Of mice and men (and petri dishes)

Science, Exercise, Physiology, Research

It takes eggs to make an omelet; it often takes lots of mice to do science. (And like the eggs, they don’t survive the process.)

How much do you understand about science?

In particular, when it comes to science in the news, how much of it do you really understand?

And when it comes to research about the effect of nutrition and exercise on health, can you really tell what is good science and what is not?

A recent piece of news about fake research, which you might have read about, should cause you to consider carefully your answer. (You can read a shorter perspective here.) Anti-science folks will take heart, no doubt, to once again see that it appears possible to make science say whatever we want it to. But that is not the point. (And it is not actually true, at least not of well-done science.)

Let’s face it, we can’t all be research scientists, or experts at evaluating which study is well designed and performed, and which is flawed. That’s why we rely on experts.

To be clear: I love science. Science is a wonderful thing. It is our best bet for making sense of the universe. It has been wildly successful at bringing about our technological world. Which is precisely why anyone who is trying to sell you something uses what appears to be science, but often is shaky, or not at all, in order to convince you to buy.

Therefore, there are peculiarities of scientific research about physiology, health, and biology in general, that we should all keep in mind when reading or hearing about new results. And that’s what I’d like to offer in this post.

Who am I to say those things?

For full disclosure, you need to know that I am “only” a physicist.

So, while I know a lot about particles and galaxies, I’m more fuzzy about things of sizes in between (like the human body). However, because I have training in science, I understand the general process of research, and the inherent limitations of the methodologies employed. And I tend to be very critical of what I read.

My purpose is therefore not to impart absolute truths (we don’t have such things in science, by the way, only very reliable understandings about how things work).

If the only thing you remember from this post is that you should be very doubtful of what journalists write, I’ll claim a big victory. So let’s get going.

Petri dishes

The most basic way of doing research in biology is to study cells and tiny living organisms in a special environment in which they normally should thrive. That’s what petri dishes are.

It used to be, and in many cases it still is the case, that in order to identify what ails someone, you would take a swab, and smear it onto various petri dishes. Depending on the characteristics of the medium in each dish, and where the bacteria would actually thrive, you could tell what bacteria were actually causing the infection. (That explains in part why it took so long to get the results.)

We’ve gone a little away from that nowadays, but what is still often being done is still using petri dishes.

For instance: Take cells of a certain type, like cancer cells, and cultivate them in a medium that is nourishing to them (i.e. a petri dish with the right medium for cancer cells to grow). Then you add some substance and see if the cells still thrive, or stagnate, or even die.

Research, Science, Physiology

A scientist “doing” the (petri) dishes…

If you find something that can kill cancer cells (or bacteria, or some fungus), you may have a candidate for a drug or medication.

That is how a lot of research on anti-oxidants is being done, for instance. Anti-oxidants of all sorts are found to be bad for cancer because in petri dishes they clearly impede the growth of the cells.

But there is a big, really big, problem with that approach. In fact, there are two huge problems:

  1. Petri dishes are not like a living organism. So what takes place there might not be the same as what will take place in the body, especially for cancer cells, because they interact with the entire organism.
  2. It is easy to deliver a specific molecule or drug to a cell (or bacteria or fungus) in a petri dish, but delivering it in a living organism is not the same. Our bodies have natural mechanisms for treating what comes into them; through eating, there’s digestion, through the blood, there is filtering by the liver and kidneys, our natural detoxifiers. So just because in works in a petri dish, it does not mean it will get to the right target in the right kind of shape in a real body.

This explains in large part why you should probably not give too much credence to anything about anti-oxidants and food supplements in general. They have been shown to not have much of an effect, if any, in humans in part because our bodies handle them in such a way that they are not the same once they reach cells. Moreover, once they reach cells living in real, complex organisms, often the interactions are not the same as those taking place in petri dishes.

Mouse model

A lot of research on the effect of drugs and nutrition regimen is done on what is called the “mouse model”. Basically, mice are being used, and researchers perform studies while maintaining a keen awareness that mice are an approximation, a stand-in, thus a “model,” for the human body.

