Research Proposal

350 million people in the world suffer from depression. It is the leading cause of disability and number four on the leading causes of global disease burdens.[1] 44 percent of American college students report having symptoms of depression, while 75 percent of college students do not seek help for mental health problems. Depression is also the number one reason students drop out of school or commit suicide, and if diagnosed with depression, students are five times more likely than adults to attempt suicide [2]. It is commonly treated with antidepressants, which show little difference from placebo under scrutiny of meta-analyses. Electroconvulsive therapy lacks results and proof for specific cognitive interventions is weak[3]. Depression is often mentioned when talking about Vitamin D, and associations between depression and lack of sunlight is well established. It is formed in the body mainly through photosynthesis. Vitamin D deficiency is steadily increasing, likely caused by our ever-increasing indoor lifestyle. Other diseases linked to its deficiency are cancer, cardiovascular disease, diabetes, and premature mortality[4]. Almost all knowledge on Vitamin D has been published in the last 15 years[5], and we now know that it works via Vitamin D receptors in the endocrine, paracrine, and autocrine systems[6], meaning it affects the brain and most physiological systems. Enzymes responsible for conversion to its active form are found in the hypothalamus, substantia nigra, and the cerebellum [Husemoen, L.L., et al.]. Vitamin D has also been shown to regulate adrenaline and noradrenaline through the hypothalamic-pituitary-adrenal axis, and dopamine production through Vitamin D receptors[7], and to protect against depletion of serotonin and dopamine.[8] With this knowledge we can propose a link between depression and Vitamin D.

The relationship between Vitamin D and depression has been studied substantially, but few meet the strict standards of PRISMA. At the time of Spudding’s meta-analysis (2014) there were no other meta-analyses and only four systematic reviews published. However even in these reviews they lacked studies and they were inconclusive due to including inappropriate studies. My intentions are to design a study tailored after PRISMA guidelines and without biological flaws, only seven of which existed at the time of Spudding’s meta-analysis. In this study I will investigate if rectifying Vitamin D levels decrease feelings of depression in clinically depressed people. I strongly believe it will based on prior results, which show that six out of seven studies without flaws demonstrated improvements in depression with Vitamin D supplementation. If research in this domain progresses we are likely to see big changes to how we view and treat depression, among with new approaches for other mental illnesses. Supplementing with Vitamin D is remarkably economical to both personal health and finance, not to mention the diminished burden on healthcare, colleges, and taxpayers.

Definitions

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses. “PRISMA is an evidence-based minimum set of items for reporting in systematic reviews and meta-analyses. PRISMA focuses on the reporting of reviews evaluating randomized trials, but can also be used as a basis for reporting systematic reviews of other types of research, particularly evaluations of interventions.”

Beck Depression Inventory: “A 21-item, self-report rating inventory that measures characteristic attitudes and symptoms of depression” (Beck, et al., 1961)

RCTs: randomized placebo-controlled trials

25-OHD: “A prehormone that is produced in the liver by hydroxylation of vitamin D3″ Used by physicians to measure Vitamin D intake. The conversion from Vitamin D to 25-OHD takes roughly 7 days.

Meta-analysis: “Meta-analysis is a quantitative, formal, epidemiological study design used to systematically assess previous research studies to derive conclusions about that body of research. Outcomes from a meta-analysis may include a more precise estimate of the effect of treatment or risk factor for disease, or other outcomes, than any individual study contributing to the pooled analysis.”

Confounding variables“variables that the researcher failed to control, or eliminate, damaging the internal validity of an experiment.” “an extraneous variable in a statistical model that correlates (directly or inversely) with both the dependent variable and the independent variable.”

Biological flaws: “limitations in the design of primary studies which preclude them from testing the research hypothesis.”[Spudding, S, et. al.]

IU: International Units

Lit Review

All sources originate from primary, peer-reviewed journal articles.

  • Husemoen, L.L., et al., Serum 25-hydroxyvitamin D and self-reported mental health status in adult Danes. Eur J Clin Nutr, 2016. 70(1): p. 78-84.
  1. “Low serum 25(OH)D is not associated with self-reported symptoms/diagnosis of depression and anxiety.”

