Pat Hartman | Childhood Obesity News

Coronavirus Chronicles — Suspicions Arose, Then Voices

Pat Hartman February 24, 2022 No Comments

We are looking at the journey to recognition, the road along which long COVID traveled to become acknowledged as a real and worrisome condition, leading eventually to the awful realization that it can also affect teens and even children.

The first big step was accepting that the lungs are not the only target. It became more and more apparent that the virus is all up in every organ system, and capable of sending its bad news to every nook and cranny of the body, including tiny blood vessels in the toes. First, suspicions arose, then voices. The voices demanded that the medical and government establishments needed to stop using “mild” as a word to describe all non-hospitalized cases.

Writing for The Atlantic, Ed Yong put it like this:

They should agree on a definition of recovery that goes beyond being discharged from the hospital or testing negative for the virus, and accounts for a patient’s quality of life.

In her epic article for the same magazine, referenced by Childhood Obesity News in an earlier post, Meghan O’Rourke stood up for patients who felt ignored or dismissed. Most doctors depended solely on lab tests, a collection of measurements totally inadequate to do the job of figuring out what was going on. She reported on a group called Patient-Led Research for COVID-19, made up of nearly 4,000 long COVID sufferers, plus medical professionals who listened to them, and collected and organized their information.

Astonishingly, months after they were expected and alleged to be all better, almost all the patients still experienced incidents of relapse. Nearly a quarter of them were unable to return to work yet. O’Rourke wrote,

One of the disease’s great mysteries is why some 30-year-olds die from it while others barely notice they have it, and still others initially have a mild acute case but end up unable to manage a flight of stairs. This pandemic has vividly dramatized the variability — and lingering complexity — of the human host’s response to a pathogen.

She outlined the broad hypothesis: that in some patients, “either the virus or the immune system’s reaction to it had caused dramatic dysregulation of the autonomic nervous system.” The problem looked a lot like myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), characterized by exercise intolerance and profound fatigue. Still, it wasn’t exactly the same, or the same as autoimmune conditions, either. But here’s the thing:

These are all poorly understood conditions that, evidence suggests, can be triggered by the body’s response to infections, with clusters of system-roaming symptoms that get grouped under one name.

Writer Nick Whigham noted the growing social media presence of coronavirus long-haul patients on Facebook. As often happens, presence became pressure, especially when people sounded off about the obstacles between them and effective medical attention.

Your responses and feedback are welcome!

Source: “Long-Haulers Are Redefining COVID-19,” TheAtlantic.com, 08/19/20
Source: “Unlocking the Mysteries of Long COVID,” TheAtlantic.com, 03/08/21
Source: “’Dying not only worry’: Coronavirus ‘long-hauler’ details horrific symptoms,” Yahoo.com, 08/02/20
Image by Eva Rinaldi/CC BY-SA 2.0

Coronavirus Chronicles — Suspicions Arise

Pat Hartman February 23, 2022 No Comments

We are looking at how the consciousness of the serious nature of long COVID originated and then progressed over the ensuing months. In mid-2020, Dr. Eric Topol of the Scripps Research Institute contributed some words about the early understanding of the problem. It was becoming clear that being “asymptomatic” did not guarantee an absence of damage from the virus. Dr. Topol wrote,

If you do a CAT scan of these patients’ lungs, you see significant abnormalities tied to Covid, and these are woefully understudied. We also know this the virus can go to the heart and kidneys, so that needs to be looked at too.

He warned of the possibility that “below-the-surface problems” could increase a coronavirus victim’s risk for long-term health complications. At the same time, from Israel, Nathan Jeffay reported on people who tested positive and yet had no symptoms — and their opposites, those who tested negative, or who had ostensibly “recovered,” but who still experienced massively disturbing symptoms.

Prof. Gabriel Izbicki of the Shaare Zedek Medical Center shared with the Times of Israel reporter that “More than half the patients, weeks after testing negative, are still symptomatic.” Some were unable to sleep. Doctors were puzzled by the appearance of symptoms in arms, legs, and other places where the virus was presumed not to have a direct impact. Patients had “freak pains,” and some reported their pain level as 10 on a 1-to-10 scale.

