4 Tips on Spotting BAD Research

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When is a study NOT worth reading?

Darlings,

LaDiva here – Totally annoyed!

Here is an article about NEW Fascinating research important about kids with cow milk allergies having bone problems.  The original article is from Pediatrics magazine, the journal of the American Academy of Pediatrics.  Please open it and read along.

  1. Scary Headlines – Here’s the articles headline: Cow’s Milk Allergy in Childhood May Lead to Weaker Bones: Study

    What you may miss is the subtitle:
    But one expert contends that difference in bone density wasn’t enough, on average, to worry about fractures

    So, what is the point to this article?  Or what does one person’s opinion mean?  What should I look for in this article?  You should look for the supporting evidence that clearly states that my kid, or kids I know, that have cow milk allergies will have weaker bones or may have weaker bones later in life.

    Scary titles are a red flag for me.  This usually means I will have to read between the lines to figure out what is really being said.  A prime example is “Butter – Great Again!”  This was completely flawed meta-analysis research.  Please contact me if you want the skinny on it.

  2. Be clear on what is actually being studied or compared.
    Here’s the first paragraph:
    Children who are allergic to cow’s milk may have weaker bones than kids with other food allergies, a small study suggests

    Ok, in the first paragraph the writer totally backpedals.  The kids may have a bone problem, but only when compared to kids with other food allergies, not most kids.  So, what does that mean to the kids I know?  I have no idea.
  3. How many people?
    Then, the article continues with “small study suggests”.  Again, this is a suggestion, not an actual truth for the average kid.  So, for how many kids?  This is a small study, but how small?  52 kids.  Yep, that’s it.  So, 56 kids studied have this problem.  Oops, I’m wrong.  Only 6% of 52 kids.  That’s 3-4 kids.  THREE or FOUR KIDS?  Why is this even making news?  This data would not even qualify you for a graduate term paper much less a published article in an internationally recognized journal.
    Alright, I’m just jealous.  Anyone know the submission protocols for Pediatrics magazine?  I need some cash and am going to publish my own study.  I work with kids in a residential treatment facility.  There are at least 10 out of a 100 kids where I work that are allergic to tomato sauce.  This is a bigger population than the milk study and would be classified as a more “Robust” study.  Tomato sauce contains lycopene.  Lycopene decreases risk for heart attack and different cancers. If I tested for inflammation [there is a biomarker we test for to show whether there is inflammation in the body] in these kids, I would probably find it increased.  Increased inflammation is one risk factor for heart disease.   If I published this as a study the headlines would be:
    Tomato Allergy in children may lead to increase heart disease: Study
    But, what about what else is going on in their diets and lives?
    Absurdity on wheels.  But I will cash the check and do the book tour.
  4. Does the methodology of the study make sense?
    How long did they study these kids?  For 5 years?  10 years?  Did this condition persist?  That would possibly mean something.  Nope. Testing was done once.  Now, the kids did have lower bone mineral density, but bones need 17 nutrients to be built.  This just talks about calcium intake.  What about the other 16?  The study mentions that Vitamin D levels were taken, but we have no idea what they were.  The article only states that the intake [which we don’t know if that was from 1 day or 4 weeks] was lower than recommendations.
    Here’s another statement from the article:
    Long-standing cow’s milk allergy in adults has been linked to reduced bone density.
    Um, many studies of Asian and African women, prior to urbanization, who have many children and have no cow milk source have great bones.  Where is evidence to support the article’s statement?
  5. Are the outcomes repeatable?  This means that you should be able to find other studies doing, basically, the same thing showing the same result.  Okay, “study suggests” is part of the original article language.  So, we are not to take this as established fact. On the other hand, what can we take away from 3-4 kids?  FYI, Kathy Doheny [writer of this], repeats the idea of low calcium intake is equated with negative bone health.  I have two thoughts on this:
    1. Where the most amount of calcium from cow milk is drunk or eaten is also where there are the highest incidents of hip fractures.  Part of my evidence is this little study from Harvard where they looked at milk consumption in the teen years for 96,000 people for 22 years.  In fact, an article from the British Medical Journal including many, many participants showed that the galactose [sugar found in cow milk (“gala” is Greek for “milk”)] led to increases of all causes of mortality in women and men, especially those drinking 3 glasses a day.
    2. The study researchers state that these 3-4 kids had low bone mineral density, however, they DID NOT have low bone density.  There is a profound difference.  The kids bones appeared just fine.  And there is a mountain of evidence, including my cited studies, that cow milk or calcium supplements do not support older bone health.  The World Health Organization recommends around 350 mg of calcium daily for kids, not the over 900 mg stated in the article.  Kids can absorb that amount of calcium from legumes, vegetables, nuts, seeds and fruits.