That keen awareness is not always communicated by reporters of the results.

The good side to doing this is that mice are short-lived, compared to a human being, and scientists have developed breeds of mice that have very well known characteristics over the years. We even have mice that are bred to have cancer with a very high probability. Furthermore, we can manipulate mice genomes to the point of being able to induce certain conditions that can then be “cured” by drugs or specific food or exercise patterns.

Hence it is possible to do a lot of research in a fairly short amount of time. Generations of mice stand in for generations of human beings, but the research takes months instead of decades.

The downside, and you must keep this in mind, is that mice are not men. Especially mice that are bred for some very specific traits or diseases. Therefore, what takes place in mice is only a hint of what might be taking place in the human body.

I recently heard a top cancer scientist talking about how, according to her, we need to move away from the mouse model in medication research. Her argument was that many drugs that were found promising in specially bred mice were later on found to be totally ineffectual in humans. That’s a big downside, and a lot of research money wasted.

Despite opinions to the contrary by conspiracy theorists, scientists don’t like to waste money, and time, on fruitless research. Especially cancer researchers, who are human as well, and have loved ones who are affected by those diseases.

The bottom line is that just because some research says an effect was found in mice, it does not hold that the same is true for humans.

Science, Research, Physiology, Biology

From petri dish to humans, there is a really big step.

Cohort (and longitudinal) studies

Perhaps the least understood of the research methodologies is that of the cohort study. Sure, you probably think, one should be careful of petri dish and mouse model research, but when it comes to health and fitness being studied in real human beings, that’s another matter entirely.

Is it?

The advantages of petri dish and mouse model research come from the ability to observe in details what is taking place. The mechanisms might be observable through microscopes, and mice can be (and often are) dissected to verify what is going on.

Humans are not, as a general rule, dissected, as part of physiology research. At best, some biopsies are taken, but even that is limited. (This is a bit of humour. The part about dissection. Not the part about biopsies. That hurts for real.)

What researchers rely on instead is recruiting willing subjects (i.e. a cohort), asking them to follow a specific regimen (which could consist of a special diet, or exercise, or both), and then following-up on their progress through surveys over a period of time (long ones are called “longitudinal” for that reason).

Yup, basically, they are asking participants to fill a questionnaire about what they did, what they ate, how much of it, etc.

In the best designed research, there is close follow-through of the program by researchers. They might even sequester the subjects for the duration of the study, but that is very, very rare. In many cases, the questionnaires are asking about stuff that happened days, and even weeks, earlier, and there is no direct verification.

How well do you remember what you did, and how much you ate, on Wednesday of last week?

Therefore, often the researchers only ask about general habits and levels of activity, or take a sampling that they hope is representative by asking about the most recent day.

I think you understand where that is going: What you do on any given day may, or may not, be representative of your general diet and exercise habits…

Where does that leave us?

Again, I’m all for science. The more, the better. As a scientist, I am keenly aware that, at the very least, science is self-correcting; by which I mean that if somebody gets the answer wrong, for whatever reason, someone else will eventually point it out, and overall we’ll get it right.

But it might take a while. Because it is difficult to do science well when the subject is the human body and its complex, diverse, interactions with the environment.

There are things about physiology that we understand very well by now; I’ll get back to that topic next time. But keep in mind that biology, in comparison to physical sciences, is bloody complicated. Climate science, in comparison, as complex as it gets, is a breeze.

There is a lot of research that is well designed that can help us make sense of how our bodies work. The accumulation of individual pieces of evidence eventually lead to a more accurate bigger picture. That’s the process, and it works.

Just be careful of individual pieces of research being reported as having widespread, and very radical, implications for your health. The more fantastic the implications, the more cautious you should be.

Especially if somebody is using the findings to sell you something.

Images from Pixabay

Do we really need more evidence?

Exercise, Daily, Fitness, Health, Diet

You can rejoice in the high level of confidence of at least one thing: Exercise is good for you.

The results keep pouring in.

The titles are often exaggerated, sometimes misleading, occasionally downright wrong. But that’s journalists for you. You gotta read beyond the headlines.