Exhausted by life

They were unable to walk more than a few steps, or too lethargic to find the motivation to do anything but exist. They had breathing problems, unconquerable weakness, and extreme weight loss (not the flattering, fashionable kind). Patients who had allegedly been “recovered” for months kept coming back with unusual patterns of symptoms that could not be found in the textbooks.

Dr. Izbicki was puzzled by his inability to predict which patients were able to shake off the disease, as opposed to those who would still be suffering months later. He told the reporter, “There is no correlation between seriousness of disease during hospitalization and extent of symptoms afterwards.”

Suspicion began to grow that COVID-19 was not just a lung condition but quite possibly involved the circulatory system and thus the entire body. Eran Schenker, director of the clinic for recovered COVID patients, told the reporter,

The damage was not done by the virus, but by an inflammation process which, we know from other diseases, will not leave lungs with the capacity to exchange oxygen as before.

Mitchell Tsai, who interprets medical matters for laypeople, described how coronavirus makes the blood “sticky” seven months later, and is prone to clog the tiny vessels that carry oxygenated blood not only to the lungs, but to the heart, brain, and every other organ, as well as to the mundane parts like arms and legs. He also described demyelination, where the immune system attacks the body’s own nerve cells, “causing weakness, numbness, and tingling.” In some cases, demyelination can lead to psychosis and hallucinations.

A team of MSN.com reporters soon described how the virus inflames and damages blood vessels in a way that can negatively affect the brain. They also related how a preliminary study of COVID patients (who were mostly able to avoid hospitalization) nonetheless showed that about a quarter of the subjects still endured at least one symptom after 90 days. A European study of nearly 2,000 non-hospitalized patients revealed that three months after their first symptoms appeared, about one-third of those victims were still dependent on a caregiver for their daily needs.

They also quoted Mount Sinai’s Dr. Zijian Chen, who said,

I haven’t really seen any other illness that affects so many different organ systems in as many different ways as Covid does.

Your responses and feedback are welcome!

Source: “What You Need to Know About Asymptomatic Spread of Covid-19,” Medium.com, 06/10/20
Source: “‘It’s frightening’: Doctors say half of ‘cured’ COVID patients still suffer,” TimesOfIsrael.com, 06/28/20
Source: “Seven months later, what we know about Covid-19 — and the pressing questions that remain,” Quora.com, 08/19/20
Source: “Doctors Begin to Crack Covid’s Mysterious Long-Term Effects,” MSN.com, 11/01/20
Image by Jernej Furman/CC BY 2.0

Coronavirus Chronicles — Long COVID on the Road to Recognition

Pat Hartman February 22, 2022 No Comments

The point here is, if we thought that merely staying indoors was bad for childhood obesity statistics, it looks like the country needs to prepare for the painful revelation that “We ain’t seen nuthin’ yet.” Just wait until all the kids who had COVID-19 and ostensibly got over it begin to show up with long COVID or MISC-C or some other long-term damage that hasn’t even been identified yet. On the darkest days, it is all too easy to foresee an entire generation so debilitated they’re unable to do anything but creep around indoors, remaining inactive and putting on weight.

A lot of people never wanted to believe in long COVID, and many still do not, but the evidence has piled up relentlessly. In yesterday’s post, we referenced an article by Meghan O’Rourke, tracing the history of awareness as it grew among individual doctors and researchers.

When Mount Sinai hospital opened up its Center for Post-COVID Care, endocrinologist Zijian Chen was chosen to be the medical director. He studied the results of a survey of around 1,800 patients who were “more than a month past their initial infection but still experiencing symptoms.” In other words, according to the established criteria, they were officially better. But somehow, their bodies had not received the memo.

One mystifying aspect was, in the acute stage, most of those lingering cases had not been particularly serious. Many of the respondents had not even been hospitalized. They tended to be on the young side, and their demographic had not been rife with pre-existing conditions. They had expected the illness to be an unpleasant but brief chapter of life, and instead it was showing a tendency to become their new normal. Here they were, multitudes of patients who still experienced heart palpitations, chest pain, shortness of breath, brain fog, and mainly a debilitating and seemingly intractable fatigue.

