McDonalds now counting calories September 13, 2012Posted by Cameron Shelley in : STV202 , comments closed
From NPR comes the news that McDonalds will post calorie counts with its menus in all its US locations. The move comes in advance of government regulations that may well require McDonalds and other restaurants to do so anyway. Spokespeople for the chain restaurant say that their pre-emptive move is meant to respond to customer demand, and to help educate their customers as well.
If the change is intended to help people reduce their caloric intake, then it may be doomed to failure. Studies of meal orders in restaurants that already post calorie counts reveal that customer choices do not change significantly. The same is true for McDonalds itself, in cities where the restaurant has already made this move:
In U.S. cities such as New York and Philadelphia where posting calorie information is already required, however, Fields [president of McDonald's USA] notes that the information has not changed what customers choose to order.
“When it’s all said and done, the menu mix doesn’t change,” she said. “But I do think people feel better knowing this information.”
It seems that most people understand that they might be healthier if they did reduce their caloric intake. However, merely counting calories is evidently not sufficient to change the way people eat. There are at least a couple of reasons why this might be:
- Eating patterns are habits that may be hard to break. (Just ask Pavlov’s dog.) The environment within a McDonalds restaurant is well designed to sell food, and repeat customers become used to eating there in a certain way, perhaps re-ordering their favorite items. Merely posting calorie counts does not change the situation profoundly.
- Customers can always re-contextualize the calorie counts. Instead of taking them as diet advice, people can reconstrue calorie counts as a reminder of the reason they came to McDonalds in the first place: To gratify a craving for junk food. As one man remarked in the report, “I don’t come to McDonalds to eat healthy.” As a result, the counts could simply reinforce the behavior they are meant to inhibit.
So, as an exercise in education, meaning a mere transfer of information, the calorie postings will work. As a means of changing people’s behavior for the better, they probably will not.
(Find more postings about McDonalds!)
Making fat work for you March 8, 2012Posted by Cameron Shelley in : STV203 , comments closed
A recent study suggests that fat cells can be recruited into the “war on obesity” through new drugs. The body contains so-called “brown fat” cells whose function appears to be the burning of calories to help maintain body temperature. This is in contrast to “white fat” cells that store calories. The new work suggests that “white fat” cells may be converted into “brown fat” cells. In so doing, the body would change from a regime of calorie storage to one of calorie burning:
Now Kajimura and his UCSF colleagues have demonstrated how [the conversion process] works. In their research, they showed that PPAR-gamma interacts with the protein PRDM16, making it more stable and leading to its accumulation inside cells. This essentially throws a genetic switch and converts the white fat cells to brown — at least in mice.
So, it may be that overweight people could be put on a regime of PPAR-gamma, which would convert some of their overactive “white fat” cells into “brown fat” cells, causing them to store fewer calories and thus lose weight.
In addition, there is research linking the amount of “brown fat” in the body to obesity:
And in recent years, doctors also have discovered the amount of brown fat in the body is inversely proportional to the likelihood of obesity — the more brown fat people have, the less chance they are obese.
So, by administering a drug that changes the amount of “brown fat” in an obese person to resemble that of someone at a healthy weight, the obese person will assume a healthier condition.
Given the stubborn nature of the problem of obesity, the prospect of an effective treatment is welcome. Of course, this new work comes with some cautions. For example, the correlation between weight and “brown fat” level is not proof of a causal relationship. An obese person with the “brown fat” cell level of a healthy person plus a dose of PPAR-gamma is not necessarily going to assume the same condition as the healthy person. And what effects might the change in fat cell levels have on the rest of the subject’s body? Perhaps a heavy person with a lot of calorie-burning fat might overheat. Of course, these sorts of questions may be addressable through further research.
Another concern is how such drugs might affect calorie consumption patterns in the general population. I noted in an earlier post that calorie intake among Canadians has been increasing, from 2358 calories per person per day (1976) to 2788 calories (2002), on average. People like to eat. If people can take a pill to increase their calorie-burning efficiency, then could they respond by consuming even more calories? Perhaps, if the drug is cheaply and easily available, and has no adverse side-effects. If so, then the drug might paradoxically help individuals suffering from obesity but also spread the problem of overeating more widely in the population.
Well, we are not there yet, but it is something to consider as the research moves ahead.
In-car infarctions July 28, 2011Posted by Cameron Shelley in : STV202 , comments closed
A FastCompany article reports that Toyota plans to equip steering wheels in their cars with ECGs in order to detect when the driver is having a heart attack. The idea seems to be to read the drivers’ heart rates through their hands gripping the wheel. Why?
