photoshelter.com/index and (if you happen to be one of our Australian followers) on show at Pine Street Creative Arts Centre, 64 Pine Street, Chippendale, Sydney until 28th January


Clore Leadership Programme
Applications for 2012/13 Fellowships are now open and close 24 February 2012.
Since 2004, the Clore Leadership Programme has awarded over 200 Fellowships to outstanding individuals from across the cultural sector.  Fellows come from diverse backgrounds, they may be working freelance or within organisations, both large and small,  in areas ranging from archives to theatre production, and including visual and performing arts, film and digital media, heritage, creative industries, museums, libraries and cultural policy.

In Our Times call out
Calling artists & others incensed by poverty & inequality. We need you to help us use art to expose the truth and galvanise action. Find out how to get involved in In Our Times. We’d love to hear your thoughts.  How do you think art can best speak to people?  How can it best incite action?
http://collective-encounters.org.uk/2012/01/in-our-times-call-out/ 


Because We’re Worth It: National Summit on Participatory Arts
22nd March 2012 (10am – 4pm: registration begins at 9.30am)
Cost: £15 per person (to cover minimum costs)
Venue: The Institute of Contemporary Arts, The Mall, London, SW1Y 5AH
Because we’re worth it! is an important national Summit exploring and celebrating the value of participatory arts. Participatory arts have the power to change people’s lives for the better; provide connections, experiences and rich stories. The UK’s participatory arts scene is constantly changing, innovating, developing, celebrating, exploring and recording fantastic and ground breaking work.
To book: www.eventelephant.com/becausewereworthit. For more information: 01254 674 777 or email hello@mailout.co

VI
Kick up the fire, and let the flames break loose
To drive the shadows back;
Prolong the talk on this or that excuse,
Till the night comes to rest
While some high bell is beating two o’clock.
Yet when the guest
Has stepped into the windy street, and gone,
Who can confront
The instantaneous grief of being alone?
Or watch the sad increase
Across the mind of this prolific plant,
Dumb idleness?
Philip Larkin
from The North Ship, 1945

Tuesday, January 17, 2012

Simon Armitage on Manifesto Part 1, Consultation on Well-Being, Arts/Health Training...

More feedback and comments for your delectation, with more to follow over the next two weeks. If the visuals on these films do nothing for you, don't worry as all the comments, critiques and developments will be shared on the blog alongside Part 2, which will be published in hard-copy too! Next week includes Mike White. Big thanks to Kamila Kasperowicz for her help with the design of Part 1 and Simon Armitage for reading and responding.

Deadline approaches (23rd Jan) to make the case for the impact of the arts and culture on wellbeing
Regular readers of this blog will know that on Thursday 7th April, (I blogged it HERE) I took part in a consultation event with the Office for National Statistics (ONS) at Bolton University called; Are the Best Things in Life Free? A Public Discussion and Debate. Alongside fellow panellists Dr John Howarth – (Expert on wellbeing), Gillian Halliwell – (Manager of £17m Big Lottery Wellbeing Projects), Reverend Canon Mike Williams – (Spirituality and Wellbeing) and Rachel Burke – (Bolton Lads and Girls Club), I took the position that creativity, culture and the arts have a significant part to play in the ‘well-being’ agenda. This event gave each of us the opportunity to make a ‘pitch’ for our area of interest and, we hope, influence the ONS.

The event was chaired by Carole Truman, Professor of Health and Community Studies at Bolton University, and an opening address on the ONS consultation process was given by Stephen Hicks, Assistant Deputy Director of the Measuring National Wellbeing programme, Office for National Statistics.

So, its with great frustration that I must report that the consultation makes no explicit reference to the arts, creativity or cultural activity impacting on well-being! This is an outrageous omission and I urge you to read the article in Arts Professional and follow the links below to respond to the consultation.

I suggest that Stephen Hicks revisits the notes of this consultation event, and that we contribute to this debate as a matter of urgency.

http://www.artsprofessional.co.uk/Magazine/view.cfm?id=6091&issue=246  
The consultation document is at www.bit.ly/saqsrB  
Download a consultation form at www.bit.ly/tiiy8M
Respond online at www.surveymonkey.com/s/QCRY8HS 


(...remember, it is not a statistician that defines happiness, but the sentient human being)

Arts/Health Training Intensive 2012
Over May/June 2012, Arts for Health will be delivering training modules that offer artists the opportunity to refine their knowledge and practice within the arts and health sector. All sessions will be led by Clive Parkinson. For further details go to http://www.artsforhealth.org/opportunities/


Want to go on a Speed Date?
We've had lots of networking events at MMU and around the region, and as a one-off this spring, we're going to try something different: Speed Dating! have you something to share...a burning question to ask? Are you looking for collaborators...training opportunities? This will give us the opportunity to find out more about each other and ask how might we work together and grow?