Where is it?

Because different body systems were affected, Dr. Chen got together a multi-disciplinary group of specialists to figure out what was going on. But rather than remaining consistent, the patients’ symptoms were all over the shop, sending them from one type of specialist to another. Members of the team ordered reams of lab tests, whose results left them none the wiser.

One thing going on with the supposedly recovered patients was their breathing not normalized. O’Rourke wrote,

Evidence began to accrue that long-COVID patients were breathing shallowly through their mouths and into their upper chest. By contrast, a proper breath happens in the nose and goes deep into the diaphragm; it stimulates the vagus nerve along the way, helping regulate heart rate and the nervous system.

A company was brought on board that “introduced a science-based breathwork program” or, some might say, rebranded a centuries-old system called yoga. O’Rourke’s article points out several important aspects of the long COVID problem. While the needed care is not generally high-tech, it is “time-consuming and attention-intensive.” Clinicians are called upon to give attention to a great deal of nuance and ambiguity, two qualities that modern medicine is not particularly well equipped to deal with.

Today’s doctors are used to a quick, or at least definitive, answer. Find the right medication, or perform the appropriate surgery, and voilà! — problem solved. Few medical professionals are used to dealing with conditions that drag on, with the shapeshifting characteristics of a science fiction movie monster. After interviewing many of the hospital’s specialized team, O’Rourke noted that while most of Mount Sinai’s post-acute COVID patients were headed toward recovery, none of them could report feeling like they did before COVID-19 entered their lives.

Your responses and feedback are welcome!

Source: “Unlocking the Mysteries of Long COVID,” TheAtlantic.com, 03/08/21
Image by muffinn (modified)/CC BY 2.0

Coronavirus Chronicles — Is Long COVID a Thing?

Pat Hartman February 21, 2022 No Comments

Scientists are curious, but there is more to it than just an inquisitive nature. Part of the skill is in knowing what to be curious about. Another part is the ability to sense when a vague anomaly is worth investigating. In the beginning, COVID-19 was believed to have an acute period of two weeks. A year ago, for The Atlantic, Meghan O’Rourke wrote a comprehensive article called “Unlocking the Mysteries of Long COVID.” It included this definition:

Acute COVID-19 refers to the distinct period of infection during which the immune system fights off the virus; the acute phase can range from mild to severe.

At Mt. Sinai Hospital in New York City, Zijian Chen, an endocrinologist, had been appointed medical director of the hospital’s new Center for Post-COVID Care. The facility was dedicated both to research and to helping recovering patients “transition from hospital to home.” So Dr. Chen was soaking up information, maybe not expecting to stumble upon anything monumental, just looking at details and piecing odd facts together.

He encountered an online survey whose database included 1,800 patients or thereabouts. It seems as if any number would be impressive, because among the long-haul symptoms are fatigue and brain fog. In those states, it is sometimes difficult to accomplish the most basic maintenance activities, much less journal about the sickness.

Such patients also cope with chest pain, heart palpitations, and shortness of breath, but the after-effects can also be much worse. Dr. Chen was puzzled to find, again and again, references to patients who were more than a month past their initial infection but still experiencing symptoms:

We expect that with viral infections as a whole, with few exceptions, you get better… Many patients were, for unknown reasons, not recovering… [M]ost had had mild cases of COVID-19 — they had neither been hospitalized nor developed pneumonia. Before contracting the virus, many had had no known health issues. Yet they were reporting significant ongoing symptoms.

Chen quickly convened a multidisciplinary group of clinicians to do research in the area of post-COVID care, and since then, knowledge has grown enormously. For instance, Childhood Obesity News has mentioned writer Eleanor Cummins, who has also told the public about the Body Politic COVID-19 support group.