This study is a prime example of the disagreements in the scientific community on this subject. The study was thorough, yet did not find an association between depression/anxiety and vitamin D.

  • Sparling, T.M., et al., The role of diet and nutritional supplementation in perinatal depression: a systematic review. Matern Child Nutr, 2016.

    This study looked at 35 prior studies that filled the inclusion criteria. One study pertained to vitamin D, where they, with post-partum women, compared a vitamin D and calcium supplement with a multivitamin. They found that the multivitamin group had a significantly lower EPDS score.

    This highlights the complexity of interactions that occur in the body, which could be one of the reasons data on this subject is split.

    Allan, G.M., et al., Vitamin D: A Narrative Review Examining the Evidence for Ten Beliefs. J Gen Intern Med, 2016.

     In this study we focus on part 4. Through review, they found that “vitamin D supplementation does not improve mental well-being scores in the general population without clear depression, even when 25-OHD levels are low.” Moreover, Vitamin D supplementation in patients with depression has conflicting, poor-quality evidence .” However, one case-control study found that patients with depression had lower vitamin D levels than the healthy control group.

More disqualifying and conflicting evidence. My main extract from this article is their insight to why we see conflicting results: “Many of the RCTs on mental health and vitamin D are at high risk of bias, with poor randomization, lack of blinding, no description of patient characteristics, no intention-to-treat analysis and large loss to follow-up.” I’ll see how I can propose to correct for these fallacies.

Okereke, O.I. and A. Singh, The role of vitamin D in the prevention of late-life depression. J Affect Disord, 2016. 198: p. 1-14.

  • Inverse associations of vitamin D blood level or vitamin D intake with depression were found in 13 observational studies
  • Results from all but one of the RCTs showed no statistically significant differences in depression outcomes between vitamin D and placebo groups
  • Vitamin D level-mood associations were observed in most, but not all, observational studies
  • “results indicated that vitamin D deficiency may be a risk factor for late-life depression. However, additional data from well-designed RCTs are required to determine the impact of vitamin D in late-life depression prevention.”
    • We can question whether vitamin D can help against depression. Many observational studies confirm vitamin D to help against depression and with general mood, I’ll have to check more clearly if this is preventative.

Sanders, K.M., et al., Annual high-dose vitamin D3 and mental well-being: randomised controlled trial. Br J Psychiatry, 2011. 198(5): p. 357-64.

  • Even though the subjects had 41% higher 25-OHD levels than the control group, there was no correlation with depression scores.
    • I’ll look more into this one.

Spedding, S., Vitamin D and depression: a systematic review and meta-analysis comparing studies with and without biological flaws. Nutrients, 2014. 6(4): p. 1501-18.

  • With a strict eligibility criteria, 15 RCT studies were reviewed.
  • “For the meta-analysis of studies without biological flaws, the size of the effect was statistically significant being +0.78 (CI 0.24, 1.27). As the measure of effect size was the standardized mean difference (SMD), this was 0.78, using Cohen’s Rule-of-Thumb, a SMD of 0.8 is considered to indicate a large effect”
  • “However the overall mean weighted effect size value for antidepressants was only 0.15 (CI 0.08,0.22) for unpublished studies and 0.37 (CI 0.33, 0.41) for published studies. Thus, the effect size of Vitamin D demonstrated in our meta-analysis may be comparable with that of anti-depressant medication.”
  • “The main finding is that all studies without flaws and the meta-analysis of studies without biological flaws support the efficacy of Vitamin D supplementation for depression, as compared with the negative results of meta-analysis for studies with biological flaws.”
  • “The main limitation of this review was the diversity of study methodology precluding more extensive meta-analyses, and leaving only two studies in each meta-analysis. The variability in outcome measures and reporting suggest agreement should be sought within the research community to underpin standard conduct and reporting of future studies to support meta-analysis. ; not measuring 25OHD levels throughout the study”
    • This is where things get interesting though and the reason we continue despite massive disqualifying evidence. My approach will be to examine the disqualifying studies listed above and look into their methods. I will look to use the best methods without biological flaws.

