Does that mean fewer sick people? Foodservice embraces big data

Tim York, CEO of Salinas, Calif.-based Markon Cooperative writes in The Packer that we have all been hearing for some time about “big data” and the value — and risk — it may pose. 

lsjpgI prefer to call it data.

York says New York-based restaurant Fig & Olive has used software to track more than 500,000 guests and $17.5 million in checks. 

But data, big or small, didn’t prevent Fig & Olive from sickening at least 150 people with Salmonella last year.

That’s not mentioned in the column.

Squatty potty: Too easy to be true

Thanks to an alert reader, I have the rebuttal to the Squatty Potty and its magical unicorn turds, via Skeptoid.com. Because we all care about poop.

1223_squatty_potty_630x354The Squatty Potty is an invention by Robert Edwards; its express purpose to to improve the quality and ease of your bowel movements while on the toilet. It has a catchy name and is sold everywhere from Target to Amazon.com. The squatty potty is a stool that is designed to fit around the front of a standard toilet bowl, providing lift to your legs and resulting in a squatting-type position rather than sitting position while moving your bowels.

Among the Squatty Potty’s claims are these:

The modern day toilet is convenient, but has one major fault; it requires us to sit. While sitting to do our business may be considered “civilized”, studies show the natural squat position improves our ability to eliminate.

[…]

The puborectalis muscle creates a natural kink to help maintain continence. Squatty Potty relaxes this muscle for fast, easy elimination.

The marketing declares that sitting on the toilet is not as beneficial or effective as squatting. Since this is an obvious naturalistic fallacy, we have the refreshing twist of a new device intended to make one more “natural.” This is common in marketing, where one often sees the equation of “natural=good,” with total disregard for reality. The Squatty Potty is a simple yet interesting device with a catchy name. The marketing is what draws my skeptical eye. They make very specific claims about the research and anatomical benefit—testable claims. Let’s take a close look at the research and find out if the claims are full of it.

The first thing any good skeptic should do when faced with a marketing claim is evaluate the plausibility of the claim. Low plausibility means that claims require more rigorous proof. The Squatty Potty actually scores pretty high on the plausibility scale. The position that the device places you in is a very plausible mechanism for easier stooling.

Raising your legs can be a mechanism to improve your bowel movements. This is irrelevant to the claimed colon-kinking anatomical issue. When you bear down on the toilet, you are performing what’s called a Valsalva maneuver. You are forcing expiration against either a closed glottis, or contracting strongly your thoracic and abdominal muscles increasing intra-abdominal pressure. Similar changes can also occur when a person lifts a heavy weight while holding their breath. Sitting in any squat-type position while bearing down is likely to increase that intra-abdominal pressure, resulting in a more effortless bowel movement. Although this is not the claim in the marketing, the Squatty Potty has a very plausible mechanism to improve the ease of bowel movements.

What about the other claims? Namely that it produces an anatomically improved position and produces a “cleaner colon.” These things are easy to claim and hard to prove. The Squatty Potty is not the first product to claim this benefit. It is a smaller and cheaper version of other squat-position devices, such as the Lilipad and the Nature’s Platform. There are others. Basically they all make the same claims. The Squatty potty claims that it has developed a sweet spot (pun intended) of not too much sitting, not to much squatting.

The website lists several research papers supporting their position:

The first is a Japanese study, “The Influence of Body Position on Defecation in Humans.” It is a small-scale, six-person, uncontrolled study. Sure, I buy it as research, but it is a index study. It limits include tiny non-heterogenous (one male, five female) cohort, with no controls and without blinding. Interestingly, full squat is considered the best, which is not the Squatty Potty position. It doesn’t support the claim that Squatty Potty’s squat is better than a full squat.

The next study has my favorite title of the the group: “Impact of Ethnic Habits on Defecographic Measurements.” (As an aside, I think I need to add “defecographic measurements,” which means “poop X-ray study,” to my medical lexicon… but I digress.) This was a small study that used barium enemas and radiography to evaluate the anorectic opening in defecation.Imaging revealed that the rectal opening was measurable larger in a squatting position. But this study has two major issues. If you use a population that squats to move their bowels and then place them on a first-world toilet bowl, as was done here, you are disrupting their accustomed maneuver. You would need a control group of Europeans to do the same tests to realistically support superior evacuation. Plus moving your bowels is an activity that has deep social and cultural taboos associated with it. Making major changes may cause the participants to rush or change their normal structure. Imaging revealed that the rectal opening was measurable larger in a squatting position. Any of these factors can have a major impact upon on bowel evacuation.

The third research paper posted was “Comparison of Straining During Defecation in Three Positions.” It’s a larger study than the first, but it’s still very small. Researchers used a subjective questionnaire to have subjects rate straining. The findings were similar to the other studies: full squat results in the lowest straining.

