Science vs. status quo (high school edition)

Ugh, I’m tired.  Why?  My oldest started high school this week, complete with it’s utterly absurd 7:25 start time.  My own high school started school at 7:30, but I did not recognize until years later that I basically spent my entire high school years chronically sleep-deprived.  Then I got to college, never took classes before 9:10, and knew what it meant to be sufficiently rested.

I don’t know the history of the early high school start times, but when these decisions were first made, we did not have scientists and doctors telling us that these times were simply not compatible with optimal adolescent health.  But now we know.  The evidence on the inappropriateness of these early start times keeps piling up and school districts just keep ignoring it.  Status quo bias is a very, very powerful thing.  Very nice piece in the Atlantic summarizing the evidence on the matter:

These early school start times result in sleepy kids and frustrated parents. But, as of Monday, those kids and parents have the formidable weight of the American Academy of Pediatrics on their side. The organization released a new policy statement saying that “insufficient sleep in adolescents [is] an important public health issue that significantly affects the health and safety, as well as the academic success, of our nation’s middle and high school students.”

“The empirical evidence [of] the negative repercussions of chronic sleep loss on health, safety and performance in adolescents … has been steadily mounting for over the past decade,” wrote Judith Owens, a pediatrician and the lead author of the report, in an email. “For example, an important recent study published this spring by Dr. Kyla Wahlstrom documented the positive effects of school start time delay in over 9000 students from eight high schools in three states, including improved grades and standardized test scores and up to a 65 to 70 percent reduction in teen car accidents.”

Lest you thing, “those damn whiny kids (and their whiny parents) just need to go to bed earlier,” it is not so simple:

Moving bedtimes earlier is not going to fix the problem, particularly for adolescents. Teens stay up later not because they don’t want to go to sleep, but because they can’t. Due to the delayed release of melatonin in the adolescent brain and a lack of “sleep drive” in response to fatigue, teens do not feel sleepy until much later at night than young children or adults and have difficulty falling asleep, even when they are tired.

That’s why the American Academy of Pediatrics is focusing on school start times. “Although many changes over the course of adolescence can affect the quality and quantity of sleep, one of the most salient and, arguably, most malleable is that of school start times,” it says.

We actually give David supplemental melatonin every night and it generally works (he’s predispositionally prone to insomnia plus he’s got remaining Adderall in his system).  I honestly wonder if parents of most high school kids with these 7:30 and similar start times just shouldn’t be given their kids melatonin every night.  Now, of course, the obvious solution is right in front of everybody with moving the start times, but that is a lot of change.  I do understand the reluctance, but I wish people would listen to the science and their over-tired teenagers.

I think at some point enough school districts will make a change and show a clear relationship to rising test scores that it will finally catch on widely (that would be one good effect of our standardized test obsession).  Hopefully before Sarah goes to high school, otherwise I’ve got 15 years of these early start times ahead of me.

Where did all the teen moms go?

Loved this post from last week at Vox looking at the rather dramatic, and not well-understood, decline in the teen birthrate.  Sarah Kliff systematically explores each hypothesis and the evidence in favor and against.  Now that’s good stuff, damnit, and hard to imagine many places other than Vox where you’d find analysis like this.  First, the decline and why it’s a good thing:

For five years now, America’s teen birth rate has plummeted at an unprecedented rate, falling faster and faster. Between 2007 and 2013, the number of babies born to teens annually fell by 38.4 percent, according to research firm Demographic Intelligence. This drop occurred in tandem with steep declines in the abortion rate. That suggests that the drop isn’t the product of more teenagers terminating pregnancies. More simply, fewer girls are getting pregnant…

The massive decline in teen birth rates is undeniably good news for public health advocates. Teen mothers are significantly more likely to drop out of high school. Most teen mothers do not receive financial support from their child’s father; 48 percent live below the poverty line. Avoiding early motherhood undeniably opens additional doors in a teen’s future.

But there’s something uniquely frustrating about the recent, steep decline in teen birth rates: nobody knows why it’s happened.

So, why has the teen birth rate gone down so much?  Best guess is a perfect storm of a whole bunch of factors working in concert:

We may have just gotten lucky.

It’s not an especially scientific answer, but it’s one that seems to describe how teen pregnancy researchers view the dramatic slowdown in the birth rate: a collision of lots of trends that all serendipitously happened in the late 2000s and early 2010s.

The recession, the uptick in IUD use, a hit MTV show that deglamorized teen pregnancy — each of these factors could have have caused a small decline on their own. Taken together, it’s possible they caused a much bigger change.

And if that is the case, that doesn’t portend especially well for the fast decline continuing. A few of the factors might: use of IUDs, for example, might continue to rise as the health care law eliminates co-pays for the contraceptive. Cost has often been a barrier to IUD use, as co-pays could range between $500 and $1,000.

