How important for children is imaginary play?

Olde tyme tea party. Girls engaging in pretend play, 19th c.
Photo via Wikimedia; public domain in US.
Did you engage in imaginary play as a child? A recent study–which like the organic foods study involved evaluation of existing reports in one big chunk–has led its authors to conclude that imaginary or pretend play doesn’t seem to boost intelligence, creativity, or the ability to tackle problems. The researchers did find that such play might be beneficial for language and social development, storytelling, and self-regulation. Their findings are set to appear in the Psychological Bulletin (abstract here).

According to the study authors, says Farris Samarri writing at the NESCA blog, previous studies suggesting links between pretend play and intelligence and other features might have had flaws in design and methods and been “overheated” in their conclusions. The article quotes study lead author Angeline Lillard, a professor at the University of Virginia, as saying:

When you look at the research that has been done to test that, it comes up really short… It may be that we’ve been testing the wrong things; and it may well be that when a future experiment is really well done we may find something that pretend play does for development, but at this point these claims are all overheated. This is our conclusion from having really carefully read the studies.

To me, this finding isn’t that surprising. Intelligence, creativity, and addressing problems can be the activities of a brain on its own, reinforced through solo pursuits within the real world like reading, self-directed learning or hands-on activities, or even watching certain television shows. But while children can, of course, engage in imaginary play on their own, “play” as we generally think of it tends to involve interaction and even practice with other people. 

Play of any kind requires energy, and across the animal kingdom, energy is a precious commodity. That we and so many other species spend time in play suggests its importance. Of course, play comes in different flavors. Rolling around on the ground in a giant dogpile with your brothers might be more basic “lion cub” play than what we’d consider imaginary play or pretend play. From my adult perspective, very little imagination is involved in that sort of play; just a lot of noise and chaos, but they seem to like it. Pretend play, on the other hand, according to the NESCA piece, is

any play a child engages in, alone, with playmates, or with adults, that involves uses of the imagination to create a fantasy world or situation, such as making toy cars go “vrrooooom” or making dolls talk.

Whether we’re talking about lion cubs or children, about pretend play or just rolling around in a pile, these interactions guide a number of social behaviors, communication, and bonding and help young animals orient to the world around them (PBS video about play here). In addition to social interactions, storytelling is another feature that I can easily see would sharpen with imaginary play, particularly with an increasing understanding of what an audience is and how they respond. And even though the term might imply otherwise, self-regulation is something we generally don’t acquire by ourselves. We learn a lot about how to control what we present through feedback from others, including parents and peers. What’s unclear to me is what intrinsic factor pretend play might have that goes beyond non-pretend social interactions to reinforce self-regulation.

The NESCA post notes that an absence of pretend play is still a red flag for developmental conditions on the autism spectrum, particularly if noted between the ages of 18 months and 2 years. With an anecdatum alert, my oldest son is on the autism spectrum and engaged in pretend play. He just did it ways that in retrospect stand out as unusual for his age–and he still does. A lack of pretend play in a toddler is not pathognomonic–a definite indicator–of autism (nothing is), but if you have concerns about it, ask your pediatrician about an evaluation.

Do the findings of this large analysis surprise you? Had you thought that pretend play might boost creativity or intelligence or problem-solving skills? If you have a child, does she or he engage in pretend play?

LEGO those gender stereotypes

My daughter, patiently waiting to get her own balloon jetpack.
Photo credit: Phil Blake
Why can’t you understand that my daughter wants a damn jetpack?

Last weekend, I took my daughters to a birthday party that featured a magician/balloon artist.  He was really fantastic with the kids, and kept their attention for close to 1 hour (ONE HOUR!!!).  At the end of his magic show, he began to furiously twist and tie balloons into these amazing shapes, promoting energetic and imaginative play.  Of these shapes was his own, very intricate invention: a jetpack.  

When he completed the first jetpack, I watched as the eyes of my five-year-old daughter, who happens to be a very sporty kid, light up with wonder.  She looked at me and smiled, indicating through her facial expression alone that she wanted the same balloon toy.  But, alas, when it was her turn for a balloon, her requests were met with opposition.  Here was the conversation:

Magician: How about a great butterfly balloon?

Daughter: No thanks, I’d like a jetpack please.

Magician: I think you should get a butterfly.

Daughter: I’d prefer a jetpack.

Magician: But you’re a girl.  Girls get butterflies.

Daughter (giving me a desperate look): But I really want a jetpack!

Realizing that my daughter was becoming unnecessarily upset, especially given the fact that there were 3 boys already engaging in play with their totally awesome jetpacks, myself and the hostess mother intervened.  We kindly reiterated my daughter’s requests for a jetpack.  And, so she was given a jetpack.

Later that evening, my daughter asked me why the magician insisted that she get a butterfly balloon when she explicitly asked for a jetpack.  Not wanting to reveal the realities of gender stereotype at that very point in time, I simply stated that sometimes we (a gender neutral “we”) might have to repeat ourselves so that others understand what we want.  Then she asked, “but why are butterflies only for girls?”

I was able to more or less able smooth it over with her, but it was clear to me that a very archaic reality was still in play, and my daughters were about to inherit it.  While I have nothing against typically female role-playing or dolls or princesses, I do not like when they are assumed to be the preferred activities.  I also do not like the idea that some toys, based on years of “market research,” are designed to basically pigeonhole girls into a June Cleaveresque state of being, especially without alternative play options.

The five LEGO Friends 
For instance, LEGO has recently launched a “for-girls-only” campaign, exemplified by the new “Friends” LEGO kit.  Slathered in pink and purple, this kit is designed around a narrative involving five friends and a pretend city named Heartlake.  Like nearly all cities, Heartlake boasts a bakery, a beauty salon, a cafe, and a veterinarian’s office to take care of sick animals.  However, unlike every city, Heartlake lacks things like a hospital, a fire department, a police station, and a local airport (thought they do have a flying club).  In essence, this toy is facilitating pretend play that centers ONLY on domestication, which absolutely limits both experiences and expectations for girls playing with this toy.  In essence, LEGO is assuming that all girls want the butterfly balloon instead of the jetpack.

Some might think, “jeeze, it’s just a toy!” and dismiss my objection to all that the Friends kit encompasses.  And perhaps when the Friends kit is offered in addition to a variety of toy types – gender neutral, masculine, and feminine – it may not have a significant effect on the mindset of its young, impressionable owner.  But what if that’s not the case?

Traditional LEGO bricks: For boys AND girls, goshdarnit!
LEGO has also gotten it wrong when it comes to the assumption that girls are not into the traditional LEGO blocks.  In fact, just last night, my daughter (the very one who wanted a jetpack) saw a commercial for a LEGO City product – I forgot which one – and asked that we put it on her ever expanding Christmas list.  Furthermore, both of my daughters are huge fans of the LEGO produced show on the Cartoon Network, Ninjago: Masters of Spinjitzu, which is based on the traditional LEGO figures and game.  My oldest daughter is arguably very sporty and may be more inclined to like “boy” things, but my younger daughter is chock-full of sugar and spice and yada yada yada.  She prefers to wear dresses, LOVES shoes, and demands to have her nails painted at all times.  And she still gets down with regular LEGOs and monster trucks and basketball and karate (all her own choices).  So why is LEGO shoving pastel bricks down girls’ throats?    

Gender and play

Play is an important part of cognitive development.  When children engage in play, they learn through discovery, become familiar with their own limitations, gain a better understanding of spatial relationships, become introduced to cause and effect, and, most relevant to this discussion, play exposes children to societal and cultural norms, as well as family values.  Placing limits on play can affect how a child sees him or herself in the world, which can impact both career and lifestyle choices.   

Research (and experience) has shown that the toys kids choose are shaped by societal expectations; however, these expectations are often dictated by marketing teams and their assumptions of what they think their customers want to see, perpetuating a toy culture that has changed little since the 1950s.  Furthermore, parents may impose toys that are gender “appropriate,” or even punish play that does not align with traditional gender expectations.  But what toys do kids actually want to play with?

In 2003, researchers at the University of Nebraska conducted a study to, in part, identify the impact that stereotyped toys have on play in young children.  There were 30 children who participated in this study, ranging in age from 18-47 months.  They were observed for 30 minutes in a room full of toys, with each toy defined as being traditionally masculine, feminine, or gender neutral.  Interestingly, when assessing the toy preferences of the children, boys tended to play with toys that were either masculine or gender neutral, whereas girls played with toys that were largely gender neutral.  These findings were consistent with previous studies showing that girls tend to play with toys that are not traditionally gendered (i.e. blocks, crayons, puzzles, bears, etc).  
Cherney, et al, 2003
Why is there a disconnect between the natural tendencies of toy choice among female children and what marketing executives deem as appropriate toys for girls?  While fantasy play based on domestic scenarios does have its place during normal development, restricting children to certain types of gendered toys can promote a stereotypical mindset that extends into adulthood, possibly adding to the gender inequity seen in the workplace.  Furthermore, assigning and marketing toys to a specific gender may also contribute to the gendering of household duties and/or recreational activities (i.e. only boys can play hockey or only girls do laundry).

This is obviously problematic for females, especially given the disproportionately low number of women executives and STEM professionals (just to name a few).  However, a conclusion from this study that I hadn’t even considered is the idea that overly feminized toys are not good for boys. 

How “girls only” is disadvantageous to boys

When looking at “masculine” versus “feminine” play, one would see that there is some non-overlap when it comes to learned skills.  For instance, “masculine” play often translates into being able to build something imaginative (like a spaceship or other cool technology) whereas “feminine” toys tend to encourage fantasy play surrounding taking care of the home (like putting the baby to sleep or ironing clothes). 

Both types of learning experiences are useful in today’s world, especially given that more women enter the work force and there is growing trend to more or less split household duties.  So when a kid is being offered toys that encourage play that has both masculine and feminine qualities, there is enhanced development of a variety of skills that ultimately translate into real, modern world scenarios.

However, the issue lies in the willingness to provide and play with strongly cross-gender-stereotyped toys.  Because of the number of toys having this quality, there is a huge gender divide when it comes to play, and boys are much less likely to cross gender lines, especially when toys are overtly “girly” (see figure above).  This is most often because of parents and caregivers who discourage play with “girl” toys, usually citing things like “they will make fun of you.”  Toys heavily marketed to match the stereotypical likes of girls, such as the Friends LEGO kit, clearly excludes boys from engaging in play that develops domestic skills (in addition to pigeonholing girls into thinking that girls can only do domestic things).   

Just yesterday, I came across an article on CNN discussing this issue, and it contained anecdotes similar to the one I described above.  The author described how a little girl was scoffed for having a Star-Wars thermos as well as how a little boy was told (by another little girl) that he could not have the mermaid doll he wanted.  My arguments thus far have been centered on developing a variety of skills through play, but I’d also like to add that limiting self-expression could be disastrous for the future wellbeing of an individual. 

