Vegetarians Are Thinner but Less Healthy than Omnivores in New Study

For a few decades now, vegetarians have been arguing that eating meat is unhealthy and leads to diseases such as "hypertension, cholesterol problems, some chronic degenerative diseases, coronary artery disease, type II diabetes, gallstones, stroke, and certain cancers." A new study from Nathalie T. Burkert, et al (PLoS ONE, Feb 7 2014; 9(2): e88278) finds that vegetarians have a lower BMI than omnivores (on average) but that they are more likely to have allergies, mental health issues, and various forms of cancer.

However, the authors are clear in the discussion that this study has very specific limitations that prevent any broad conclusions being drawn (especially that there was no difference in smoking behavior among the four groups - it seems even vegetarians smoke in Austria).

[T]he survey was based on cross-sectional data. Therefore, no statements can be made whether the poorer health in vegetarians in our study is caused by their dietary habit or if they consume this form of diet due to their poorer health status. We cannot state whether a causal relationship exists, but describe ascertained associations. Moreover, we cannot give any information regarding the long-term consequences of consuming a special diet nor concerning mortality rates. Thus, further longitudinal studies will be required to substantiate our results.

In addition, the study does not break down the nutrient consumption of any of the four groups (1. vegetarian, 2. carnivorous diet rich in fruits and vegetables, 3. carnivorous diet less rich in meat, and 4. carnivorous diet rich in meat), for example, carbohydrate intake (and sources), fatty acid intake and ratios, and ratios of macronutrients in the overall diet.

One other limitation that authors emphasize is that there is no way to know (based on information gathered) if the vegetarians are consuming said diet as a result of their health issues or of their health issues are a result of their diet (much less likely, even though I believe a vegetarian diet is not generally a healthy approach to eating).

Nutrition and Health – The Association between Eating Behavior and Various Health Parameters: A Matched Sample Study

Nathalie T. Burkert, Johanna Muckenhuber, Franziska Großschädl, Éva Rásky, and Wolfgang Freidl

Abstract

Population-based studies have consistently shown that our diet has an influence on health. Therefore, the aim of our study was to analyze differences between different dietary habit groups in terms of health-related variables. The sample used for this cross-sectional study was taken from the Austrian Health Interview Survey AT-HIS 2006/07. In a first step, subjects were matched according to their age, sex, and socioeconomic status (SES). After matching, the total number of subjects included in the analysis was 1320 (N=330 for each form of diet – vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, and carnivorous diet rich in meat). Analyses of variance were conducted controlling for lifestyle factors in the following domains: health (self-assessed health, impairment, number of chronic conditions, vascular risk), health care (medical treatment, vaccinations, preventive check-ups), and quality of life. In addition, differences concerning the presence of 18 chronic conditions were analyzed by means of Chi-square tests. Overall, 76.4% of all subjects were female. 40.0% of the individuals were younger than 30 years, 35.4% between 30 and 49 years, and 24.0% older than 50 years. 30.3% of the subjects had a low SES, 48.8% a middle one, and 20.9% had a high SES. Our results revealed that a vegetarian diet is related to a lower BMI and less frequent alcohol consumption. Moreover, our results showed that a vegetarian diet is associated with poorer health (higher incidences of cancer, allergies, and mental health disorders), a higher need for health care, and poorer quality of life. Therefore, public health programs are needed in order to reduce the health risk due to nutritional factors.

Introduction

Our diet has an impact on our well-being and on our health. Studies have shown a vegetarian diet to be associated with a lower incidence of hypertension, cholesterol problems, some chronic degenerative diseases, coronary artery disease, type II diabetes, gallstones, stroke, and certain cancers [1]–[7]. A vegetarian diet is characterized by a low consumption of saturated fat and cholesterol, due to a higher intake of fruits, vegetables and whole-grain products [3], [4], [8]. Overall, vegetarians have a lower body mass index [1], [4], [5], [7], [9]–[12], a higher socioeconomic status [13], and better health behavior, i.e. they are more physically active, drink less alcohol, and smoke less [9], [13], [14]. On the other hand, the mental health effects of a vegetarian diet or a Mediterranean diet rich in fruits, vegetables, whole-grain products and fish are divergent [9], [15]. For example, Michalak et al. [16] report that a vegetarian diet is associated with an elevated prevalence of mental disorders. A poor meat intake has been shown to be associated with lower mortality rates and higher life expectancy [17], and a diet which allows small amounts of red meat, fish and dairy products seems to be associated with a reduced risk of coronary heart disease as well as type 2 diabetes [18]. Additionally, evidence concerning lower rates of cancer, colon diseases including colon cancer, abdominal complaints, and all-cause mortality is, however, inconsistent [5]–[7], [19]–[22].

Not only is the intake of certain nutrients, like red meat, associated with an increased health risk [18], [23]–[26], high-caloric intake also plays a crucial role [23], [27]. Moreover, there seems to be proof that lifestyle factors like physical activity may be more crucial in lowering disease rates than individual dietary habits [20], [28]–[29]. While, generally speaking, diets based on plants, like vegetarian diets, seem to be associated with a certain health benefit, a lower risk to contract certain chronic diseases [30], and the ability to improve health [31]–[32], restrictive and monotonous vegetarian diets include the risk of nutritional deficits [2], [18], [19], [30], [33]. Baines et al. [9] report that vegetarians take more medication than non-vegetarians.