 

  • From  Husemoen, L.L., et al., Serum 25-hydroxyvitamin D and self-reported mental health status in adult Danes. Eur J Clin Nutr, 2016. 70(1): p. 78-84.
    • Vitamin D receptors and vitamin D-metabolising enzymes are present in the brain and in the central nervous system at sites responsible for the regulation of emotions and behaviour. This raises the hypothesis that low vitamin D is related to poor mental health. ; mental disorders, such as depression and anxiety, affect an increasing number of individuals worldwide.1,2 ; Poor mental health is related to a reduced quality of life, an increased sickness, absence from work”
    • “Vitamin D receptors and vitamin D-metabolising enzymes are also present in the brain and in the central nervous system at sites that are responsible for the regulation of emotions and behaviour.3 In addition, there is evidence suggesting that vitamin D affects the biosynthesis of numerous neurotransmitters and neurotropic factors relevant to mental health.4 and more hospital admissions.1”

Design Approach

I aim to have roughly 50 participants. Participants need to be diagnosed with clinical depression and have insufficient Vitamin D levels. Participants will hail from the hospitals in Boulder and Denver. I plan to do this by working with doctors through the hospital. If the patient shows insufficient levels of Vitamin D and is clinically depressed, the doctor will refer them to me. If there are not enough participants at any one point in time I will sustain the study over a longer period with less concurrent participants. Upon beginning the study, participants will complete the Beck Depression Inventory and have their 25-OHD levels tested. If 25-OHD levels are deficient, we will proceed. Participants will be given Vitamin D pills of 5,000 IU and instructed to take them daily. There will also be a control group intended to include 50 participants, all of which will be given a placebo.  After 8 weeks there will be a follow-up session where we check 25-OHD levels, BDI score, and compliance. I intend to oversee the study, collect, compile, and analyze the data. 25-OHD levels will be tested without supervision at a doctors or physician, then emailed to myself. 25-OHD levels are tested because it is the most reliable way to test for Vitamin D levels. Upon completion I will compile and analyze the data and finally present and publish it.

Ethics

There are minimal ethical concerns in this study, but they exist. The ethical issue at hand will be participants releasing personal information regarding their mental health to myself. There are two ways around this: A certified doctor or physician could be hired to manage personal details, or the participants could sign to release their information to myself and if needed I would sign a confidentiality agreement.

 

Reliability and Validity of Methods and Results

My method is carefully thought out, adheres to PRIMA, and is without biological flaw. Outcome variables are changes in 25-OHD levels and the BDI as functions of Vitamin D intake.

Timeline

September, 2016

– Begin working with hospitals to recruit participants

December, 2016

– Study begins

February, 2017

– Follow-up session

March, 2017

– Findings presented and published

Resources/Materials

  • A room to meet with participants and for them to take the BDI
  • 5,000 IU Vitamin D supplements
  • Placebo pills

Budget

25-OHD tests are expensive at roughly $60 per test.

at $60 * 100 people * 2 tests we have a cost of $12,000.

A 60 pill Vitamin D supplement costs $5, costing a total of $250

2600 placebo pills are needed, at a total cost of $18

A total of $12,268 will be needed to conduct this study.

 References

  1. Hyman, S.; Chisholm, D.; Kessler, R.; Patel, V.; Whiteford, H. Mental disorders. In Disease Control Priorities in Developing Countries, 2nd ed.; Jamison, D.T., Breman, J.G., Measham, A.R., Alleyne, G., Claeson, M., Evans, D.B., Jha, P., Mills, A., Musgrove, P., Eds.; Oxford University Press: New York, NY, USA, 2006; pp. 605–626.
  2. http://www.healthline.com/health/depression/college-students
  3. Bracken, P.; Thomas, P.; Timimi, S. Psychiatry beyond the current paradigm. Br. J. Psychiat. 2012, 201, 430–434.
  4. Holick, M.F. The Vitamin D deficiency pandemic: A forgotten hormone important for health. Public Health Rev. 2010, 32, 267–283.
  5. Heaney, R.P. Does inconclusive evidence for Vitamin D supplementation to reduce risk for cardiovascular disease warrant pessimism? [Letter to the editor]. Ann. Intern. Med. 2010, 153, 208–209.
  6. Hendrix, I.; Anderson, P.; May, B.; Morris, H. Regulation of gene expression by the CYP27B1 promoter—study of a transgenic model. J. Steroid Biochem. Mol. Biol. 2004, 89–90, 139–142.
  7. Puchacz, E.; Stumpf, W.; Stachowiak, E.K.; Stachowiak, M.K. Vitamin D increases expression of the tyrosine hydroxylase gene in adrenal medullary cells. Mol. Brain Res. 1996, 36, 193–196.
  8. Cass, W.A.; Smith, M.P.; Peters, L.E. Calcitriol protects against the dopamine- and serotonin-depleting effects of neurotoxic doses of methamphetamine. Ann. N. Y. Acad. Sci. 2006, 1074, 261–271.