There is some progress being made with regard to how toys are being presented in stores.  For instance, the same article described the new Toy Kingdom at Harrod’s, which does not conform to the traditionally separated “boy” and “girl” sections.  Instead, it has “worlds,” such as The Big Top(with circus acts and fairies) or Odyssey(with space crafts and gadgets).  This type of organization allows any child, regardless of gender, to engage in play that facilitates imagination and cognition.

Hey Toys’R Us, are you listening?                

 Final thoughts

Please don’t misinterpret this as being anti-pink, anti-princess, or anti-feminine.  I embrace my own femininity with vigor and pride.  I like to wear dresses and makeup and get my hair did.  Give me a pair of Manolo Blahniks and I will wear the shit out of them.  But I will do so while elbow deep in a biochemical analysis of intracellular cholesterol transport.    

My point is that if you are going to make a toy more appealing to girls by painting it pink, don’t forget to include facets that allow girls to be comfortable with their femininity while providing an experience that promotes empowerment and an unlimited imagination.  Furthermore, don’t exclude boys from getting an experience that helps them acquire skills that are applicable (and desirable) in the modern world.  As it stands right now, toys like the Friends LEGO kit does neither of these and I believe that they major fails, both of the Double X and the XY variety.    

For more, check out Feminist Frequency’s takedown of LEGO:

Judith E. Owen Blakemore and Renee E. Centers, Characteristics of Boys’ and Girls’ Toys, Sex Roles, Vol. 53, Nos. 9/10, November 2005 [PDF, paywall]

Gerianne M. Alexander, Ph.D., An Evolutionary Perspective of Sex-Typed Toy Preferences: Pink, Blue, and the Brain, Archives of Sexual Behavior, Vol. 32, No. 1, , pp. 7–14, February 2003 [PDF, paywall]

Isabelle D. Cherney, Lisa Kelly-Vance, Katrina Gill Glover, Amy Ruane, and Brigette Oliver Ryalls, The Effects of Stereotyped Toys and Gender on Play Assessment in Children Aged 18-47 Months, Educational Psychology: An International Journal of Experimental Educational Psychology, 23:1, 95-106, 2003

Carol J. Auster and Claire S. Mansbach, The Gender Marketing of Toys: An Analysis of Color and Type of Toy on the Disney Store Website, Sex Roles, 2012 [abstract link]

Isabelle D. Cherney and  Kamala London, Gender-linked Differences in the Toys, Television Shows, Computer Games, and Outdoor Activities of 5- to 13-year-old Children, Sex Roles, 2006 [PDF]

Isabelle D. Cherney and Bridget Oliver Ryalls, Gender-linked differences in the incidental memory of children and adults, J Exp Child Psychol, 1999 Apr;72(4):305-28 [abstract link]

Biology Explainer: The big 4 building blocks of life–carbohydrates, fats, proteins, and nucleic acids

The short version
  • The four basic categories of molecules for building life are carbohydrates, lipids, proteins, and nucleic acids.
  • Carbohydrates serve many purposes, from energy to structure to chemical communication, as monomers or polymers.
  • Lipids, which are hydrophobic, also have different purposes, including energy storage, structure, and signaling.
  • Proteins, made of amino acids in up to four structural levels, are involved in just about every process of life.                                                                                                      
  • The nucleic acids DNA and RNA consist of four nucleotide building blocks, and each has different purposes.
The longer version
Life is so diverse and unwieldy, it may surprise you to learn that we can break it down into four basic categories of molecules. Possibly even more implausible is the fact that two of these categories of large molecules themselves break down into a surprisingly small number of building blocks. The proteins that make up all of the living things on this planet and ensure their appropriate structure and smooth function consist of only 20 different kinds of building blocks. Nucleic acids, specifically DNA, are even more basic: only four different kinds of molecules provide the materials to build the countless different genetic codes that translate into all the different walking, swimming, crawling, oozing, and/or photosynthesizing organisms that populate the third rock from the Sun.


Big Molecules with Small Building Blocks

The functional groups, assembled into building blocks on backbones of carbon atoms, can be bonded together to yield large molecules that we classify into four basic categories. These molecules, in many different permutations, are the basis for the diversity that we see among living things. They can consist of thousands of atoms, but only a handful of different kinds of atoms form them. It’s like building apartment buildings using a small selection of different materials: bricks, mortar, iron, glass, and wood. Arranged in different ways, these few materials can yield a huge variety of structures.

We encountered functional groups and the SPHONC in Chapter 3. These components form the four categories of molecules of life. These Big Four biological molecules are carbohydrates, lipids, proteins, and nucleic acids. They can have many roles, from giving an organism structure to being involved in one of the millions of processes of living. Let’s meet each category individually and discover the basic roles of each in the structure and function of life.

You have met carbohydrates before, whether you know it or not. We refer to them casually as “sugars,” molecules made of carbon, hydrogen, and oxygen. A sugar molecule has a carbon backbone, usually five or six carbons in the ones we’ll discuss here, but it can be as few as three. Sugar molecules can link together in pairs or in chains or branching “trees,” either for structure or energy storage.

When you look on a nutrition label, you’ll see reference to “sugars.” That term includes carbohydrates that provide energy, which we get from breaking the chemical bonds in a sugar called glucose. The “sugars” on a nutrition label also include those that give structure to a plant, which we call fiber. Both are important nutrients for people.

Sugars serve many purposes. They give crunch to the cell walls of a plant or the exoskeleton of a beetle and chemical energy to the marathon runner. When attached to other molecules, like proteins or fats, they aid in communication between cells. But before we get any further into their uses, let’s talk structure.

The sugars we encounter most in basic biology have their five or six carbons linked together in a ring. There’s no need to dive deep into organic chemistry, but there are a couple of essential things to know to interpret the standard representations of these molecules.

Check out the sugars depicted in the figure. The top-left molecule, glucose, has six carbons, which have been numbered. The sugar to its right is the same glucose, with all but one “C” removed. The other five carbons are still there but are inferred using the conventions of organic chemistry: Anywhere there is a corner, there’s a carbon unless otherwise indicated. It might be a good exercise for you to add in a “C” over each corner so that you gain a good understanding of this convention. You should end up adding in five carbon symbols; the sixth is already given because that is conventionally included when it occurs outside of the ring.

On the left is a glucose with all of its carbons indicated. They’re also numbered, which is important to understand now for information that comes later. On the right is the same molecule, glucose, without the carbons indicated (except for the sixth one). Wherever there is a corner, there is a carbon, unless otherwise indicated (as with the oxygen). On the bottom left is ribose, the sugar found in RNA. The sugar on the bottom right is deoxyribose. Note that at carbon 2 (*), the ribose and deoxyribose differ by a single oxygen.

The lower left sugar in the figure is a ribose. In this depiction, the carbons, except the one outside of the ring, have not been drawn in, and they are not numbered. This is the standard way sugars are presented in texts. Can you tell how many carbons there are in this sugar? Count the corners and don’t forget the one that’s already indicated!

If you said “five,” you are right. Ribose is a pentose (pent = five) and happens to be the sugar present in ribonucleic acid, or RNA. Think to yourself what the sugar might be in deoxyribonucleic acid, or DNA. If you thought, deoxyribose, you’d be right.

The fourth sugar given in the figure is a deoxyribose. In organic chemistry, it’s not enough to know that corners indicate carbons. Each carbon also has a specific number, which becomes important in discussions of nucleic acids. Luckily, we get to keep our carbon counting pretty simple in basic biology. To count carbons, you start with the carbon to the right of the non-carbon corner of the molecule. The deoxyribose or ribose always looks to me like a little cupcake with a cherry on top. The “cherry” is an oxygen. To the right of that oxygen, we start counting carbons, so that corner to the right of the “cherry” is the first carbon. Now, keep counting. Here’s a little test: What is hanging down from carbon 2 of the deoxyribose?

If you said a hydrogen (H), you are right! Now, compare the deoxyribose to the ribose. Do you see the difference in what hangs off of the carbon 2 of each sugar? You’ll see that the carbon 2 of ribose has an –OH, rather than an H. The reason the deoxyribose is called that is because the O on the second carbon of the ribose has been removed, leaving a “deoxyed” ribose. This tiny distinction between the sugars used in DNA and RNA is significant enough in biology that we use it to distinguish the two nucleic acids.

In fact, these subtle differences in sugars mean big differences for many biological molecules. Below, you’ll find a couple of ways that apparently small changes in a sugar molecule can mean big changes in what it does. These little changes make the difference between a delicious sugar cookie and the crunchy exoskeleton of a dung beetle.

Sugar and Fuel

A marathon runner keeps fuel on hand in the form of “carbs,” or sugars. These fuels provide the marathoner’s straining body with the energy it needs to keep the muscles pumping. When we take in sugar like this, it often comes in the form of glucose molecules attached together in a polymer called starch. We are especially equipped to start breaking off individual glucose molecules the minute we start chewing on a starch.

Double X Extra: A monomer is a building block (mono = one) and a polymer is a chain of monomers. With a few dozen monomers or building blocks, we get millions of different polymers. That may sound nutty until you think of the infinity of values that can be built using only the numbers 0 through 9 as building blocks or the intricate programming that is done using only a binary code of zeros and ones in different combinations.

Our bodies then can rapidly take the single molecules, or monomers, into cells and crack open the chemical bonds to transform the energy for use. The bonds of a sugar are packed with chemical energy that we capture to build a different kind of energy-containing molecule that our muscles access easily. Most species rely on this process of capturing energy from sugars and transforming it for specific purposes.

Polysaccharides: Fuel and Form

Plants use the Sun’s energy to make their own glucose, and starch is actually a plant’s way of storing up that sugar. Potatoes, for example, are quite good at packing away tons of glucose molecules and are known to dieticians as a “starchy” vegetable. The glucose molecules in starch are packed fairly closely together. A string of sugar molecules bonded together through dehydration synthesis, as they are in starch, is a polymer called a polysaccharide (poly = many; saccharide = sugar). When the monomers of the polysaccharide are released, as when our bodies break them up, the reaction that releases them is called hydrolysis.

Double X Extra: The specific reaction that hooks one monomer to another in a covalent bond is called dehydration synthesis because in making the bond–synthesizing the larger molecule–a molecule of water is removed (dehydration). The reverse is hydrolysis (hydro = water; lysis = breaking), which breaks the covalent bond by the addition of a molecule of water.

Although plants make their own glucose and animals acquire it by eating the plants, animals can also package away the glucose they eat for later use. Animals, including humans, store glucose in a polysaccharide called glycogen, which is more branched than starch. In us, we build this energy reserve primarily in the liver and access it when our glucose levels drop.

Whether starch or glycogen, the glucose molecules that are stored are bonded together so that all of the molecules are oriented the same way. If you view the sixth carbon of the glucose to be a “carbon flag,” you’ll see in the figure that all of the glucose molecules in starch are oriented with their carbon flags on the upper left.