To summarize, a number of studies have shown vegetarian diets and diets with poor meat intake to be associated with lower mortality rates for certain diseases. Research about the dietary habits in Austria is, however, rather sparse and mainly focused on genetic factors [33]–[36]. Therefore, the aim of this study was to investigate health differences between different dietary habit groups among Austrian adults.

Methods

Study Design and Study Population

The sample for this cross-sectional study was taken from the Austrian Health Interview Survey (AT-HIS) which ran from March 2006 to February 2007 [37]. The AT-HIS is a standardized survey which is conducted at regular intervals in Austria (currently every eight years). The subjects included in the survey form a representative sample of the Austrian population. They were chosen from the central population register and are distributed across the different geographic regions of Austria. The AT-HIS is part of the European Health Interview Survey (E-HIS; http://www.euhsid.org), an important high-quality survey. The interviews were conducted by free-lancers engaged by the Austrian Statistic Agency. To ensure that all interviews were conducted in the same way, interviewers had to participate in a training day where they were instructed on how to conduct the survey. Time measurement, non-response analyses, and analyses of error dialogs were performed in order to ensure consistency between interviewers. Additionally, all interviewers were supervised by field supervisors. Overall, 15474 individuals, aged 15 years and older, were questioned in computer-assisted personal interviews (CAPI; 54.7% female; response rate: 63.1%).

While 0.2% of the interviewees were pure vegetarians (57.7% female), 0.8% reported to be vegetarians consuming milk and eggs (77.3% female), and 1.2% to be vegetarians consuming fish and/or eggs and milk (76.7% female). 23.6% reported to combine a carnivorous diet with lots of fruits and vegetables (67.2% female), 48.5% to eat a carnivorous diet less rich in meat (60.8% female), and 25.7% a carnivorous diet rich in meat (30.1% female). Since the three vegetarian diet groups included a rather small number of persons (N=343), they were analyzed as one dietary habit group. Moreover, since the vegetarian group was the smallest, we decided to match each of the vegetarians (1) with an individual of each other dietary habit group (carnivorous diet rich in fruits and vegetables (2), carnivorous diet less rich in meat (3) and a carnivorous rich in meat (4)).

Matching Process

In a first step, subjects consuming a vegetarian diet were identified (N=343). All vegetarians were categorized according to their sex, age (in age-groups spanning 5 years, e.g. 20- to 24-year-olds), and socioeconomic status (SES). Each such vegetarian was then matched with one subject consuming a carnivorous diet rich in fruits and vegetables, one individual eating a carnivorous diet less rich in meat, and one subject consuming a carnivorous diet rich in meat. Only 96.2% of the vegetarians were included in the analyses, since not all of them corresponded to a subject of the same sex, age, and SES from a different dietary habit group. Therefore, the total number of analyzed subjects was 1320 (comprising 330 vegetarians, 330 subjects consuming a carnivorous diet rich in fruits and vegetables, 330 individuals eating a carnivorous diet less rich in meat, and 330 subjects consuming a carnivorous diet rich in meat). Each dietary habit group was set-up according to the demographic characteristics shown in Table 1.

Table 1
Data definition and structure for each of the four dietary habit groups.

Ethical Approval

The study was carried out in compliance with the principles laid down in the Helsinki Declaration. No minors or children were included in the study. Verbal informed consent was obtained from all subjects, witnessed, and formally recorded. The Ethics Committee of the Medical University of Graz approved the consent procedure as well as the conductance of this study (EK-number: 24–288 ex11/12).

Variables and Measurements

Face-to-face interviews were conducted by questioning the subjects about their socio-demographic characteristics, health-related behavior, diseases, medical treatments, and also psychological aspects.

The independent variable in this study was the dietary habit of individuals. Concerning eating behavior, the respondents were given a list of six different dietary habits and asked which one describes their eating behavior best (1=vegan, 2=vegetarian eating milk/eggs, 3=vegetarian eating fish and/or milk/eggs, 4=carnivorous diet rich in fruits and vegetables, 5=carnivorous diet less rich in meat, 6=carnivorous diet rich in meat). Participants described their dietary habit, without interviewers giving a clear definition of the various eating categories. Since, overall, only 2.2% of all participants consumed a vegetarian diet, these individuals were analyzed as one dietary habit group. We created a scale that would reflect the animal fat intake for each dietary habit (1=vegetarian diet, 2=carnivorous diet rich in fruits and vegetables, 3=carnivorous diet less rich in meat, 4=carnivorous diet rich in meat).

Since age, sex, and the socioeconomic background of subjects all have an influence on health [38]–[41], we matched the subjects according to these variables in order to control for their influence. The SES of the subjects (ranging between 3 and 15) was calculated using the following variables: net equivalent income, level of education, and occupation. Net equivalent income was calculated based on an equivalence scale provided by the OECD [42], and divided by quintiles. Level of education was measured by an ordinal variable, distinguishing between (1) basic education (up to 15 years of age), (2) apprenticeship/vocational school, (3) secondary education without diploma, (4) secondary education with diploma, and (5) university education. The occupation of the subjects was differentiated into the following five levels: (1) unskilled worker, (2) apprentice/skilled worker, (3) self-employed/middle job, (4) qualified job/academic, (5) executive position. To verify the combination of variables that served to calculate the SES, correlations with the different variables were calculated. They ranged between r=.70 and r=.80.