Not everything in this article is terrible.  Luckily, it’s short.  I’m glad Ms. Doheny cites someone saying this doesn’t amount to much.  It’s great that she gives some alternative sources for calcium. However, she doesn’t mention that tofu, collard greens and bok choy all have more absorbable calcium than cow milk without the galactose complications. She does mention that cow’s milk is fortified [has added in] with Vitamin D because cow milk does not come with Vitamin D.  Other milks are also fortified.  Any milk that has Vitamin D will equally supply the kids.

Now, Darlings, I know that Ms. Doheny is NOT a researcher, but if she is going to take on the role as science expert she should know how to report on what really counts.

 

 

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The New Slave?

National Constitution Center

National Constitution Center edifice

Darlings,

Happy New Year!

The first weekend of the New Year found me at the National Constitution Center in Philadelphia, PA.  Perfect for a cold, damp, rainy day.

Truly a fantastic place filled with interesting facts about how and why the American Revolution happened.  For a fact wonk like me, heaven on earth.  In addition to the permanent exhibit detailing and exploring the full document, was an exhibit about Thomas Jefferson and his home/plantation, Monticello.

Monticello was Jefferson’s experiment in architecture and agriculture.  But one can also learn a great deal about the mentality of that era and how it is still reflected today.

On the grounds of Monticello were 200 enslaved people.  Within the exhibit is a large sign in naming most of the enslaved that were born or bought, worked and died on the premises.  Many names are repeated for various workers, including several John’s and three Sukey’s, plus more Sukey’s with variety of second names.  People with names no one remembers who had little to no hope of being in charge of their own destiny due, mainly, to circumstances beyond their control.

The signers of the Constitution were smart, caucasian, male, land and business owners.  Many believed that the entire economy, not to mention their own wealth, would collapse if slavery were abolished.  What would happen to their inferiors – women, the poor and non-whites?

At the time of the revolution, 1 in 5 citizens in the colonies was enslaved.   Currently,1 in 5 US citizens goes to bed hungry, 1 in 31 citizens of the United States is on parole, probation or incarcerated, 1 in 3 has a criminal record, 1 in 2 homeless are under the age of 18.

Signers of the Constitution

Signers of the Constitution

If you have read this blog you will know that I work in a small residential treatment facility for teens with “anger management challenges.”  That’s the politically correct or let’s-keep-positive-at-all-times term for problems.  They and their families are represented in the statistics listed above.  Many encompass all categories.  What are we doing, as a society, to give these folks hope for a better future?

I am a big believer in the idea that I am in control of my destiny, but I had help.  I was not born in poverty or had to live with multiple families because my parent, the one not incarcerated, couldn’t keep a decent roof over my head.  I never had to figure out how to get to school from a new homeless shelter.  I never had to go to bed hungry as a child or without a winter coat, albeit my coat was a hand-me-down.  I was never sexually abused as a child or beaten into submission.