The orientation of monomers of glucose in polysaccharides can make a big difference in the use of the polymer. The glucoses in the molecule on the top are all oriented “up” and form starch. The glucoses in the molecule on the bottom alternate orientation to form cellulose, which is quite different in its function from starch.

Storing up sugars for fuel and using them as fuel isn’t the end of the uses of sugar. In fact, sugars serve as structural molecules in a huge variety of organisms, including fungi, bacteria, plants, and insects.

The primary structural role of a sugar is as a component of the cell wall, giving the organism support against gravity. In plants, the familiar old glucose molecule serves as one building block of the plant cell wall, but with a catch: The molecules are oriented in an alternating up-down fashion. The resulting structural sugar is called cellulose.

That simple difference in orientation means the difference between a polysaccharide as fuel for us and a polysaccharide as structure. Insects take it step further with the polysaccharide that makes up their exoskeleton, or outer shell. Once again, the building block is glucose, arranged as it is in cellulose, in an alternating conformation. But in insects, each glucose has a little extra added on, a chemical group called an N-acetyl group. This addition of a single functional group alters the use of cellulose and turns it into a structural molecule that gives bugs that special crunchy sound when you accidentally…ahem…step on them.

These variations on the simple theme of a basic carbon-ring-as-building-block occur again and again in biological systems. In addition to serving roles in structure and as fuel, sugars also play a role in function. The attachment of subtly different sugar molecules to a protein or a lipid is one way cells communicate chemically with one another in refined, regulated interactions. It’s as though the cells talk with each other using a specialized, sugar-based vocabulary. Typically, cells display these sugary messages to the outside world, making them available to other cells that can recognize the molecular language.

Lipids: The Fatty Trifecta

Starch makes for good, accessible fuel, something that we immediately attack chemically and break up for quick energy. But fats are energy that we are supposed to bank away for a good long time and break out in times of deprivation. Like sugars, fats serve several purposes, including as a dense source of energy and as a universal structural component of cell membranes everywhere.

Fats: the Good, the Bad, the Neutral

Turn again to a nutrition label, and you’ll see a few references to fats, also known as lipids. (Fats are slightly less confusing that sugars in that they have only two names.) The label may break down fats into categories, including trans fats, saturated fats, unsaturated fats, and cholesterol. You may have learned that trans fats are “bad” and that there is good cholesterol and bad cholesterol, but what does it all mean?

Let’s start with what we mean when we say saturated fat. The question is, saturated with what? There is a specific kind of dietary fat call the triglyceride. As its name implies, it has a structural motif in which something is repeated three times. That something is a chain of carbons and hydrogens, hanging off in triplicate from a head made of glycerol, as the figure shows.  Those three carbon-hydrogen chains, or fatty acids, are the “tri” in a triglyceride. Chains like this can be many carbons long.

Double X Extra: We call a fatty acid a fatty acid because it’s got a carboxylic acid attached to a fatty tail. A triglyceride consists of three of these fatty acids attached to a molecule called glycerol. Our dietary fat primarily consists of these triglycerides.

Triglycerides come in several forms. You may recall that carbon can form several different kinds of bonds, including single bonds, as with hydrogen, and double bonds, as with itself. A chain of carbon and hydrogens can have every single available carbon bond taken by a hydrogen in single covalent bond. This scenario of hydrogen saturation yields a saturated fat. The fat is saturated to its fullest with every covalent bond taken by hydrogens single bonded to the carbons.

Saturated fats have predictable characteristics. They lie flat easily and stick to each other, meaning that at room temperature, they form a dense solid. You will realize this if you find a little bit of fat on you to pinch. Does it feel pretty solid? That’s because animal fat is saturated fat. The fat on a steak is also solid at room temperature, and in fact, it takes a pretty high heat to loosen it up enough to become liquid. Animals are not the only organisms that produce saturated fat–avocados and coconuts also are known for their saturated fat content.

The top graphic above depicts a triglyceride with the glycerol, acid, and three hydrocarbon tails. The tails of this saturated fat, with every possible hydrogen space occupied, lie comparatively flat on one another, and this kind of fat is solid at room temperature. The fat on the bottom, however, is unsaturated, with bends or kinks wherever two carbons have double bonded, booting a couple of hydrogens and making this fat unsaturated, or lacking some hydrogens. Because of the space between the bumps, this fat is probably not solid at room temperature, but liquid.

You can probably now guess what an unsaturated fat is–one that has one or more hydrogens missing. Instead of single bonding with hydrogens at every available space, two or more carbons in an unsaturated fat chain will form a double bond with carbon, leaving no space for a hydrogen. Because some carbons in the chain share two pairs of electrons, they physically draw closer to one another than they do in a single bond. This tighter bonding result in a “kink” in the fatty acid chain.

In a fat with these kinks, the three fatty acids don’t lie as densely packed with each other as they do in a saturated fat. The kinks leave spaces between them. Thus, unsaturated fats are less dense than saturated fats and often will be liquid at room temperature. A good example of a liquid unsaturated fat at room temperature is canola oil.

A few decades ago, food scientists discovered that unsaturated fats could be resaturated or hydrogenated to behave more like saturated fats and have a longer shelf life. The process of hydrogenation–adding in hydrogens–yields trans fat. This kind of processed fat is now frowned upon and is being removed from many foods because of its associations with adverse health effects. If you check a food label and it lists among the ingredients “partially hydrogenated” oils, that can mean that the food contains trans fat.

Double X Extra: A triglyceride can have up to three different fatty acids attached to it. Canola oil, for example, consists primarily of oleic acid, linoleic acid, and linolenic acid, all of which are unsaturated fatty acids with 18 carbons in their chains.

Why do we take in fat anyway? Fat is a necessary nutrient for everything from our nervous systems to our circulatory health. It also, under appropriate conditions, is an excellent way to store up densely packaged energy for the times when stores are running low. We really can’t live very well without it.

Phospholipids: An Abundant Fat

You may have heard that oil and water don’t mix, and indeed, it is something you can observe for yourself. Drop a pat of butter–pure saturated fat–into a bowl of water and watch it just sit there. Even if you try mixing it with a spoon, it will just sit there. Now, drop a spoon of salt into the water and stir it a bit. The salt seems to vanish. You’ve just illustrated the difference between a water-fearing (hydrophobic) and a water-loving (hydrophilic) substance.

Generally speaking, compounds that have an unequal sharing of electrons (like ions or anything with a covalent bond between oxygen and hydrogen or nitrogen and hydrogen) will be hydrophilic. The reason is that a charge or an unequal electron sharing gives the molecule polarity that allows it to interact with water through hydrogen bonds. A fat, however, consists largely of hydrogen and carbon in those long chains. Carbon and hydrogen have roughly equivalent electronegativities, and their electron-sharing relationship is relatively nonpolar. Fat, lacking in polarity, doesn’t interact with water. As the butter demonstrated, it just sits there.

There is one exception to that little maxim about fat and water, and that exception is the phospholipid. This lipid has a special structure that makes it just right for the job it does: forming the membranes of cells. A phospholipid consists of a polar phosphate head–P and O don’t share equally–and a couple of nonpolar hydrocarbon tails, as the figure shows. If you look at the figure, you’ll see that one of the two tails has a little kick in it, thanks to a double bond between the two carbons there.

Phospholipids form a double layer and are the major structural components of cell membranes. Their bend, or kick, in one of the hydrocarbon tails helps ensure fluidity of the cell membrane. The molecules are bipolar, with hydrophilic heads for interacting with the internal and external watery environments of the cell and hydrophobic tails that help cell membranes behave as general security guards.

The kick and the bipolar (hydrophobic and hydrophilic) nature of the phospholipid make it the perfect molecule for building a cell membrane. A cell needs a watery outside to survive. It also needs a watery inside to survive. Thus, it must face the inside and outside worlds with something that interacts well with water. But it also must protect itself against unwanted intruders, providing a barrier that keeps unwanted things out and keeps necessary molecules in.

Phospholipids achieve it all. They assemble into a double layer around a cell but orient to allow interaction with the watery external and internal environments. On the layer facing the inside of the cell, the phospholipids orient their polar, hydrophilic heads to the watery inner environment and their tails away from it. On the layer to the outside of the cell, they do the same.
As the figure shows, the result is a double layer of phospholipids with each layer facing a polar, hydrophilic head to the watery environments. The tails of each layer face one another. They form a hydrophobic, fatty moat around a cell that serves as a general gatekeeper, much in the way that your skin does for you. Charged particles cannot simply slip across this fatty moat because they can’t interact with it. And to keep the fat fluid, one tail of each phospholipid has that little kick, giving the cell membrane a fluid, liquidy flow and keeping it from being solid and unforgiving at temperatures in which cells thrive.

Steroids: Here to Pump You Up?

Our final molecule in the lipid fatty trifecta is cholesterol. As you may have heard, there are a few different kinds of cholesterol, some of which we consider to be “good” and some of which is “bad.” The good cholesterol, high-density lipoprotein, or HDL, in part helps us out because it removes the bad cholesterol, low-density lipoprotein or LDL, from our blood. The presence of LDL is associated with inflammation of the lining of the blood vessels, which can lead to a variety of health problems.

But cholesterol has some other reasons for existing. One of its roles is in the maintenance of cell membrane fluidity. Cholesterol is inserted throughout the lipid bilayer and serves as a block to the fatty tails that might otherwise stick together and become a bit too solid.

Cholesterol’s other starring role as a lipid is as the starting molecule for a class of hormones we called steroids or steroid hormones. With a few snips here and additions there, cholesterol can be changed into the steroid hormones progesterone, testosterone, or estrogen. These molecules look quite similar, but they play very different roles in organisms. Testosterone, for example, generally masculinizes vertebrates (animals with backbones), while progesterone and estrogen play a role in regulating the ovulatory cycle.

Double X Extra: A hormone is a blood-borne signaling molecule. It can be lipid based, like testosterone, or short protein, like insulin.


As you progress through learning biology, one thing will become more and more clear: Most cells function primarily as protein factories. It may surprise you to learn that proteins, which we often talk about in terms of food intake, are the fundamental molecule of many of life’s processes. Enzymes, for example, form a single broad category of proteins, but there are millions of them, each one governing a small step in the molecular pathways that are required for living.

Levels of Structure

Amino acids are the building blocks of proteins. A few amino acids strung together is called a peptide, while many many peptides linked together form a polypeptide. When many amino acids strung together interact with each other to form a properly folded molecule, we call that molecule a protein.

For a string of amino acids to ultimately fold up into an active protein, they must first be assembled in the correct order. The code for their assembly lies in the DNA, but once that code has been read and the amino acid chain built, we call that simple, unfolded chain the primary structure of the protein.