The body mass index (BMI) and lifestyle factors (physical activity, smoking, and alcohol consumption) were included as covariates in all analyses. The BMI was calculated by dividing the weight of a person in kilograms by the square of their height in meters (kg/m2) [43]. Physical exercise was measured using the short version of the International Physical Activity Questionnaire (IPAQ), a self-reported instrument, which asks for an estimate of the total weekly physical activity (walking, moderate- and vigorous-intensity activity) performed during the last week. The short version of the IPAQ does not discriminate between leisure-time and non-leisure time physical activity. The total MET score was calculated by weighting the reported minutes per week within each activity by a MET energy expenditure estimate that was assigned to each category [44]. Smoking behavior was measured as the number of cigarettes smoked per day. Alcohol consumption was surveyed as the number of days on which alcohol was consumed during the last 28 days.

The dependent variables focusing on ill-health included self-perceived health, ranging from 1 (very good) to 5 (very bad), and impairment to health, ranging from 1 (very impaired) to 3 (not impaired). We further assessed the presence of 18 specific chronic conditions (asthma, allergies, diabetes, cataract, tinnitus, hypertension, cardiac infarction, apoplectic stroke, bronchitis, arthritis, sacrospinal complaints, osteoporosis, urinary incontinence, gastric or intestinal ulcer, cancer, migraine, mental illness (anxiety disorder or depression), and any other chronic condition). Each condition was coded as present (1) or absent (0). We calculated a total frequency score by summing up the chronic conditions present (0–18, sum index). Additionally, a vascular risk score was calculated by summing up the variables “hypertension”, “enhanced blood cholesterol level”, “diabetes”, and “smoking” (0–4, sum index). Each variable was coded as present (1) or absent (0).

A dependent variable concerning health care was created as the sum index of the number of doctors consulted in the last 12 months (0–8, sum index). Each of the 8 medical treatments (general practitioner, gynecologist, urologist, dermatologist, ophthalmologist, internist, orthopedist, and ENT physician) was coded as “consulted” (1) or “not consulted” (0). The number of vaccinations was analyzed by calculating a sum index combining 8 different vaccinations (influenza, tetanus, diphtheria, polio, FSME, pneumococci, hepatitis A and B; 0–8, sum index). Each vaccination was coded as present (1) or absent (0). In addition, preventive health care was analyzed by calculating a sum index of the variables “preventive check-ups”, “mammography”, “prostate gland check-up”, and “Papanicolaou test” (0–4, sum index). Each variable was coded as present (1) or absent (0).

The dependent variable concerning quality of life was measured using the short version of the WHOQOL (WHOQOL-BREF) [45]. Four domain scores (physical health, psychological health, social relationships, and environment) were calculated. These domain scores ranged between 4 and 20.

Statistical Analysis

In a first step subjects with different dietary habits (vegetarian, carnivorous diet rich in fruits and vegetables, carnivorous diet less rich in meat, carnivorous diet rich in meat) were matched according to their sex, age, and SES. Differences in lifestyle factors (BMI, total MET score, number of cigarettes smoked per day, and alcohol consumption in the last four weeks) between the different dietary habit groups were calculated by multivariate analysis of variance.

In order to analyze the differences between the dietary habit groups, multivariate analyses of variance were calculated for the three domains: (1) health (self-reported health, impairment due to health problems, number of chronic conditions, vascular risk), (2) health care (number of visits to the doctor, number of vaccinations, number of used preventive care offers), and (3) quality of life (physical and psychological health, social relationships, and environment). To address the bias of lifestyle factors impacting health, analyses of variance were calculated, controlling for the aforementioned lifestyle variables (BMI, physical activity, smoking behavior, and alcohol consumption).

In the domain of “health”, the two variables “self-reported health” and “impairment due to health problems” were originally assessed using an ordinal scale. Therefore, we controlled the results using non-parametric tests (Kruskal Wallis Test). Since the results were the same, only results of the analyses of variance are reported.

In addition, Chi-square tests were calculated for the aforementioned 18 chronic conditions in order to establish which one occurs significantly more often, depending on the form of nutrition. p-values <.050 were considered as statistically significant. All analyses were calculated using IBM SPSS software (version 20.0) for Windows,

Results

Participant Characteristics and Lifestyle Differences between the Dietary Habit Groups

In total, we analyzed the data of 1320 individuals (330 in each dietary habit group). Each dietary habit group was set-up according to the demographic characteristics shown in Table 1. Overall, 23.6% of all subjects were male and 76.4% female. 40.0% of the individuals were younger than 30 years, 17.8% between 30 and 39 years, 17.6% between 40 and 49 years, 9.4% between 50 and 59 years, 8.4% between 60 and 69 years, 4.4% between 70 and 79 years, and 2.4% than 80 years or older. 30.3% of the subjects had a low SES (they had an SES score of ≤6), 48.8% a middle one (SES between >6 and ≤10), and 20.9% had a high SES (SES>10).