Even without reading beyond the headlines, however, the general trend is very clear: Exercise is good for you. Even in large doses, it is certainly better to be exercising than not exercising at all.

Thus the question I ask in the title: Do we really need more evidence?

As a scientist, I understand that there cannot be absolute certainty. It is a matter of “degree of confidence.” And it is difficult to tease apart the effects of various lifestyle decisions in something as complex as health. So I cannot begrudge researchers wanting to do more research, needing to clarify (or identify) causality among the sea of correlations that past research has brought to our attention.

But no matter how much clarification and specific causality determination still remains, no one is claiming that exercise is NOT a good thing for you. On the contrary. That’s pretty much the best, most agreed-upon, common denominator to all the research out there (on the subject of fitness and health). There is a lot of confidence.

So for you and me, normal folks, it truly is a no-brainer: Exercise. Move. Regularly. Everyday. The more, the better.

But because it is always fun to do (and it provides good fodder for a blog), here are a few recent conclusions from articles published on the subject.

Answers

First of, it really looks like exercising is not only good for increasing the odds of long-term health, but it is also a really good idea if you are sick or have suffered from a serious illness.

Then, if you are getting older (and who isn’t?), exercise can really help keep your head in better shape, not just your body.

Speaking of which, I’d be remiss not to mention this really interesting piece of research about the effect of diet, particularly greens, on cognitive health. I do love my greens, even though I promote exercise first and foremost.

There’s a passage in the summary of that particular article that is worth copying here:

They followed participants for 2 to 10 years, assessing cognition annually with a comprehensive battery of 19 tests and adjusted for age, sex, education, smoking, genetic risk for Alzheimer’s disease and participation in physical activities when estimating the effects of diet on cognitive decline.

By the way, when a researcher talks about “adjusted for (…) participation in physical activities” to estimate the effect of diet, it means that exercise was already understood as an important contributor to health (high correlation between exercise and health) and what is being looked for is the remaining contribution of diet. Get it? Exercise comes first, diet comes later. Just sayin’.

In closing, let’s go back to one of the earlier things I hinted at: Even if you do “too much” (and the exact definition of “too much” is unclear), you are still better off than if you are not doing any. So exercise, regularly. Vigorously at times.

That’s a no-brainer for which your body (and your brain) will thank you later.

Questions

You think my section titles are backwards? Answers first, then questions? Nope. Answers always lead to other questions. At least if you are serious about asking questions.

So let’s.

Do we really need more evidence that exercise is good for us? Ok, we know the answer to that. It is a resounding “no!”

Do we really need more evidence in order to get us moving more? That’s a different question. The answer is also, probably, no.

So what do we need, if not evidence, to get us moving more? That’s a far more intriguing question.

Perhaps it has to come from our emotions? Perhaps it is simply a commitment? The big stick of Discipline, or the easy persuasion of our Purpose?

I don’t know for sure, and it probably depends. And it is a good question to finish with.

One thing is certain: It is what I’ll spend my next post talking about…

Picture from Pixabay.

The correct way to run

Running, Technique, Shoes

Shoes matter, but so does technique…

*** Modified post. I’ve been able to get a hold of the original paper about transitioning to Vibram FiveFingers. So read on, or read again, for some slight changes to the text. ***

There’s been noise lately about a settlement that Vibram, the maker of the famous (or infamous, according to some) FiveFingers “shoes”, has agreed to pay to their customers.

The issue is over false claims, or so the class action lawsuit alleged, that FiveFingers prevent injuries and make muscles and tendons stronger.

A quick search on the subject will surely reveal quite a bit, but I’ve sprinkled a few links in this post, to provide more details. First, the oldest reference to the lawsuit I could find, from July 2012.

Blog item from ABC

The most recent article, in a Canadian magazine, appears to provide the conclusion of the process. Note that Vibram has agreed to pay; I’m no lawyer (I’m a scientist), so I would be willing to bet that the issue revolves around what would constitute a solid enough proof of the statements made by Vibram. I’m pretty sure no scientist would be willing to proclaim the statements are proven beyond a doubt. That’s just the way science works…

Blog in Canadian Running

But what fascinates me about this is the tone of some of the articles. Some “reporters” and bloggers clearly showed their stripes and did not hesitate to bash Vibram, minimalist shoes, and the whole barefoot running movement. It felt like a deep, quasi-religious, fighting line has been drawn. I won’t bother you with those articles; the ones in reputable running magazines were far more neutral, and carefully written, as they should be.

