Massive new study confirms higher BMI linked with serious increase in multiple diseases in the UK

In a brand-new study released today (29th April 2019), scientists from Novo Nordis have confirmed that people living in the UK who are overweight or obese are more likely to experience a wide variety of life-threatening diseases. This cutting-edge research was revealed at the 2019 European Conference on Obesity, held in Glasgow this week. 60% of the UK population are classified as overweight or obese by BMI, or body mass index1.

BMI is calculated by comparing weight to height, and is commonly used as an indicator of total body health. A ‘healthy’ range is 18-24, and BMI of over 25 is considered overweight. 30 and above is classified as ‘obese’, 35-40 is obesity class II, and 40-45, the most seriously obese group, is obesity class III2.

Researchers found that people with a BMI greater than 25 are far more likely to experience comorbid diseases, directly rising from their weight. This includes type-2 diabetes; cardiovascular difficulties such as angina, heart failure, sleep apnoea, and stroke; and certain types of cancers. 

This study used anonymous data gathered from General Practitioner’s databases (the ‘UK Clinical Practice Research Datalink’) from January 2000 to July 2018, as opposed to data from clinical trials. Clinical trials are highly selective and often have a low sample size, and frequently exclude specific members of the public, like pregnant women and those with certain illnesses. As clinical trial participation is voluntary, people involved may have a greater level of health literacy, compared to a large study like this. This study used 2.8 million anonymous people’s data to ascertain the risks between weight and disease. This sample was representative of the UK’s population, and the average age for participants was 51.

Compared with ‘healthy’ weight individuals, individuals falling into the ‘obese’ bracket are 5 times more likely to develop type 2 diabetes and sleep apnoea, and these risks are 8 and 14 fold higher in those with classes II or III obesity respectively. Class III obese individuals have triple the risk of heart failure and high blood pressure. Perhaps most shockingly, these individuals are at a 50% higher risk of dying prematurely, which is “phenomenally high”.

“Comparing BMI risk across a large number of outcomes in the same large population sample suggests that risk levels associated with BMI are different for different health outcomes. The health risks linked with having excess body weight are particularly high for type 2 diabetes and sleep apnoea”, says author Christiane Haase from Novo Nordisk, Denmark. “With the number of people living with obesity almost tripling worldwide over the past 30 years (105 million people in 1975 to 650 million in 2016), our findings have serious implications for public health. Body mass index represents an important modifiable risk factor for ameliorating the risk of a wide variety of serious health problems in the general population.”

Nick Finer of Novo Nordisk showing the group’s research efforts. Credit: Emily May Armstrong

Most importantly, the development of new disease over the course of the study was highly dependent on if the patient had any pre-existing diseases at the beginning of the study. For example, a history of heart problems doubles the risk of future heart attack, stroke, and heart failure.

The authors are keen to underline that correlation does not necessarily equal causation. If a member of the study visited their GP and had their BMI recorded, they may be experiencing illness or disease symptoms, as people in good health are less likely to visit their GP. This bias may skew the final results of the study. 

This study eclipses previous research efforts into the link between weight and disease in the UK, because of its size, scope, and detail. It will inform and steer how healthcare professionals in the UK approach obesity as a disease, allowing holistic treatment and improving patient outcomes.

This article was edited by Kirstin Leslie.

References

  1. https://www.nhs.uk/live-well/healthy-weight/bmi-calculator/
  2. https://www.cdc.gov/obesity/adult/defining.html

Objectification of Disability in 2018

My Ehlers Danlos and Postural Orthostatic Tachycardia Syndrome mean I’m often awake at odd times of the day. My shoulders roll out, a rib slips, and I’m awake until the pain dies down. My wrist had popped out, and at 4am on Wednesday the 14th of March 2018, a little Guardian notification popped up on my phone, telling me Stephen Hawking had passed away at the age of 76. I sat, resolved in deep thought about a man who was my largest role model, for both his meteoric scientific achievements and his normalisation of disability. I realised that this was a make-or-break moment in journalism: how ableist could it possible get?