Overall the research is flawed and not very compelling. It does have the upside of replications of results. Interestingly, the results do not support the website’s assertion that the Squatty Potty is superior to squatting fully. So I’m not really sure why the website lists this research as scientific evidence for their modified toilet stool.

Based on my reading of the research offered I would say the squatting is the most beneficial for anatomical opening. That is about all the research says. How suboptimal sitting and partial squatting is remains unclear. The study related to straining is too qualitative and small to make that distinction.

Overall, the direct claims  The Squatty Potty specifically makes—such as “elevating your feet during elimination is healthier” and “primary (simple) constipation is a consequence of habitual bowel elimination on common toilet seats”—are unsupported by the research they provide.

This is where the Squatty claims are full of it, in my estimation. They cite figures such as these:

“4-10 million Americans have chronic constipation (defined as having a bowel movement less than three times per week), and as many as 63 million people are suffering at any time from occasional constipation.”

The real research is left out of the website’s facts page. Self-reported constipation in the United States and the United Kingdom is more prevalent in women, nonwhites, and those over age 60. And surveys of physician visits for constipation have also confirmed this, finding more visits by women, nonwhites, those with lower incomes, and patients with less than 12 years of education. After adjusting for these factors, it is more common in individuals with little daily physical activity, low income, and poor education.

The prevalence of chronic constipation rises with age, most dramatically in patients 65 years of age or older. In this older age group, approximately 26 percent of men and 34 percent of women complain of constipation. Constipation appears to correlate with decreased caloric intake in the elderly but not with either fluid or fiber intake.

The glaring omission by Squatty Potty here is the fact that constipation correlates with many issues. Yet none of them are position-related. So although the research they offer can suggest that squatting makes bowel movements easier it doesn’t automatically follow that sitting contributes to constipation.

Constipation is a complicated medical issue. There are a myriad of medical conditions, medications, and diseases that cause constipation. Constipation has too many variables to lock it down to a single vague, unproven supposition that your anatomy is interfering with your stooling. Your lower intestines are not a standpipe and fecal consistency is another variable. There is just no credible evidence that sitting is a problem. It may be dangerous to assume that sitting is a problem. Treating simple constipation with a stool may work but it could also be dangerous: you may miss a serious health issue early because you assume that your position is giving you constipation. That is not the only downside for using a toilet stool.

The Squatty Potty marketing gives the false impression that better bowel movements equates with better health. They are not alone; many alternative treatments tend to give the impression that our bowels are trying to kill us. Brian Dunning went over this in Skeptoid episode #83, “The Detoxification Myth.” There is no real evidence that better bowel movements equate with better health. There is no evidence that squatting produces a larger or more complete bowel movement. Even though the position may make an easier bowel movement, that doesn’t equate to bigger or healthier. Anyone who has had to undergo a colonoscopy will tell you that cleaning out your colon is fatiguing and undesirable. Medically speaking, bowel cleansing claims can be dangerous or nonsensical. Your colon is not the center of healthy living, and consequently cleansing is of marginal health benefit.

Overall I would say this about the Squatty Potty: on the positive side it almost certainly enhances your ability to bear down when you go. There is some replicated evidence that squatting does foster ease of going. As for the negatives, there is no evidence that it prevents or treats uncomplicated constipation. There’s no real evidence that anatomic position is a risk factor for constipation, and no real evidence that it is significantly different than other types of toilet squat devices. It leads you to believe that sitting is an impairment to normal bowel movements. That implied problem is not supported by the research and is unlikely, based on uneven distribution of constipation problems.

So why buy a Squatty Potty? I can’t say I think it’s worth it. Truthfully, it looks a little ridiculous, not that that means anything during a bowel movement. It really has no effect on other factors that impact constipation—diet, exercise, age and medical issues. I am uncertain that changing your position is enough of a benefit to help anyone suffering from chronic constipation. I can say that it is not dangerous and it may make it easier for you to bear down or reduce straining if you are constipated. It is just not reasonable to say that it has any significant effect on your overall bowel habits.

On the upside, Squatty Potty is relatively inexpensive, seems safe, and as long as you have a realistic view of the benefit I can see someone using it.

A pooping unicorn on proper posture

After a 6-2 victory last night – thanks to Amy and Sorenne for supporting my hockey fantasies – I returned home to find a teammate had posted about a pooping unicorn which had missed the barfblog.com radar.

It’s deeply weird and somewhat disturbing, but everyone poops.

Pooping will never be the same. This Unicorn shows the effects of improper toilet posture and how it can affect your health. The Squatty Potty toilet stool has been featured on Shark Tank and Dr OZ show and has thousands of happy customers.