Our multivariate analysis regarding lifestyle showed a significant main effect for the dietary habit of individuals (p=.000), showing that the different dietary habit groups differ in their overall health behavior. However, results of the univariate analyses showed that the dietary habit groups only differ concerning their BMI and their alcohol consumption.

Concerning BMI: vegetarians have the lowest mean BMI (M=22.9), followed by subjects eating a carnivorous diet less rich in meat (M=23.4), rich in fruits and vegetables (M=23.5), and rich in meat (M=24.9). Heavy meat eaters differ significantly from all other groups in terms of their BMI (p=.000).

Concerning physical exercise: no significant difference was found in the total MET score between the various dietary habit groups (p=.631).

Concerning smoking behavior: the number of cigarettes smoked per day did not differ between the various dietary habit groups (p=.302).

Concerning alcohol consumption: Subjects following a vegetarian diet (M=2.6 days in the last 28 days) or a carnivorous diet rich in fruits and vegetables (M=3.0 days) consume alcohol significantly less frequently than those eating a carnivorous diet less rich in meat (M=4.4 days) or rich in meat (M=4.8 days; p=.000).

Health Differences between the Dietary Habit Groups

In the domain of health, the multivariate analysis of variance showed a significant main effect for the dietary habit of individuals (p=.000). Overall, vegetarians are in a poorer state of health compared to the other dietary habit groups. Concerning self-reported health, vegetarians differ significantly from each of the other groups, toward poorer health (p=000). Moreover, these subjects report higher levels of impairment from disorders (p=.002). Vegetarians additionally report more chronic diseases than those eating a carnivorous diet less rich in meat (p=.000; Table 2). Significantly more vegetarians suffer from allergies, cancer, and mental health ailments (anxiety, or depression) than the other dietary habit groups (Table 3). Subjects who eat a carnivorous diet rich in meat more often report urinary incontinence (p=.023). No differences between individuals consuming different forms of diet were found regarding their vascular risk (p=.150; Table 2).

Table 2
Differences in health and health care between the different dietary habit groups.

Table 3
Differences in suffering from various chronic conditions between the different dietary habit groups.

Differences in Health Care between the Dietary Habit Groups

Our multivariate analysis regarding health care has shown a significant main effect for dietary habits (p=.000) and confirmed that, overall, subjects with a lower animal fat intake demonstrate worse health care practices. Vegetarians and subjects eating a carnivorous diet rich in fruits and vegetables consult doctors more often than those eating a carnivorous diet less rich in meat (p=.003). Moreover, vegetarians are vaccinated less often than all other dietary habit groups (p=.005) and make use of preventive check-ups less frequently than subjects eating a carnivorous diet rich in fruits and vegetables (p=.033; Table 2).

Differences in Quality of Life between the Dietary Habit Groups

Regarding quality of life, the main effect of the multivariate analysis of variance showed no significant difference between the dietary habit groups (p=.291). The results obtained in the univariate analyses of variance, however, revealed that vegetarians have a lower quality of life in the domains of “physical health” (p=.026) and “environment” (p=.037) than subjects consuming a carnivorous diet less rich in meat. Moreover, vegetarians have a lower quality of life regarding “social relationships” than individuals eating a carnivorous diet rich in fruits and vegetables, or those with a carnivorous diet less rich in meat (p=.043). All results are shown in Table 4.

Table 4
Differences in quality of life between the different dietary habit groups.

Discussion

Overall, our findings reveal that vegetarians report poorer health, follow medical treatment more frequently, have worse preventive health care practices, and have a lower quality of life. Concerning the variable “eating behavior”, we tried to generate a variable that would reflect the animal fat intake (1=vegetarian, 2=carnivorous diet rich in fruits and vegetables, 3=carnivorous diet less rich in meat, 4=carnivorous diet rich in meat). The mean BMI of subjects is coupled in nearly linear progression with the amount of animal fat intake. This is in line with previous studies showing vegetarians to have a lower body mass index [1], [4], [5], [7], [9]–[12].

Our results have shown that vegetarians report chronic conditions and poorer subjective health more frequently. This might indicate that the vegetarians in our study consume this form of diet as a consequence of their disorders, since a vegetarian diet is often recommended as a method to manage weight [10] and health [46]. Unfortunately, food intake was not measured in more detail, e.g. caloric intake was not covered. Hence, further studies will be necessary to analyze health and its relationship with different forms of dietary habits in more detail.

When analyzing the frequency of chronic diseases, we found significantly higher cancer incidence rates in vegetarians than in subjects with other dietary habits. This is in line with previous findings, reporting that evidence about cancer rates, abdominal complaints, and all-cause mortality in vegetarians is rather inconsistent [5]–[7], [19]–[22]. The higher cancer incidence in vegetarians in our study might be a coincidence, and is possibly related to factors other than the general amount of animal fat intake, such as health-conscious behavior, since no differences were found regarding smoking behavior and physical activity in Austrian adults as reported in other studies for other countries [9], [13], [14]. Therefore, further studies will be required in Austria in order to analyze the incidence of different types of cancer and their association with nutritional factors in more depth.

