Dear pain warriors,  At U.S. Pain Foundation, we deeply believe in the power of sharing patient stories. Talking about our experiences with pain helps us to educate others, to create change, and to offer hope. That’s why our theme for Pain Awareness Month 2019, which begins Sunday, is #LetsTalkAboutPain. I first got involved in patient advocacy by writing a book about my experiences with complex regional pain syndrome. It enabled me to process my personal journey, take control of my story, and help create awareness for those like me.  I hope speaking up about pain this September can do the same for you.  This year, we have dozens of opportunities for you to help bring pain to the forefront of public conversations, ranging from our daily storyathon to social media giveaways to weekly events. All of these activities are presented in collaboration with our generous sponsor, Thrive Tape, the creator of an innovative, far-infrared kinesiology tape for all types of musculoskeletal conditions and injuries. (We encourage you to check them out! Use the code USPAIN for a discount.) How you can participate We have something for everyone! Most activities are online, which means you can take part from the comfort of your home.  Storyathon. Each day in September, U.S. Pain will be sharing a video story of a real person living with pain. These individuals–from all walks of life–bravely submitted their personal stories in August to help create awareness. To watch the videos, follow us on Facebook and Twitter. Missed the video storyathon deadline? Share your written story. Educational events.Events include: “Talking publicly about pain: A Q&A with Ed Coghlan of National Pain Report,” on Sept. 5 at 1 pm EST, “Expression and movement: A dance class for chronic pain,” on Sept. 10 at 8 pm EST, “Becoming Incurable: A Q&A with Film Director Victoria Suan” on Sept. 17 at 1 pm EST, and more. Get details and register. Social media challenge & giveaways.Each day, we’ll be posting a daily task across our social media channels. On certain days, participation will enter you to win awesome prizes, including: kinesio tape from our presenting sponsor, Thrive Tape; pain relief devices from Quell; Oska; and Enso; and a copy of the book, “Taming Chronic Pain.” Learn more. Profile frame. Social media is an easy tool for generating awareness. For a quick way to call attention to pain, customize your Facebook or Twitter profile picture with our Pain Awareness Month frame, featuring this year’s campaign theme, #LetsTalkAboutPain. Keep it up throughout the month of September–or even beyond–and encourage others to do the same. Resources & materials toolkit. U.S. Pain has launched a toolkit of downloadable and/or printable materials–including a chronic pain infographic, Pain Awareness Month flyers, social media graphics, sample social media posts, and more–to help you spread the word about chronic pain in your local community and online. Access the toolkit here.  Public awareness efforts. U.S. Pain volunteers have been busy obtaining government proclamations, getting buildings and landmarks to light up in blue on Sept. 13, having locations decorated in blue, organizing wear blue days on Sept. 27, and more. To see these efforts in action, subscribe to our newsletter or follow us on Facebook, Twitter, and Instagram. The above is just a sampling of opportunities to engage. To learn more about all Pain Awareness Month 2019 activities, visit our website.Let’s start talking! Remember: pain may be silent. But we don’t have to be. Thank you for working with us to create change for our community. If you have any questions about getting involved, please email us! Sincerely, Nicole HemmenwayInterim CEOU.S. Pain Foundation

Speak up today!

August 6, 2019 By 23andMe under 23andMe Research

By Rafaela Bagur Quetglas, PhD

You are what you eat, is the old adage, but what does your diet actually say about you? 

23andMe has a unique opportunity to explore that question, as we investigate how dietary habits, along with genetics, demographics, lifestyle and other data can influence overall health outcomes.

Looking at diet specifically, our scientists analyzed the data of more than 850,000 people who consented to participate in research and who shared details about their own eating habits. 

Using machine learning techniques* we were able to see that dietary choices clustered into four distinct types of eaters, which were mainly characterized by two dietary behaviors. The first one represents the spectrum of foods’ nutrient content from high nutrient-dense foods (i.e. low caloric foods with high nutrient content like vegetables, leafy greens, fruit, beans or whole-grains) to low nutrient-dense foods (i.e. high caloric foods with low nutrient content like. processed foods, sweets, sodas, pastries, saturated fats or  fast food). The second main behavior differentiating diet groups is the meat intake, in particular, red and processed meat (e.g., sausages, hot dogs, ham, or cured bacon).  

Dietary Types

Using these two behaviors as axes, we can plot the four main diet groups: 

• On one end, we find people who eat high nutrient-dense (HND) foods like  vegetables, leafy greens and fruits and tend to avoid high caloric foods with low nutrient content like refined carbs, processed foods, saturated fats and fast food. Depending on their meat intake, these people can either be classified as HND + Carnivores (high meat intake) or Herbivores (low meat intake). Importantly, not all Herbivores are vegetarian or vegan; they just eat less meat than the other diet groups. 
• On the other end, we find people with a diet low in vegetables, leafy greens and fruits who also tend to eat more high caloric foods with low nutrient content, low nutrient-dense foods (LND). People in this group also tend to eat more meat, particularly processed and red meat (LND + Carnivores). Curiously, in this study we couldn’t find a group of people with a diet rich in low nutrient-dense foods that have a low meat intake (group absent in the lower-right corner of Figure 1). 
• Finally, the people in the middle we called Omnivores because they ate a little of everything.