Board Member Hannah Davis, who had the virus along with her children, described this as the place where she had “encountered hundreds of other people describing stranger symptoms and longer recovery times than anyone anticipated.” They need the rest of the world to understand what is going on, because many COVID survivors…

[…] have reported feeling dismissed or gaslit by their doctors for unusual symptoms. They’ve also received skepticism from loved ones, who have dismissed their pain as attention-seeking or the result of an overactive imagination.

Davis knows about such subjects as computational linguistics. Her background is in machine learning and data analysis with a special interest in “tools for countering bias in machine learning datasets.” What Survivor Corps wants to do, is “work directly with a research institution and a biotech company on a long-term study of Covid-19 patients’ outcomes.”

Your responses and feedback are welcome!

Source: “Unlocking the Mysteries of Long COVID,” TheAtlantic.com, 03/08/21
Source: “Guidelines Say Covid-19 Symptoms Last Two Weeks. Survivors Know Better.,” Medium.com, 05/20/20
Source: “Meet the Team,” WeareBodyPolitic.com, undated
Images by Alastair Gilfillan and hobvias sudoneighm/CC BY 2.0

Coronavirus Chronicles: The Struggle for Recognition

Pat Hartman February 18, 2022 No Comments

The struggle for recognition was not of the virus itself, of course, but of its insidious and invidious long-term effects. Today’s obese adults are yesterday’s obese children. Today’s obese children are tomorrow’s obese adults. And since a couple of years ago, COVID-19 is all mixed up in it somehow. And… it looks like this factor might become much more significant as time goes on.

By now it is obvious that, in the words of Prof. Resia Pretorius, “even mild and sometimes asymptomatic initial Covid-19 infection may lead to debilitating, long-term disability.” The creator of LongCovidKids.org writes,

One of the biggest failures during the Covid-19 pandemic is our slow response in diagnosing and treating long Covid. As many as 100 million people worldwide already suffer from long Covid.

Since early 2020, we and other researchers have pointed out that acute Covid-19 is not only a lung disease, but actually significantly affects the vascular (blood flow) and coagulation (blood clotting) systems.

Among other ongoing yet often-varying symptoms, long COVID victims experience “recurring fatigue and brain fog, muscle weakness, being out of breath and having low oxygen levels, sleep difficulties and anxiety or depression.” People in this condition are not often found on elliptical machines, or shopping for fresh veggies. Often, they are lucky if they can get out of bed and make it to the bathroom.

People are sick at home for a long time, either alone or with others who possibly are not well-trained caregivers. Even with the best intentions about healthful eating, victims of PASC (post-acute sequelae of SARS-CoV-2) may not be able to shop for themselves. Some Americans are so really, desperately ill, that managing their diets — or those of their dependent children — would be a hopelessly ambitious project. And kids who feel so lousy are probably not going out for football anytime soon.

This plague is still in its infancy, so how can anyone know what the future holds? There is, however, a strong suspicion in some quarters that the obesity statistics will continue to become even more discouraging.

Not hopeless?

Early in the game, the official word was that recovery after the acute illness took about two weeks. Immediately, dissenting voices were heard. These were not just unhappy, underpaid employees looking for a reason to ditch work. Early in 2020, for instance, journalist Eleanor Cummins wrote about a medical expert, a virologist named Peter Piot, director of the London School of Hygiene & Tropical Medicine — in other words, not some lollygagging layabout. He reported that after recovery from acute coronavirus, it was almost two months before he “started feeling like himself again.”

A few months ago, the Americans With Disabilities Act was extended to protect people suffering from long COVID. This directly impacts obesity, because suffering from PASC is probably a good indication that a person is not in peak form, and possibly doesn’t even have the energy or the will to weigh their food portions at mealtime. To make matters worse, recovery is rarely an orderly, linear progression. The person tends to improve for a short time, or in one respect, but then fall prey to an unpredicted relapse. But now, possibly, more parents and children will be able to get better.

Your responses and feedback are welcome!