Several studies have shown the mental health effects of a vegetarian diet to be divergent [9], [15], [16]. Vegetarians in our study suffer significantly more often from anxiety disorder and/or depression. Additionally, they have a poorer quality of life in terms of physical health, social relationships, and environmental factors.

Moreover, the use of health care differs significantly between the dietary habit groups in our study. Vegetarians need more medical treatment than subjects following another form of diet. However, this might be due to the number of chronic conditions, which is higher in subjects with a vegetarian diet.

Among the strengths of our study are: the large sample size, the matching according to age, sex, and socioeconomic background, and the standardized measurement of all variables. Other strengths of our study include considering the influence of weight and lifestyle factors on health, e.g. physical exercise and smoking behavior.

Potential limitations of our results are due to the fact that the survey was based on cross-sectional data. Therefore, no statements can be made whether the poorer health in vegetarians in our study is caused by their dietary habit or if they consume this form of diet due to their poorer health status. We cannot state whether a causal relationship exists, but describe ascertained associations. Moreover, we cannot give any information regarding the long-term consequences of consuming a special diet nor concerning mortality rates. Thus, further longitudinal studies will be required to substantiate our results. Further limitations include the measurement of dietary habits as a self-reported variable and the fact that subjects were asked how they would describe their eating behavior, without giving them a clear definition of the various dietary habit groups. However, a significant association between the dietary habit of individuals and their weight and drinking behavior is indicative for the validity of the variable. Another limitation concerns the lack of detailed information regarding nutritional components (e.g. the amount of carbohydrates, cholesterol, or fatty acids consumed). Therefore, more in-depth studies about nutritional habits and their effects on health are required among Austrian adults. Further studies should e.g. investigate the influence of the various dietary habits on the incidence of different cancer types. To our knowledge this is the first study ever in Austria to analyze differences in terms of dietary habits and their impact on health. We admit that the large number of participants made it necessary to keep the questions simple, in order to cover the large sample. Overall, we feel that our results are of specific interest and contribute to extant scientific knowledge, notwithstanding some limitations regarding causes and effects.

Conclusions

Our study has shown that Austrian adults who consume a vegetarian diet are less healthy (in terms of cancer, allergies, and mental health disorders), have a lower quality of life, and also require more medical treatment. Therefore, a continued strong public health program for Austria is required in order to reduce the health risk due to nutritional factors. Moreover, our results emphasize the necessity of further studies in Austria, for a more in-depth analysis of the health effects of different dietary habits.

Funding Statement
The authors have no support or funding to report.

References available at the PLoS ONE site.

Rediscovering the Unconscious with Daniel Kahneman

Princeton psychologist and 2002 Nobel Prize winner Daniel Khaneman recently was in conversation with Walmsley University (Harvard law School) Professor Cass Sunstein at Harvard University. I haven't found any video of it, but here is a summary from Harvard magazine. Kahneman is the author most recently of Thinking, Fast and Slow (2011); Sunstein is co-author of Nudge: Improving Decisions About Health, Wealth, and Happiness (2009) and more recently is the author of Simpler: The Future of Government (2013)

Rediscovering the Unconscious

From left: Daniel Kahneman and Cass Sunstein
Posted 2.3.14

Intuition, happiness, and memory were the topics on the table Monday night as Princeton psychologist Daniel Kahneman, LL.D. ’04, discussed his work on human judgment and cognitive bias, which won him a share of the 2002 Nobel Prize in economics. In conversation with Walmsley University Professor Cass Sunstein, Kahneman considered implications of and modifications to his theory of heuristics—the trial-and-error process of learning—popularized in his 2011 bestseller, Thinking, Fast and Slow.

The work began, said Kahneman, as “a series of accidents.” At Hebrew University of Jerusalem, fellow researcher Amos Tversky told Kahneman about some research on decisionmaking that suggested human behavior was reasonably rational, displaying a good intuitive grasp of statistics—a conclusion that seemed to contradict Kahneman’s own experiences. The ensuing discussion led to a lengthy collaboration, as the two delved into the realities of how people assign probabilities to events and think when facing uncertainty. That research would prove formative for the modern field of behavioral economics. (Tversky, who died in 1996, was ineligible to share the Nobel Prize.)

“When you try to answer a question,” said Kahneman, “you sometimes answer a different question.” In a seminal 1979 paper, he and Tversky described a series of experiments that questioned the classical economic assumption of “homo economicus,” a rational actor motivated by self-interest. In its place, they defined what they termed prospect theory, a description of the mental shortcuts, or heuristics, that guide people’s everyday decisions, as well as the systematic biases that could result from them. “A heuristic,” Kahneman explained, “is just answering a difficult question by answering an easy one.” When asked, for instance, the number of divorces at one’s university, one might substitute the question of how easy it is to think of examples of divorces, a heuristic Kahneman and Tversky dubbed “availability.” “Evaluation happens in a fraction of a second,” Kahneman said. Reflecting on this theory’s place in the history of psychology, he noted, “In the last 20 years, [psychologists] have rediscovered the unconscious…but it didn’t come from Freud. It came from experimental psychology.”