What is the long term outlook of those who have grown up with these “challenges”?  When the kids I work with made posters of occupations they would like to have, the jobs were: bereavement counselors, hair and nail stylists, parole officers, therapists, lawyers and basketball players.  Where were the doctors, nurses, pilots, actors, writers, business owners, teachers, real estate agents, chefs, journalists, mechanics, welders, engineers, hospitality professionals, architects, scientists and designers?

These kids see themselves as a cog somewhere within one of the fastest growing businesses in the country – the prison system.

The United States has, by a wide margin, the largest amount of its own people in lock up.  Being at the Constitution Center, I read this incredible, historic document put together to govern a country, not by rule of a family or separate section of the populace, but by the people as a whole.  The difference of 1700’s slavery and 21st century poverty is apparent.  Yet, we share the same percentage of the citizenry who have little notion of liberty to pursue their happiness.  Now a paycheck deems where they live, what foods they can eat, life expectancy and future possibilities, or lack thereof.

Even though Wall Street is having a huge resurgence, the notion of increasing the minimum wage is shunned because it will “put businesses out of business.”  Again, the wealthy few breed fear of a collapse in the economy for the majority of minimum wage workers – women, the poor and non-white.

Is this the modern form of slavery?

I took a number years ago, when is it my turn?

Take a ticket and wait

Take a ticket and wait

Darlings,

The kids I work with are not the reason I hate my job.  It is the frustration of nothing ever moving forward. . . and the 4 hour commute once a week.

So, I have been looking at other projects and positions for about 3 years.  A number of single event opportunities have come my way such as conference presentations, fat camps, corporate wellness, county agencies, but they all fold after first happy use like toilet paper.  Nothing moves to the next bigger step.

Yet again, I find another opportunity.  This one is to create nutrition videos, something I already Toilet paper rolldo, in the program I already use.  I read and comprehend the project that the company has emailed as the first hoop to jump through to decide worthiness.  The project was something I have done about 1,000 times.  I read everything, do the project and realize that I have an upgrade version of the slide presentation software and their computers have a problem with that.  I check the project for accuracy.  I now rack my brain trying to think how I can downgrade the version of the file I have to match the company’s software version.

Eureka, on another login for my laptop [replacing the stolen one from the summer with all of my book on it] I find an older version of the program.  I will now re-do the slide stuff.  I write to the contact from the company and state this is what I am going to do and here are a few other questions before I do a final checklist.

But the company’s files I need to complete the project in the older version need to be downloaded again.  However, the company’s download program, Dropbox, will not download what I need as a simple pdf.  The files open as blank pages.  My laptop has Dropbox loaded and I have used it before on .docx files.  Mr. Company Contact contacts me via email, congratulates me on my pithy questions and states that there are ambiguities because they want to see if people can think.  I do not mention the Dropbox issue.

I spend the next 8 hours working on this program, visiting around 15 sites trying to find out how to download these files again in a simple pdf format.  Apparently, hundreds of people have the same problem.  It seems that the computer system the company wants their work done on and Dropbox have some major communication issues.  I do all of the work-arounds detailed on all sites.  One works for about 3 minutes.

Brilliance arrives and I download the files onto a friend’s PC, that does not know Dropbox exists, and email them to myself.  I checked to see that I was not supposed to upload it to Dropbox.  I run through the final checklist and email.

The next day, an UNDELIVERABLE message shows up in my inbox.  I check everything, again.  I write the parts I worked on and quote the company’s instructions on how I completed the project just to cover my . . . tracks.  Resend.

This would be a great job.  I could do it from everywhere there is internet service.  I am in sync with the nutrition info put out.  I give myself a visa to Happyville because I know my work is good.

Today, I get rejected.  “You are not what we are looking for.”

Rereading the initial email with all the instructions, I realize that he wrote an incorrect instruction.  Or I think he did.  I put 2 pieces of different instructions together and now see that he may have wanted another thing done to the document.  The 2 pieces of different instructions shows that he doesn’t know how to count.