If a vehicle can detect that a driver is having a heart attack, alert him to pull over, and then automatically call 911, many lives could be saved.
Well, who would question the saving of lives on the road?
Some obvious issues with this plan relate to the sorts of errors such a system would make.
- False positives: The system could mistake some other event for a heart attack. Can the system distinguish the rhythm of a heart attack from, say, the rhythm caused by swerving to avoid a collision? Suppose that the driver was maneuvering suddenly to avoid a deer when the car says, “Hey! You’re having a heart attack! Pull over immediately.” Or, we might find out just how many people really watch porn while driving.
- False negatives: The system could mistake a real heart attack for something else. In that event, the system does not help to prevent consequences of a heart attack.
Then there is the problem of effectiveness of the response. Would alerting someone that they are having a heart attack help to save them from creating an accident? At low speeds, the driver may be able to pull over. However, news reports of drivers having heart attacks seem often to speak of the driver losing control of the car, as in the case of Macho Man Randy Savage:
TMZ spoke with Randy’s brother, Lanny Poffo, who tells us the wrestling legend suffered a heart attack while he was behind the wheel around 9:25 AM … and lost control of his vehicle.
Florida Highway Patrol tells TMZ … Savage was driving his 2009 Jeep Wrangler when he veered across a concrete median … through oncoming traffic … and “collided head-on with a tree.”
Would a flashing light or verbal alert prevent such outcomes or would the driver be too incapacitated? In that event, perhaps the car should flash the four-way lights and bring itself to a gradual stop. (Of course, that would not please porn viewers.)
Here’s an interesting thought: Suppose that the system can distinguish reasonably well between heart attacks and other sources of heart-rate anomalies such as sexual arousal. Should the car then issue you a warning in the latter case? Alert the police that you are a potential menace to others on the road? Or, perhaps, simply issue you a ticket? Once such data is available, the community may have a legitimate interest in its use to preserve public safety.
Another benefit touted for the system would be a simple increase in medical data:
A daily reading of your heart could result in patterns that might not be seen at your less-than-annual physical.
That may not be a bad idea, although it encounters the same issues as above regarding false positives and false negatives. Since we have not routinely collected massive amounts of health data on individuals (who are not currently hospitalized), your doctor, and Toyota, may not be sure how to interpret it. Which patterns merit concern and which are merely within normal variation?
Also, what would Toyota do with the avalanche of health data it receives about all these drivers? Would the company have the right to sell it to third parties? (Did you know that car rental agencies can share your credit card data with companies that operate speed cameras?) I can imagine that drug companies would be very interested. Perhaps they could identify new, suspicious heart-rate patterns in drivers that could be treated with patented drugs. And, as always, insurance companies might be interested also.
The good that might emerge from data-collection systems can be substantial. To realize these benefits, we have to be mindful of the potential challenges as well.
Technology and anxiety March 10, 2011Posted by Cameron Shelley in : STV202, STV302 , comments closed
Last month, I discussed how medical information technology is not a panacea, meaning that the mere application of high tech in medicine does necessarily lead to improved medical results. In the article in question, a medical doctor discussed the tradeoffs involved in computerizing existing medical practices. I chimed in that designers of the technology tend to overlook some of the disadvantages of computerization because of their optimistic attitude towards the technology itself. This phenomenon of optimism leading to exaggerated views of the advantages of computerization I put down to motivated design.
It was interesting, then, to see this article on the potential overuse of diagnostic technology in pediatric medicine. Dr. Sean Palfrey of the Boston University School of Medicine argues that pediatricians sometimes rely too much on diagnostic high tech and not enough on simple physical examinations and their own training. Dr. Palfrey notes that increasing reliance on diagnostic technology raises challenging questions:
The evaluation of a child with fever and cough is a good example. There are many possible causes, and we have a huge battery of available tests that might give us potentially relevant information. But why should we no longer trust our physical exam, our knowledge of the possible causes and their usual courses, and our clinical judgment? How much will we gain by seeing an x-ray, now, and how likely is it that the result will necessitate a change in our management? How dangerous would it be if we chose to perform certain tests later or not at all? Might our residents not learn more by thinking, waiting, and watching?
I can think of a number of reasons whey pediatricians might be risk-averse in their diagnostic practices:
- Doctors, parents, and people in society in general have a special concern for the health and well-being of children. When a child appears in difficulty, their doctors naturally want to take special measures to help.
