GER1000: D4 G1 Summary

Chuan Sze Min Ayn (A0158301N) May Chan Shu Zhen (A0161940J)
Jonathan Lim Zhi Wei (A0156098U) Nurul Afiqah Binte Rashid (A0160361R)

On 4 August 2016, Daily Mail Online published an article "Obese People's Brains Age More Rapidly,
Research Finds". It reports that fat people have OLDER brains based on a scientific study that was
conducted and reported in the journal Neurobiology of Ageing, showing that white matter in
overweight and obese people is equivalent to that of a lean individual who is a decade older.

The study involved 527 healthy subjects with an age range of 20 - 87 years who were recruited over 5
years. The variables which were considered to determine the aging of brain based on being lean,
overweight or obese, were body mass index (BMI) and white-matter volume. The conclusion of the
study has stated that there is an association between obesity and brain aging, and such effects may be
equivalent to an increase in brain age up to 10 years in overweight and obese individuals.

Based on our research findings, it is difficult to conclude that there is an association due to
inaccuracies reported in both the article and the study.

One of the inaccuracies is due to Quantitative Bias Analysis. For instance, the study states that a
self-report questionnaire was distributed to calculate the total estimated physical activity per week
(measured as kJ/d/Kg). This means that participants were required to estimate the amount of energy
they spent on physical activities, resulting in human error as the estimations were subjected to human
judgement.

Moreover, a research study entitled Many of us overestimate how hard we work out carried out by
York University shows that individuals tend to overestimate their pace of activity. This will result in
inaccuracies as participants may inaccurately estimate the intensity of their exercise, leading to a
problem in the Collection and Analyze portion of the Quantitative Reasoning(QR) framework.

Muscle mass is a confounder. In the study conducted, a conclusion was made where adiposity
modulates the relationship between white-matter volume and age. The determinant that segregates the
lean, overweight and obese were their BMI values. However, BMI only takes into account an
individuals height and weight, but not their muscle mass. This might cause a very fit individual with
high muscle mass and low fat percentage to be classified as obese, introducing a confounder to the
study. This is a problem in the Specify portion of the QR framework.

Another inaccuracy is due to Sampling Frame Error. In the study conducted, there is an error in the
sampling frame of the subjects. With the comparison conducted on middle-age subjects of
approximately 40 years old, no obese subjects were available to conduct the comparison as the age of
obese subjects ranged from 45 77 years old. As a result, the studys comparison of white-matter
volume between lean and overweight or obese subjects is potentially inaccurate due to unfair
sampling frame. This exhibits imprecisions in the Collect and Analyse portion of the QR framework.

In addition, with the absence of obese subjects of 40 years in age, the study combined overweight and
obese subjects into a single group and compared the overweight subjects white-matter volume with
lean subjects. This shows an Atomistic Fallacy as an incorrect inference was done on overweight and
obese subjects using the information from overweight subjects, leading to an inaccurate conclusion of
results. This shows a problem in the Communication portion of the QR framework.

Moreover, the study states that participants were cognitively healthy adults recruited from the local
community over a period of 5 years as part of an ongoing project to investigate the effects of aging on
memory and cognition at the Cambridge Centre for Aging and Neuroscience. This shows that the
participants were not randomly selected from the population, resulting in selection bias as the
participants may not be representative of the population, leading to a problem in the Collection
portion of the QR framework.

The final inaccuracy is due to range restriction. The study states that there were two groups of
participants omitted from the data: (1) 54 participants were excluded on the basis of being
underweight (BMI < 18.5kgm1), under the age of 20, or for reasons of poor MR image quality and
also, (2) the omission of severely obese participants due to scanner limitations. Both categories,
underweight and severely obese, were omitted from the study due to limitations which may affect the
true scale of the effect of brain aging. However, enforcing a range restriction on the BMI, i.e.
excluding the severely obese and underweight participants, can be misleading as it alters the
correlation between the two variables, brain aging and BMI. This will eventually create an attenuation
effect, leading to a problem in the Analyze portion of the QR framework. However, tackling the
problem of having poor MRI image quality is not easy. As of now, the MRI scanner, 3T Siemens TIM
Trio system, is one of the best MRI machines and even caters to carry up obese individuals.

All in all, the article titled Fat people have OLDER brains: White matter in overweight people is the
equivalent to someone who is a decade older suggests a causation that fat people will have older
brains. However, there is insufficient evidence to prove that there is a causation between these two
factors as this is an observational study where the researcher had no control over the composition of
the control groups. Hence, to deduce a definite conclusion, further studies should be carried out to
gather sufficient evidence.