Some, however, did something very clumsy, unlike the main magazines: They linked the lawsuit to a piece of research pertaining to indicate that wearing FiveFingers leads a high percentage of runners to foot bone injuries. You can read the news about the report there:

Report on study in Runner’s World

Note that the study, and the lawsuit, are in no way related. But it sure is convenient as a coincidence. Especially for the makers of conventional running shoes.

Before going any further, allow me to state a few key points, just to be clear:

  1. In my experience as runner and coach, it is possible to run correctly in almost any pair of shoes, be they “conventional running shoes” or “minimalist”.
  2. I do not believe there is a conspiracy by running shoe manufacturers to cause harm to runners by making shoes that they know will cause injury. Even though by some accounts 70% of runners using “conventional running shoes” will get hurt at some point.
  3. What I do believe is this: there is a natural tendency to want to protect your business and market share. That’s called having a vested interest in a certain situation. There is no need for any kind of conspiracy when the incentives are aligned. Companies will do what is in their best interest.
  4. There is a correct way of running, and it is easily demonstrated. No matter what anyone in the running shoe industry says about each of us being different. They only try to muddle the issues, and it is very sad.
  5. What has probably happened with the minimalist and barefoot movement is not an indication that the safety and benefits of those shoes have been overstated, but rather that the weakening of our bones, muscles, and tendons over the years of walking, and especially running, in shoes designed to “protect us”, has been grossly under-estimated.

Now, perhaps the lawsuit was brought about by someone “strongly encouraged” to do so by the big shoe manufacturers. And maybe the study referred to in Runner’s World was also similarly sponsored. (There are some issues about that research, so please see at the end of this post for my notes. But the main problem I’ve encountered is that the second-hand source all seem bent on using it to point nasty fingers towards Vibram and minimalist and barefoot running, whereas the research paper was pretty much simply stating that transitioning must be done slowly, and carefully.)

But, ultimately who cares? The lawsuit was settled, so let’s move on. Preferably, by continuing to run.

Full disclosure: I currently own 3 pairs of FiveFingers, and a fourth one I used to own recently “died” after a long and satisfying life. Like some of the commentators on the blog posts and articles I’ve read, if I get a refund from Vibram, I will use the money to get an extra pair of FiveFingers, and I’ll keep using them for running. I even got married in a pair of FiveFingers. I hesitate to call them shoes as to me they are more like gloves for feet. I also own Ecco’s Biom Project shoes, and Asics runners (2 pairs), which I still use at times, when running marathons and ultras, and when racing triathlons. So there.

Now allow me to finish with the main point, before I forget: The correct way to run.

It is my contention that there is such a correct way, as already stated, and that it can be done in any pair of shoes. How do I know?

Not from understanding physics (which I do) and its application to bio-mechanics, or coaching a lot of runners (which I have), or transitioning myself late in life from a heel striker to a forefoot runner (which I have, over a period of 2 years). The answer is actually much easier to understand.

Consider the animals that we are. Remove us from this modern society we’ve built, and in which, by and large, we are no longer fit in an evolutionary sense. Let’s travel to the Land Before Shoes. How did we run then? Not on our heels, that’s for sure!

Test it for yourself. Take your shoes off, and try to run, even if for just a few steps.

You’ll immediately, instinctively, switch to a forefoot striking gait, and that striking will be absorbed in large part by the arches and ankles of your feet, and the tendons and muscles of your legs. Because that’s what they have evolved to do! (Normally, I urge people to do this test on soft grass, but it is possible to heel strike on very soft ground, so be cautious, and do it on a hard but clean surface, for full effect.)

Watch young children run barefoot. You’ll immediately notice that when not taught otherwise, we all run with a forefoot striking gait.

That is the correct way to run.