Source: “Could microclots help explain the mystery of long Covid?,” TheGuardian.com, 01/05/22
Source: “Guidelines Say Covid-19 Symptoms Last Two Weeks. Survivors Know Better.,” Medium.com, 05/20/20
Source: “Biden Extends Americans With Disabilities Act Protections To COVID Long-Haulers,” HASC.org, 07/26/21
Images by Timothy Fenn and Nathan/CC BY 2.0

Coronavirus Chronicles — Are Excuses Being Made?

Pat Hartman February 17, 2022 No Comments

Last month, the Centers for Disease Control and Prevention reported on a study of COVID-19 patients between the ages of 12 and 17, and guess what? About two-thirds of those patients were obese.

Of all underlying conditions, obesity was found to be the most common. Also, children with underlying conditions — including obesity — are more likely to wind up in the Intensive Care Unit. As if that were not enough, obese kids tend to stay hospitalized for about twice as long as those who are not obese.

Just to put the icing on the cake, “hospitalization rates were 10 times higher for unvaccinated adolescents.” Is there some reason why obese teenagers are less likely to be vaccinated than others? This whole relationship between obesity and COVID is just a tangled can of worms, and if somebody doesn’t get a handle on it, children and teens with weight issues will continue to be prime victims.

Not exactly news

Readers of Childhood Obesity News have absorbed plenty of information on the close relationship between the two epidemics. For NationalReview.com, journalist Jack Butler emphasized once more the futility of hiding our heads in the sand and ignoring this alignment of interests between two heavy-duty health villains:

Over the course of last year, two related facts that many had already reasonably intuited became undeniable: Obesity is a coronavirus comorbidity, making people likelier to get it and to suffer seriously from it. And at the same time, lockdowns which increased unhealthy habits overall, contributed to America’s already-extant obesity epidemic, particularly for children.

It is unfortunate that “lockdown” has become the shortcut term representing the whole spectrum of measures designed to prevent the spread of the virus. Compared to what goes on in other parts of the world, to call almost anything that has happened in the USA a “lockdown” is an exercise in hyperbole. But we know what is meant. The closing of schools, daycare centers, parks, gyms, and community centers has taken a toll, in terms of calories unexpunged by exercise. Even without armed enforcers patrolling the streets, American kids have tended to stay indoors more in the past couple of years, sitting on their duffs and spending way too much time engaged with electronic devices.

Words count

Butler also brought up some troublesome details about the official language employed to describe the link between COVID and obesity, and its strangely passive tone at times, which seems to imply that obesity is some kind of curse visited upon us, like a hurricane, rather than a thing that can be predicted, prevented, or maybe even eliminated. It’s as if we are totally at the mercy of not only the virus, but of obesity itself. The writer hints that the terminology sometimes slides into a sort of “political correctness” that has run amok.

He suggests that certain restrictions against physical activity might be considered a futile strategy “that made many people less healthy and more vulnerable to the disease against which the measures were supposedly implemented.” Another of his thoughts is,

We’ll also need to abandon the notion that obesity is just something that happens to people and that they are helpless to do anything about it.

Your responses and feedback are welcome!

Source: “CDC cites obesity as culprit for hospitalizing children with COVID-19,” KRQE.com, 01/04/22
Source: “CDC Confirms What We Already Knew: Obesity Makes Coronavirus Worse,” NationalReview.com, 01/04/22
Image by Phil Roeder/CC BY 2.0

A Bit More About Hyper-Processed Food

Pat Hartman February 16, 2022 No Comments

In the realm of hyper-processed or ultra-processed foods, the writings of registered dietitian Anne-Marie Stelluti seem particularly apropos. She owns Modern Gut Health, described as a private practice with a special focus on digestive health nutrition.

As anyone who has seen an unnecessarily realistic war movie can attest, each adult human has at least 20 linear feet of intestines curled up inside. There is plenty of room in there for all kinds of hijinks., and as time goes by, the importance of what goes on in the digestive system becomes increasingly evident.

Under the NOVA classification system, salt, sugar, oils and fats have been normalized as food additives. But then, there are…

[…] substances not used in culinary preparations, in particular flavours, colours sweeteners, emulsifiers, and other additives used to imitate sensorial qualities of unprocessed or minimally processed foods and their culinary preparations or to disguise undesirable qualities of the final product.