The other particulars, however, seem less likely to forecast long-term change. The economy is recovering, and so is the birth rate among older women — it’s possible that younger women could follow. Teen Momstopped airing in 2012  (a Teen Mom 2 series still does exist) and 16 and Pregnant, which wrapped up its fifth season this year, doesn’t deliver the blockbuster ratings it used to.

Researchers are waiting for the other shoe to drop: there’s a general expectation that at some point the statistics have to turn around. “A 10 percent decline per year is not something that happens forever,” said Levine. “I don’t know that it’s necessarily a bad thing if it goes back to the 2.5 percent declines we saw before.”

Anyway, good news for teens and public health, a a great example of Vox doing truly value-added journalism.

Also, Jon Cohn builds off the piece to make the point that free birth control is a really, really good thing (sorry, curmudgeonly conservatives):

Maybe this is a good time to remind everybody why this requirement [the contraceptive mandate] matters so much to those of us who support it. Many conservatives look at the price of oral contraceptives, available at places like Target or Walmart for as little as $9 a month, and wonder why anybody except the very poor would need help paying for it. But numerous studies have shown that even modest co-payments can reduce use of medications, particularly when you’re talking about less affluent people who must be careful with every dollar they spend. That’s the whole point of making certain drugs that prevent medical conditions cost-free. It works that way for diabetes and hypertension and, yes, it works that way for pregnancy. Besides, the most effective and, for some women, the most medically appropriate forms of birth control are intrauterine devices (IUDs). Those cost $500 or even $1000 out-of-pocket. Reducing their cost can have fairly dramatic effects on their usage, if the available research is correct…

Late last week, lots of people were talking about a story by Sarah Kliff, of Vox, on why teen pregnancy has been declining in just the last few years. It’s a great article, well worth your time, but the part that jumped out at me was the much bigger decline in teen births that occurred many decades agoin the 1960s, when the teen pregnancy rate fell by about 25 percent. What changed? The big factor, as social scientists (and friends of QED) Harold Pollack and Luke Shaeferreminded me over the weekend, was birth control. The Food and Drug Administration first approved the pill in 1960.

Birth control.  Good for the users.  Good for society.  Bad for conservatives who want to control women’s sexuality.

Ice bucket activism

I’ve read a lot of complaints about the ice bucket challenge, but I think too many of them are hoping for a better world where people simply give money to charities without viral campaigns to inspire them to do so.  I thus, very much enjoyed this rebuttal to the skepticism from a young ALS sufferer:

Yes, people are spending money on ice to dump over their heads, but that’s an element of fundraising, like making team T-shirts for a charity or bringing cookies to a bake sale. All the cynics who want people to donate in humility and not post it on our social media feeds completely overlook the fundamental reality that humans are social animals. In the hierarchy of needs, we search for community and fulfill the urge to belong, so donating without dumping buckets of water on our heads disconnects us from a cause. It’s about being a part of something.

The hashtag activists actually create that community. Since when did fighting for something—whether a cure for a disease or gay rights—mean that you needed permission to sit with the cool kids at lunch? What’s the harm of having them there, even the ones who ended up there by accident, the people dumping buckets of iced water on their heads with zero connection to the cause? They are the people who end up at a bar where the proceeds go to charity, and they’re only drinking for fun, but who the fuck are you to kick them out of the party? They’re pumping up the crowds, having a fabulous time, and building momentum. Or are you that desperate for your Facebook feed to go back to engagement announcements and mediocre attempts at food photography?

Keep dumping buckets of iced water over your head and I’ll keep “liking” it. The Ice Bucket Challenge is one of the few things that’s given me hope since I got diagnosed with early ALS six weeks ago, at age 29.

 

If this link works [cool, wordpress handles FB video embeds], here’s my version.  The screaming has been a big hit.

Diet Coke diet

Naturally, I cannot let the latest research on diet soda go uncommented upon.  There is some research that correlates diet soda with overweight, but I think it is a great example of correlation does not equal causation.  The other day at lunch when I got my Diet Coke, a friend mentioned that I was about the only thin person they know that drinks diet soda (I can think of many others, prominently JP who is surely the biggest Diet Coke addict I know and reading this post).

I think a lot of overweight people drink diet soda because they are overweight.  But if that’s the only change you make to an unhealthy diet, it surely will not be enough.  As I think about it, most of my healthier friends don’t drink soda at all, diet or otherwise.  That is probably the healthiest course.  But it has always seemed pretty clear to me that if the diet soda is replacing regular soda, that’s very likely got to be a good thing.

Anyway, onto the latest research via James Hamblin (who makes the most wonderful oddball videos on health, by the way) in the Atlantic:

The September issue of The American Journal of Clinical Nutrition just published a meta-analysis of the existing research on artificial sweeteners and weight gain. The conclusion lands in support of artificial sweeteners in the right context, specifically when they are substituted for sugar. People tend to see “modest weight loss,” suggesting that low-calorie sweeteners (LCSs) indeed “may be a useful dietary tool to improve compliance with weight-loss or weight-maintenance plans.”