Kahneman added several new heuristics to the original three—availability, representativeness, and framing—that he and Tversky had initially defined. The “affect” heuristic, a measure of emotion, is central to how people make decisions regarding issues like genetically modified organisms or endangered wildlife: emotions circumvent rational cost-benefit analysis. He also called into question the “framing” heuristic, which describes how people’s answers can be influenced by irrelevant numbers; for instance, he and Tversky had observed that subjects who were asked whether the tallest redwood was taller or shorter than 1,200 feet gave different answers when the reference point was changed to 80 feet. While acknowledging that the exact classification of the “framing” phenomenon was a matter of “inside baseball,” Kahneman said his own thinking had changed. He argued that framing was a more deliberate, strategic mechanism than the genuinely intuitive heuristics; it “doesn’t fit the description of substituting something for something else.”

Similar heuristics affect people’s perceptions of happiness, Kahneman continued. Rather than remembering the entirety of an experience, he said, people rate their overall happiness based on their moment of peak happiness and their emotional state at the experience’s end. Early on, he sought to explore this conundrum; he used “experience sampling” techniques developed in other fields to ask subjects to rate their happiness in real time—using, for instance, phone surveys asking, “How happy are you right now?”—rather than relying on retrospective evaluations. “I thought this was really the most important,” he recalled. “Whether people are happy in their life is more important than how happy they are when they think about their life.” But his opinion has changed; he now thinks that retrospective impressions also influence decisionmaking. “It turns out that when people make plans for the future, they’re not trying to maximize the quality of their [actual] experience,” he said. “In a way, when you think about the future, you’re maximizing the quality of your anticipated memories.”

In response to audience questions—several hundred people filled Harvard Business School’s Burden Auditorium to hear the psychologist speak—Kahneman affirmed his support for applying behavioral economics to public policy, an approach championed by Sunstein and University of Chicago economist Richard Thaler in their book Nudge: Improving Decisions about Health, Wealth, and Happiness. “We don’t know much,” Kahneman acknowledged, “but we know a few things, and we know a few things that can be good to use.”

In his own life, though, the scholar admitted that he is as prone to cognitive biases and errors of judgment as anyone else. “When we were studying biases and errors of judgment, we were studying our own,” he said. With humorous regret, he added, “I’ve been doing that for 25 years now, and I think I haven’t improved at all.”

Researchers at the University of Arizona (here in Tucson) have been identifying where language centers lie in the brain and how they can formulate therapies to restore function after those areas are damaged in stroke (or otherwise).

Pélagie Beeson, professor and head of Dept. of Speech Language and Hearing at the University of Arizona, will be speaking tonight as part of the UA College of Science’s series “The Evolving Brain.” These talks are FREE and therefore quite popular - get there early for good seating.

You can teach a damaged brain new tricks

Courtesy UA - Pélagie Beeson, professor and head of Dept. of Speech Language and Hearing at the University of Arizona.

February 11, 2014
By Tom Beal

Like much of what we know about the brain, knowledge of the areas involved in spoken and written language comes mainly from studying the loss of those abilities to trauma or disease.

Pélagie Beeson, who studies the neural substrates of written language, will talk Monday about “The Literate Brain.” She will describe where those language centers lie and how she and her colleagues formulate therapies to restore function after those areas are damaged.

The lecture, part of the UA College of Science’s series “The Evolving Brain,” is at 7 p.m. in Centennial Hall on the University of Arizona Mall. [See below for more info.]

Beeson is a professor and head of the Department of Speech, Language and Hearing Sciences at the University of Arizona, with a joint appointment in the Department of Neurology.

Speech and writing problems usually develop after damage to the left hemisphere of the brain, though a small number of people (usually left-handers) develop those skills in the right hemisphere, she said.

Through years of cataloging symptoms and imaging the brain, specialists such as Beeson and her research group have developed a pretty good understanding of where those centers are and can usually predict, before the brain is imaged, where the damage has occurred, based on symptoms.

Beeson’s Aphasia Research Project sees clients at least six months and sometimes years or decades after loss of speech or writing function.

That six-month period, during which there is ongoing therapy, is also the period in which the brain repairs itself to the extent that it can.

Subjects can continue to improve through behavioral therapy by harnessing other, usually nearby, parts of the brain, to perform functions previously performed by damaged cells, she said.

This is especially true for younger patients, whose “elastic” brains can often develop language capabilities in the right hemisphere, Beeson said. That elasticity vanishes with youth.

Aphasia is the term applied to the acquired impairment of language, usually after stroke or trauma, but sometimes occurring with progressive neurological diseases.

It can be spoken, written or both. The acquired impairment of reading is known as alexia, and the impairment of spelling and writing is called agraphia.

Researchers in the UA’s Aphasia Research Project have developed an algorithm called a “decision tree” that personalizes treatment based on symptoms and performance on a battery of tests.

Functional Magnetic Resonance Imaging of the brain, during which a subject performs reading and writing tasks, further refines the picture of the impairment by allowing researchers to see what parts of the brain “light up” when certain tasks are performed.

Those who suffer a stroke or brain injury have a wide variety of aphasia symptoms — ranging from those who have no understandable speech to those who talk easily and form sentences but “can’t pull up the right word,” Beeson said.

Beeson said she’s never had to advertise for subjects for her research.

She receives a steady stream of referrals from neurologists and therapists in the Tucson area and from elsewhere in the country.