There’s a lot of dangerous E. coli in cow poop

Shiga toxin–producing Escherichia coli (STEC) serogroups O26, O45, O103, O111, O121, and O145, called non-O157 STEC, are important foodborne pathogens.

french.dont.eat.poopCattle, a major reservoir, harbor the organisms in the hindgut and shed them in the feces. Although limited data exist on fecal shedding, concentrations of non-O157 STEC in feces have not been reported. The objectives of our study were (i) to develop and validate two multiplex quantitative PCR (mqPCR) assays, targeting O-antigen genes of O26, O103, and O111 (mqPCR-1) and O45, O121, and O145 (mqPCR-2); (ii) to utilize the two assays, together with a previously developed four-plex qPCR assay (mqPCR-3) targeting the O157 antigen and three virulence genes (stx 1, stx 2, and eae), to quantify seven serogroups and three virulence genes in cattle feces; and (iii) to compare the three mqPCR assays to a 10-plex conventional PCR (cPCR) targeting seven serogroups and three virulence genes and culture methods to detect seven E. coli serogroups in cattle feces.

The two mqPCR assays (1 and 2) were shown to be specific to the target genes, and the detection limits were 4 and 2 log CFU/g of pure culture–spiked fecal samples, before and after enrichment, respectively. A total of 576 fecal samples collected from a feedlot were enriched in E. coli broth and were subjected to quantification (before enrichment) and detection (after enrichment).

cow.poop2Of the 576 fecal samples subjected, before enrichment, to three mqPCR assays for quantification, 175 (30.4%) were quantifiable (≥4 log CFU/g) for at least one of the seven serogroups, with O157 being the most common serogroup. The three mqPCR assays detected higher proportions of postenriched fecal samples (P > 0.01) as positive for one or more serogroups compared with cPCR and culture methods.

This is the first study to assess the applicability of qPCR assays to detect and quantify six non-O157 serogroups in cattle feces and to generate data on fecal concentration of the six serogroups.

Multiplex Quantitative PCR Assays for the Detection and Quantification of the Six Major Non-O157 Escherichia coli Serogroups in Cattle Feces

Journal of Food Protection, January 2016, No. 1, pp. 4-178, pp. 66-74(9)

DOI: http://dx.doi.org/10.4315/0362-028X.JFP-15-319

B. Shridhar, L. W. Noll, X. Shi, B. An, N. Cernicchiaro, D. G. Renter, T. G. Nagaraja, J. Bai

http://www.ingentaconnect.com/content/iafp/jfp/2016/00000079/00000001/art00009

It’s hard to poop on vacation

More than 100 million people in the U.S. are expected to travel at some point between this Christmas and New Year’s Day—and each and every one of them will take roughly 100 trillion intestinal microbes along for the ride.

poop.travelsAmong the various other things influenced by these gut bacteria—like eating habits, for example—they also help control how much, or how little, a person poops. For many travelers, “how little” is the operative phrase: By one estimate, as many as 40 percent of people experience constipation while they’re away from home, due partially to their gut bacteria’s reaction to the change of setting.

“Any time you leave your general habitat, it’s throwing your gut microflora off balance,” says Brooke Alpert, a New York-based registered dietician. Sometimes, that begins before you reach your new destination: In some people, the very act of traveling from point A to point B can cause constipation. Movement stimulates the gut, so sitting on a plane or in a car for long periods of time can cause the intestines to clog; ignoring the urge to go while in the air or on the road can also make it more difficult once you finally sit down on the toilet.

Time differences can also pose a problem. Many people have a normal bowel-movement routine, pooping at regular intervals throughout the day. But when jetlag or a new time zone shifts that schedule ahead or backwards by a few hours, it can mess up that routine, causing constipation.

Even the stress of traveling can make it difficult for people to poop while they’re away. Researchers have nicknamed the gut “the second brain” for the millions of neurons that line the intestines. These cells play a role in digestion, but less understood is the interplay between a person’s gut and her mental state. Researchers do know, however, that things like anxiety can affect the way this “second brain” functions. (Think of butterflies in the stomach, or a stomach tied up in knots.)

Don’t eat poop – or cook it; Women’s Health edition

It seems like the food industry’s been getting into a lot of, well, sh*t lately.

dont.eat.poopBetween reports that all hamburger meat contains traces of poop to the poop-infested cilantro incident that made us rethink our guac obsession, you’d think that hazmat suits would be trending. Food production is a huge industry, so it’s (unfortunately) impossible for producers to avoid contamination 100 percent of the time—but don’t go on a germaphobe rampage just yet, say experts.

While the thought of stuffing your face with foods that are laced with poop bacteria is enough to make anyone gag, the odds of it happening are extremely low. There are uber-strict guidelines in place for the food industry called Good Manufacturing Practices (GMP), which outline acceptable and unacceptable practices within a food production setting, says Angela M. Shaw, Ph.D., assistant professor of food science and human nutrition at Iowa State University. If a food contains traces of fecal matter, it’s because of food-safety management issues within a particular company that isn’t following proper GMP.