That might seem obvious, but several studies have suggested that eating/drinking these nutritive sweeteners actually leads to weight gain. That has to do with satiety signals, effects on insulin levels, changes in the body’s fluid balances, and other not-immediately-apparent downstream factors…

Those are all just correlations, but consuming artificial sweeteners in isolation has also been shown to make people hungrier later on. Dr. Barry Popkin, a distinguished professor of global nutrition at the University of North Carolina, wrote in a recent literature review that since most artificial sweeteners aren’t consumed in isolation, that’s not really an issue. So the key distinction in studying and using these sweeteners is the idea of replacement as opposed to addition…

“It would not be expected for a single dietary change, i.e., replacement of sugar with low-calorie sweeteners, to cause clinically meaningful weight loss,” the current study reads. Weight management is really about overall dietary and lifestyle patterns. But it’s worth considering if you think of an afternoon Diet Coke as a bonus, as opposed to replacing a regularly scheduled Coke heavy.

In my case, the strategic replacement is exactly what I’m doing.  Since I often track my food intake weight watchers style (and stick with weight watchers principles even when not tracking), I’m quite confident that my lunch time binge of 4-5 Diet Coke (or Diet Dr Pepper at the places fortunate enough to have it) are simply replacing regular soda (or water) and not leading me to consume any extra calories.  And now I can say the science is backing me up.

Quick hits (part II)

1) The complex historical factors behind poverty in NC.

2) A journalist volunteered to go to prison (you can do that!) in Arizona.  It wasn’t pretty.

3) Love Michael Pollan’s takedown of the Paleo diet.

4) Can you really say you are sure there’s no such thing as Bigfoot?

5) Very nice essay on the dumbing down of America.

6) On the parallels between Voter ID laws and leash laws for unicorns.  Love this.

7) Love this from a former Marine on the bad combination of military weapons given to police officers without proper training in how to use military weapons.

8) Did you hear about Facebook’s plan to tag satirical posts (e.g., Onion, etc.) because too many people are fooled by them.  Sad.  Love this website that has actual reactions to Onion posts where people did not get the satire.  Good, good stuff.

9) There was an absolutely horrible Op-Ed from a cop in the Washington Post about how citizens need to meekly obey all police authority and we’d have no problems.  I wanted to write a post and didn’t.  Big Steve wrote a better one than I would have anyway.

10) Great piece from Jon Lee Anderson on ISIS and James Foley.  A big part of the problem is that Europeans pay ransoms (not that this would have helped Foley).  They shouldn’t.  And a nice Vox piece on what Obama should do about ISIS.

11) I love cave art.  I’m still waiting for my wife to figure out that I want her to surprise me with some sometime (a reproduction, obviously– though I sure wish I could see the real thing some day).  Some scientists are now suggesting that art is part of the feminization of the human species which proved crucial for the development of human cooperation and society:

A new scientific-minded guess at this riddle is both intriguing and politically appealing, not to say politically correct: it suggests that ape-men made art and culture only when ape-men finally became more like ape-women. A group of five scientists just last week proposed that the great symbolic transformation happened at around the time the human face, and the hormones that shape its growth, became—and this is the scientists’ word—feminized. Indeed, that’s the title of a paper in this month’s issue of Current Anthropology: “Craniofacial Feminization, Social Tolerance, and the Origins of Behavioral Modernity.”

The argument is tight enough. “Social tolerance” seems, from long anthropological observation, not to mention common sense, to be necessary for symbolic communication: if you can’t stay put in the circle around the fire long enough to listen, there’s no point in sharing good stories. As human groups got bigger, more social tolerance is what they had to have. Very early man, alas, of the kind who appears on the fossil record for some four hundred thousand years, shows every sign of social impatience; his big, testosterone-fuelled brows seem made merely to intimidate his fellow early man—to scare him (or her) away before the talking and symbol-sharing can even start. As testosterone ebbed and the aggressively masculine stare-downs faded, Paleolithic life had to become less a scene red in tooth and claw and more like an afternoon program on NPR, with thoughtful-voiced disputants sharing the day’s news and seeking its moral points.

12) Nut allergies are quite the growing problem these days.  Immunotherapy can be quite effective, but it’s long and hard.  Here’s an idea… change the nuts themselves to be less allergenic.  It’s the early stages, but seems to hold some promise.

13) North and South Carolina are working together to clarify their border– which will apparently be modified.  Pretty amazing to think that state borders could have been wrong all this time.

Quick hits (part I)

1) NPR on the power of peer groups in preventing campus rape.

2) Cool optical illusion.