In Stephen Hawking’s death I was hoping to see a celebration of his scientific achievements; a fantastic chance for his theories to be explained accessibly to the masses. A moment to re-ignite the world’s attention and love of scientific pursuits. Instead, I ­was greeted with a barrage of ignorant, belittling, and outright rude recantations of his life.

Steven Hawking in the 1980s

For those not au fait with the term ‘abelism’, it’s much like racism or sexism: “discrimination in favour of able-bodied people.” It’s fetishization, bias, ‘inspiration porn’, bravery. It’s everything I, as a disabled woman in 2018, am profoundly against. I’m going to use the social model of disability: or ‘disabled-person’, and I believe we are disabled only by society’s responses to our bodies; not by our bodies themselves.

Disabled people are put on a pedestal. We’re rewarded for basic, and boring functioning. A disabled person, in my eyes, isn’t brave for going about their day to day lives. I am not brave for coming into work the day after a major hip dislocation and A&E visit. If anything, I’m an absolute idiot.

In the gym with my crutch, physio bands & 24 holter monitor.

Disabled people are not brave for getting up, brushing their teeth, or doing their food shopping. A disabled person is brave for running into traffic to save a cat. Or intervening in a hate-crime. Or sustaining years of medical malpractice at the hands of ignorant doctors. If you think I’m brave for remembering what day it is when I wake up, then I’d suggest you have a bit of a reality check. I was brave for persevering through 10 years of incorrect diagnoses. I am brave for standing up and calling people out on their bullshit.

Bravery leads to ‘inspiration porn’. Ever heard the phrase “The only disability in life is a bad attitude”? As Stella Young points out on her 2012 TEDX talk, “no amount of smiling at a flight of stairs has ever made it turn into a ramp.” She’s not wrong.

https://upload.wikimedia.org/wikipedia/commons/f/fa/Stella_Young.jpg

Stella Young in 2012, a disability rights activist, comedian, and journalist.

I’ve been called inspirational multiple times, in many different circumstances. I’d be much happier if people were applauding my academic prowess, my photography skills, or my progress in skateboarding. (Yes, disabled people can skateboard). Instead I’m reduced to a set of symptoms, pathologies, and hospital visits. This of course isn’t always the offenders fault, it’s years of socialisation and normalisation. Disabled people often exist within abled spaces purely to inspire hope, overcoming, and perseverance. Maybe I should look at becoming a de-motivational speaker. There are plenty of inspirational women out there;  and I’d like to join their ranks one day – but for now I’m just a woman going about her daily business trying to study.

I speak so openly about being a disabled woman in science because, well, I’m a disabled woman in science. There’s virtually none of us out there and speaking about it. We are invisible, imaginary, and crossing multiple intersections with very little for it. Disabled people, as a whole, are hidden away. How many disabled doctors, manicurists, teachers, dog walkers do you know of? Probably very few.

Why’s that? Because the society we live in prevents disabled people from achieving what they intend to do. Disabled people often end up in poverty because abled-bodied people don’t understand or believe they can be anything else but disabled. We are painted as frauds, scroungers, cheats, fakes. We are often not allowed to become productive members of society, because of abled people’s prejudice. I only fit into this ‘achievement’ narrative because I, like Stephen Hawking, was privileged enough to have access to higher education.

one of the ableist images floating around Twitter: depicting Hawking’s leaving his chair.

Disabled people’s narratives are constantly erased in favour of ‘overcoming’ their problems. It breaks my heart when I see my friends get excited that my crutches didn’t accompany me to the pub/club/social situation, “Oh! You don’t have your crutch! That’s excellent!” they proudly exclaim. What they don’t realise is that they are effectively erasing a massive part of my life. They want to see me be not disabled. They (subconsciously) believe that disability is de facto wrong, bad, and sad. And that’s not their fault, we are socialised to see disability as a big fat sad thing.

In fact, being disabled has done nothing but enrich my life. It drives me to push myself to my limits. To constantly achieve, succeed, and exceed others expectations. I have no idea who I’d be without my disability, and I have no interest in finding out.