Because the rules and regs are super-strict on every level, the icky cases of cross-contamination we hear about are usually linked to unforeseen circumstances—and can happen at any time during the production process.

‘Excreman’ the humanized pop character from Hong Kong

A toilet manufacturer is drawing attention to its products in an unusual way with an outdoor installation featuring cartoon poop characters sitting on commodes.

excremanTOTO Hong Kong is promoting its new “smart toilets” by showing off the multicolored thrones outside the World Trade Center in Hong Kong with statues of a cartoon character named “Excreman” — an anthropomorphic pile of dung bearing a resemblance to a brown snowman– sitting on some of the toilets.

Visitors to the installation are being offered rolls of toilet paper branded with Excreman’s likeness and the words, “Excreman’s [expletive]-y garden — a fecal pleasure hunt and toilet roll.”

Some visitors to the installation objected to the perceived vulgarity, as the Cantonese version of Excreman’s name is roughly equivalent to an English-language profanity oft-used as a euphemism for feces.

The company said Excreman was created 10 years ago by Brian Tse Lap-mun and Alice Mak Ka-bik and stars in a three-part book series about his life in the sewers and his dreams of being fertilizer for plants.

‘There’s a poop in my burger’ – 16 of worst prank 999 calls to Cambridgeshire police amid sharp rise

Sorenne said the other day, the emergency number in Spain is 112.

sorenne.science.fair.aug.15We checked it out and she was right.

She said someone spoke in her grade 1 class about telephones.

We emphasized that the emergency number in Australia is 000.

In North America its 911, and apparently in the UK it’s 999.

A child asking for toilet roll and a report of a “poop in my burger” are among a tripling in the number of hoax 999 calls to Cambridgeshire police prompting a stark warning.

Valuable police time is being taken up by hoax and malicious callers reported fake crimes and emergencies.

A total of 366 calls deemed “inappropriate” were made to the force last year up from 109 the previous year and from January to October this year a total of 259 of the calls have been made.

Figures released using freedom of information laws also show that between August 2010 to July 2011 a total of 590 calls were made to the force that were deemed a “hoax”.

The number increased in the same period the following year to 604 and fell to 587 from August 2012 to July 2013. And the total number of officers deployed to the calls over the three years was 1,074.

The number of crimes linked to the hundreds of hoax calls was 17.

A police spokeswoman said: “The force has seen a rise in the number of hoax calls for service in the last couple of years.

“When a call for service comes in we have a duty to take that report seriously, and by wasting police time on dealing with fictitious calls people are seriously jeopardising the safety of those in genuine need of police help.”

Cambridgeshire police has released a list of hoax calls.

  A youth called, saying ‘your mum’ a couple of times, and then hung up

  Child called saying a robber had stolen his ‘di*k’, laughed, then hung up

  Fake call about an ‘orange glow’ coming from a house – regular hoax caller about fires as ‘likes seeing firefighters’ turn up

  Child asked for a toilet roll and then hung up

  Drunk person telling us they were off to get a kebab

  Child wanting to order a pizza

  Child saying their friend has been kidnapped and killed, laughing, swearing and hung up

  Fake reports of break ins

  Claims that a school was on fire

  Man saying ‘yeah, me and my girlfriend are hard core’ then hung up

  Woman reporting in hospital and nurses have taken her cigarettes off her (not mental health related)

  ‘I meant to call my friend’

  ‘There is a poop in my burger’

  ‘F**k you’

  Neighbour is killing my chickens

  Girl claiming to have been beaten up and was bleeding from ‘everywhere’ when we said we could she her on CCTV she hung up.

 

Poop-flavored curry now available in new Tokyo restaurant; how did owner know what poo tastes like?

I don’t like curry.

Poop-flavored curry sounds worse.

poop.curryA new restaurant in Tokyo named Curry Shop Shimizu is unlike any other curry shop. They offer their signature dish in a toilet-shaped plate, and for good reason – the restaurant offers poo-flavored curry.

Apparently, Curry Shop Shimizu’s main reason for opening a shop which specializes in poo curry is originality. The restaurant reportedly wanted to be “the world’s first” something, and following some brainstorming, the creators came up with the idea thinking nobody else in the world would offer such a curry.

According to Kotaku, even Japanese site NariNari has called the poo-flavored curry “shocking” with the eatery being certainly a “first for mankind.”

The restaurant calls their poop curry “unko curry.” The name might sound disgusting, but the contents of the unko curry isn’t really inedible. The poop curry is reportedly made from “exceedingly healthy ingredients,” including green tea, cocoa powder and goya, to name a few.

Sounds like poop.