We have to ask ourselves, why would they want to do that? Preservatives are probably the most morally justifiable additives. They can be looked at as miraculous substances that prevent starvation by extending the food supply’s availability, and also prevent sickness because the foods they are added to remain, technically, fresh. Food laced with preservatives can also be looked at as disgusting zombified matter, which in nature would have been dead a long time ago, yet somehow remains viable.

For commercial reasons, health reasons, aesthetic reasons, and more, preservatives are here to stay. Another category seems to be composed of ingredients whose addition to the recipe could be called arbitrary. Whether the effect is intentional or not, several additives can tend to increase the addictive lure of some foods.

Big trouble

The acceptability line may shift, or vary among different consumers, but there is at any given time an approved amount of food tampering, as well as a point where at least some customers start talking about court actions, legislation, boycotts, and other remedies.

But what about health issues where processing is not to blame? Some basic problems are caused by food. Plenty of edible substances cause internal disturbance to some people. Stelluti writes that hyper-processed foods are “addictive, nutritionally void, and contain pro-inflammatory ingredients…”:

I recommend avoiding pro-inflammatory foods to my clients, especially for those with inflammatory conditions such as inflammatory bowel disease (IBD) and obesity, or digestive health conditions like irritable bowel syndrome (IBS) and diverticular disease.

This is where things get really complicated. Probably about one American in five has some form of intestinal disorder that is capable of being alleviated. What if a person decides to clean up their diet, avoid hyper-processed foods, and eat as much fresh stuff as possible — but what if that person also needs to avoid foods that will trigger IBS?

To obscure matters further, the IBS avoidance strategy is not exactly the same for everyone. As always, individual differences can and do occur, and to figure it out requires some experimentation and record-keeping. But for the person who is beginning to suspect IBS, some of the “don’ts” are shocking. No cauliflower? No broccoli? Are you kidding? Broccoli is the ultimate go-to cliché that represents a healthful vegetable. No kidney beans or avocado? No peaches? No apples? Really?

To arrive at understanding that what you eat affects everything, a LOT, is one of the cruelest of life’s lessons. Remember Dr. Chris van Tulleken, who charted the horrible physical and mental results of an intensely processed diet? He said,

My concern is that children’s brains are still developing and they’re much more malleable than mine, which means the changes are likely to be even greater.

Your responses and feedback are welcome!

Source: “Everything in moderation? Focusing on ultra-processed foods,” BadGut.org, undated
Source: “Here’s What Happens When You Eat Mostly Ultra-Processed Foods For A Month,” IFLScience.com, October 2021
Image by Paul Narvaez/CC BY 2.0

It’s Ultra! It’s Hyper! It’s Food?

Pat Hartman February 15, 2022 No Comments

What is ultra-processed or hyper-processed food? That is a trick question, because apparently some of the stuff, by the time we shove into our pie-holes, barely even qualifies as edible.

Here’s the thing… Pretty much all food is processed, if we go by the definition provided by the International Food Information Council, which includes any deliberate change that occurs before the food is ready to eat. In the most elementary sense, picking a berry from a bush could be construed as processing, because using the fingers to remove it and convey it to the mouth might legitimately be one definition.

Generally, the first degree of processing just makes the substance minimally edible, and still eligible for the category of “whole” food. This might include harvested grain, shelled nuts, and slaughtered chickens. The next stage of processing is still pretty benign, and includes pasteurizing, canning, drying, heating, and even refrigeration or freezing. The third stage is where the manufacturer jazzes up the product with artificial flavors and sweeteners, added fats, chemical preservatives, extra vitamins, etc.

Here is a little trade secret, revealed by registered dietitian nutritionist Carrie Gabriel, who explained,

I would love to say there is consensus on the definitions of processed and ultra-processed foods, but I’ve seen plenty of arguments on what qualifies as one or the other.