This chain can consist of hundreds of amino acids that interact all along the sequence. Some amino acids are hydrophobic and some are hydrophilic. In this context, like interacts best with like, so the hydrophobic amino acids will interact with one another, and the hydrophilic amino acids will interact together. As these contacts occur along the string of molecules, different conformations will arise in different parts of the chain. We call these different conformations along the amino acid chain the protein’s secondary structure.

Once those interactions have occurred, the protein can fold into its final, or tertiary structure and be ready to serve as an active participant in cellular processes. To achieve the tertiary structure, the amino acid chain’s secondary interactions must usually be ongoing, and the pH, temperature, and salt balance must be just right to facilitate the folding. This tertiary folding takes place through interactions of the secondary structures along the different parts of the amino acid chain.

The final product is a properly folded protein. If we could see it with the naked eye, it might look a lot like a wadded up string of pearls, but that “wadded up” look is misleading. Protein folding is a carefully regulated process that is determined at its core by the amino acids in the chain: their hydrophobicity and hydrophilicity and how they interact together.

In many instances, however, a complete protein consists of more than one amino acid chain, and the complete protein has two or more interacting strings of amino acids. A good example is hemoglobin in red blood cells. Its job is to grab oxygen and deliver it to the body’s tissues. A complete hemoglobin protein consists of four separate amino acid chains all properly folded into their tertiary structures and interacting as a single unit. In cases like this involving two or more interacting amino acid chains, we say that the final protein has a quaternary structure. Some proteins can consist of as many as a dozen interacting chains, behaving as a single protein unit.

A Plethora of Purposes

What does a protein do? Let us count the ways. Really, that’s almost impossible because proteins do just about everything. Some of them tag things. Some of them destroy things. Some of them protect. Some mark cells as “self.” Some serve as structural materials, while others are highways or motors. They aid in communication, they operate as signaling molecules, they transfer molecules and cut them up, they interact with each other in complex, interrelated pathways to build things up and break things down. They regulate genes and package DNA, and they regulate and package each other.

As described above, proteins are the final folded arrangement of a string of amino acids. One way we obtain these building blocks for the millions of proteins our bodies make is through our diet. You may hear about foods that are high in protein or people eating high-protein diets to build muscle. When we take in those proteins, we can break them apart and use the amino acids that make them up to build proteins of our own.

Nucleic Acids

How does a cell know which proteins to make? It has a code for building them, one that is especially guarded in a cellular vault in our cells called the nucleus. This code is deoxyribonucleic acid, or DNA. The cell makes a copy of this code and send it out to specialized structures that read it and build proteins based on what they read. As with any code, a typo–a mutation–can result in a message that doesn’t make as much sense. When the code gets changed, sometimes, the protein that the cell builds using that code will be changed, too.

Biohazard!The names associated with nucleic acids can be confusing because they all start with nucle-. It may seem obvious or easy now, but a brain freeze on a test could mix you up. You need to fix in your mind that the shorter term (10 letters, four syllables), nucleotide, refers to the smaller molecule, the three-part building block. The longer term (12 characters, including the space, and five syllables), nucleic acid, which is inherent in the names DNA and RNA, designates the big, long molecule.

DNA vs. RNA: A Matter of Structure

DNA and its nucleic acid cousin, ribonucleic acid, or RNA, are both made of the same kinds of building blocks. These building blocks are called nucleotides. Each nucleotide consists of three parts: a sugar (ribose for RNA and deoxyribose for DNA), a phosphate, and a nitrogenous base. In DNA, every nucleotide has identical sugars and phosphates, and in RNA, the sugar and phosphate are also the same for every nucleotide.

So what’s different? The nitrogenous bases. DNA has a set of four to use as its coding alphabet. These are the purines, adenine and guanine, and the pyrimidines, thymine and cytosine. The nucleotides are abbreviated by their initial letters as A, G, T, and C. From variations in the arrangement and number of these four molecules, all of the diversity of life arises. Just four different types of the nucleotide building blocks, and we have you, bacteria, wombats, and blue whales.

RNA is also basic at its core, consisting of only four different nucleotides. In fact, it uses three of the same nitrogenous bases as DNA–A, G, and C–but it substitutes a base called uracil (U) where DNA uses thymine. Uracil is a pyrimidine.

DNA vs. RNA: Function Wars

An interesting thing about the nitrogenous bases of the nucleotides is that they pair with each other, using hydrogen bonds, in a predictable way. An adenine will almost always bond with a thymine in DNA or a uracil in RNA, and cytosine and guanine will almost always bond with each other. This pairing capacity allows the cell to use a sequence of DNA and build either a new DNA sequence, using the old one as a template, or build an RNA sequence to make a copy of the DNA.

These two different uses of A-T/U and C-G base pairing serve two different purposes. DNA is copied into DNA usually when a cell is preparing to divide and needs two complete sets of DNA for the new cells. DNA is copied into RNA when the cell needs to send the code out of the vault so proteins can be built. The DNA stays safely where it belongs.

RNA is really a nucleic acid jack-of-all-trades. It not only serves as the copy of the DNA but also is the main component of the two types of cellular workers that read that copy and build proteins from it. At one point in this process, the three types of RNA come together in protein assembly to make sure the job is done right.

 By Emily Willingham, DXS managing editor 
This material originally appeared in similar form in Emily Willingham’s Complete Idiot’s Guide to College Biology

Is the bar high enough for screening breast ultrasounds for breast cancer?

The stormy landscape of the breast, as seen
on ultrasound. At top center (dark circle) is
a small cyst. Source: Wikimedia Commons.
Credit: Nevit Dilmen.
By Laura Newman, contributor

In a unanimous decision, FDA has approved the first breast ultrasound imaging system for dense breast tissue “for use in combination with a standard mammography in women with dense breast tissue who have a negative mammogram and no symptoms of breast cancer.” Patients should not interpret FDA’s approval of the somo-v Automated Breast Ultrasound System as an endorsement of the device as necessarily beneficial for this indication and this will be a thorny concept for many patients to appreciate.

If the approval did not take place in the setting of intense pressure to both inform women that they have dense breasts and lobbying to roll out all sorts of imaging studies quickly, no matter how well they have been studied, it would not be worth posting.

Dense breasts are worrisome to women, especially young women (in their 40s particularly) because they have proved a risk factor for developing breast cancer. Doing ultrasound on every woman with dense breasts, though, who has no symptoms, and a normal mammogram potentially encompasses as many as 40% of women undergoing screening mammography who also have dense breasts, according to the FDA’s press release. Dense breast tissue is most common in young women, specifically women in their forties, and breast density declines with age.

The limitations of mammography in seeing through dense breast tissue have been well known for decades and the search has been on for better imaging studies. Government appointed panels have reviewed the issue and mammography for women in their forties has been controversial. What’s new is the “Are You Dense?” patient movement and legislation to inform women that they have dense breasts.

Merits and pitfalls of device approval
The approval of breast ultrasound hinges on a study of 200 women with dense breast evaluated retrospectively at 13 sites across the United States with mammography and ultrasound. The study showed a statistically significant increase in breast cancer detection when ultrasound was used with mammography.

Approval of a device of this nature (noninvasive, already approved in general, but not for this indication) does not require the company to demonstrate that use of the device reduces morbidity or mortality, or that health benefits outweigh risks.

Eitan Amir, MD, PhD, medical oncologist at Princess Margaret Hospital, Toronto, Canada, said: “It’s really not a policy decision. All this is, is notice that if you want to buy the technology, you can.”

That’s clearly an important point, but not one that patients in the US understand. Patients hear “FDA approval” and assume that means a technology most certainly is for them and a necessary add-on. This disconnect in the FDA medical device approval process and in what patients think it means warrants an overhaul or at the minimum, a clarification for the public.

Materials for FDA submission are available on the FDA website, including the study filed with FDA and a PowerPoint presentation, but lots of luck, finding them quickly. “In the submission by Sunnyvale CA uSystems to FDA, the company stated that screening reduces lymph node positive breast cancer,” noted Amir. “There are few data to support this comment.”

Is cancer detection a sufficient goal?
In the FDA study, more cancers were identified with ultrasound. However, one has to question whether breast cancer detection alone is meaningful in driving use of a technology. In the past year, prostate cancer detection through PSA screening has been attacked because several studies and epidemiologists have found that screening is a poor predictor of who will die from prostate cancer or be bothered by it during their lifetime. We seem to be picking up findings that don’t lead to much to worry about, according to some researchers. Could new imaging studies for breast cancer suffer the same limitation? It is possible.

Another question is whether or not the detected cancers on ultrasound in the FDA study would have been identified shortly thereafter on a routine mammogram. It’s a question that is unclear from the FDA submission, according to Amir.

One of the problems that arises from excess screening is overdiagnosis, overtreatment, and high-cost, unaffordable care. An outcomes analysis of 9,232 women in the US Breast Cancer Surveillance Consortium led by Gretchen L. Gierach, PhD, MPH, at the National Institutes of Health MD, and published online in the August 21 Journal of the National Cancer Institute, revealed: “High mammographic breast density was not associated with risk of death from breast cancer or death from any cause after accounting for other patient and tumor characteristics.” –Gierach et al., 2012

Proposed breast cancer screening tests
Meanwhile, numerous imaging modalities have been proposed as an adjunct to mammography and as potential replacements for mammography. In 2002, proponents of positron emission tomography (PET) asked Medicare to approve pet scans for imaging dense breast tissue, especially in Asian women. The Medicare Coverage Advisory Commission heard testimony, but in the end, Medicare did not approve it for the dense-breast indication.

PET scans are far less popular today, while magnetic resonance imaging (AKA MR, MRI) and imaging have emerged as as adjuncts to mammography for women with certain risk factors. Like ultrasound, the outcomes data is not in the bag for screening with it.

In an interview with Monica Morrow, MD, Chief of Breast Surgery at Memorial Sloan-Kettering Cancer Center, New York, several months ago concerning the rise in legislation to inform women about dense breasts, which frequently leads to additional imaging studies, she said: “There is no good data that women with dense breasts benefit from additional MR screening.” She is not the only investigator to question potentially deleterious use of MR ahead of data collection and analysis. Many breast researchers have expressed fear that women will opt for double mastectomies, based on MR, that in the end, may have been absolutely unnecessary.

“There is one clear indication for MR screening,” stressed Morrow, explaining that women with BRCA mutations should be screened with MRI. “Outside of that group, there was no evidence that screening women with MR was beneficial.”

At just about every breast cancer meeting in the past two years, the benefits and harms of MR and other proposed screening modalities come up, and there is no consensus in the field.  It  should be noted, though, that plenty of breast physicians are skeptical about broad use of MR– not just generalists outside of the field. In other words, it is not breast and radiology specialists versus the US Preventive Services Task Force – a very important message for patients to understand.