Stephen Hawking was not “bound to his wheelchair”. You don’t call someone with glasses and “lens bound”, so why say that about another tool people use to improve their lives? His wheelchair was his freedom, just like my crutches are. Stephen Hawking did not “suffer from” ALS. He lived with it. Just like I don’t “suffer from” my Ehlers-Danlos. I live with it. What I do frequently suffer from is able bodied nonsense and a society built against me. Stephen Hawking was not “inspirational” for living his life in a way different to able-bodied narratives. He was inspirational for being a ground-breaking physicist, and dedicated voice of reason. He was also a misogynist, and there’s nothing inspirational about that.

Here’s some excellent think-pieces on how Hawking’s death has been portrayed in the media

Ace Ratcliff (a fellow EDS, POTS/DYS & MCASer) wrote this amazing article on HuffPost

Alia breaks down some of the best tweets about the matter on USAtoday

Nicole on Mashable picks apart Gal Gadot’s problematic language

Keah Brown lays down the truth on TeenVogue

Frances Ryan dissects disability discussion on The Pool

Plant-based biomaterials: engineering the future

I’m lucky enough to have been invited to write for The Biochemist Blog – an online sister publication to their popular in print magazine.

This edition they’re discussing biomaterials, so I jumped on board to share the newest insights into plant tissue engineering and repurposing in biology today.

You can find the article here.

I discuss apple pectins as bone in-growth promoters in dental implants, apple derived cellulose as a scaffold for cell colonisation, and re-purposing spinach leaves as a scaffold for heart tissue growth.

I’d love to hear your feedback!

Meet The Scientist

I was featured in Erica’s ‘Meet the Scientist’ series. Check it out for my thoughts on disability, changing the old-boys-network of science into something more accessible, and what I get up to with my spare time.

A scientist called Erica

Hello everyone and welcome to the latest “Meet the scientist”!

In this series I wanted to show you the range of research being undertaken by PhD students across the country- specifically in the area of Plant science, and shine a light on the secret world of the PhD student. The scientists showcased in this series are all amazing scientists and role models, and will be sharing their stories about life as a Scientist- I hope they interest and inspire you!

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HOW TO: deal with failure in a PhD

I’m writing this as I’m sat in the postgrad office of the Plant Science Department at the University of Warwick. This trip, including reagents, time, hotels, food, and travel, has cost well over £1000 for five days. I’m writing this because my experiment, which I’ve been planning for over 4 months, is no longer viable because of an equipment failure. I’m writing this because I need to remind myself not to beat myself up about something outside of my control. I’m also writing this because if I stress eat any more yoghurt, I will become yoghurt.

There’s no two ways about it, PhD’s are no walk in the park, even for the most experienced and innovative researcher. What works one day might completely stop working the next (and for forever), and it can seem completely overwhelming when everything grinds to a halt. Whether it’s writer’s block, literature overload, or equipment failure, there’s nearly always a way to fix it.

I’ve summed up some of my tips for researchers for successfully navigating equipment failure, result crises, and most importantly, the often crippling self-doubt which invariably accompanies research.

Practical solutions to impractical problems

  • The problem: When well-optimised experiments fail.

It is infuriating when a perfectly optimised and easy-to-follow experiment just stops working. It’s very easy to blame it on the direction of the wind, the day of the week, or an undergraduate. It’s definitely a lot less easy to logically trouble-shoot.

The solutions: draw the steps you normally take to prepare your experiment on a blank page in your lab book. The reagent preparation steps, the centrifugation & mixing steps, the volumes you need, and what you do with them. What temperature do reagents need to be stored at? What kits do they come from? This logical flow chart will show you which crucial steps could determine experimental success, and will provide a handy visual how-to for any future students.

Now you know the workflow off by heart, investigate your reagents one-by-one. Are they being stored in the right temperature or darkness? Are they way past their expiry date? Have they mysteriously reappeared after someone else used them? Has the kit changed slightly or call for a new buffer? Logically interrogate every single variable, and more often than not, you’ll find the culprit. If everything seems in order, ask a more senior researcher, or field your question to useful forums like Bitesize Bio or ResearchGate.