A few years back, the University of Sao Paulo, Brazil, broke it down even further when a team of academics at the Center for Epidemiological Studies in Health and Nutrition codified the NOVA Food Classification system. The middle group was divided, to represent processed culinary ingredients in one pile, and reasonably, sanely processed foods in another.

Anne-Marie Stelluti, R.D., listed some ultra-processing additives as “high fructose corn syrup, invert sugar, modified starches, hydrogenated oils, and colorings, as well as de-foaming, bulking, and bleaching agents” as just a few examples. This was on behalf of the Canadian Society of Intestinal Research, an organization that has realized the futility of trying to get manufacturers to halt the aggressive marketing of these “very addictive products,” and prefers instead to spend the energy on aggressively marketing real food.

Ultra-processed foods can be identified in a commercial setting by the lengthy lists of ingredients (depending on the country, if that nicety is even required) on the packaging, and often by the packaging itself, which is as garishly colorful and shiny as a Mardi Gras parade. The Brazilian team defined a group of ultra-processed foods which looks eerily familiar when compared, for example, with the surveys Dr. Pretlow has conducted about children’s “problem foods,” and here it is:

pop and fruit drinks
sweetened yogurt
sweet or savoury packaged snacks (e.g., cookies)
candies and cake mixes
mass-produced packaged breads and buns
margarines and spreads
breakfast cereals
cereal and energy bars
energy drinks
instant soups, sauces, and noodles
poultry and fish nuggets, hot dogs
many ready-to-heat products: pre-prepared pies, pasta, and pizza dishes

(To be continued…)

Your responses and feedback are welcome!

Source: “What’s the Difference Between Processed and Ultra-Processed Food?,” Healthline.com, 10/18/18
Source: “Everything in moderation? Focusing on ultra-processed foods,” BadGut.org, undated
Image by Steve Jurvetson/CC BY 2.0

Doctors Do Own Research

Pat Hartman February 14, 2022 No Comments

Xand and Chris van Tulleken, the very media-savvy twin doctors with weight issues, have a complicated history regarding both obesity and each other. Xand was initially the identified patient. This video is a very brief teaser, mentioning how, during a stressful period of life, he woke up one day weighing 19 stone, the equivalent of 266 pounds.

Now, over to Dr. Chris, who once said of his brother,

Because he has lived with obesity, and because he is currently living with being overweight — that ages you. It’s a clumsy phrase, but increased body weight is associated with many of the problems that are also linked to increased chronological age. You end up with the average health measurements, by any metric, of someone around about a decade older.

This may or may not have been related to the experiment that Dr. Chris put himself through, or as DigisMak.com phrased it, “the 42-year-old doctor did his best to test a theory and experimented on himself.” For four weeks, he assigned himself the task of following a diet based on 80% ultra-processed food. In another video, he explains that the parameters of the experiment included permission to eat whenever he felt hungry.

Cinéma vérité

There is a scene where Dr. Chris pores over the long list of unpronounceable ingredients printed on a food package, and another of him at 4 AM saying, “I’ve had to come to the kitchen. I can’t sleep. I’ve got heartburn. I’ve got a headache. I feel like eating more food.”

Over the month, his weight increased by 14 pounds. Imagine gaining 14 pounds a month for, say, a year! In the United Kingdom, no imagination is needed, because one person in five stays on 80% processed food, all the time. Even the obesity expert who worked on this project became more aware about feeding her kids.

At any rate, all the on-demand banquets of hyper-processed food culminated in “constipation, insomnia, anxiety, heartburn, headaches, rapid weight gain, mood swings…” and other problems. The sensation of waking up feeling hungover was an additional drawback, and even a diagnosis of addiction seemed plausible.

During the experimental month, blood tests showed that Dr. Chris’ fullness hormone decreased while his hunger hormone increased by 30%. MRI scans revealed that “following a diet high in ultra-processed foods connects the reward centers in the brain with the areas that drive repetitive automatic responses.” The experimenter/subject said,

My diet has linked up the reward centers of my brain with the areas that drive repetitive automatic behavior, so eating ultra-processed food has become something my brain simply tells me to do without me even wanting it.