3) Police shoot dogs all the time.  Just hope the police never come to your house looking for a criminal (Balko on the epidemic of shoot first, worry about whether the dog is a potential threat later).

4) Post editorial on the wrong-headedness of the Rick Perry prosecution.  DJC sent me a link suggesting that Perry will be convicted.  I just don’t see it happening.

5) Can taxing the wealthy strengthen democracy?  Probably yes:

The historical record, however, suggests that taxing the wealthiest does have an important, but different, consequence: making the wealthy vested in the common good. In fact, taxing the wealthy was crucial for the emergence of representative government itself.

6) George Will confirms Nixon’s attempts to sabotage peace in Vietnam in order harm LBJ and HH.  Nixon may have done some good things as president, but he was an absolutely abominable human being who would do anything to achieve and protect power.   Or so it was made pretty damn clear to me watching the new HBO documentary on the Nixon tapes.

7) Interesting libertarian piece by Mike Munger on government by unicorn.  Raises good points, to which I say I’ll still take government by horribly fallible humans over the alternative.

8) People in rich counties disproportionately search google about tech stuff (and boy do they love Canon cameras).  In poor counties it’s all about diabetes.  And hell.

9) John Oliver with his typically brilliant job on police militarization.

10) Interesting essay by Lev Grossman on how he struggles as a writer until he started writing fantasy.  I’ve been meaning to read The Magicians for a while.  Will try to do so soon unless some of you tell me otherwise.

11) Dahlia Lithwick on how the police in Ferguson have run roughshod over all sorts of Bill of Rights protections.

12) Lenore Skenazy on helicopter parenting run amok and how today’s parents want to criminalize the behavior that was the parenting approach of their own parents.

13) Fascinating study of why some people, but not others, in a near-death experience (a plane crash) develop PTSD.   I’ve always been a very psychologically stable person, but I’ve never really been pushed.  I’ve always wondered how I would respond to something like this or being in a war zone.  Of course, I hope I never have to find out.

14) That toddler injured by the flash-bang grenade thrown it its crib during a no-knock warrant search?  The county does not think it needs to pay for his medical bills.  Is this America or Russia damnit?!

15) Turns out breakfast is not the most important meal of the day after all.  Maybe.  I actually never ate breakfast at all until I got married and then started eating it every day just because Kim was.  I cannot imagine not doing so now (though sounds like not a bad way to save some calories, actually).

 

On GMO food

This year’s incoming freshman reading at NCSU (of which I always volunteer to be a discussion leader) was on Tomorrow’s Table: Organic Farming, Genetics, and the Future of Food.   Right in my sweet spot.  (For the record, not the best book, but an interesting set of ideas.  And short.) Personally, I am a big fan of organic food due to its emphasis on sustainability and minimizing environmental harm.  I eat mostly conventional, but I will choose organic (especially fruits and vegetables) when there’s good options.   That said, I’m also, as you know, quite comfortable with GMO food.  Yes, Monsanto, blah, blah, blah, but that is a problem with how we regulate corporations as public policy, not a problem with GMO food, per se.  In many cases GMO means increased crop yield without any greater environmental harm.  And, in the best cases, GMO means creating food like Golden Rice or flood-resistant rice which can literally mean the difference between life and starvation in the poorest countries.  Also, if you eat any processed food at all, you’re already eating GMO, so get over it.

To me, the most interesting part of the controversy is that there is basically zero evidence that GMO food is deleterious to health (as compared to similar non-GMO food), but so many people remain convinced GMO food has to be bad for you.  My favorite moment in our freshman discussion this week was when a young woman said, “I know there’s no evidence that GMO food is harmful, but I believe…”  So hard for me to not just say, “no, stop.  Stop right there.”  You don’t get to say science says one thing and then just blithely assert something else.  Anyway, a major point of the book is that GMO is de facto considered non organic and that the two approaches are seen as polar opposites.  But, in many cases GMO foods can be designed to reduce pesticide usage– one of the main goals of organic farming.  And other features of GMO foods can also lead to more sustainable farming.

My favorite tidbit from the book was how a naturally-occurring soil bacteria has been genetically-engineered into corn to prevent corn worms eating up the ears.   End result… less need to use pesticide and no nasty worms when shucking your corn.  I realized that worms were always a feature of corn when I was kid, but that I never see them any more (and we do love fresh corn).  As Jessie Pinkman would say, Yeah Science!

And, as long as I’m at it.  Nice post of GMO charts in Vox this week.  If you are eating any corn or soy or wearing cotton, chances are good it’s GMO:

Imagegen.ashx-4

Now, there are certainly many problematic issues with GMO.  But I”m not so sure they are all that independent of the problematic issues of big Agribusiness, which is a whole different kettle of corn worms.  These issues are real and we should take them seriously and try and address them.  But don’t throw the GMO baby out with the bathwater.  Especially when there truly is so much potential benefit in under-developed countries.

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