Using Schemas as an Aperture Into Perception

After scavenging the internet for ‘expert bloggers’ of psychology, I finally settled with a lady that I am not the most enthusiastic about. Her name is Dr Melanie Greenberg and she is a psychologist in Mill Valley, California. She offers individual and couples therapy to clients struggling with relationship issues and life stress.

The reason I’m not the fondest is the way she has been writing her articles on her blog. In one article she writes about how practicing self-compassion can help someone feeling unworthy, but she doesn’t provide anything of substance. In another – titled “50 Encouraging Things to Say to Yourself” (agh!) – she offhandedly mentions her clients, appeals to people that lack love and encouragement, and proceeds to list fifty sayings a la “You’re doing the best you can”. On the flip-side, perhaps I am too quick to judge this practitioner for being of no novel understanding and a sellout. Her intentions are endearing and number 6 on her list, “This too will pass”, although an incorrectly translated Buddhist saying, is something I can resonate with.

I chose her article: How to Identify and Heal Negative Core Beliefs

Before I summarize, I should explain Schemas. They are preconceived mental structures;  “a concept or framework that organizes and interprets information a mental structure that represents some aspect of the world. … Examples of schemata include stereotypes, social roles, scripts, worldviews, and archetypes.” They are our way of familiarizing the world, but when interacting with our filter of perception, can impact what we perceive as our reality.

Like her other articles, she starts with appealing to persons that feel damaged. She explains that negative schemas can make us interact with the world in a way we do not desire. She covers examples of negative schemas, like:

  • DEFECTIVENESS – You feel there is something wrong with you, that you are unlovable, incompetent, or “bad.”  You don’t trust your own judgment and don’t feel you deserve good treatment.

She explains how schemas can limit our lives and relationships, and then finally how schema therapy can help, in such a way that makes me do a double-take and question the legitimacy of the entire article, but I digress.

What is interesting here is the concept of schemas and how they relate to our perception of reality.

To begin, Melanie mentioned two interesting schemas:

  • How we deserve to feel
  • How we should expect to be treated by the world

These beliefs are held close to heart and impacts everything you do in life. I know people that give very different answers to these two questions. My psychology teacher in High School was of the belief that we can only feel happy for so long until we would run out of ‘happiness-molecules’. I’m not going to go into the complex theories of neuroscience, but its various systems of neurotransmitters, endorphins, hormones, and re-uptake mechanisms, turns her schema into a limiting belief. And this is the point that is so interesting, that when we are of an opinion, it becomes a part of our identity and therefore subject to our.. subjectivity, so to say. When these beliefs are discredited, it brings us to question our ability of judgement, our understanding, and whatever intricate belief-structures we have created. It is simply easier to ignore conflicting information than to change core beliefs. This reminds me of 15 year-old me trying to convince my mother that weightlifting does indeed not stunt growth, but despite hard evidence, a mother is stern in her beliefs.

Is it perhaps a survival mechanism? Personally I think most things psychology or pertaining to biology can be explained by evolutionary theory. We assume that we interpret the world like it is, but many die without becoming aware of their limitations. We can only interpret three dimensions, heck, we can’t even prove that we live in three dimensions. If there were more dimensions, we would have no way of telling. Our perception is very much like that of a computer, Hermann von Helmholtz said: “We perceive the simplest or most likely perception that fits the stimulus configuration” (1960). Just like our mental processes, we familiarize objects perceived by our visual system.