Her department recently kept its No. 5 spot in the annual U.S. News and World Report ranking of speech-language pathology programs.

Part of the center’s charge is to spread the word about new therapies through publishing results and reporting them at conferences, she said.

Promulgation of the latest therapies is part of the charge given by the National Institute on Deafness and Other Communication Disorders, one of the National Institutes of Health, which partly funds the research.

If you go

What: The UA College of Science 2014 lecture series on "The Evolving Brain."
When: Mondays at 7 p.m.
Where: Centennial Hall, 1020 E. University Boulevard 1020 E. University (campus mall east of North Park Ave.)
Admission: Free
Parking: (Fee charged) Tyndall Avenue Garage, between North Tyndall and North Park avenues south of University Boulevard.
Information: Call 520-621-4090621-4090cq

• Feb 17 (Monday): "The Literate Brain" by Pélagie M. Beeson, professor and head of Speech, Language and Hearing Science
• March 3: "The Ancestors in Our Brains" by Dr. Katalin M. Gothard, associate professor of Physiology, Neurobiology, and the Evelyn F. McKnight Brain Institute
• March 10: "More Perfect Than We Think" by William Bialek, the John Archibald Wheeler/Battelle Professor in Physics, Princeton University

Ann Hamilton — Making, and the Spaces We Share (On Being)

From NPR's On Being, this episode features Ann Hamilton, who is a visual artist and self-described "maker." She is Distinguished University Professor in the Department of Art at Ohio State University.

From her website:

Ann Hamilton is a visual artist internationally recognized for the sensory surrounds of her large-scale multi-media installations. Using time as process and material, her methods of making serve as an invocation of place, of collective voice, of communities past and of labor present. Noted for a dense accumulation of materials, her ephemeral environments create immersive experiences that poetically respond to the architectural presence and social history of their sites. Whether inhabiting a building four stories high or confined to the surface of a thimble, the genesis of Hamilton's art extends outwards from the primary projections of the hand and mouth. Her attention to the uttering of a sound or the shaping of a word with the hand places language and text at the tactile and metaphoric center of her installations. To enter their liminality is to be drawn equally into the sensory and linguistic capacities of comprehension that construct our faculties of memory, reason and imagination.

Cool stuff - enjoy the conversation.

Ann Hamilton — Making, and the Spaces We Share

February 13, 2014

The philosopher Simone Weil defined prayer as “absolutely unmixed attention.” The artist and self-described maker Ann Hamilton embodies this notion in her sweeping works of art that bring all the senses together. She uses her hands to create installations that are both visually astounding and surprisingly intimate, and meet a longing many of us share, as she puts it, to be alone together.

Listen

• Radio Show/Podcast  (mp3, 51:00)
• Unedited Interview » Ann Hamilton  (mp3, 87:05)
• Transcript

Voices on the Radio

Ann Hamilton is a visual artist and self-described maker. She is Distinguished University Professor in the Department of Art at Ohio State University.

Production Credits

• Host/Executive Producer: Krista Tippett
• Head of Content: Trent Gilliss
• Technical Director: Chris Heagle
• Senior Producer: Lily Percy
• Associate Producer: Mariah Helgeson

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From The Brain Channel on UCTV, a production of the UC San Diego Department of Neurosciences. This episode looks at the use of deep bran stimulation (DBS) in the treatment of various brain disorders, including Parkinson's Disease.

There is considerable research suggesting that DBS is a much more targeted and effective way of treating depression and bipolar disorder. Below the video there is some overview of the use of DBS from the American Association of Neurological Surgeons.

Michael Okun, MD - Lessons Learned in the Electric Brain

Published on Feb 13, 2014 
(Visit: http://www.uctv.tv/) Michael Okun, MD discusses the processes and prospects for deep bran stimulation (DBS). Learn about why we apply electricity to the brain, how DBS works, and how we can use DBS to treat conditions such as Parkinson's Disease. Series: "The Brain Channel"

 * * * * *

Deep Brain Stimulation

April, 2007 

Deep Brain Stimulation (DBS) has been used to treat intractable pain for several decades. More recently, use of this technology has proven to be a safe and effective treatment for essential tremor, as well as tremor and involuntary movements associated with Parkinson’s disease, dystonia and multiple sclerosis, with more than 35,000 DBS implants worldwide. The applications for DBS therapy are expanding rapidly.

The procedure is comparable to that of a cardiac pacemaker in which the pacemaker helps maintain an appropriate cardiac rhythm. DBS is presumed to help modulate dysfunctional circuits in the brain so that the brain can function more effectively. This is accomplished by sending continuous electrical signals to specific target areas of the brain, which block the impulses that cause neurological dysfunctions. These targets are the ventralis intermediate nucleus of the thalamus (Vim), the globus pallidus pars interna (GPi), and the subthalamic nucleus (STN).

The DBS system consists of three components:

• The lead (also called an electrode) is a thin, insulated wire inserted through a small opening in the skull and implanted in the brain.
• The extension is an insulated wire that is passed under the skin of the head, neck, and shoulder, connecting the lead to the internal pulse generator (IPG).
• The IPG or neurostimulator is the third component and is usually implanted under the skin near the collarbone. In some cases it may be implanted in the chest or under the skin over the abdomen.