- As a doctor, the pediatrician’s job is to restore their patient to health. The effects of their treatment decisions on others, or on society in general, is not their responsibility. So, they arrange for whatever tests they feel might be useful to decide on an appropriate diagnosis and treatment.
- Insurance requirements and professional standards may demand the use of a diagnostic technology even where it may not be warranted in the view of a doctor in a given case.
- Then there is a simple aversion to failure. My impression, at some remove, is that doctors are strongly success-oriented and thus particularly averse to the possibility of making a mistake. They see diagnostic technology as a means to avoid failure and so they make use of it.
All these reasons are coloured, to some extent, by anxiety. That is, doubt about the outcome is present, and the pediatrician must consider the (possibly negative) view that others will take of their conduct. The result is that they experience anxiety, for which diagnostic technology provides some relief.
(Image courtesy of US Navy Journalist Seaman Joseph Caballero via Wikimedia Commons.)
So, the uptake of medical technology is driven by a push-pull mechanism. One form of push is provided by the optimism of the designers of medical technology. A form of pull is provided by the anxiety that doctors experience in diagnosing the ailments of their patients. If the result is too much reliance on diagnostic technology, then we might consider alternative routes for satisfying the mechanism that produces it. Dr. Palfrey suggests more professional discipline from doctors and more education for patients. I would not deny the importance of such measures. Yet, it seems to me that designers and doctors should think about some way of increasing their confidence, appropriately, in existing and established diagnostic technologies, such as the old-fashioned flashlight and tongue depressor.
An implant to end obesity March 7, 2011Posted by Cameron Shelley in : STV202, STV302 , comments closed
… the surgically-implanted pacemaker detects when a patient downs food or drink, and zaps the stomach with a series of electrical impulses to generate a feeling of fullness…
The device tries to calibrate feelings of satiety in order to allow the patient to maintain a health intake. Also, the device collects data that can be downloaded into a computer for monitoring by the patient, family, doctors, etc.
(Image by Thomas Nast courtesy of Mkoyle via Wikimedia Commons.)
The idea certainly seems plausible. Heribert Watzke talked about the brain in your stomach in a recent TED talk. “About the size of a cat’s brain.” So, modifying the function of this gastro-brain should affect people’s feelings of fullness or hunger with consequences for their physique.
Such a device could be a boon to those who cannot resolve their weight problems through less drastic measures. Of course, there are also challenges that need to be considered, such as:
- As with heart pacemakers, the abiliti might be sensitive to electromagnetic interference from cellphones, store security alarms, airport scanners, etc. Provisions to prevent or avoid such interference must be considered.
- Since the device is remotely accessible, its vulnerability to hackers must be considered. Hackers could violate the privacy of a patient by accessing their data without permission. Also, of course, hackers might be able to change the programming of the abiliti, resulting in harm to the patient.
- If the device becomes widely and cheaply available, then it may alter people’s perception of who qualifies as obese or just overweight. People who are sensitive to their body image, even if it is medically healthy, may feel under pressure to receive an abiliti to become more trim. It might even become popular with sufferers of anorexia who could use it to injure themselves.
- If the abiliti proves effective, then there will also have to be debate on whether it should be included in public health programs. In Canada, each province maintains a list of treatments that are covered by public insurance. At what point should abiliti be included in this plan?
- The abiliti will create a stream of health data about each patient. What should be done with this data? Undoubtedly, it will be put to work in illness prevention. However, a deluge of data from novel types of sensors may lead to a deluge of false positives, that is, blips that may seem threatening but prove to be benign. Doctors and patients should consider how they will respond to the kinds of alerts that the abiliti might generate.
As usual, none of these issues mean that the abiliti is a bad idea. Indeed, it may be a great idea, considering the challenges we face regarding obesity in our society. It is just that the abiliti raises challenging questions that we should begin answering before introducing the device for general consumption.
The Pill May 21, 2010Posted by J. Andrew Deman in : Uncategorized , comments closed
It is hard to deny that the single most influential development in pharmaceutical technology is the birth control pill. Penicillin, sure; synthetic insulin, yes; but in terms of radically realigning our culture and society, nothing in recent history trumps the pill. The fact that we still refer to it as “the” pill is perhaps the greatest testimony to it’s influence. So too, however, is the controversy surrounding it. The social tensions, conflicts, marches, riots and even random acts of violence that came out of the introduction of the pill (and in most cases still recur) indicate the radical nature of the change that it created. Furthermore, in some ways, this social upheaval is exactly what the pill was designed to do. A good concise history of its origins can be found at:
As the article notes, the synthetic hormone that constitutes the active ingredient of the pill existed years prior to its introduction. What really spurred the mass-production and distribution of the pill were a pair of women’s rights activists. What we may have here then is an interesting example of pharmaceutical advocacy. People trying to change the social and cultural context of the world through the development of drugs. Hard to deny that it worked. Some claims made about the effect of the birth control pill:
-enabled women to enter the workplace
-formed the basis of the “sexual revolution” (Hugh Hefner, for example, credits the pill for this)
-enabled the so-called “second wave” of feminism, which sought true gender equality (the first simply sought the right to vote).