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Our visual system is highly optimized for survival. We are extremely good at processing information, to spot movement, detect spatial orientation, and we have three color cones that allow us to contrast colors. Colors. Those 300 nanometers of the electromagnetic spectrum is all we use, because it is sufficient and effective for survival. Light does not even have a color property: we evoke color out of light! To believe that we know anything is vanity.

Even more interesting is that our primal reactions can interact with our conscious understanding of the world. An ‘attentional blink’ is a visual phenomenon, “when presented with a sequence of visual stimuli in rapid succession at the same spatial location on a screen, a participant will often fail to detect a second salient target occurring in succession if it is presented between 180-450 ms after the first one.” In this experiment, the subjects were shown numbers following a positive or negative word, and we can see how the negative word caught their attention, which in turn gave them better results.

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Having established that there is indeed a dissonance between reality and our perception, and then our initial perception and final interpretation, we can investigate ways to put it to use. Returning to schemas, becoming aware of our coping-techniques allows us to take a step back and objectively verify if reality and perception coincide. A subtle but popular mechanism is to subconsciously choose to interpret the experience differently, this can often be coupled with ignoring evidence that would disprove you. A concerned parent not letting their kids play outside because they believe it is a possibility their kid will be kidnapped, simply because they saw it on TV last month, yet the rates are at an all-time low.

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Or a person subject to believing a stereotype reaffirms their belief when presented with the occasional occurrence, despite much evidence saying otherwise. The list goes on and it is bothering beyond belief and when it comes to a point, it begs the question of exactly how rational are human beings? Simply because we value rational thought in Western society does not mean that there are not several bugs in our code, and we should really really consider that more when evaluating our own belief structures.

Humans will go a long way to protect their own identity and autonomy, in this case it is a battle of mental property. It seems that its validity is secondary to preservation and this to me seems like a primal instinct. Because we have this fallacy where we often misinterpret the world, it is important to recognize and attempt to make up for our shortcomings, as apposed to becoming subject to coping mechanisms. These insights raises questions such as: are all humans conscious, or perhaps our consciousness, like our self-awareness, must be nurtured? I say this because I recognize that I presently hold the belief that consciousness comes with a certain level of rationality, and that succumbing to coping mechanisms is a lack of self-awareness, which I equal to consciousness. Perhaps in the end it is best to have schemas that maximize positive personal influence, or perhaps no schemas at all? After all, there are no rules.

Controlling Obesity: A White Paper

 

Humans have used fire since the dawn of our time and it is this defining relationship that sets humanity apart from the rest of the animal kingdom.Our learned ability to cook foods allowed us to spend less time chewing, and more time hunting and gathering. Given that the brain uses a disproportionate amount of energy, this allowed our brains to flourish over the course of generations, until we are where we are today. We are now facing a different problem of the same nature: just as we would die without fire, this relationship is exponentially causing our demise in the form of obesity. We are creatures with superhuman capabilities and stone-age instincts, humans were not designed to live in our urban environment and now it is imperative that we learn fast.

Like other modern issues, obesity is progressing at an alarming rate. Starting around 1980, we can see a sudden increase, leading to populations around the globe almost doubling in their percentage of overweight people. WP graph

It is equally alarming when looking at overweight & obesity in children:

WP graph2

This increase in obesity is likely a product evolution, as “the evolution of humans and other animals [as it] has been most shaped by scarcity of food rather than surpluses, which has favored the accumulation of genetic, behavioral and physiological adaptations favoring energy conservation” (PSYC 4021).

To measure obesity, we utilize something called the Body Mass Index (BMI). One’s BMI is calculated by taking one’s weight in kilograms divided by the square of height in meters. The result puts you in one of four categories: one of four categories:

  • If your BMI is less than 18.5, it falls within the underweight range.
  • If your BMI is 18.5 to 24.9, it falls within the normal or healthy weight range.
  • If your BMI is 25.0 to 29.9, it falls within the overweight range.
  • If your BMI is 30.0 or higher, it falls within the obese range.