My first professional job in the entertainment business was over 30 years ago.  I spent years in the film and TV world.  My artistic habit was fed doing exactly what this new opportunity wants.  I did this job at international finance institutions for 15 years.

I never got what I personally wanted out of my artistic career, so after realizing I would just become old and bitter, I thought forget the frustration and do a job based on objectives [science] not subjectives, [art].  I jumped through the education hoops, the forget-everything-science-based and puke out 1950 medical-answers-on-the test hoops, the you-have-two-ears-and-one-mouth-use-them-in-that-proportion hoop, the find-out-what-you-do-well-and-do-that hoop and the ever popular I-will-do-everything-to-make-this-happen hoop.  When do I stop jumping and land?

Stay tuned, because you never know when there could be breaking news

Hang on!

Hang on!

that I get what fulfills my soul and life needs.

Until then- I did have a piece of interesting mail.  The second letter of its kind in 5 years.  One of the kids I work with sent me a letter thanking me for the birthday card I sent and he wants to be able contact me when he gets out and tell me how he is doing.  Not sure what I did to make this connection, but perhaps his family didn’t see the remember-my-kid’s-birthday or attend-family-therapy-day hoop.

This week the two hours each way will be, subjectively, worth it.

Mad-itude and attitude

Darlings,

Shooting a film in Montreal. [Thanks to Julie for housesitting with her friends!]  Will be having reviews on eateries The Green Panther, ChiChai, Sophie Sucre, Trois Brassierer, Grumpy’s and Biere & Compagnie.  I’ll update as they become available on HappyCow.net.

However, I had to learn a life lesson, AGAIN before I left.

If you have read earlier posts, you know I am a part-time dietitian for a residential treatment facility in Philadelphia whose clientele are teens with anger management issues. I drive 2 hours there, work 10 hours and drive 2 hours home.  Why do I do this – mucho better dinero than is found in my little burg.

Most of these teens have been through a number of foster care situations and other residential facilities before they get to us.  Most only have one parent that may or may not be biological, have another parent either non-existent or incarcerated, and/or being raised by a relative with children of their own.  The history of many of them would not only break your heart, but also leave you wondering how they every made it to age 15. It is little wonder that these kids are apt to break into fights or have a personal melt down replete with screams, self injuries and fists flying.

My primary job is to conduct one-on-one assessments with every client within 30 days of them arriving.  I am the conduit of informing the kitchen and nursing department of allergies, dietary problems, eating disorders and food preferences s.

One of my goals when I was hired was to teach cooking classes.  Many of these kids will age out of the system into life on their own with little life skills to succeed.  Having been cash-challenged at times in my life, I know how to eat healthily and on a tiny budget.  In fact, that is usually when I am eating the best because every calorie and penny counts.

However, the idea of having a few acting out teens cook every week with boiling water, blender blades and knives was daunting for my higher-ups.  Amazingly, our school principal got some funding and made it happen.  We rotate one class at 8-9am with one of the sets of boys and another at 3-4pm with one of the sets of girls each week.

A couple of weeks ago, I stayed overnight in Philly and did back to back 10 hour days.  Big mistake, sort of.

I had little sleep the night before the first day.  I went from cooking class to meetings to consulting with a few kids on the fly to realizing I forgot my lunch to finally reading all my emails from the last week at 1pm to buying additional supplies to prepping for the next cooking class.  By the end of the day and the younger girls class, I was totally beat.  They are very nice girls with your average teenage distractions and sense of respectful boundary testing.  At the end of class, I was going to visit a friend who had just had surgery.  The only thing stopping me from running out the door and getting to my surgery friend in a sane manner was that the storage room door for our equipment was locked with no one around to open it.  It took every fiber of my being not to yell out, “I asked housekeeping to open this 2 hours ago.”  I took a deep breath and thought what am I going to do with all this cooking equipment in the hallway.  How can I end this day?