One thing is clear: as these new technologies gain FDA approval, it will be a windfall for industry. If industry is successful and doctors are biased to promoting these tests, many may offer them on the estimated 40% of women with dense breasts who undergo routine mammograms, as well as other women evaluated as having a high lifetime risk.  The tests will be offered in a setting of unclear value and uncertain harms. Even though FDA has not approved breast MRI for screening dense breasts, breast MR is being used off label and it is far more costly than mammography.

When patients raise concerns about the unaffordability of medical care, they should be counseled about the uncertain benefit and potential harms of such a test. That may be a tall bill for most Americans to consider: it’s clear that the more is better philosophy is alive and well. Early detection of something, anything, even something dormant, going nowhere, is preferable to skipping a test, and risking who-knows-what, and that is something, most of us cannot imagine at the outset.

[Today's post is from Patient POVthe blog of Laura Newman, a science writer who has worked in health care for most of her adult life, first as a health policy analyst, and as a medical journalist for the last two decades. She was a proud member of the women’s health movement. She has a longstanding interest in what matters to patients and thinks that patients should play a major role in planning and operational discussions about healthcare. Laura’s news stories have appeared in Scientific American blogs, WebMD Medical News, Medscape, Drug Topics, Applied Neurology, Neurology Today, the Journal of the National Cancer Institute, The Lancet, and BMJ, and numerous other outlets. You can find her on Twitter @lauranewmanny.]

Ed note: The original version of this post contains a posted correction that is incorporated into the version you’ve read here.

The opinions in this article do not necessarily conflict with or reflect those of the DXS editorial team. 

Leaky gut and wonky immune response might be double whammy leading to inflammatory bowel disease (in mice)

A case of ulcerative colitis, a form of inflammatory bowel disease.
Photo via Wikimedia Commons. Credit: Samir.

A two-hit punch in the gut might explain why some people find themselves alone among their closest relatives in having inflammatory bowel disease (IBD). The double gut punches come in the form of a compromised intestinal wall coupled with a poorly behaved immune system, say Emory researchers, whose work using mice was published in the journal Immunity. IBDs include ulcerative colitis and Crohn’s disease, the latter of which is slightly more common in women.

An inflamed gut is the key feature of IBD, which affects about 600,000 people in the United States each year. Typical symptoms include bloody diarrhea, fever, and cramps, which can come and go with bouts of severe inflammation punctuating relatively calm periods. The going explanation for these disorders is a wonky immune system, but some breach of the barrier that keeps your gut contents in their place is also implicated. Researchers also have identified a link between bouts of gastroenteritis–known around my house as “throw-up” illnesses–and development of IBD. What’s remained unclear is how people who have these so-called “leaky guts” don’t develop a disease like Crohn’s when a close family member with a leaky gut does.

These hints in humans led the Emory investigators to examine the interaction of a compromised gut and the immune system in mice. The mice in the study had ‘leaky’ gut walls because they lacked a protein that usually ties cells together into water-tight sheets. Without these proteins sealing up the intestinal lining, bacteria and other components can make their way their deeper into the intestinal wall, triggering chronic inflammation.

The thing is, these mice with their leaky guts don’t develop colitis spontaneously, a situation, the investigators hypothesized, that  reflects families full of people with leaky guts but rarely IBD.  Permeable intestines alone aren’t enough. Some other dysfunction related to the immune system, they figured, must pile onto that leakiness and bring on the inflammatory disorder.

If you’re an immunologist–which I am not–an obvious choice for investigation is a class of immune cells called T cells. These cells come in a dizzying array of types, but one way to narrow them down relies on a protein that some but not all of them make. Pulling out the T cells that make this protein, says Timothy Denning, PhD, a mucosal immunologist at Emory and study author, is “the simplest way” to start examining the immune system involvement because these cells play a ton of roles in balancing different immune responses. So, they first collected the T cells carrying this protein from the mouse intestines.

“There are good and bad” versions of T cells carrying these identifier molecules, though, says Denning, so the next step was to find the “good” ones that might be protecting mice in spite of their sieve-like intestinal linings. To achieve that goal required some fancier lab moves. “We stimulated the cells and looked at the cytokines (immune signaling molecules) they make,” explains Charles Parkos, MD, PhD, an experimental pathologist and mucosal immunologist at Emory and also a paper author. “We found that the cells in the mice that were better protected predominantly secreted TGF-beta, a prototypic marker for ‘good’ cells.”

One of the things T cells do with TGF-beta is to talk to B cells, another class of immune cell. B cells take responsibility for remembering what’s attacked you in the past and marshaling forces if it attacks again. Also, when B cells are stimulated, explains Parkos, one way they respond is to release proteins–antibodies–that target the offending invaders. In the gut, the kind of antibody the B cells make in response to the TGF-beta message is immunoglobulin A, or IgA. This antibody “keeps bacteria in check,” says Denning, and also probably “broadly neutralizes lots of different microorganisms” in the intestines, adds Parkos.

The Emory-based team found that when the leaky-gut mice also had an IgA deficiency, they became more open to the types of immune cells that cause gut inflammation. The animals also were far more susceptible to colitis triggered by a chemical treatment in the lab and had much worse disease. Without the IgA, the mice couldn’t dampen inflammation triggered by bacteria slipping through the intestinal breaches. The results of this two-step physiological fail, in mice, at least: severe inflammatory  gut disease.

Denning cautions that these results in mice don’t suggest a rush to TGF-beta or IgA treatment for inflammatory diseases. “TGF-beta has many effects and on many different cell types, and too much is not a good thing because it’s known to play a role in fibrosis and cancer,” says Denning. “If your child had IBD, the last thing you’d want to do is to give TGF-beta.” Much more work has to be done, he adds, for a better understanding of the implications of these results before anyone starts talking about therapies. Parkos agrees. “To our knowledge, administration of TGF-beta is not a viable therapy.”

The same applies for IgA, Denning says. “We couldn’t just take any old B cells and get them to make IgA and put it in and hope that it would do something,” he says. The reason, he explains, is because B cells make many different types of IgA molecules specific to foreign invaders they encounter, a process that happens on the spot, not in a lab dish. “We need to understand much more about the basic mechanisms, but we do believe that these pathways would be critical to induce in people who are more susceptible to IBD, such as first-degree relatives.”

Some research groups are conducting trials to treat IBDs with helminth worms–intestinal parasites–on the hypothesis that their presence would induce a balance in the immune system and tamp down an overactive inflammatory response. The balance in this case is supposed to be between two competing aspects of the immune system, called Th1 and Th2. But one issue in these intestinal inflammatory disorders, says Denning, is that Crohn’s is linked to Th1 hyperactivity while ulcerative colitis is associated with Th2.

Yet the worms appear to show some beneficial effects in both disorders, in spite of the different involvement of Th1 and Th2. The TGF-beta signaling effect on IgA that the Emory group identified operates by a third component, tentatively identified as Th3. Both Denning and Parkos are intrigued by the possibility that the presence of helminths might trigger this pathway, rather than influencing Th1 or Th2, explaining why worm treatment has sometimes proved useful for both Crohn’s and ulcerative colitis.

As for why IBD arises, the researchers hope their findings answer some questions. “There are different camps in the IBD community,” says Parkos. “Some say immune system, some say barrier, others say genetics or environment.” What they have with their results, he says, is evidence showing that a leak alone is not enough and that a wonky immune system alone is not enough. But the double-whammy of a leaky gut and an absence of immune protection “dramatically increase susceptibility to disease, and that helps explain why diseases are so complicated,” he says.

The use of parasitic worms for these inflammatory diseases arose from the concept of the hygiene hypothesis, the idea that we’re too clean in the modern developed world, leading to an immune imbalance that can include chronic inflammation and autoimmune disorders. Asked about any links between the hygiene hypothesis and this pathway to IBD they identified in mice, Denning says, “It’s not obviously all about the parasites. That’s just one key thing–it’s probably an exposure to a lot of different types of things in your gut and airways.” He describes the immune system as being a thermostat that registers a specific set-point early on based on these exposures. This set-point, he says, is lower in people who grow up in developed countries like the United States and leads to a “trigger-happy immune system that is ready to fire much more easily.”

That doesn’t mean that a worm infection or just being dirty will prevent your developing IBD. That said, these immunologists both have the same general advice for parents regarding their children. “Being too clean is not a good thing,” they agree. As immunologists, he adds, “We feel exactly the opposite. Go play in the dirt.”


Parenting paranoia comes in different forms

It could be Andrew Wakefield or a brain-hijacking microbe.

by Meredith Swett Walker

I’m a scientist, but I’ve learned that when we become parents, paranoia can trump the powers of rational analysis I’ve so carefully nurtured and developed. For some parents, media-whipped fears about vaccines take front and center in the anxiety lineup. For me, a brain-infecting microbe that makes mice hang around cats is at the top of my parenting paranoia list.

Parenting requires making many, many choices. Some seem inconsequential, like whether your child will wear overalls or sweatpants, pigtails or a pixie cut. But other choices have to do with health issues such as circumcision, immunization, and breast milk vs. formula – just a few in an endless list. For geeks like me, the first impulse is to research each issue, make a choice, and prepare an argument for anyone who questions the decision (and believe me, someone will.) My response usually goes something like this: “Well, recent studies have shown that yada yada yada…” Then I pat myself on the back for being so informed and making such a well-reasoned decision.

My process ran into trouble, though, when my relationship with a university and its online library access ended. What happens when you can’t get your hands on peer-reviewed scientific journal articles? One consolation should be that we live in the “Information Age.” Surely, Google, a fast internet connection, and an overwhelming flood of information should lead to what we need to make well-reasoned, science-based parenting choices. Surely.

Maybe not. A friend recently shared with me an article from the open-access (i.e., free) online journal PLoS: “Why Most Biomedical Findings Echoed by Newspapers Turn Out to be False: The Case of Attention Deficit Hyperactivity Disorder.”  The gist is that the news media preferentially cover initial findings described in the most prominent scientific journals. The key word there is initial. No initial result is going to be the final word in science, and all results require confirmation from other researchers repeating or extending the experiments. Sadly, in practice, many of the follow-up studies don’t get published in the most prominent journals because they are not “a big scoop.” Yet they often show that the initial, Big Headline Finding was overblown or even incorrect.

That brings me to an example that really pushes my buttons — childhood immunizations. In 1998, Andrew Wakefield and colleagues published a study in the prominent British medical journal the Lancet. The paper examined a hypothesized association between the MMR (measles, mumps, rubella) vaccine and autism, but the authors used fairly moderate language in their conclusions. But then, Wakefield participated in a press conference about the paper and asserted in much stronger language that the MMR combined vaccine and autism were linked and that parents should turn to single shots for measles, mumps, and rubella. The news media ate it up.

The scientific community immediately pointed out a number of glaring flaws in the study, and subsequent investigations over the next decade failed to reproduce or confirm the results. But it was too late. The popular media and celebrities like Jenny McCarthy had already done the damage. Parents were terrified, vaccination rates dropped, and deadly measles and whooping cough outbreaks starting cropping up.