For example, if you were 5’9″ you would be categorized the following way:

WP table

Obesity is a result of storing excessive fat, and fat is a product of food intake, or more accurately, energy intake. This is a complicated process whose end product can be summed up in one simple equation: Energy in > Energy out. Our goal is to shift that arrow in our favor. The measurement that we use for for energy is ‘Calories’ and different foods & beverage have varying measurements. These calories, or the energy we obtain, are digested from three macro-nutrients:

  1. Carbohydrates: 4 Calories
  2. Protein: 4 Calories
  3. Fat: 9 Calories

How do these macro-nutrients differ?

  • Carbohydrates
    • Used purely as energy in the body. Found in foods like potatoes and bread, they are also in the form of sugars. They are the commonly over-consumed in most obese cultures. The reason carbohydrates are easy to over-consume lies in the diverse nature of these simple molecules. The Glycemic Index is a measure that ranks carbohydrates based on the rate they are converted to glucose (sugar) in the human body, where higher values cause the most rapid increase in blood sugar. Sugar being at 100, one can consume a lot of sugar and still feel hungry within the hour, despite consuming a lot of calories. This happens because, once carbohydrates are converted to glucose, there is an insulin response which lets the body use the glucose for energy. Overall this causes a massive increase followed by a decrease in blood-sugar, leaving one lethargic and hungry, ready to repeat the process. Due to being used purely for energy, one is recommended to use carbohydrates to supplement the extra calories needed after the daily calories from protein and fat levels are reached. To clarify: you are not being told to eat carbohydrates only at the end of the day, but that they should be prioritized the least. In the absence of blood glucose, fat storage, and then protein, are used as energy sources.
  • Protein
    • Used by the body for their amino-acid building blocks, they are the basis of our DNA, products produced from said DNA, enzymes, messengers, and so forth. For our concern, they help our body function normally and aid with muscle recovery and increase in muscle mass. Our bodies can produce most of the amino acids found in proteins, but of the 21, there are 9 Essential Amino Acids one should seek to supplement in one’s diet. This is partly why one is recommended to eat a balanced diet. Protein can be found in meats, beans, nuts, seafood, and any living organism. How much protein one needs, like calories and other nutrients, varies quite a bit between individuals, but a benchmark can be set at 56 grams and 46 grams a day for adult men and women respectively.
  • Fat
    • Used for a wide range of bodily processes and are vital to our health. They make you feel more full, and are thus, contrary to popular opinion, useful for weight loss. One should keep in mind that one gram of fat is roughly equal to 2.3 carbohydrates, thus be mindful of excess intake. Fats can be found in oils, nuts, and animal fat. There are four types of fats, categorized by their number of double bonds. Saturated fat has none and is therefore found in a solid state at room temperature. Unsaturated has one, and polyunsaturated fats have multiple. Popularly one is recommended to limit one’s consumption of saturated fat, but this theory has limited validity. Lastly, trans fats are produced as a by-product of hydrogenating unsaturated fats into saturated fats. Trans fats are presently understood as being dangerous to one’s health. For health purposes one should attempt to eat a diversity of fats, but when it comes to obesity their differences are not significant, but trans fats are linked to obesity.

After our molecular excursion, our logical progression leads us to ask:

how many calories does one need?

The answer isn’t a single number, as it depends on one’s energy expenditure and basal energy requirements, which depends on height, muscle mass, sex, ethnicity, and overall health. Medical News Today provides us with the general consensus:

“Health authorities around the world find it hard to agree on how many calories their citizens should ideally consume. The US government says the average man requires 2,700 calories per day and the average woman 2,200, while the NHS (National Health Service), UK, says it should be 2,500 and 2,000 respectively.

The FAO (Food and Agriculture Organization) of the United Nations says the average adult should consume no less than 1,800 calories per day.”

In order to apply this knowledge, we must know how excess calories are converted to fat. Scientists have failed to reach consensus on the exact conversion, but one can assume that one pound of fat (454 grams) is between 2,843 and 3,752 calories. This means that if you eat 500 excessive calories each day, we’d be looking at 3500 excessive calories in one week, which equates to roughly one pound of fat gained. Conversely, if a person on average consumes an excess of 60 calories per day, they are looking at gaining over 6 pounds in a year. One can quickly become overweight and obese without eating noticeably too much, therefore knowledge is of utmost importance, as it can happen to you.