Wednesday 29th February 6 - 8pm
(venue to be confirmed nearer the time)

So, it’s an experiment to give each of us a voice and will be how big, or small you decide. Want to be involved? Well don't be nervous. Think about what it is that you want to share and come along. Like all of our events, it will be informal and absolutely free. Let us know if you want to be involved by emailing artsforhealth@mmu.ac.uk  before Friday 10th Feb

Monday, January 16, 2012

The China Study II: Wheat’s total effect on mortality is significant, complex, and highlights the negative effects of low animal fat diets

The graph below shows the results of a multivariate nonlinear WarpPLS () analysis including the variables listed below. Each row in the dataset refers to a county in China, from the publicly available China Study II dataset (). As always, I thank Dr. Campbell and his collaborators for making the data publicly available. Other analyses based on the same dataset are also available ().
    - Wheat: wheat flour consumption in g/d.
    - Aprot: animal protein consumption in g/d.
    - PProt: plant protein consumption in g/d.
    - %FatCal: percentage of calories coming from fat.
    - Mor35_69: number of deaths per 1,000 people in the 35-69 age range.
    - Mor70_79: number of deaths per 1,000 people in the 70-79 age range.


Below are the total effects of wheat flour consumption, along with the number of paths used to calculate them, and the respective P values (i.e., probabilities that the effects are due to chance). Total effects are calculated by considering all of the paths connecting two variables. Identifying each path is a bit like solving a maze puzzle; you have to follow the arrows connecting the two variables. Version 3.0 of WarpPLS (soon to be released) does that automatically, and also calculates the corresponding P values.


To the best of my knowledge, this is the first time that total effects are calculated for this dataset. As you can see, the total effects of wheat flour consumption on mortality in the 35-69 and 70-79 age ranges are both significant, and fairly complex in this model, each relying on 7 paths. The P value for mortality in the 35-69 age range is 0.038; in other words, the probability that the effect is “real”, and thus not due to chance, is 96.2 percent (100-3.8=96.2). The P value for mortality in the 70-79 age range is 0.024; a 97.6 percent probability that the effect is “real”.

Note that in the model the effects of wheat flour consumption on mortality in both age ranges are hypothesized to be mediated by animal protein consumption, plant protein consumption, and fat consumption. These mediating effects have been suggested by previous analyses discussed on this blog (). The strongest individual paths are between wheat flour consumption and plant protein consumption, plant protein consumption and animal protein consumption, as well as animal protein consumption and fat consumption.

So wheat flour consumption contributes to plant protein consumption, probably by being a main source of plant protein (through gluten). Plant protein consumption in turn decreases animal protein consumption, which significantly decreases fat consumption. From this latter connection we can tell that most of the fat consumed likely came from animal sources.

How much fat and protein are we talking about? The graphs below tell us how much, and these graphs are quite interesting. They suggest that, in this dataset, daily protein consumption tended to be on average 60 g, whatever the source. If more protein came from plant foods, the proportion from animal foods went down, and vice-versa.


The more animal protein consumed, the more fat is also consumed in this dataset. And that is animal fat, which comes mostly in the form of saturated and monounsaturated fats, in roughly equal amounts. How do I know that it is animal fat? Because of the strong association with animal protein. By the way, with a few exceptions (e.g., some species of fatty fish) animal foods in general provide only small amounts of polyunsaturated fats – omega-3 and omega-6.

Individually, animal protein and wheat flour consumption have the strongest direct effects on mortality in both age ranges. Animal protein consumption is protective, and wheat flour consumption detrimental.

Does the connection between animal protein, animal fat, and longevity mean that a diet high in saturated and monounsaturated fats is healthy for most people? Not necessarily, at least without extrapolation, although the results do not suggest otherwise. Look at the amounts of fat consumed per day. They range from a little less than 20 g/d to a little over 90 g/d. By comparison, one steak of top sirloin (about 380 g of meat, cooked) trimmed to almost no visible fat gives you about 37 g of fat.

