Showing posts with label exercise. Show all posts
Showing posts with label exercise. Show all posts

Sunday, September 19, 2021

Self Test - Part II: the effect of ezetimibe on visceral fat

 

This post focuses on the power of smoothing, which is a process that picks out trends from noisy data.  We'll see that using a low-cost bathroom scale that has a visceral fat reading, we can see an observable effect that is correlated with the start of taking Ezetimibe, a cholesterol-reducing medication. 

My Yunmai bathroom scale provides a measure of visceral fat, that greasy stuff that lines our organs.  Higher percentages of it in our body increases risks of all sorts of diseases, so visceral fat is a good quantity to track and try to minimize.  The best way to reduce its percentage is to exercise to turn fat to muscle and to lose weight.

My scale has four electrodes, which are arranged in two pairs.  The left and right pair measure the resistance of the soles of each foot.  The resistance from one foot to the other measures the resistance of your body.  Combined with your weight and height, a formula is used to estimate the visceral fat.

I talked to an engineer at Cal Tech whose research was in the general area of biometrics, and she told me that such resistance measurements are related to the visceral fat, but they are not so accurate.  Furthermore, scales such as mine are biased towards the lower part of the body while those that use electrodes that you grasp in your hands is biased to the upper body.  So, corrections need to be made.

The bottom line is that I do not trust the absolute measurement but changes in the reading has some meaning provided that the scale is sensitive enough to detect the changes.  In my case, my reading ranges from 5 % to 9% percent as whole numbers.  The black points in the figure above show the visceral fat percentage as a function of date.  These points form horizontal lines at the whole numbers and alone give us very little useful information.

However, readings fluctuate between 8% and 9% at early times then between 7% and 8% and so on, implying that the visceral fat is falling with time.  Smoothing is the process of averaging adjacent points.  The red points show 50-point smoothing, where 25 consecutive points to the left of the data point and 25 to the right are averaged and plotted at the middle point of the range.  As a result, we get values between the whole numbers.  Suppose that my visceral fat is at 6.8%.  Then, the scale would read 7.0% more often that 6.0%, so the 50-point average would yield something around 6.8%.  Smoothing also eliminates day to day fluctuations that might hide the long terms trends.

The blue line shows 200-point smoothing, corresponding to over a half-year smoothing window.  This eliminates all but the most long-term trends.  The light blue vertical line in mid-2018 shows the date on which I started to take Ezetimibe, a medication that reduces cholesterol.  In my last post, I described how I used smoothing and a fit to a saturated exponential that found that my weight increased by 3 pounds after I started taking Ezetimibe.  The visceral fat data correlates with the observed weight gain.

To summarize the graph, smoothing shows my visceral fat falling from late 2016 and leveling off in early 2018 while I was on my high-fat diet.  This correlates with my weight loss.  Then, after taking Ezetimibe, my visceral fat started a long-term climb from 6% to about 6.5%.  Smoothing has allowed me to determine this rise to a precision that exceeds the whole numbers provided by the scale.

Finally, there is a dip in the 50-point smoothed curve that falls below 6%.  There is also one reading of 5% as seen by the black point.  The date corresponds to one week after my radical prostatectomy surgery and correlates with my initial weight loss then weight gain after the surgery.  Interestingly, the 200-point smoothed curve shows two plateaus – the first after starting the Ezetimibe and the second one after my prostate surgery.

As I have stressed in my past posts, this is a single experiment with potentially many confounding factors, so we cannot conclude that Ezetimibe increases visceral fat.  However, the result provides a hypothesis that could be tested with a larger number of participants.  Putting it all together, Ezetimibe drastically reduced my serum cholesterol (a huge effect that is consistent with controlled experiments) and is correlated with a small weight gain.  This added data shows that it might add to visceral fat.  This brings up the point that medications have complex effects on the body.  They work as intended to treat one condition, but the side effects might oppose some of the benefits.  In this case, the drop in cholesterol is far greater than the potentially ill effects of a small gain in visceral fat.

If there are others out there like me, pooling our data together could increase the confidence that the correlation is not a mere coincidence.  So give it a try!

Saturday, August 20, 2011

Hormesis - A little radiation may be a good thing



Last Thursday, my wife and I gave a presentation to the new students in the Honors College at WSU on the common reading book, Physics for Future Presidents. One large chunk of the book discusses nuclear power and its risks. When extrapolating to low dose, the author is careful to always state "assuming the linear hypothesis."

This got me thinking about an article in Scientific American that I read back in 2003 on the topic of Hormesis. The idea is that toxins might actually be beneficial when taken in low doses. As an example of Hormesis, exercise wreaks all sorts of havoc on the cellular level, but is healthy in moderation. The explanation is that the body's response in repairing the damage does some good that goes beyond the status quo. At higher levels of exposure, the body cannot keep up with the damage, and toxic effects become - well, toxic.