A small opening is made in the skull under a local anesthetic. The patient is awake during the DBS surgery to allow the surgical team to assess his or her brain functions. While the lead (electrode) is being advanced through the brain, the patient does not feel pain because of the human brain’s unique inability to generate pain signals. Computerized brain-mapping technology is utilized to pinpoint the precise location in the brain where nerve signals generate the tremors and other symptoms. Highly sophisticated imaging and recording equipment are used to map both the physical structure and the functioning of the brain. The electrodes are connected via wires to an internal pulse generator (IPG) that is placed in the chest wall. 

A magnet is used with the IPG to adjust the stimulation parameters so that the appropriate level of stimulation is applied at the electrode tip. The patient is provided with an access control device or handheld magnet to turn the IPG on and off at home. Depending on the application, the battery can last three to five years. When the battery needs to be replaced, the IPG is also replaced, usually under local anesthesia as an outpatient procedure.

DBS Surgery Advantages

• Surgery can be performed on both sides of the brain for control of symptoms affecting both sides of the body.
• The effects are reversible and can be tailored to a patient’s clinical status.
• Stimulation parameters can be adjusted to minimize potential side effects and improve efficacy over time.
• The device can provide continuous symptom control 24 hours a day.
• Patients who have undergone DBS are still candidates for other treatment options such as stem cell or gene therapy when they become available.

DBS Surgery Risks

In properly selected patients, DBS is quite safe and effective, but there are some risks. There are also potential side effects, although they are generally mild and reversible. There is an estimated 2-3 percent risk of brain hemorrhage that may either be of no significance, or may cause paralysis, stroke, speech impairment or other major problems. There is a small risk of leakage of cerebrospinal fluid, which can lead to headaches or meningitis. There is a 15 percent risk of a minor or temporary problem associated with implantation, including infection. While treatment of infection may require removal of the electrodes, the infection itself does not cause lasting damage.

Side effects may include the following:

• Temporary tingling in the face or limbs
• Temporary pain/swelling at implantation site
• Allergic reaction to the implant
• Slight paralysis
• Speech or vision problems
• Jolting or shocking sensation
• Loss of balance
• Dizziness
• Reduced coordination
• Concentration difficulties

The electrodes and electrical systems that provide stimulation are generally very well tolerated with no significant changes in surrounding brain tissue. Migration of the electrode from the original implantation site may occur. There also may be temporary rebound worsening of the tremor when stimulation is stopped. Surgery risks increase in people age 70 and older, and in those with other health conditions such as cerebrovascular disease and high blood pressure. The benefits of surgery should always be weighed carefully against its risks. Although a large percentage of patients report significant improvement after DBS surgery, there is no guarantee that surgery will help every individual.

Parkinson’s Disease

Early in Parkinson’s disease (PD), there is a loss of brain cells that produce the chemical dopamine. Normally, dopamine operates in a delicate balance with other neurotransmitters to help coordinate the millions of nerve and muscle cells involved in movement. Without enough dopamine, this balance is disrupted, resulting in tremor (trembling in the hands, arms, legs and jaw); rigidity (stiffness of the limbs); slowness of movement; and impaired balance and coordination – the hallmark symptoms of PD.

DBS of the STN has increasingly been recognized as an effective treatment for patients with medically intractable PD because of its demonstrated safety and efficacy. It provides consistent clinical benefit and can reduce dopamine replacement therapy requirements by 50 to 70 percent. While DBS provides symptomatic relief, it does not slow or reverse the underlying neurodegenerative process of PD.

Appropriate candidates for DBS should have moderate to severe medically intractable Idiopathic PD, as diagnosed by a neurologist experienced in movement disorders. The disease should be present for at least three years with two or more of the four hallmark symptoms mentioned above before DBS is considered. Other indicators for DBS are when there are motor response complications or medication side effects from multiple medical therapy options including levodopa, and medication adjustments have not alleviated the complications/side effects.

Other Conditions
 
Dystonia

Current research demonstrates that DBS at the GPi significantly improves symptoms of torsion dystonia in the majority of patients treated. DBS appears to be more effective in patients with primary dystonia than secondary dystonia, most likely due to the absence of structural brain abnormalities. Unlike PD, which responds soon after the onset of stimulation, dystonia may require weeks of stimulation before an improvement is evident. Moreover, the full benefit of stimulation may not be realized for 12-18 months after the onset of therapy. Complications thus far have been minor and few.
 
Multiple Sclerosis

The main goal of performing DBS in multiple sclerosis (MS) patients is to control arm tremor. While tremor of the head and body may be helped, the decision to perform DBS should be aimed at decreasing arm tremor. Other MS symptoms such as loss of vision, sensation or strength are not helped by DBS, nor will this cure, reverse or slow the progression of the disease.

Severe Psychiatric Disorders

Preliminary research has demonstrated that DBS results in significant improvement in mood, memory recall, as well as reductions in anxiety, obsessions and compulsions in select patients with both OCD and treatment resistant depression (TRD).To date, this treatment has been undertaken on a small number of patients in clinical trials and is not widely available. However, findings are promising enough to indicate the need for more extensive studies to further understand how DBS enables these improvements.