These results do suggest that consumption of animal fats, primarily saturated and monounsaturated fats, is likely to be particularly healthy in the context of a low fat diet. Or, said in a different way, these results suggest that longevity is decreased by diets that are low in animal fats.

How much fat should one eat? In this dataset, the more fat was consumed together with animal protein (i.e., the more animal fat was consumed), the better in terms of longevity. In other words, in this dataset the lowest levels of mortality were associated with the highest levels of animal fat consumption. The highest level of fat consumption in the dataset was a little over 90 g/d.

What about higher fat intake contexts? Well, we know that men on a high fat diet such as a variation of the Optimal Diet can consume on average a little over 170 g/d of animal fat (130 g/d for women), and their health markers remain generally good ().

One of the critical limiting factors, in terms of health, seems to be the amount of animal fat that one can eat and still remain relatively lean. Dietary saturated and monounsaturated fats are healthy. But when accumulated as excess body fat, beyond a certain level, they become pro-inflammatory.

Tuesday, January 10, 2012

Alastair Campbell on Happiness, David Edgar on the value of the Arts, Field Music, Culture Shots and more...

A constant stream of comments, thoughts and ideas have been coming in around part one of m a n i f e s t o, some of which are here for your delectation. All will be revealed over the next few weeks. Thank you EVERYONE. Please feel free to email any comments which must be received before 31st January.
BlueSCI and Field Music
Our friends and colleagues at BlueSCI were featured in the Guardian this week and to hear their collaborative work with Field Music and see the work of Arts for Health alumni Caro Inglis, you have until the 17th January to get to The Lauriston Gallery in Sale. 


‘...happiness is all the more intense for knowing what it’s like to be utterly miserable.’ Alastair Campbell
A really interesting take on the ‘happiness’ debate that continues to fill the columns and obsess politicians, out for a quick hit. Alastair Campbell has written a book about his experience of clinical depression and the affect of his best friends death on his own understanding of what aspiration to happiness might be about. The book’s out on 12th Jan, but a good extract from it shows some considered thinking; that its not all about simpering positivism, but the grief, anger and depression that life throws at us, tempered by friendship and love (and some of those five ways+) that might add up to a life well lived and reflected on as we face our death. Click on the photo below for the extract.

Why should we fund the arts?
Publicly funded arts institutions are under more pressure than ever to quantify the social benefits they bring, as would be done for schools and hospitals. But isn't the crucial role of art to challenge the way society is run? An excellent article by playwright David Edgar. Click on the photograph below. 


Dementia and Imagination with Claire Ford
I’m thrilled that the artist Claire Ford will be sharing reflections of her Churchill Fellowship at our first network event of 2012 on Thursday January 26th between 6:00 and 8:00pm (venue to be confirmed at MMU). As usual the event is free to our members, and will be informal. Claire spent 10 weeks in the USA exploring different approaches to dementia and the arts, and will be sharing this experience, her findings and ideas about future developments in the field. Thanks to those who’ve said they want to attend. Anyone who hasn’t yet expressed an interest, please get in touch by the 19th January. Venue will be confirmed by email one week prior to the event.

+Culture Shots 
Museums and Galleries Week
Culture makes a difference. Experience it.
7 days
5 hospitals
70 creative workshops
6-12 February 2012


+Culture Shots is a week-long series of creative events run by museums and galleries in all five Central Manchester University Hospitals this February. From museum collections, music, film and photography to Wild food foraging, painting and the science of football, these unique sessions give you the chance to discover how culture can enhance your own life, your professional practice, and your patients’ health and wellbeing. www.HealthandCulture.org.uk


...and finally, although I know its a little overdone, the recent edit of the Great Dictator speech has been doing the rounds and is worth a few moments. Thanks, C.P

Monday, January 9, 2012

Ground meat treats: Beef and bison meatza

At the time of this writing, there was no Wikipedia article for the term “meatza”, which surprised me a bit given the number of recipes on the web. In fact, I could not find anything concrete about the dish’s tradition or  history.

Another thing that surprised me about this dish is how much my family and I like it. It has become a regular weekend treat for us for quite some time now.

The recipe below is for a meal that feeds 4-8 people. Like in my previous recipe for a zucchini and onion meatloaf (), the ground beef used here has little fat, and thus a relatively low omega-6 content. Most of the fat comes from the ground bison, which has a higher omega-3 to omega-6 ratio.

