Wednesday, August 27, 2008

Damn! Boggled again!

I worked in construction one summer when I was 18. I recall encountering various workers working very hard, day after day. They carried, pulled, pushed, hammered, shoveled, etc. They did this for hours on end. I was very impressed. Actually, I was somewhat horrified.

My father was in construction, an electrician. I recall his telling me once that he got lots of exercise on the job, and that seemed right to me, though it also seemed to me that other tradesmen and construction workers worked even harder than the electricians.

But, in general, despite their intense daily exertions, these people didn’t look like they worked out. Most of them were overweight. And they didn’t appear to be healthy.

It was puzzling.

On Saturday, The Guardian’s Ben Goldacre wrote about a recent study that focused on work and exercise (Healthy mind, healthy body). According to Goldacre, two Harvard psychologists focused on 84 hard-working female hotel attendants. The psychologists observed that, while working, the attendants were getting lots of exercise. Nevertheless, 2/3 of the workers reported that they did not exercise regularly and 1/3 reported that they did not exercise at all.

The health of each worker was carefully measured. The psychologists then divided the workers into two groups: “One group got a one hour presentation on what a fabulous amount of exercise they were getting, how they were meeting and clearly exceeding recommendations for an active lifestyle.” It was made clear to them that, whatever they may have thought, in truth, in the course of doing their jobs, they were burning lots of calories and working lots of muscles.

Meanwhile, the other group went about their work unburdened by this happy information.

Four weeks later, the health of each worker was again measured. The workers who had been enlightened about their actual levels of exercise experienced clear improvement in health. The other workers did not.

“It’s an outrage,” jokes Goldacre. Funny guy.

It is possible, of course, that the study was flawed. Maybe the “enlightened” workers subtly changed their work habits, wielding their vacuum cleaners more quickly, scrubbing toilets more forcefully.

Time will tell.

But what if the study was unflawed and the workers’ attitudes really made all the difference? What, then, are we to make of this study? Is it that the workers’ exercise was healthful all right but its benefits were blocked by “negative” attitudes? Or is it that the exercise had nothing to do with these health benefits—it’s “positive attitude” that did the trick?

The literature on the placebo effect is disconcerting. It appears to me that, contrary to popular opinion, it is not clear that the placebo phenomenon ever occurs. I suppose that I hope that it does. But, right now, the matter is clouded.

Still, there are many studies of the kind described above. They unsettle me. I sense that massive folly is afoot. But I don’t know what it is.

I can just imagine people fifty years from now shaking their heads at our time and the appalling spectacle of tens of millions of people taking medicines, undergoing procedures, suffering through taxing regimens—all of them inefficacious. All placebos. Powerful ones.

On the other hand, I can equally imagine the future looking back at this dismal earlier period of gross and absurd oversimplification of the subtle complexities of health and disease. “These clueless bastards,” they’ll say, “were so narrow in their thinking that they resorted to the notion that just thinking you’ll get better sometimes causes you to get better!”

“Ha ha ha. Ha ha ha!”

I’ve been following the science of diet and disease for many years now, though not closely. By two or three years ago, I was strongly under the impression that the relevant authorities were fairly sure which diets were “healthy” and which were "unhealthy." All of the population studies seemed to point to the same culprits: saturated fat, etc.

But then a study came along that questioned all of that. Evidently, it was very impressive in scope and methodology. It was better than the earlier population studies. But it painted a different picture.

People were taking this seriously.

What could this mean? I asked. How can this be?

I hate being boggled.

But I also like it.


Bohrstein said...

I agree Chunk, being boggled is a fun state to be in. It's fun to have a puzzle, or to speculate freely within reason... hell sometimes it's fun to just let the imagination wander.

Regarding the "happy thoughts" bit though, I wonder about stress. Working jobs that are physically demanding, especially if you don't like it, can make you feel "stressed out." Couple this with low pay and other life problems and I would bet the body is in a state of "fight or flight" (especially if you're dealing with stupid people).
With as little of this subject that I know, I believe that different people respond to this in different ways. Some people's bodies will start craving and storing energy in a crazy urgency, and other people's bodies will begin craving more and more energy and using it all.
If this is true, then it might make sense that a group of people doing the same job (one group seeing a clear benefit, and the other not) would get different results.

Roy Bauer said...

Bohrstein: agreed, some forms of work, though forms of exercise, are also accompanied by stress, and stress is likely unhealthy.

Fair enough, but what does this have to do with the present case? Two groups of about forty hotel workers participated in the test. If there is a reason to suppose that one group experienced stress, isn't it reasonable to suppose that the other group equally experienced stress? (Further, the experimenters would be stunningly incompetent if they did not notice some systematic difference in stress level between the two groups.)

So I don't get your point about stress as applied to this case. No doubt these hotel workers do experience some significant level of stress (surly bosses, etc.). But, evidently, that did not prevent the one group from experiencing improvement in their health owing, evidently, to their recognition that their work routinely involved "healthy exercise."

Bohrstein said...

[If there is a reason to suppose that one group experienced stress, isn't it reasonable to suppose that the other group equally experienced stress?]

I definitely think that it is probable that both groups were exposed to the same stressors, but one group was exposed to what I am suggesting is a DEstressor. That DEstressor is the information that you are doing the same job and getting more benefit than you once thought.

Does this make sense?