Yes, the news media covered subsequent studies reporting no link between vaccines and autism, but let’s face it: Science is slow, and news is fast. In the interval, scary information takes root. The Lancet retracted the article 12 years after its publication, and in 2011, British investigative journalist Brian Deer demonstrated that Wakefield actively falsified data. Still, to this day, vaccination rates have not fully recovered, and many parents remain misinformed and concerned about vaccinating their children. Indeed, the Wakefield debacle has been directly blamed for a huge and ongoing measles outbreak in Wales.

I could haz Toxoplasmodium in my poop, so be careful.

I could haz Toxoplasmodium in my poop, so be careful.

Admittedly, the MMR case is an extreme example but also a good one of how a single initial study and the ensuing media hysteria can have a huge effect on parents — and on children’s health.

And we all have our trigger points for fear. One (of the many) things in our family tree is schizophrenia. A member of our extended family developed schizophrenia as an adolescent and has never recovered. Schizophrenia can run in families, so my two children have up to a 4% chance of developing this disorder compared to the 1.1% chance of someone without close relatives who have it.

So along comes my March 2012 issue of The Atlantic featuring “How Your Cat Is Making You Crazy” by Kathleen MacAuliffe. I would have found this article fascinating even if schizophrenia weren’t a concern. Its subject is a parasite called Toxoplasmosis gondii, which usually cycles through two hosts: cats and rodents. Toxo, as I’ll call this beast, starts life as an egg in a cat, is pooped out, and then gets picked up by a new cat. How does it get into a new cat? Cats, unlike dogs, are pretty fastidious and don’t tend to eat or otherwise mess around with cat poop. So Toxo gets itself into a less fastidious but tasty morsel like a mouse, instead, making its way into the cat when the mouse becomes dinner.

That seems simple enough, but there’s more. Toxo infection ups the odds of a mouse–cat encounter by hijacking the mouse’s brain and changing its behavior. The mouse’s activity level increases (cats love to chase fast-moving objects), and the rodent might become less wary in exposed areas and even attracted to the smell of cats. Watch these videos, and you’ll see how the infected mice move faster and wander into unknown spaces, seemingly without fear, as you can see in this video and this one.

The trouble for humans is that we also can pick up Toxo through contact with cat poop or eating undercooked meat or unwashed veggies from a garden where cats poop. Becoming infected with Toxo during pregnancy can be very harmful to a fetus, so pregnant women have long been warned off cleaning kitty litter boxes. But healthy, non-pregnant adults infected with Toxo weren’t thought to experience any detrimental effects — until recently. According to MacAuliffe’s article, which focuses on the work of Czech biologist Jaroslav Flegr, Toxo might alter human behavior, too, in mouse-like ways, such as reducing fearfulness. In most people, these purported behavioral shifts are probably very subtle and unremarkable. But Flegr suggests that in some people, Toxo infection serves as the trigger for mental illness, including schizophrenia.

Schizophrenia likely develops because of interactions between genes and the environment. Having risk gene variants isn’t a guarantee a person will develop schizophrenia, and it can arise in people without those risk variants. The list of potential environmental triggers is long and includes childhood stress, prenatal undernutrition, drug abuse, and …  infections with microbes like Toxo.

Reading this article set me off on a tear of worrying. We have a cat, but I wasn’t worried about her. She is an indoor cat (we love birds), and there is a very low incidence of Toxo infections in indoor cats. But we have outdoor cats and feral cats in our neighborhood. They sometimes hang out in our yard, where my kids like to play in the dirt and eat things out of the garden, including the dirt itself. Oh, poop.

I took to Google and researched cat traps and repellents and how to get kids to wash their hands. I laid awake at night for hours strategizing about how to keep my home and yard Toxo free. And then I realized, even if I managed to exclude all cats from my yard and the totally impossible feat of getting my children (ages 1 and 2) to wash their hands before they touched their faces or food every time, I was still doomed to failure. My kids would go to friend’s houses and play in their Toxo-infested yards.  Or they might already have encountered Toxo anyway.

Toxo was something I couldn’t control, and I needed to let it go. At our next check-up, I talked to our pediatrician about it, who had never heard about the potential Toxo–schizophrenia link. She graciously concealed her “Oh, Lord, another parent with a loony theory” reaction and calmed me down. As she put it, my only real option to prevent Toxo infection was to never allow my children to play outdoors or in the dirt, and the detrimental effects of that were likely far greater than the risk of schizophrenia, Toxo or no Toxo.

And she also reminded me of what I already knew and should have remembered: These findings about Toxo are initial findings.

As a scientist, I know that the schizophrenia–Toxo link needs more study. A lot more study. As a parent, well … yeah. I still worry, and no lack of replication or confirmation is likely to stop me.

[Image credits: cat on this page by Sasan Geranmehr under Creative Commons 3.o license; mouse under same license.] Continue reading

Double Xpression: Debbie Berebichez, PhD Physicist

Deborah is the first Mexican woman to graduate with a physics PhD from Stanford University. She is a physicist, author, and media personality whose initiatives to popularize science have impacted thousands of people around the world. Her passion is to popularize science and motivate young minds to think analytically about the world. This has led her to pioneer learning initiatives in schools and universities in Mexico, Africa, the US and Israel. She is a frequent public speaker and has been recognized by numerous media outlets such as Oprah, CNN, WSJ, TED, DLD, WIRED, Martha Stewart, City of Ideas, Dr. Oz Show, Celebrity Scientist and others. She regularly appears as a science expert on different international TV networks; currently she is the TV host of National Geographic’s “Humanly Impossible” show. And she will appear on the Discovery Channel’s upcoming show ‘You’ve Been Warned.’  You can find Deborah on Twitter, or on her blog, Science With Debbie.  You can also find Deborah telling her story for The Story Collider.

DXS: First, can you give me a quick overview of what your scientific background is and your current connection to science?

I grew up in Mexico City in a fairly conservative community, and as a child, I was discouraged from doing and studying science.  My parents, family, and peers would all ask, “oh, why don’t you study a more feminine career?” Although I was pretty good in school, I wasn’t exactly a math wizard.  I used to say that I loved philosophy and physics – because philosophy was a deep discipline of asking questions about the world.  And physics studied the world itself.   
It was clear when I was born that my personality was was quite different to the one of my mom.  When I was growing up, my mom was scared because she didn’t know what to do with this little girl that was smart and always asking questions.  She is not a naturally curious person, so she kept trying to tame down my curiosity and kept telling me not to tell boys that I was interested in math and science because I would never find a husband.  According to her, the life goal for a girl was to find a husband, have kids, and that’s it.  Women didn’t have to have a career.  (Not that there is anything wrong with not having a career.)  My high school teachers and counselors were not so different and encouraged me to go into philosophy or literature, not into math or physics.  And my friends in school told me I literally had to be an out of the world genius to be able to study physics.      
Given the circumstances, I started studying philosophy in Mexico.  There were some classes with logic, and some with a little bit more math, and those were the ones I just devoured!  And, at the same time – secretly – I was reading the biographies of scientists.  For some bizarre reason, I was hugely attracted to their life stories.  I didn’t have any family members, or anyone else for that matter, that had pursued a career in science, so I didn’t have a mentor or a role model.  I felt an extreme kinship with Tycho Brahe, who in the late 1500’s was locked in a tower, doing all of these calculations for years, hated by everyone in the town.  Go figure! I felt some kinship with these scientists.   But I didn’t have the courage nor the means to switch majors.  I did confess that I wanted to study another area (physics), but in Mexico one cannot study two majors. So, I studied philosophy for two years.

In the middle of it, I felt way too curious about science and I decided to apply to schools in the US.  It was hard at the time because college in Mexico was a lot cheaper than in the states.  At the private school where I was attending, my tuition was about $5,000 per year.  If I were to come to the US, I would be looking at costs exceeding $35,000 per year. I couldn’t really ask my dad to help me with that price tag so I started to apply everywhere and anywhere that had scholarship opportunities.

I ended up getting a letter from Brandeis 

University saying that they would let me take this advanced placement test and write an essay, which, if I did well, would give me a full scholarship.  I received a full Wien Scholarship and was to continue studying philosophy in the US.  This was probably the nicest thing that has ever happened to me because it opened the path of opportunity.

Brandeis transformed me as a person – I saw females doing science!  But, the bravado moment that changed my life was a very general course called Astronomy 101.  The teaching assistant, Roopesh, was a very sweet man from India and he saw that my eyes would just light up when I was in that class – I was much more curious than the random student that was just taking it to fulfill some requirement.   
At the end of that year, Roopesh and I 

were walking around Harvard Square and stopped to sit under a tree.  I started to tell him, with tears in my eyes, that I just don’t want to die without trying.  What I meant by that is I don’t want to die without trying to do physics.  Everyone’s questioning of my decision made me question my actual ability.  Everyone telling me ‘no’ hampered my development.  I mean, I was good at math, but I definitely didn’t have the same background as all the kids coming in with advanced math and physics courses. 

I told Roopesh that I don’t even remember how to solve the equation (a+b)2 – even my algebra was rusty!  But, he believed in me and went back to his professor and told him my story.  This professor decided to meet with me and ends up telling me about someone who had done this sort of thing in the past.  His name was Ed Witten and he went on to become the father of string theory.  

He said “Witten had switched from history to physics, and I will let you try too.”  With that, he handed me a book on vector calculus called ‘Div, Grad and Curl’ and told me that If I could master it in three months by the end of the summer, they would let me switch my major to physics and also let me bypass the first two years of course work.  This would allow me to graduate by the time my scholarship ran out.        
I have never in my life experienced the level of scientific passion condensed into such a short amount of time and I am jealous of the person I was that summer.  I had so much perseverance and focus.  I don’t think I can ever reproduce that intensity again.  From the moment I woke up to the moment I went to sleep, and even in my dreams, I only thought about physics. Roopesh, who became my mentor for the summer, taught me.  

I always wanted to pay Roopesh for his tutoring, but he would never accept any money.  He told me that when he was growing up in the mountains of Darjeeling in India, there was this old man who would climb up to his home and teach him and his sisters English, the musical instrument Tabla, and math.  Roopesh’s father always wanted to pay the old man for his tutoring, but the man always declined.  The man said that the only way he could ever pay him back was if Roopesh did the same thing with someone else in the world.  And by mentoring me, Roopesh fulfilled his payment to the old man.  
Out of that, that became a seed for my physics journey and purpose.  It is now my life’s mission to do the same for other people in the world – especially women – who feel attracted to science but feel trapped.  They for some reason, whether it is social, financial, etc., just can’t find the way toward science.  That is the motivation that dictates my actions.
I was able to pull it off and graduated Brandeis Summa Cum Laude with highest honors in physics and philosophy. I went back to Mexico afterwards to figure out what to do next and to spend some time with my family. At the same time, I did a master’s degree in physics at the largest university in Mexico UNAM.  My curiosity for physics didn’t diminish and in 1998, I randomly applied to two physics PhD programs in the US.  I applied very, very late, but, fortunately, I won a merit-based full scholarship from the Mexican government who provided me with funding, which made it easier for me.    