I found the school secretary who promised she would get housekeeping to open the door.  One of my students said, “Miss, take all the knives with you.”  Good idea.  I put them in my bag, took the girls to their floor and ran for the car.

My parked my car where I was staying overnight and walked a mile or so to see my surgery buddy who was, thankfully, pretty doped up and not into talking.  On my walk back I started to crash quickly from the 29 hour day. I bought some food and ended up chatting at my friend’s apartment longer than prudent.

I woke up early the next day and anxious.  So, the day began.

Again, I cooked with a set of guys, the older ones, who were on Planet Oppositional.  They tested boundaries and whether the corn chowder recipe we were making was worth eating.  All the spices “stink”.   I tried explaining how ingredients change when you bring them together.  No one was buying it.

The day sprinted past and my head was swimming by the time of the second cooking class – the older girls.  I went to get them on their unit.  No one was ready.  I thought, “Maybe no one will come. Yay!” Two decided not to come, and one was screaming my name and nasty language as the other three went downstairs with me.

I wanted to leave and not teach the class, but I thought I would tough it out.  It was only one more hour.

By the time one participant, who kept insisting I stop having her use a knife safely because she KNOWS how to cook, almost chopped off the tip of her finger, I lost it.  I yelled, “I’m done.  We are done.  Let’s go upstairs.”

Ms. Chop-off-finger repeatedly informed me that holding a knife in an upright position and telling me that I should leave her alone was not a confrontation.  I snapped, “You’re done.  We’re done.  This class is over.”

What really ticked me off is that some 17 year old goof ball that I will never see after two months was the straw that broke the camel’s back.  She was gloating a bit in her ability to get under my skin.  But I had to apologize, which I did, for getting angry and exploding verbally.  I am the adult.  I was so embarrassed I felt a tear roll down my cheek.

Another staff member took the girls into her room and reminded me that everyone has breaking points.  She told me, “What these kids need to see is how you deal with it.  Don’t be so hard on yourself.”

I agreed, but personally didn’t because I saw the train wreck coming and didn’t do anything to derail it.  I had those quiet, slow set of tears.

Now, my eyes were red. Great. The other staff member asked the girls and me if we wanted to finish the cooking class.  They said yes and I agreed.

My nose ran a little.  Ms. Chop-her-finger-off came back.  I don’t know why, but she did.

At one point the girls asked how I learned to cook.  I told them how I started at age 9, but learned recipe reading at 14.  I said that when I was their age I was in a body cast for nine months.  My father decided we would cook together on his days off.  For some reason going back to being in the cast, being out of school that year, never leaving the house due to my illness, the glares from people seeing me in this huge cast hit me like a tidal wave.  But I decided to not let it stop me talking or cooking.  I talked right through the slow, quiet tears because to me they were an emotional release, not a lack of strength.  The other girls and I finished the recipe and relaxed into a regular conversation.  Ms. Chop wouldn’t do anything and complained about the visuals of the chowder. Whatever.  We cleaned up and I left.

There is a saying in this business, When you are no longer therapeutic, it’s time to get out.  I almost quit my job.   I felt defeated and stupid.  I had a Mad-itude.  On the other hand, I have bills to pay.

My next work day, would encompass teaching all four sets of kids, conducting assessments, two meetings, emails and whatever else.  Yuck.

Then a day or so later I thought, change your attitude and everything changes.  You are just fearing the confrontations the kids have to anything new, to any mistakes you make in speech, or directions.  Release the fear and let any negativity be the sole property of the person dishing it out.  But, set some safety boundaries.  Not setting boundaries at the beginning of the class was my fault.  And it came back to bite me big time.

I got to work, set up for the first class.  I told myself I was going to have a great day and that everything was going to work out.  I only have to own my attitude.

The guys came in and I stated a safety policy about knives and equipment.  We had a great class.  The older guys came in, one kid in particular that had mad-itude during the last class, said he had to help set something up, but wanted to come back.  My meetings went off with no conflicts.  The younger girls were making jokes off each other and helping each other.  I went to get the older girls.