The red curve in the figure shows the linear hypothesis; the toxicity of a toxin, quantified in terms of the death rate, increases with dose. Hormesis, shown in green, yields a benefit at low exposure levels. Serious scientific studies are finding a hormesis response in many toxicological studies.

Hormesis may describe the effect of ionizing radiation on living creatures such as humans (see the references below). Karl Grossman furiously protests on the anti-Nuke website NuclearFREEPlanet.org. He sees these studies as an obvious ploy by nuclear scientists to pollute the planet, "These scientists don't just want to minimize or even flatly deny the deadly impacts of radioactivity - they want people to think it's healthy." What if it is actually healthy?

Our presentation to the students of the Honors college focused on the notion that decisions that are made based on the facts have better outcomes when not clouded by ideology. We should not bash science just because its conclusions weaken those arguments that support our beliefs.

My point in using this example is not to be an advocate for nuclear energy, nor is it to support the hormesis hypothesis. Rather, it is to illustrate the pitfalls of clinging to an ideology. If the best evidence shows that low levels of radiation is safe and potentially beneficial, then why not loosen standards to reflect the best science?

Some readers may find these arguments reminiscent of the homeopathy hypothesis, that ingesting toxins at levels of zero concentration can cure various ailments. There is absolutely no evidence for homeopathic effects. Wikipedia devotes a page to Jacques Benveniste, who purported to observe such effects (published in the prestigious journal Nature), but whose work has been discredited many times since (blue dot in the figure). A site visit by a team assembled by the editors of Nature at the time of the report in 1988 found serious procedural problems that explained the spurious result.

Sadly, homeopathic remedies are found on the shelves of my local pharmacy and are even covered by the health plans of many countries. I would venture a guess that there is a large overlap between people who use homeopathic remedies and those who deny hormesis based on their anti-nuke sentiments. If so, they may be wrong on two counts.

At the risk of accusations of being pro nuclear, I will post some interesting statistics on radiation, and a comparison of the dangers of various energy sources including nuclear power. Until then, I encourage you to read the informative links in this post. For someone with a more serious interest, I recommend the articles in the reference list, which appear in hard-core scientific journals. If you are left with a desire to dig deeper, there are several hundred more articles on the topic. But, stay away from ideological websites, unless your aim is to feed your ideology rather than learning the truth.

Buon Pomeriggio!

References

Title: Hormesis: The dose-response revolution
Author(s): Calabrese EJ; Baldwin LA
Source: ANNUAL REVIEW OF PHARMACOLOGY AND TOXICOLOGY Volume: 43 Pages: 175-197 DOI: 10.1146/annurev.pharmtox.43.100901.140223 Published: 2003

Title: The frequency of U-shaped dose responses in the toxicological literature
Author(s): Calabrese EJ; Baldwin LA
Source: TOXICOLOGICAL SCIENCES Volume: 62 Issue: 2 Pages: 330-338 DOI: 10.1093/toxsci/62.2.330 Published: AUG 2001

Title: Hormesis: A highly generalizable and reproducible phenomenon with important implications for risk assessment
Author(s): Calabrese EJ; Baldwin LA; Holland CD
Source: RISK ANALYSIS Volume: 19 Issue: 2 Pages: 261-281 DOI: 10.1111/j.1539-6924.1999.tb00404.x Published: APR 1999

Title: Evidence for beneficial low level radiation effects and radiation hormesis
Author(s): Feinendegen LE
Source: BRITISH JOURNAL OF RADIOLOGY Volume: 78 Issue: 925 Pages: 3-7 DOI: 10.1259/bjr/63353075 Published: JAN 2005

Title: Multiple stressors in Caenorhabditis elegans induce stress hormesis and extended longevity
Author(s): Cypser JR; Johnson TE
Source: JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES Volume: 57 Issue: 3 Pages: B109-B114 Published: MAR 200

Title: RADIATION HORMESIS - ITS EXPRESSION IN THE IMMUNE-SYSTEM
Author(s): SHU ZL; LIU WH; SUN JB
Source: HEALTH PHYSICS Volume: 52 Issue: 5 Pages: 579-583 Published: MAY 1987

Title: Exercise and hormesis: oxidative stress-related adaptation for successful aging
Author(s): Radak Z; Chung HY; Goto S
Source: BIOGERONTOLOGY Volume: 6 Issue: 1 Pages: 71-75 DOI: 10.1007/s10522-004-7386-7 Published: JAN 2005

Title: Effect of a continuous gamma irradiation at a very low dose on the life span of mice
Author(s): Caratero A; Courtade M; Bonnet L; et al.
Source: GERONTOLOGY Volume: 44 Issue: 5 Pages: 272-276 DOI: 10.1159/000022024 Published: SEP-OCT 1998