Figure 1. Left graph represents the four defined diets projected in the two main behaviors axis (nutrient content of foods and meat intake). Right panel describes the nutritional differences between these diets, the dots represent the average response to the survey question: “How frequently do you eat this food?” Possible responses were: “not at all” (all dots empty), “1-2 times per week” (one filled dot), “3-6 times per week” (two filled dots), “once per day” (three filled dots) or “more than once a day” (all dots filled).

Men versus Women

After defining these dietary clusters, we looked to see if there were any obvious demographic differences between these groups, and there were. We found that women tend to group in the Herbivore or HND + Carnivore groups. Far fewer women — only about 20 percent in our study — were in the LND + Carnivoregroup. In contrast, about 30 percent of men were in that group. Women also tended to eat more fruits and vegetables and avoid meat more than men. About one in four women, versus one in six men were classified in the Herbivore group. (Figure 2)

Figure 2. Percent of users belonging to each diet class depending on their gender.

Younger versus Older 

As with gender, if we look at age we also are able to see differences within each of the dietary classifications. In this study, younger people appeared to eat fewer fruits and vegetables and more high caloric foods with low nutrient content. We found that about 40 percent of adults under 30 belong to LND + Carnivorecategory, and only about 10 percent of this age group were in the Herbivore category. The reverse is true for individuals over 60, with people in that age group more likely to eat fruits and vegetables and less likely to eat refined carbs or fast food. This is not surprising since our diets change over time — think about the difference between the typical diet of a college freshman versus the typical diet of a senior citizen. Interestingly, when we look at Omnivores, their numbers don’t seem to change as they age. Is a part of the population resilient to changing their nutritional habits as they get older? We can’t say for sure without further study (Figure 3).

Figure 3. Percent of users belonging to each diet class depending on their age. Users were divided into four different age bins: under 30 (<30), between 30 and 45 (30-45), between 45 and 60 (45-60) and older than 60 (>60).

BMI by Dietary Groups

We also wanted to look at how these different dietary categories might impact weight, specifically BMI. What we found was that those individuals who ate more fruits and vegetables — Herbivores — were more likely to have a BMI in the healthy range — between 18.5 and 24.9 as defined by the Centers for Disease Control and Prevention (Figure 4). However, without exercise, those individuals in the Herbivore group were still likely to be overweight. That said, looking at our data it may be even more difficult to maintain a healthy BMI if your diet is in one of the other three dietary categories HND + Carnivore, Omnivore and LND + Carnivore.

Figure 4. Description of the relationship between the average body mass index (BMI) of each diet class and the users’ age (left panel) and the number of times that they exercise per week during at least 30 min (right panel).

A really surprising finding was that the difference in average BMI between the LND + Carnivore group and the Herbivore group is higher in women than in men. This raises the question: is a woman’s weight more sensitive to eating high caloric foods?

BMI by Gender

The differences between women and men in this study could be explained by many reasons. It’s important to highlight that BMI is a measure of weight adjusted for height, but it doesn’t take body composition into account. The difference in BMI between men and women could be partially explained by the differences in fat storage observed in men and women [3]. On average, women have from 6 to 11 percent more body fat than men. Studies show that estrogen reduces a woman’s ability to burn energy after eating, resulting in more fat being stored around the body. Experts in this field speculate that the likely reason for the differences in fat storage is to prime women for childbearing [3]. One could speculate that since there are gender-specific differences in fat storage, we might expect a fat-rich diet to impact women’s and men’s BMI differently.

Figure 5. Difference in BMI between users (divided by their gender) belonging to the LND+Carnivore group compared to that belonging to the Herbivore group.

Eating Behavior

This study has shed some light on the eating behaviors of the 23andMe community and how they vary by age and gender. More importantly, we have shown that diet plays a really important role to maintain a healthy weight which is really important for your health: The higher your BMI, the higher your risk for heart disease, high blood pressure, type 2 diabetes, and certain cancers [1], [2]. However, what you eat is not enough to define your weight since our data showed that even people in the Herbivore group need to exercise at least five times a week in order to have a healthy weight. In a future blog post we will look further into the differences in activity in the 23andMe research community broken down by age, sex and diet behaviors.

Rafaela Bagur Quetglas is a Data Scientist in Health Research and Development at 23andMe.

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*Two machine learning techniques were used in this study. The first method, called k-means clustering, was used to place people with similar diet behavior into k distinct groups; in this case, k is four. The second method, called principal component analysis, identifies exactly which dietary details set those four groups apart from each other.

[1] Donald  M. Lyall et al., (2017) Association of Body Mass Index With Cardiometabolic Disease in the UK Biobank: A Mendelian Randomization Study. JAMA Cardiol. 10.1001/jamacardio.2016.5804

[2] Bhaskaran K. et al., (2014) Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Lancet. 10.1016/S0140-6736(14)60892-8

[3] Betty N. Wu and Anthony J. O’Sullivan (2011) Sex Differences in Energy Metabolism Need to Be Considered with Lifestyle Modifications in Humans. J Nutr Metab. 10.1155/2011/391809Tags: BMI, diet, Featured