Tag: obesity

  • What I’ve Changed My Mind on Over the 2010s

    I’ve been reading a lot of year-end/decade-end reflections (as one does this time of year) — and while a part of me wanted to #humblebrag about how I got a 🏠/💍/👶🏻 this decade 😇 — I thought it would be more interesting & profound to instead call out 10 worldviews & beliefs I had going into the 2010s that I no longer hold.

    1. Sales is an unimportant skill relative to hard work / being smart
      As a stereotypical “good Asian kid” 🤓, I was taught to focus on nailing the task. I still think that focus is important early in one’s life & career, but this decade has made me realize that everyone, whether they know it or not, has to sell — you sell to employers to hire you, academics/nonprofits sell to attract donors and grant funding, even institutional investors have to sell to their investors/limited partners. Its a skill at least as important (if not more so).
    2. Marriage is about finding your soul-mate and living happily ever after
      Having been married for slightly over half the decade, I’ve now come to believe that marriage is less about finding the perfect soul-mate (the “Hollywood version”) as it is about finding a life partner who you can actively choose to celebrate (despite and including their flaws, mistakes, and baggage). Its not that passionate love is unimportant, but its hard to rely on that alone to make a lifelong partnership work. I now believe that really boring-sounding things like how you make #adulting decisions and compatibility of communication style matter a lot more than things usually celebrated in fiction like the wedding planning, first dates, how nice your vacations together are, whether you can finish each other’s sentences, etc.
    3. Industrial policy doesn’t work
      I tend to be a big skeptic of big government policy — both because of unintended consequences and the risks of politicians picking winners. But, a decade of studying (and working with companies who operate in) East Asian economies and watching how subsidies and economies of scale have made Asia the heart of much of advanced manufacturing have forced me to reconsider. Its not that the negatives don’t happen (there are many examples of China screwing things up with heavy-handed policy) but its hard to seriously think about how the world works without recognizing the role that industrial policy played. For more on how land management and industrial policies impacted economic development in different Asian countries, check out Joe Studwell’s book How Asia Works
    4. Obesity & weight loss are simple — its just calories in & calories out
      From a pure physics perspective, weight gain is a “simple” thermodynamic equation of “calories in minus calories out”. But in working with companies focused on dealing with prediabetes/obesity, I’ve come to appreciate that this “logic” not only ignores the economic and social factors that make obesity a public health problem, it also overlooks that different kinds of foods drive different physiological responses. As an example that just begins to scratch the surface, one very well-controlled study (sadly, a rarity in the field) published in July showed that, even after controlling for exercise and calories, carbs, fat, fiber, and other nutrients present in a meal, diets consisting of processed foods resulted in greater weight-gain than a diet consisting of unprocessed foods
    5. Revering luminaries & leaders is a good thing
      Its very natural to be so compelled by an idea / movement that you find yourself idolizing the people spearheading it. The media feeds into this with popular memoirs & biographies and numerous articles about how you can think/be/act more like [Steve Jobs/Jeff Bezos/Warren Buffett/Barack Obama/etc]. But, over the past decade, I’ve come to feel that this sort of reverence leads to a pernicious laziness of thought. I can admire Steve Jobs for his brilliance in product design but do I want to copy his approach to management or his use of alternative medicine to treat his cancer or condoning how he treated his illegitimate daughter. I think its far better to appreciate an idea and the work of the key people behind it than to equate the piece of work with the person and get sucked in to that cult of personality.
    6. Startups are great place for everyone
      Call it being sucked into the Silicon valley ethos but for a long time I believed that startups were a great place for everyone to build a career: high speed path to learning & responsibility, ability to network with other folks, favorable venture funding, one of the only paths to getting stock in rapidly growing companies, low job seeking risk (since there’s an expectation that startups often fail or pivot). Several years spent working in VC and startups later, and, while I still agree with my list above, I’ve come to believe that startups are really not a great place for most people. The risk-reward is generally not great for all but the earliest of employees and the most successful of companies, and the “startups are great for learning” Kool-aid is oftentimes used to justify poor management and work practices. I still think its a great place for some (i.e. people who can tolerate more risk [b/c of personal wealth or a spouse with a stable high-paying job], who are knowingly optimizing for learning & responsibility, or who are true believers in a startup’s mission), but I frankly think most people don’t fit the bill.
    7. Microaggressions are just people being overly sensitive
      I’ve been blessed at having only rarely faced overt racism (telling me to go back to China 🙄 / or that I don’t belong in this country). It’s a product of both where I’ve spent most of my life (in urban areas on the coasts) and my career/socioeconomic status (it’s not great to be overtly racist to a VC you’re trying to raise money from). But, having spent some dedicated time outside of those coastal areas this past decade and speaking with minorities who’ve lived there, I’ve become exposed to and more aware of “microaggressions”, forms of non-overt prejudice that are generally perpetrated without ill intent: questions like ‘so where are you really from?’ or comments like ‘you speak English really well!’. I once believed people complaining about these were simply being overly sensitive, but I’ve since become an active convert to the idea that, while these are certainly nowhere near as awful as overt hate crimes / racism, they are their own form of systematic prejudice which can, over time, grate and eat away at your sense of self-worth.
    8. The Western model (liberal democracy, free markets, global institutions) will reign unchallenged as a model for prosperity
      I once believed that the Western model of (relatively) liberal democracy, (relatively) free markets, and US/Europe-led global institutions was the only model of prosperity that would reign falling the collapse of the Soviet Union. While I probably wouldn’t have gone as far as Fukuyama did in proclaiming “the end of history”, I believed that the world was going to see authoritarian regimes increasingly globalize and embrace Western institutions. What I did not expect was the simultaneous rise of different models of success by countries like China and Saudi Arabia (who, frighteningly, now serve as models for still other countries to embrace), as well as a lasting backlash within the Western countries themselves (i.e. the rise of Trump, Brexit, “anti-globalism”, etc). This has fractured traditional political divides (hence the soul-searching that both major parties are undergoing in the US and the UK) and the election of illiberal populists in places like Mexico, Brazil, and Europe.
    9. Strategy trumps execution
      As a cerebral guy who spent the first years of his career in the last part of the 2000s as a strategy consultant, it shouldn’t be a surprise that much of my focus was on formulating smart business strategy. But having spent much of this decade focused on startups as well as having seen large companies like Apple, Amazon, and Netflix brilliantly out-execute companies with better ‘strategic positioning’ (Nokia, Blackberry, Walmart, big media), I’ve come around to a different understanding of how the two balance each other.
    10. We need to invent radically new solutions to solve the climate crisis
      Its going to be hard to do this one justice in this limited space — especially since I net out here very differently from Bill Gates — but going into this decade, I never would have expected that the cost of new solar or wind energy facilities could be cheaper than the cost of operating an existing coal plant. I never thought that lithium batteries or LEDs would get as cheap or as good as they are today (with signs that this progress will continue) or that the hottest IPO of the year would be an alternative food technology company (Beyond Meat) which will play a key role in helping us mitigate food/animal-related emissions. Despite the challenges of being a cleantech investor for much of the decade, its been a surprising bright spot to see how much pure smart capital and market forces have pushed many of the technologies we need. I still think we will need new policies and a huge amount of political willpower — I’d also like to see more progress made on long-duration energy storage, carbon capture, and industrial — but whereas I once believed that we’d need radically new energy technologies to thwart the worst of climate change, I am now much more of an optimist here than I was when the decade started.