Because I loved biophysics, I did a search on who was doing this line of research.  I came across Steven Chu, who is currently the secretary of energy.  At the time I was applying, he was at Stanford and was one of the first to manipulate a single strand of DNA with his ‘optical tweezers.’  To me, his story was fascinating!  Without really knowing who he was other than what I found on the web, I wrote him an email asking him if I could work in his lab.  Had I known who he was – that he had just won the Nobel prize in 1997 – I would have been too intimidated.  

I was admitted to Stanford and was invited to work with Dr. Chu, but after two years I decided to switch labs.  As expected, it was a very challenging environment and having only studied two years of physics at Brandeis, I wasn’t as prepared as most of the other students.  I struggled for the first two years.  Everyone worked so extremely hard at Stanford and there I was, struggling to be the best, but, in the beginning, I couldn’t even be average.

Fast forward four years.  I had worked my butt off and ended up becoming the first Mexican woman to graduate with a PhD in physics from Stanford.  It was the best day of my life – I kept thinking that I was so blessed to have my parents live to see this!  It was so moving, I was crying so much and I couldn’t believe what had happened.  My friends had flown in from all over the world to be with me.  It was amazing. 

When people hear what I do, they – especially teenage girls – feel intimidated.  But, when they hear the whole story, their tune changes.  I tell them that I know what it is like to not understand something.  I was not the kind of person where comprehension of my science came naturally.  But I did it.  And if I can do it, anyone can do it!  My story can be inspirational to someone who comes from a background completely lacking in science because they, like me, can reach their goal. 
DXS: What ways do you express yourself creatively that may not have a single thing to do with science?

I was always a very curious girl growing up. I had a lot of interests, one of which being theatre.  I wanted to be an actress when I was young, but my father didn’t let me pursue that as a career, which was probably a good idea.  But, during high school, I went to an after school drama program.  I wrote my own plays – three of them – and performed one of them.  I was in heaven when I was on stage. 

In NY, I have tried to do a little bit of that.  Of course, I’ve never done any big roles, but I will be an extra in a film, or if there is a small production being made in Spanish, I will play a part.  It doesn’t matter how big the role is – I just love doing something creative and getting into a character. 

DXS: What types of productions and/or films have you done?

I don’t think I would come up in the credits as an extra, but I did a movie with Simon Pegg, Kirsten Dunst and Megan Fox in the movie “How to lose Friends and Alienate People.” It was a very, very fun film!  In theatre, Jean Genet, who is a French playwright, has a play called The Maids, and I was the madame.   

DXS: Do you find that your scientific background informs your creativity, even though what you do may not specifically be scientific?

Debbie talking to the TEDYouth audience about waves.

I have a concept that I call “physics glasses.”  And what I mean by that is, for me, physics is not a subject that you just teach in a complex way in a classroom.  Rather, physics is something that is related to everyday life.  From the moment you wake up, you can just put on your physics glasses.  It is a mode of thinking – it is a way where although reality can be very rich and diverse, physics goes very deep and it abstracts commonalities, general principles that apply to many things.  To give you an example, I asked the kids in the audience of my TEDYouth talk, “what do the sun, the ocean, and a symphony orchestra have in common?”  When just looking at them on the surface, there isn’t much in common.  I mean, they are all beautiful things but they are not obviously related.  But, to a physicist, they are all waves.   You have sound waves, light waves, and water waves and you can interchange many of the concepts in physics to explain all three.

Where most of us see the world with our eyes through light waves, other might see the world differently.  Take, for example, my friend Juan, who is blind.  He “sees” the world with sound waves – he senses sound as it bounces off the objects around him.  Through this, he can bike, play basketball, and do a load of activities using sound as a guide.  This is one of my favorite analogies because, really, physics “infects” the way I see the world. 

Deborah the Physicist model

To give you a more specific example in the creativity realm, when I got to NY, I felt really un-feminine.  When I was studying physics, I felt that if I was even slightly feminine, I wouldn’t be respected.  It didn’t help that some of the other women in the physics program at Stanford were more of a “guys girl,” always wearing a baseball cap and t-shirts.  Now, since I am Latin, I first showed up wearing a skirt to class, but I quickly learned to dress down.  Looking feminine would assure that no one would talk to me in class.

So, when I got to NY, I had an explosion.  I wanted to know what it was like to express myself as a woman and my friend suggested that I do some modeling.  So I did.  It was a brief, lasting about a year.  But during that time, my friend, who was a designer from Mexico, asked me to work with her and I wrote and did some videos about the physics of fashion, which also included the physics of high heels video.  

Some people could consider fashion to be superficial, but not me.  I love fashion and color.  But, other scientists generally looked down upon you for liking this sort of thing.   This fueled my desire to prove to everyone that there actually is science everywhere, including fashion, and that they shouldn’t be snobs about it.  There is complex science in how different materials work, how they interact with the environment and you can prove to the women, like my mother and friends back home who think that science has nothing to do with their everyday lives, that it has EVERYTHING to do with it.   So I talked about a Newtonian theory for color – how to pick the right color for you based on how much light the color would reflect on that day, etc.  

DXS: Like a more sophisticated version of colors based on your “season?”

DB: Exactly! 

I also did pieces on the materials, including some of the newest engineering accomplishments with fabric.  For example, I hooked up with a woman and helped her to design a fashionable and very scientific coat.  It ended up costing $11,000, but it was made up of nano fibers and it had a patch in it that could detect the temperature and the probability of rain.  Based on this probability, it could change permeability of the fabric.  It was a very light coat that was comfortable in nice weather, but when it would rain, it would become impermeable to water once it detected a high probability of rain, transforming into a raincoat.

DXS: That’s incredible!  I wish it wasn’t $11,000!

DB:  Yeah, that’s usually the problems with these technologies.  They are often so novel, but one day I’m sure we can figure out how to make things like this scalable.

Science is very much what guides my thinking when I am being creative and I wish I had more time to do creative things while being influenced by a scientific mindset.

DXS: It is so cool that physics has such an incredible overlap with everyday living.  Like, when we take a shower, I want to know “how is the water getting pumped from the ground or through pipes and make its way out of the showerhead?”  But, as a biochemist, I often find it hard to relate everyday things to biochemistry, but I would like to!

DB: Its funny that you say that.  When I try to teach girls that the worst thing they can do is memorize.  Critical thinking is so important and they shouldn’t take anything at face value, and they should even question teachers and authoritative figures in their lives.  Always ask: what goes into making this?  Why is this here?  Why is it this way and not another?  Constantly ask questions.  That s the gift that physics will give you. 

DXS: Have you encountered situations in which your expression of yourself outside the bounds of science has led to people viewing you differently–either more positively or more negatively?

Without saying I am a scientist, I can tell you that people have come up to me and told me that before they even hear me speak, they think I am dumb.  They are usually surprised that I am smart!  I think it is because I am bubbly and friendly and that often makes an impression as being unintelligent.  For them it seems that if a woman is intelligent, she is very cold and distant and serious.  

I’ve met a lot of physicists, and yes, some of them do tend to be that way, often as a reaction to how others treat them.  Or, people would say to me that, because I am Latin, my cultural identity comes across as being warm and the last thing they’d expect me to be into was something as cold as physics.  So yeah, I have definitely been judged so many times!  

It even happens in my current job on Wall Street, especially with my male peers.  When there are off site client meetings, I’m often accompanied by my male sales colleague.  Sales people are generally required to know less about the complexities behind our risk models compared to someone on a more research-oriented role, like me and he will bring me along to these sales meetings in case the potential client has more sophisticated questions that go beyond what he can comfortably answer.  Many times upon meeting the clients for the first time they think that I am the sales person, there to be the smiling face to sell them something, and that he is the risk modeler.  They always direct their mathematical questions to him. 
It came to a point where I became so annoyed that I decided to stop caring.  Now, my sales colleague goes out for drinks with the clients and I know that I am going to be invisible. So I don’t go anymore. I know that I am always going to struggle to get the full intellectual respect in that industry – it will always be a challenge.

DXS: Have you found that your non-science expression of creativity/activity/etc. has in any way informed your understanding of science or how you may talk about it or present it to others?

Yes, absolutely.  For example in Mexico, unlike the US, you absolutely have to do an honors thesis project as an undergrad in science.  Because I had already studied philosophy for four years, I wanted to do a thesis project in philosophy.  But I also wanted to do one in physics.  I recall that back in 1997, when you presented a dissertation in front of the physics community, if you had any power point, forget it.  You would be immediately be called dumb or not a good physicist.  Because, who takes the time to do something fancy!  If you had any color in your presentation, forget it!  

So, literally, the smartest students in physics were people who didn’t really communicate that well, or didn’t really speak English that well, or just didn’t really make an effort.  Their slides were on those overhead projector things with those rolls of plastic sheets, and most of their talks were so confusing and couldn’t be interpreted!  But they were respected!  It was just assumed that if the formula looked complex, they were probably right. 
So what I did was completely different.  I infused my talk with my spiciness and color.  I did an artwork of liquid crystals, which was my research at Brandeis.  Liquid crystals are little cigar-shaped molecules that actually make up the screen of your laptop.  If you pass an electric field through them, they all orient themselves and that is how we can use them for displays in our laptops and TVs. 

I colored these cigar-shaped molecules with purples and reds and greens, and I tried to explain it at the most basic level. This is because of one my philosophy professors in Mexico, who told me that if you cannot explain what you do to your grandmother or 6 year old niece, you don’t understand what you are doing – I loved it!  

And I said to myself that I shouldn’t care what they think.  I pretty much expected to not gain a lot of respect from the physics department, but it had the opposite effect!  I actually had one of the professors from that department come up to me and tell me that he had never really understood what a liquid crystal looked like or what it really was!  He said that “finally I understand [liquid crystals] because of your drawing.  Thank you!”  It was incredible!  

To see the effect on people and from then on, I bounced up in down, I made jokes, I put in creativity.  It doesn’t always have a great effect on very serious audiences, but the younger generation is definitely appreciative.  When it keeps going well, you gain confidence.  And, for me, I even started wearing high heels to the next talk.  When someone commented about my attire, I would counter, hey I have a PhD!

DXS: How comfortable are you expressing your femininity and in what ways? How does this expression influence people’s perception of you in, say, a scientifically oriented context?