It is a common misconception that obesity is a result of lack of exercise, but this is not true. The most powerful correlation is between obesity and food intake. Thankfully making improvements to our diet, although daunting, is simple. Our goal here is to gain insight into our habits and to take appropriate action.

Here are some ways to get started:

  • Track your diet.
    • You will discover how much you tend to eat and you can adjust your diet appropriately. Now, tracking one’s diet seems extremely tedious, but I recommend that you spend that extra twenty minutes a day to inspect, weigh, and catalog your food intake – including beverages. Websites like MyFitnessPal streamline the process, all that’s left on your end is to weigh your food and search for it in their catalog. Going through just a week of this process should allow you to see the caloric values of foods you are habitually eating and if you tend to overeat.
  • Track your weight
    • Weigh yourself at your own discretion and record it. The goal here is to look for long-term changes. The premise is that this is an objective measure that can correct for a small miscalculation in food intake, allowing one to take action long before the average person.
  • Read food labels
    • Not only is this important for health related reasons, but when also tracking your diet, you develop intuitive knowledge that significantly boosts your judgement of how much you are eating without having to track your diet. The combination also helps you track macro and micro-nutrients, whose benefit stretches far beyond the realms of obesity.
  • Maximize Self-Regulation
    • Defined as: “the exertion of control to override competing urges, behaviors, or desires in order to maximize the long-term best interests of the individual”, self-regulation is a finite resource. Lacking sleep or performing work that is mentally tasking or requires self-regulation all decrease self-regulation ability. (Marcora et al., 2009 & 2014; Pageaux et al., 2014) Conversely it is increased by self-esteem and engaging in regular physical activity. (Oaten & Cheng, 2006) We see here that self-regulation regulates itself: if we treat our body and mind kindly, it becomes easier for us to do so, and vice versa. Being able to exert greater control on one’s actions is pivotal in developing new habits.

Staying within the nutritional segment, it is important to talk about metabolism. Metabolism is the overarching term for all life-sustaining chemical reactions that happen in a living organism. Based on the idea that each human is different, arguing that each person’s metabolism is different is a common excuse for obesity. While metabolism has been found to differ in some populations, significant differences, aside from related medical conditions, have not been found in individuals within the population. Metabolism has also been found to be similar in lean and obese subjects, and so far we have discovered no significant correlation between metabolism and obesity. Interestingly, there is also little correlation found between energy expenditure and obesity levels.

Exercise & Lifestyle activities

Physical activity is of utmost importance for personal well-being, but its effects on obesity are inconclusive. When one is undertaking an exercise program, one is also likely to eat more and be less active. (CITATION NEEDED). Exercise does not have to be intense to produce health benefits, particularly so in less fit or healthy subjects (Williams & Thompson, 2013). Physical activity has the same benefit whether it be in one continuous bout or shorter bouts multiple times a day (Murphy et al., 2009). It does not have to be structured (Dunn et al., 1999). Because of these factors, I recommend partaking in a lifestyle activity, which are self-selected activities that are moderate to vigorous in activity. Incorporating lifestyle-activity into one’s life is easier for many and therefore may yield better long-term results (Anderson et al., 1999). Alongside with lifestyle activity, making small changes to everyday life can result in major changes over time. Utilizing public transportation, walking, or biking to work, having a standing desk or unconventional chair, there are many ways. Now that it has been found that minimizing continuous sedentary activity is associated with lower the waist circumference, BMI, blood lipids and glucose tolerance, despite total sedentary time and physical activity (Healy et al., 2008), these tiny adjustments will pay dividends down the road.

When it comes to obesity, exercise, and nutrition, it is a lot easier not to eat a muffin than it is to run for thirty minutes, and that is the exact approach being advocated for here. Instead of feeling daunted by information overload and confused by rapidly changing opinions of nutritional experts, we focus on what we can control for. Having basic knowledge of one’s nutrition and applying it to oneself, in conjunction with small lifestyle changes, we can optimize our ability to make good choices by sustaining self-regulation and enter its perpetual positive-feedback loop. Obesity is perceived as having lack of self-control, and this is where we attack.