DigisMak.com says,

[D]espite a keen professional awareness of the harm he was doing to himself, van Tulleken declared himself quite incapable of controlling his excesses with food. In fact, he stated that despite feeling that he was no longer enjoying food, he could not stop and that is why he directly related the consumption of ultra-processed foods with a powerful addiction.

Anyway, the conclusion was, “I have aged 10 years in four weeks.”

Your responses and feedback are welcome!

Source: “My Weight Loss Story by Dr Xand van Tulleken,” YouTube.com, 01/03/17
Source: “Here’s what happens after a month of eating only ultra-processed,” DigisMak.com, 05/24/21
Source: “UK doctor switches to 80% ULTRA-processed food diet for 30 days,” YouTube.com, undated
Image by Rawpixel Ltc/CC BY 2.0

Obesity and Twin Psychology

Pat Hartman February 11, 2022 No Comments

“Nature versus nurture,” otherwise known as “heredity versus environment,” is a conversation starter in almost any field of knowledge. But no matter where someone stands with respect to the relative importance of those two factors, almost anyone would agree that identical twins are clones.

This is, incidentally, also the assumption on which specially bred laboratory animals are sold. They are supposed to all start out the same, so the researchers can eliminate the constants and focus on the variants, and recognize causes and effects. The ability to take that sameness for granted is vital to the whole enterprise.

Xand and Chris van Tulleken are identical twins, born and raised in Britain, and both doctors, so how did it get to where they were 42 years old and Xand outweighed Chris by 30 pounds? As previously mentioned, Xand had moved to the United States for educational purposes, and an unplanned pregnancy brought unexpected responsibility. He told The Atlantic that eating is his go-to stress response:

I remember eating almost continuously. So it was stress, and the food environment in America is different. Portions are bigger, and the ingredients are different as well.

These twins shared the same genetic material and were brought up in the same home environment. It would seem reasonable to expect both to be stress eaters (or neither), but Chris says that is not so:

The collision of genes and environment is terribly complicated… My response to stress is just entirely stopping eating.

The history of which twin was heavier at which life stages, and why, is a bit confusing. At some point, they set some kind of record by having the biggest weight difference recorded by a King’s College longitudinal study of twins, and that was 30 pounds. Another anecdote brings up questions. Chris says,

Once, Xand was in Sudan, eating a junky diet and probably gaining weight in basically the hottest place on Earth. I went to the Arctic for three months and lost four stone.

Four stone is 56 pounds, which is a lot to lose, whether intentionally or inadvertently. If Chris is the brother who does not stress-eat, where had so much weight come from? At any rate, it is no doubt possible to trace every wrinkle of their unusual situation, because the Drs. van Tulleken tell the world about it in hopes that others might be helped.

On the physical side, the twins have “all the major known genetic risk factors for obesity.” But that is the least of the problems. Chris confesses that they enable each other in binge behavior. (If we were all honest with ourselves, it would be evident that far too many relationships are based on that paradigm.) Apparently, the brothers have always encouraged each other to be disordered and transgressive.

There are philosophical differences and a whole lot of head trips and complicated psychological sibling rivalry nuttiness. This is interesting because it shows that relationships are complicated and varied, and some solutions don’t work for everybody.

The origin story of their podcast is that Chris wanted to start it to encourage Xand to face up to his overeating tendency, but a therapist “made Chris realize that Xand wasn’t the only one who had a problem,” wrote journalist Helen Lewis. The various media projects give the two doctors plenty of scope to air their personal differences, recognize their various blind spots, and work on their control issues. A quotation from Xand relates how his brother stopped nagging, and instead…

[…] Chris spent thousands of pounds on [making] a podcast to change the way I eat, got therapists and scientists from all over the world, and has completely changed what’s in my fridge. All in a way that I feel I took charge of it. Maybe you just have to be clever about the way you manipulate your family.

Your responses and feedback are welcome!

Source: “‘The Revelation Was That I Was the Problem’,” TheAtlantic.com, 08/07/21
Image by PitchVision/CC BY-ND 2.0

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