Science is about trial-and-error, and there’s almost definitely someone else out there who can help solve your problem. Or, it may be down to…

  • The problem: Equipment keeps breaking.

On an equal par with experimental failure, broken equipment is impossibly annoying. Thermocycler shut down? UV visualiser for gels broken? Spectrophotometer giving you ridiculous readings? Plant growth-room overheated for the 18th time this week? Take a deep breath.

The solutions: Check with other lab members: are you the first person to experience this problem? If not, someone else might have an innovative work-around that doesn’t compromise your results. Is there another version of the equipment somewhere in your department? Contact the people who own it and dialog with them, they might well be able to sort you out. Contact your technician too, they are invaluable in times of need and will be able to arrange a repair. Most importantly, try not to beat yourself up over it, equipment isn’t psychic and doesn’t know when your big deadline or supervisor meeting is.  If you’re in a large department, see if you, or a technician, can make a list of all equipment available for open use with correct training. It’ll save you in a pinch.

  • The problem: You have results (and have successfully navigated protocol failure and broken equipment), but they are either negative, or entirely meaningless.

The solution: A result is still a result. It’s still a brand new piece of information you didn’t previously have, or wasn’t previously known. The gene you expected to see upregulated under your specific test condition isn’t? Well, you know something you didn’t know before. Science is hypothesis driven, and we need to test our hypotheses to breaking point. Believe it or not, any information is better than none, no matter how frustrating it is. Is there a way this result can be applied to your research, can you explain why it’s happening? If not, then tell your supervisor and try and come up with a new way to find your answer, as infuriating as it may be at the time.

  • The problem: You are doubting your ability as a researcher. Nothing you have tried has worked, and your experiments keep failing. You are struggling to stay motivated and keep your head above water.

The solution: Take a break. It could be a 10 minute break. It could be a 10 day break. Whatever it is, gift yourself some distance, reflection, and wallowing. Constructive wallowing (which I am currently doing by writing this post instead of doing the experiments I should be) can be a relatively productive way to process the issue (my experiment didn’t work, but that’s okay, we can do it again, even if it costs another £1000.) Constructive wallowing only works you’re able to pick yourself back up after your allotted downtime. If you find yourself entirely demotivated, depressed and stressed, then it might be time to take a course of more serious action.

It’s very important to open a dialog with your supervisor or a member of your advisory panel in this instance, they can impart their years of advice, and steer you in the right direction. This is a lot harder if you’re also suffering from Absent Supervisor Syndrome, but you should still reach out with those who’ve completed their PhD.

Coping with feelings of doubt and imposter syndrome are very hard to manage, but everyone in their research career has experienced moments of this, even your esteemed supervisor. Try and talk to other members of your lab over a coffee, ask them about their biggest ‘what if I’m not good enough’ moments. Get their advice, and see how you can adapt your practices with peer reviewed techniques.

If you’ve tried all of the above, and are really not coping with your workload or failed experiments, contact your University’s mental health services. Most universities offer a 6-week intensive course to help you manage stress and anxieties arising directly from your research and workload. If you already have a pre-existing mental health condition, you may be able to use evidence from your GP to get you more long-term, university-oriented support. I’m lucky enough to have a mental health advisor who helps me manage my workload and research activities.

These are all well and good, but if you feel like you’re at your wits end and really need an intervention, you should contact your GP. They may be able to refer you to NHS services to guide you on your way to better coping mechanisms through active, intensive therapy. This may seem like a pretty big leap to make, but it’ll help you excel in your PhD research if it’s really what you need.

To sum, PhDs can often feel like a trial by fire, and problem-solving and trouble shooting is naturally part of the experience. But that doesn’t stop us from responding negativelyto the situations we can find ourselves in. So, what tips do you have for navigating failures in your line of work? Are they common or rare? What would you share with your younger self? I’m going to enjoy my break away from Glasgow, the English sunny skies and the really tasty coffee from the canteen.