Rethinking Drugs in Our Society

The use of mind-altering substances have been part of human culture for several millennia. This desire to alter one’s perception of reality has also been observed in a multitude of animals. Indigenous people of South America have been known to use Peyote and Ayahuasca, their respective active ingredients being Mescaline, and N,N-Dimethyltryptamine (DMT), in coming-of-age rituals. We can still observe this in Peru, where these rituals are legal and boys become men as they – after extensive puking and dry-heaving – delve into the innermost part of their psyche and as a result learn to live in harmony with nature and their tribe. The Psychedelics did not find their way to Europe and North America until 1943, when Albert Hoffman synthesized LSD – Lisergic Acid Diethylamide. The use of psychedelics, most notably Psylocibin and LSD, surged in popularity as their use in teenage curiosity turned to hippie counterculture that peaked in the 60s, and then abruptly stopped when the American government banned them in 1967. However in its years of legality many clinical studies were done on the effects of LSD on various conditions ranging from alcoholism to schizophrenia. In 1967 this research was discontinued and not picked up again until quite recently, as MAPS and other organizations have gained the rights to use them in research under a special license. “A few institutions still have the necessary licenses; but lack of money, restrictive rules, and public and professional hostility have made it almost impossible to continue the work. In rejecting the absurd notion that psychedelic drugs are a panacea, we have chosen to treat them as entirely worthless and extraordinarily dangerous. Collectively, we must stop being afraid of drugs. We owe it to ourselves to accurately teach about drugs in our schools. We owe it to ourselves to extensively study their functions and benefits, and we owe it to ourselves to replace our baseless fear with an empowering freedom that rekindles self-exploration and love through regulated recreational use of any drug.

The ultimate goal is the freedom of the individual to consume whatever it is they desire, given that it does not negatively impact others. The road there lies within clinical studies and administration. This ethical dilemma is very much the same as, and in fact also includes, the use of cannabis. The public perception of ‘Reefer Madness‘ as a result of Government propaganda, and its transition to the current successes of Marijuana legalization in Colorado mirrors that of other illicit drugs (namely Psychedelics and Entheogens). Like with cannabis, the next step is to show undeniable proof through research studies that these drugs have beneficial uses, and that when used responsibly, their negative effects are minimal. The good thing is that we’ve been slowly moving in the correct direction for a little while now. In the 60s and in many more recent studies we have seen that LSD is highly successful in treating alcoholism. It is even commonly known that Bill Wilson, the founder of Alcoholics Anonymous wanted to include LSD as the last step in the program. LSD has also been shown to help with anxiety and depression. Many similar studies have been done on other Psychedelics, and it is no coincidence these substances are regarded so highly in indigenous tribes. As for Entheogens, MDMA has had a success rate towards 80% in treating PTSD and is being used to treat various other psychological distresses.

In response to my desire to legalize these substances for regulated recreational use, many may refer to: the health dangers that come with these drugs, that one time their friend had serotonin syndrome, or when they themselves had a ‘bad trip’.

The risk of use and nearly all negative health effects disappear through proper usage and regulation of drugs. Most deaths or ills happen as a result of either irresponsible use, or the user receiving something else than what they buy. The road to responsible drug usage is long, but we can do better than we do now through having readily available information and a regulated distribution. A drug dealer has little incentive to care for his buyers’ health and it is therefore common that they distribute laced drugs in order to make more money with less risk. Being able to go to a pharmacy or a dispensary would guarantee you that you have what you intend to take, and they would be able to give you necessary information or perhaps require you to take classes before consumption. Currently, the only ways to know that MDMA and MAOi’s (common depression medicines) causes Serotonin Syndrome is through anecdotal stories, or underground websites like TripSit or Erowid. As for bad trips, they are real and present a problem, but they are not inherently bad, that all lies in interpretation, as we can learn a lot from these extremely powerful experiences. This hurdle can be overcome in various ways, but it is problematic when it comes to irresponsible recreational use. It is important that we learn to handle these difficult situations when they happen.

Ultimately, my argument lies with my belief that we must maximize the freedom of the individual. Although in this avenue it can be a rocky road, through the steps I laid out (and many, many more) we can reap the benefits that come with rejecting fear for progressive understanding.