This question is deep and a little bit of a struggle at the moment.  This is because I still have that fear – when I arrived in NY, I did that short stint in modeling and I expressed myself and I would dress very creatively – just like my other girlfriends who were not scientists.  But I did feel a little bit of a backlash.  By that I mean that I would post a photo of myself on Facebook or something like that.  They were pretty pictures, not at all seductive or provocative, and my high school mates, usually male, would write me saying: “I always knew you as a serious person and you have achieved so many things – I am just telling you for your own good that this can really damage your image.”  That made me reply with “so you’re telling me that being smart is actually kind of a bummer?”  That actually means that I have to dress very differently from what other women wear for the rest of my life? 

I remember feeling very upset about all of that.  I think that not being taken seriously is still a little bit of a fear of and I think my website has damaged my serious image a little bit.  As a scientist, I was very secluded from the outside world.  I didn’t have a lot of friends when I moved here, but I did know an amazing and powerful woman who happened to be the CEO of Blip TV.  She was insisting that I do videos!  So she invited me to her place and showed me how to do video.  Being the quick woman that she was, she asked me to make up a name for myself on the spot.  When I didn’t answer, she instantly coined “The Science Babe” for me.  I was like, sure, what a cool idea! 

It was kind of a cute name, but because English is not my first language, I don’t always understand some of the cultural connotations associated with some English words.  A few months later, I started to get a few emails from mothers who were upset that I was using my looks.  They would say things like “Are you saying that women have to be in the kitchen or wear short skirts  to be scientists?”  I would answer that no, that was not it at all.  I would further explain that I was trying to change the definition of “babe.”  If you are smart, if you are empowered, you will be a babe no matter how you look.  I am trying to shift what people think of when they think “scientist.”

I don’t feel quite successful with The Science Babe.  It seems like there are quite a few people, especially some from the older generation, who say that they’d love to introduce me to fancy science organizations but are worried that the name “the science babe” will make it difficult.  Also, I had the BBC wanted to talk to me about doing a TV show in NY, and then they said but there’s so much bad stuff out there about you!  And I was like, what do you mean?  They answered “All these things with the “science babe” brand…”

It doesn’t happen all the time, but some people are really critical about the science babe theme, citing that its way too feminine.  Other female scientists that haven’t gone that route have perhaps discounted my seriousness about science.  They assume that what I am doing is not really that important because I do focus on the science everyday life, which is simpler, and it is too much color and too much vivaciousness for our field.  I feel like my femininity has decreased over the last few years because I’ve been too nervous about not being taken seriously.  It s almost like the balance tipped the other way. I feel like perhaps I’ve feminized things to a fault and now I want to appear more serious.  So, I am changing my website to “Science With Debbie” because I really felt the backlash.

It is a struggle to find the balance between being able to express my femininity and presenting myself in a way that people will take me seriously.  In a way, I wish I had a little more courage to not care that much about what people have to say about the science babe but, unfortunately, agents have told me that if I don’t go to the “dumbed down version of femininity” I would get better speaking engagements.  Being feminine has literally affected my career, and it’s because of other people’s perceptions.  I’m never going to be bland, but I will try to change things so I am more serious

DXS: Do you think that the combination of your non-science creativity and scientific-related activity shifts people’s perspectives or ideas about what a scientist or science communicator is? If you’re aware of such an influence, in what way, if any, do you use it to (for example) reach a different corner of your audience or present science in a different sort of way?

The fact that I am approachable and pretty down to earth has allowed me to reach corners of society that more distant and fancy scientists would never even consider. For instance, I am going to a small university to give a talk.  Some of my friends ask why I even bother, especially considering that this insitution is not the most renowned university.  But, I feel the opposite – it is these corners that need the influence the most!  Similarly, when I go to Hispanic high schools, many of the mothers have never seen a scientist.  And there I am, a scientist from Mexico, speaking to them and their kids.  It is that powerful combination of being a smart and warm female that can be shocking, which is cool.

In line with this, there was an experiment where women were asked to draw a female scientist.  Most drew a plain, relatively unattractive woman.  Immediately when you break that mold, it has an incredible effect.  People say, “Hey! She kind of looks like me and she dresses like me.  Maybe I can do science too!”  Some girls are afraid that by being smart, boys won’t talk to them.  My femininity allows me to be a voice in a field that has tended to isolate themselves from the public, which is bad. Some of my colleagues have become a little snobbish.  The fact that I have serious credentials (PhD and 2 postdocs) shows that I had to work like crazy – looks and personality can only go so far.  It s hard work that gets you there! Serious science communication has a lot of math and problem solving in order to explain things accurately to the public. So I still feel like I am doing science!



Vaccination attitudes are contagious

The power of social ties may be stronger than you think.

by Tara Haelle Continue reading

How helpful are dense-breast right-to-know laws?

A doctor reviews a digital mammogram, pointing to a possible cancer.
Credit: National Cancer Institute.
By Laura Newman, DXS contributor
In a victory for the dense-breast patient movement, Governor Jerry Brown (D-CA) signed legislation last week requiring that doctors who discover that women have dense breasts on mammography must inform women that:

§  dense breasts are a risk factor for breast cancer;
§  mammography sees cancer less well in dense breasts than in normal breasts; and
§  women may benefit from additional breast cancer screening.

The California law goes into effect on April 1, 2013. It follows four states (Connecticut, Texas, Virginia, and New York) with similar statutes. All have enjoyed solid bipartisan support. Rarely do naysayers or skeptics speak up.
Young women who are leading the charge often bring lawmakers the story of a young constituent, diagnosed with a very aggressive, lethal cancer that was not shown on film-screen mammography. The Are You Dense? patient advocacy group engages patients on Facebook, where women share their experiences with breast cancer, organize events, and lobby for legislation. Individual radiologists work with the advocacy groups, but many radiology groups and breast surgeons do not endorse these laws.

A Closer Look at Breast Cancer Data

Living in an age when information is viewed as an entitlement, knowledge, and power, many physicians find it hard to argue against a patient’s right to know. Can sharing information be a mistake? Some epidemiologists think so. Otis W. Brawley, MD, FACP, Chief Medical & Scientific Officer, American Cancer Society, says: “I really worry when we legislate things that no one understands. People can get harmed.” Numerous issues have to be worked out, according to Brawley. For one, he explains: “There is no standard way to define density.” Additionally, “even though studies suggest that density increases the risk of cancer, these cancers tend to be the less serious kind, but even that is open to question,” Brawley says. “We in medicine do not know what to do for women who have increased density.”

A study of more than 9,000 women in the Journal of the National Cancer Institute revealed that women with very dense breasts were no more likely to die than similar patients whose breasts were not as dense. “When tumors are found later in more dense breasts, they are no more aggressive or difficult to treat,” says Karla Kerlikowske, MD, study coauthor, and professor of medicine and epidemiologist at the University of California San Francisco. In fact, an increased risk of death was only found in women with the least dense breasts.

The trouble is what is known about dense breasts is murky. Asked whether he backs advising women that dense breasts are a risk factor for breast cancer, Anthony B. Miller, MD, Co-Chair of the Cancer Risk Management Initiative and a member of the Action Council, Canadian Partnership Against Cancer, and lead investigator of the Canadian National Breast Cancer Screening Study, says: “I would be very cautious. The trouble is people want certainty and chances are whatever we find, all we can do is explain.”

Women in their forties, who are most likely to have dense breasts (density declines with age) may want to seek out digital mammography. In studies comparing digital mammography to film-screen mammography in the same women, digital mammography has been shown to improve breast cancer detection in women with dense breasts. Findings from the Digital Mammographic Imaging Screening Study, showed better breast cancer detection with digital mammography. But digital mammography is not available in many areas.  Moreover, Miller explains: “We do not know if this will benefit women at all.  It is very probable that removal of the additional small lesions will simply increase anxiety and health costs, including the overdiagnosis of breast cancer, and have no impact upon mortality from breast cancer.”

Additional imaging studies sound attractive to people convinced that there is something clinically significant to find. But as I pointed out in my last post, many radiologists and breast physicians contend that there is no evidence that magnetic resonance imaging or any other imaging study aids breast cancer screening in women with dense breasts. Brawley notes: “These laws will certainly lead to more referral for MRI and ultrasound without clear evidence that women will benefit (lives will be saved.) It’s clear that radiologists will make more money offering more tests.” Miller adds: “A number of doctors are trying to capitalize on this and some of them should know a lot better.”

Many Advocates Question More Tests, Statutes

Even though the “Are You Dense?” campaign has been instrumental in getting legislation on the books across the county, other advocacy groups and patient advocates want research, enhanced patient literacy about risks and benefits of procedures. Many recall mistakes made that led women down the path of aggressive procedures. In that group is the radical Halsted mastectomy, used widely before systematic study, but once studied,  found no better than breast-conserving surgery for many cancers, and bone marrow transplants, also found to be ineffective, wearing, and costly.

Jody Schoger, a breast cancer social media activist at @jodymswho engages women weekly on twitter at #bcsm, had this to say on my blog about the onslaught of additional screening tests:

“What is needed is not another expensive modality… but concentrated focus for a biomarker to indicate the women who WILL benefit from additional screening. Because what’s happening now is an avalanche of screening, and its subsequent emotional and financial costs, that is often far out of proportion to both the relative and absolute risk for invasive cancer. I simply don’t think more “external” technology is the answer but one that evolves from the biology of cancer.”

Eve Harris @harriseve, a proponent of patient navigation and patient literacy, challenged Peter Ubel, MD, professor of business administration and medicine, at Duke University, on his view of the value of patient empowerment on the breast density issue. In a post on Forbes, replicated in Psychology Today, Ubel argued that in cases where the pros and cons of a patient’s alternatives are well known, for example, considering mastectomy or lumpectomy, patient empowerment play an important role. “But we are mistaken to turn to patient empowerment to solve dilemmas about how best to screen for cancer in women with dense breasts,” he writes.

Harris disagrees, making a compelling case for patient engagement:

“I think that we can agree that legislative interference with medical practice is not warranted when it cannot provide true consumer protection. But the context is the biggest culprit in this situation. American women’s fear of breast cancer is out of proportion with its incidence and its mortality rate. Truly empowering people—patients would mean improving health literacy and understanding of risk…”

But evidence and literacy take time, don’t make for snappy reading or headlines, and don’t shore up political points. Can we stop the train towards right-to-inform laws and make real headway in women’s health? Can we reallocate healthcare dollars towards effective treatments that serve patients and engage them in their care? You have to wonder.
[Today's post is from Patient POVthe blog of Laura Newman, a science writer who has worked in health care for most of her adult life, first as a health policy analyst, and as a medical journalist for the last two decades. She was a proud member of the women’s health movement. She has a longstanding interest in what matters to patients and thinks that patients should play a major role in planning and operational discussions about healthcare. Laura’s news stories have appeared in Scientific American blogs, WebMD Medical News, Medscape, Drug Topics, Applied Neurology, Neurology Today, the Journal of the National Cancer Institute, The Lancet, and BMJ, and numerous other outlets. You can find her on Twitter @lauranewmanny.]

The opinions in this article do not necessarily conflict with or reflect those of the DXS editorial team.