Think, for a moment, about the ramifications of each of these claims. Think about what kind of effect dual income families have on an economy, on a culture, on the basic composition of the nuclear family. Think about what the sexual revolution did to Western culture, how it changed the way we date, marry, flirt, even just how we view members of the opposite sex (or same sex for that matter). Think about how the feminist movement has altered our social and cultural landscape. Then think that the source of all this change, all of this controversy and all of this radical restructuring of our society, was a pill. A pill did that; the pill.
Hidden costs of information technology April 15, 2010Posted by Cameron Shelley in : STV100, STV202, STV302 , comments closed
Underage, underpaid workers working 15-hour shifts, sexually predatory security guards, hourly pay of just 52 cents per hour after deductions for the canteen food. No talking during work hours, no listening to music, no bathroom breaks. These are just some of the conditions that workers at China’s KYE Systems Corp. plant in Dongguan City have to endure.
At the same time, an article from the Huffington Post discusses the fate of 23-year old On-Yang, a young South Korean man who died of leukemia after a short career in Samsung’s semiconductor plant. Other young employees and former employees have died of various cancers, leading to concerns over exposure to toxins in the workplace. Of course, it is difficult to prove such a link, and the South Korean government seems to avoid publicity over the matter.
These items are cause for concern in their own right, but they got me to thinking again about the hidden costs of our everyday IT gear. In economic terms, these hidden costs are known as externalities, costs that do not show up in prices. Here are a few kinds of externalities relating to our computers and cellphones that have made the news of late:
- Adverse working conditions. Besides the manufacturing facilities mentioned above, China is where Canadians’ computers and cell phones go to die. There, they are disassembled in highly toxic and unregulated environments, by people who have few alternatives to making a living. Similar facilities exist in other developing nations, such as India and Nigeria.
- The extraction of raw materials, like coltan, help to fuel civil wars in the Democratic Republic of the Congo. The materials are cheap because, in part, they are extracted under the guns of private militias.
- Computing imposes an environmental cost because of the electricity it uses. Demand for electricity used in computing is provided by coal burning plants, for example, which produces carbon dioxide, among other things.
What would be the price of your computer or cell phone if the costs of preventing or mitigating these problems were factored in?
To some extent, these problems can be mitigated through design. Computing devices can be made more efficient in order to reduce electricity usage, for example, and efficiency is something that is studied in the education of electronics designers. However, what more could be done, in the education of designers, to mitigate these problems further?
Safety glasses March 31, 2010Posted by Cameron Shelley in : STV202 , comments closed
The BBC reports that about 87,000 people per year are injured by glass attacks each year . After a few pints and a few words, pub patrons sometimes take to smashing glasses and attacking each other. The results can be bad cuts and scars, requiring stitches and medical treatments.
What to do? The Home Office asked designers to come up with a safer beer glass, which they have now done. The new glasses use new coatings and material arrangements to produce glasses that resist shattering into shards that are useful as weapons.
The new glasses are reminiscent of the anti-stab knife designed in Britain last year, meant to reduce injuries and deaths through stabbings with knives resulting from domestic disputes.
It is easy to deride efforts like these. For one thing, they are directed at the symptoms of social problems, such as drunkenness and domestic violence, instead of their causes. Could these glasses reduce the urgency people feel to address these social problems? Also, could the presence of these safety features backfire? Lowering the cost, in terms of injuries, of assaults could raise their frequency. Or could drunk and angry bar patrons simply turn to something worse?
While admitting the justice of these objections, the new glass designs seem worth trying out. The beer glass would tend to be the first weapon at hand when harsh language seems insufficient, and blunting that weapon promises to reduce the severity of any subsequent fight.
I am also encouraged to see designers taking an interest or even some responsibility for social problems. Not that they can solve all of society’s ills. However, our built environment is more than just a set of tools, but reflects our cultural values. Respect for personal security is one value that we should be concerned about.