    Here’s to more worldview shifts in the coming decade!

  • Fat Flora

    Source: Healthy Soul

    November’s paper was published in Nature in 2006, and covers a topic I’ve become increasingly interested in: the impact of the bacteria that have colonized our bodies on our health (something I’ve blogged about here and here).

    The idea that our bodies are, in some ways, more bacteria than human (there are 10x more gut bacteria – or flora — than human cells on our bodies) and that those bacteria can play a key role on our health is not only mind-blowing, it opens up another potential area for medical/life sciences research and future medicines/treatments.

    In the paper, a genetics team from Washington University in St. Louis explored a very basic question: are the gut bacteria from obese individuals different from those from non-obese individuals? To study the question, they performed two types of analyses on a set of mice with a genetic defect leading to an inability of the mice to “feel full” (and hence likely to become obese) and genetically similar mice lacking that defect (the s0-called “wild type” control).

    The first was a series of genetic experiments comparing the bacteria found within the gut of obese mice with those from the gut of “wild-type” mice (this sort of comparison is something the field calls metagenomics). In doing so, the researchers noticed a number of key differences in the “genetic fingerprint” of the two sets of gut bacteria, especially in the genes involved in metabolism.

    Source: Figure 3, Turnbaugh et al.

    But, what did that mean to the overall health of the animal? To answer that question, the researchers did a number of experiments, two of which I will talk about below. First, they did a very simple chemical analysis (see figure 3b to the left) comparing the “leftover energy” in the waste (aka poop) of the obese mice to the waste of wild-type mice (and, yes, all of this was controlled for the amount of waste/poop). Lo and behold, the obese mice (the white bar) seemed to have gut bacteria which were significantly better at pulling calories out of the food, leaving less “leftover energy”.

    Source: Figure 3, Turnbaugh et al.

    While an interesting result, especially when thinking about some of the causes and effects of obesity, a skeptic might look at that data and say that its inconclusive about the role of gut bacteria in obesity – after all, obese mice could have all sorts of other changes which make them more efficient at pulling energy out of food. To address that, the researchers did a very elegant experiment involving fecal transplant: that’s right, colonize one mouse with the bacteria from another mouse (by transferring poop). The figure to the right (figure 3c) shows the results of the experiment. After two weeks, despite starting out at about the same weight and eating similar amounts of the same food, wild type mice that received bacteria from other wild type mice showed an increase in body fat of about 27%, whereas the wild type mice that received bacteria from the obese mice showed an increase of about 47%! Clearly, gut bacteria in obese mice are playing a key role in calorie uptake!

    In terms of areas of improvement, my main complaint about this study is just that it doesn’t go far enough. The paper never gets too deep on what exactly were the bacteria in each sample and we didn’t really get a sense of the real variation: how much do bacteria vary from mouse to mouse? Is it the completely different bacteria? Is it the same bacteria but different numbers? Is it the same bacteria but they’re each functioning differently? Do two obese mice have the same bacteria? What about a mouse that isn’t quite obese but not quite wild-type either? Furthermore, the paper doesn’t show us what happens if an obese mouse has its bacteria replaced with the bacteria from a wild-type mouse. These are all interesting questions that would really help researchers and doctors understand what is happening.

    But, despite all of that, this was a very interesting finding and has major implications for doctors and researchers in thinking about how our complicated flora impact and are impacted by our health.

    Paper: Turnbaugh et al., “An obesity-associated gut microbiome with increased capacity for energy harvest.” Nature (444). 21/28 Dec 2006. doi:10.1038/nature05414

    Check out my other academic paper walkthroughs/summaries