- Prepare some dry seasoning powder by mixing sea salt, parsley flakes, garlic powder, chili powder, and a small amount of cayenne pepper.
- Mix 2 lb of very lean ground beef (96/4) with 1 lb of ground bison.
- Add the dry seasoning and a whole egg to the ground meat mix.
- Vigorously mix by hand until you get a homogeneous look.
- Place the mix into a sheet pan coated with olive oil. Richard’s suggestion of creating edges helps keep the sautéed vegetables on top, when they are added later ().
- Preheat oven to 375 degrees Fahrenheit.
- Bake the meatza for about 15 minutes.
- Grate 1 lb of aged cheese.
- Slice one tomato, half an onion, and one green bell pepper, and sauté them in olive oil.
- Drain the meatza after if comes out of the oven, and add the sautéed vegetables to the top, together with half a can of tomato sauce.
- Add the 1 lb of grated aged cheese on top of the vegetables and tomato sauce.
- Return meatza to the oven, still at 375 degrees Fahrenheit, and bake it for about 10 minutes.


The photo montage above shows a side dish of baked potatoes and zucchini. That is optional, as the meatza has vegetables added to it. I usually cut the meatza into 8 rectangular pieces. Each rectangle will have about 50 g of protein and 20 g of fat. The fat will be primarily saturated and monounsaturated (both healthy), with a good balance of omega-3 and omega-6 fats. Each piece of meatza will also be a good source of vitamins B12 and B6, niacin, calcium, zinc, selenium, and phosphorus.

Monday, January 2, 2012

HCE user experience: The anabolic range may be better measured in seconds than repetitions

It is not uncommon for those who do weight training to see no gains over long periods of time for certain weight training exercises (e.g., overhead press), even while they experience gains in other types of exercise (e.g., regular squats).

HealthCorrelator for Excel (HCE) and its main outputs, coefficients of association and graphs (), have been helping some creative users identify the reasons why they see no gains, and break out of the stagnation periods.

It may be a good idea to measure the number of seconds of effort per set; in addition to other variables such as numbers of sets and repetitions, and the amount of weight lifted. In some cases, an inverted J curve, full or partial (just the left side of it), shows up suggesting that the number of seconds of effort in a particular type of weight training exercise is a better predictor of muscle gain than the number of repetitions used.

The inverted J curve is similar to the one discussed in a previous post on HCE used for weight training improvement, where the supercompensation phenomenon is also discussed ().

Repetitions in the 6-12 range are generally believed to lead to peak anabolic response, and this is generally true for weight training exercises conducted in good form and to failure. It is also generally believed that muscular effort should be maintained for 20 to 120 seconds for peak anabolic response.

The problem is that in certain cases not even 12 repetitions lead to at least 20 seconds of effort. This is usually the case when the repetitions are performed very quickly. There are a couple of good reasons why this may happen: the person has above-average muscular power, or the range of motion used is limited.

What is muscular power, and why would someone want to limit the range of motion used in a weight training exercise?

Muscular power is different from muscular strength, and is normally distributed (bell curve) across the population, like most human traints (). Muscular power is related to the speed with which an individual can move a certain amount of weight. Muscular strength is related to the amount of weight moved. Frequently people who perform amazing feats of strength, like Dennis Rogers (), have above-average muscular power.

As for limiting the range of motion used in a weight training exercise, one of the advantages of doing so is that it reduces the risk of injury, as a wise commenter pointed out here some time ago (). It also has the advantage of increasing the number of variations of an exercise that can be used at different points in time; which is desirable, as variation is critical for sustained supercompensation ().

The picture below is from a YouTube video clip showing champion natural bodybuilder Doug Miller performing 27 repetitions of the deadlift with 405 lbs (). Doug is one of the co-authors of the book Biology for Bodybuilders, which has been reviewed here ().


The point of showing the video clip above is that the range of repetitions used would be perceived as quite high by many bodybuilders, but is nevertheless the one leading to a peak anabolic response for Doug. If you pay careful attention to the video, you will notice that Doug completes the 27 repetitions in 45 seconds, well within the anabolic range. If he had completed only 12 repetitions, at about the same pace, he would have done that a few seconds before hitting the 20-second mark.

Doug completes those 27 repetitions relatively quickly, because he has above-average muscular power, in addition to having above-average muscular strength.