Ms. Chop came and brought her mad-itude.  We had a new student in the class.  It took three weeks to do a one-on-one assessment with New Student when she arrived at our facility because she had so many meltdowns and fights.  I reminded myself to let everyone own their attitude and I keep mine.  The class started with my safety announcement.  Everyone took it in stride.  New Student was FAB.

We made Sweet Potato Black Bean Burritos.  Ms. Chop said how bad everything looked.  She said nobody would eat that crap.  I didn’t play into Ms. Chop.  Silently, I designated her dishwasher.  I just handed her dish after dish and said, Thanks for washing this up.

Class was easy and fun.  The girls LUVED the burritos and wanted to share them.  Ms. Chop picked up a piece of the burrito and ate it.  I looked at her.

“You don’t have to eat it or try it.”

“I know”. Sullen look.  “It taste okay.”

“Great.”  I left it at there and got everyone back to clean up.

When we got to the storage room, the door was open.  Will wonders never cease?  No, just ask Ms. Chop after she finishes that other burrito.  Drat, I thought dinner was made.

I’ll Get Something at School

Still churning out chapters for the book, but saw this and thought I should get the word out.

Raw nuts are a great snack.

Raw nuts are a great snack.

“I’ll get something at school” is a resounding phrase as your teen ager runs out the door to catch the bus.  Of course, kids in high school want more freedom.  At this point in life, you as parent having been dealing with that for years.  But, you still want them to eat something nutritious.  Now, the federal government is going to help.  Well, if you help, too.

According to Reuters news service, the United States Department of Agriculture [USDA]  is looking for public comments on whether to make vending snacks sold in schools lower in fat, sodium and sugar.

Many schools have removed vending machines, which may not be the best idea.  Hungry kids often buy foods from vending machines not just for lunch, but before after school

Active kids need snacks

Active kids need snacks

activities.  Activities maybe timed closely after the last class so buying something off campus just isn’t possible.  Lunch times can run from 10:30 am to 1:30 pm.  Teen agers need available snacks, especially for physical activities like sports or dance.

Since students usually ingest more than 30% of their daily calories from food eaten during the school day why not have those held to a higher standard?  The proposed regulations, first update in 30 years, would only allow sales of low calorie or low fat beverages and food items having less than 35% of calories comes from sugar or fat.  There was no specific limit for salt.  Jeff Novick, MS, RD, LD, LDN suggests that when reading a nutrition label sodium  content in a food product be no more than calories per serving.  Seems pretty easy to remember and easy for a school food service director to find when deciding which snacks are best to offer in vending machines.

There is a public comment period for this new regulation for the next 60 days.  Please use the links below to learn more about the proposed guidelines and add your cents on vending food sale choices.

There’s only so much control you have once your child walks out the door.  Having the school foods on board to create a healthy food environment can make your life a little easier.

Here’s where to view the proposed new regulations: http://www.usda.gov/wps/portal/usda/usdamediafb?contentid=2013/02/0019.xml&printable=true&contentidonly=true

To voice your opinion on these new regulations go to:www.regulations.gov.

Red Velvet? Only as dessert

Dawn knows her cupcakes and isn't afraid to show the world

When I told a co-worker about my cupcake blog she asked for her favorite – Velveteen.  There is a recipe for it in Vegan Cupcakes Take Over the World.

The recipe calls for Chocolate Extract, but I couldn’t find any.  So, I did the next best thing – dark creme de cacao.  Smelled like chocolate, intense flavor.  And really, do you have to follow a recipe?

The frosting was a different type suggested by the authors, Isa and Terry.  It called for super fine sugar.  That WAS at the store.  I thought the frosting was yummy, albeit a little grainy.

In all their red and pink-y perfection

I made a video of Ms. Dawn giving her unbridled opinion.

It appears my deviations didn’t disappoint!