It’s just that over years of under-use, over-protection, we have not developed the needed sturdiness to run that way as adults.

It takes time, much more than a few weeks, to compensate. And it can be painful. And you risk injury if you try to do too much, too soon. So it should probably only be attempted with the help of a good coach.

Yet the conclusion is inescapable: There is a correct way of running.

It just may not be the way everyone can run in this day and age. For having run too long in conventional shoes, or lacking the patience to rebuild their bodies…

Running, Shoes, Technique, Coaching

In case of doubt, wear shoes, and make a run for it!

Photos by Sacha Veillette.

Notes on the original research paper by Sarah T. Ridge et al.

For those interested, and because I am a scientist first and foremost…

In terms of methodology, the design of the research was sound, as far as it went. However, I have concerns over the following items, some of which may invalidate the conclusions:

  1. While selection of FiveFingers users was random (among each group of men and women, so that’s good), all runners were experienced runners. Which means they were all used to running in conventional shoes, and had not been injured (or said so) in recent past. So far, so good. Except for a bit of psychology of running: Although the runners were given instructions on how to transition, most runners who are used to running a certain distance per week have a tendency to think they know what they are doing. In a word: they feel they can do it, no matter what. The odds of the FiveFingers group actually having followed the transition plan are slim, in my estimation. And my estimation is supported by the reported fact that FiveFingers users peaked their training volume in week 4 of the study, way too early! Simply put: they probably tried to run more with the FiveFingers than they should have, got hurt, then scaled it back down, but it was too late.
  2. Regarding the MRI results, which I’m told were taken with a somewhat low quality machine, the convention of what constitutes remodeling of the bones and injury is arbitrary. And perhaps a bit conservative. Being slightly less conservative, by only one level on the scale used, might change the conclusion. Interesting fact also reported in the article: the results are comparable to having sedentary people start running and doing it for 7 days straight. No one should go from 0 to seven straight days of running, but you would expect major work to begin in the bodies of those who do, and yes, some injuries to result from the abrupt change. Duh!
  3. There were initially 43 participants recruited for the study. They were divided roughly equally between the FiveFingers, and the control. Which means there should have been 21 and 22 participants in each group. 19 completed the study in the FiveFingers group, so a drop of 2 or 3, whereas 17 completed in the control (a drop of 5 or 4, depending on the exact split between the groups). The numbers and specific reasons for the drops were not disclosed on a per-group basis, but we know 3 participants did not show up at the end for the MRI, 2 got injured for “unrelated reasons” during the training, 2 never returned calls (so probably did not even train, or perhaps trained and got hurt right away). Hiding what exactly happened to those participants is one way to bias results. What if there were 5 drops from the control group, and it was all because they got injured, and not at all for “unrelated reasons”? For instance, for reasons related to the conventional shoes, but not in the feet, like knees and hip problems? The picture would look very different, and actually quite comparable between the two groups.
  4. Leaving aside the possibility of manipulation of the results, which I’m pretty sure the authors were not trying to do, it is worth noting what their own conclusion really said: Far from an indictment of running in FiveFingers, they indicated that transition should be done very slowly, and more slowly than prescribed at the time by the folks at Vibram. (Those guidelines, we are told in the paper, had been changed between the start of the work and the publication of the paper, by the way.) I would go even further: taking a bunch of experienced runners, who in my experience are notoriously bad at following coaches’ advice, is a recipe for disaster. When you transition to minimalist shoes, you should take a lot of time, and ideally start as if you were starting to run from scratch. Very few experienced runners are willing to hold themselves back to that extent, and that is why we get hurt. Yes, I count myself in that lot, even though it took me a long time, my adaptation is not complete yet, and I had some major pains bordering on injury.
  5. The only way to get a definitive answer on this question would be to take two groups of newbie runners through a strictly controlled regimen of training. One group in each type of shoes. That would take time, but it would be better science. Of course, if you change the way you run, you will have major adaptation and risk of injury. But let’s see who, of the two groups, would actually get hurt less, and what their feet, legs, knees, and hips would look like at the end of the program. That would be interesting. Anyone has some funding available?