Product review: Globe Trotter luggage

The photo you see above is of my beloved Globe Trotter Cetenary roll aboard.  I took it with me on this last trip to Hong Kong and London, much to the chagrin of MD, who hates this piece of luggage with a passion.

MD is a packer extraordinaire and is totally practical.  When it comes to packing, ‘cool looking’ isn’t in her vocabulary.  Since we travel so much, we have gone through many pieces of luggage over the years, and she has found the Hartmann bags best for her particular style of packing.  She can cram more into her Hartmann bags than any one believes possible.  And when she pulls her packed stuff out, it all looks great.

She has evaluated other luggage (usually at my insistence), but always defaults to Hartmann whenever she needs a new bag.  She picks the Hartmann bag she thinks looks the best, but would never, ever trade looks for utility.

I, on the other hand, will put up with a little loss in utility for a big load of cool.  And, in my opinion, the Globe Trotter luggage is maximally cool.  I’ve lusted over this stuff since the first time I read about it and saw a picture.  Every time we go to London, I would head for the Burlington Arcade where the main Globe Trotter store is housed and slobber over all the different pieces.  Finally, a few years ago, much to MD’s displeasure, I succumbed and purchased the above roll-aboard or trolley, as they call it.

Every time I try to take it anywhere, MD whines.  It isn’t divided into dual compartments- it’s just one empty box on wheels.  And it doesn’t open completely so that the top lays flat.  She feels it limits the amount that can be packed and easily retrieved, and she’s no doubt correct, but that doesn’t mean it’s worthless.  It has hard sides, so stuff is protected, and it has leather straps so it can’t pop open, and it has a great wheel system, so it’s easy to pull.  But those virtues mean nothing to her, so she always beats me down when I want to take it on one of our trips.

This time, however, I manned up and took it despite her protestations.  It functioned okay at best.  It was a real pain to get into in the overhead of the airplane, what with having to deal with the straps and the locks and the lid.  It’s much easier to simply unzip a bag and reach in.  All the gripes MD had about it turned out to be correct.  I’ve realized that Globe Trotter bags, which have been made since the late 1800s, were designed and built for a time when someone else handled all of your bags when traveling.  They’re made for durability and for unloading once you get to your destination – they’re not worth a flip if you live out of your suitcase as we often do while on the road.

I no doubt looked dashing as I wheeled my trolley across the lobby of the Mandarin Oriental hotel in Hong Kong, but that didn’t make up for the  all the downside.  Globe Trotter luggage does look great, but in this case, at least for my purposes, the looks don’t trump the lack of utility.

The placebo effect and observational studies

I got the following comment (reprinted here in part) on my last post:

Dr Mike, I must say I’m a bit uneasy about your attitude to observational studies. Doesn’t that in effect disparage most “traditional” knowledge, whether architectural (”If we build things in this way, they don’t seem to fall down”), medical (”People seem to recover from their fever when I give them this combination of herbs”), societal (”If we set up this kind of committee, things seem to function more or less peacefully and efficiently”)? I understand that an observational study doesn’t prove anything by itself but it seems that it’s a more formalized kind of traditional observation, one that, crucially, makes itself transparent and therefore open to future reinterpretation. I may be misunderstanding your stance, but I worry that in effect it negates most of humankind’s historical progress, and any kind of inquiry that doesn’t fit your preferred methods.

This commenter sets up the problem in a way that it can be explained easily.  And probably more clearly than I’ve explained it in the past.

As I pointed out in my post on observational studies, these kinds of studies are worthless for proving causality, but useful in defining hypotheses that can be tested.  Let’s take one line from the comment and is it to demonstrate what I mean.

“People seem to recover from their fever when I give them this combination of herbs.”

A perfect example.  Let’s say that some witch doctor sometime in the past came up with an herbal concoction that helped his ‘patients’ recover from a fever.  Over the years this herbal therapy was passed down from witch doctor to witch doctor, and it worked without fail.  A traditional doctor heard of the cure, tried it on a few patients and found that it did indeed seem to work.  Every time the good doctor prescribed this herbal remedy, patients had their fevers break and began to get well.  This doctor told other doctors, many of whom began using the herbs, and their patients, too, recovered from their fevers.  Patients swore by the stuff and rushed to their doctors to get it whenever they got sick.  Traditional doctors and witch doctors alike were in agreement that the potion works like magic.

Then comes a scientist who looks at the data and says, hey, here is a great observational study.  All the observational data indicate this stuff works like a charm, so let’s make that our hypothesis, which, simply stated, is that Herbal Mixture X reduces fever in those who take it.

Now that the hypothesis has been developed, it needs to be tested.  The best way to test it is with a randomized, double-blind, placebo-controlled study.  Our scientist recruits doctors in several clinics across the country who are familiar with the workings of Herbal Mixture X (HMX) and provides them with a study protocol and unlabeled HMX and placebo, both of which look identical.  As per the protocol, any patient who comes into the clinic with a temperature above 101 [degrees] F gets a randomly generated number and either the HMX or the placebo.  Neither the patient nor the doctor knows who is getting the real stuff and who’s getting the placebo, which makes the study double blind.  If the doctor knew who was getting the HMX, then the study would be single-blind, not double-blind, which would not remove the physician bias from the study.  The assumption is that if the doctor doesn’t know which is which, he/she will treat all patients the same and not let some subtle bias slip into the experiment.

When a patient presents to the clinic with a fever, the doctor gives either HMX or placebo and waits to see what happens.  The doctor or staff contact the patients daily and have them report their temperatures.  When temperature has returned to normal, the data point is entered on the patient’s chart.  After a specific number of patients have gone through the protocol, the codes are broken to see which patient got the HMX and which got placebo.  The scientist then crunches the data to see whether the supposed fever-lowering ability of HMX is statistically significantly different from that of placebo.  And, lo and behold, let’s say for argument’s sake there is no difference.

There is a huge outcry from all the docs who have used the treatment.  The study was flawed, they scream.  We know this stuff works.  We’ve used it for years, and we’ve seen it work.  Same goes for the patients who have taken HMX over the years: they swear by it, too.  They say, We don’t care what one stupid study showed – we know it works.

So, another group of scientists takes on the project and repeats the study.  And gets the same results.  HMWX works no better than placebo.  All the same outcries arise, and so the study is repeated a few more times, all with the same result.  Clearly, HMX works no better than placebo when compared in a double-blind, placebo-controlled study, yet thousands of doctors and countless patients firmly believe in its efficacy.  What happened?  The observational data seemed to strongly ‘prove’ that HMX worked, but the actual testing showed it to be worthless.  What’s going on here?

What’s going on and what makes HMX work is the magic of the healer telling the patient that the therapy is potent along with the patient’s belief in both the healer and the strength of the remedy.  In other words, the placebo effect.

Don’t believe me?  With the recent death of Michael Jackson, reported by some as due to an overdose of a potent painkiller, said painkiller, Demerol, is much in the news.  I just read a piece written by a doctor on the placebo effect that describes the strength of this phenomenon.  Most physicians who have been in practice for any length of time have similar stories:

Jane D. was a regular visitor to our ER, usually showing up late at night demanding an injection of the narcotic Demerol, the only thing that worked for her severe headaches. One night the staff psychiatrist had the nurse give her an injection of saline instead. It worked! He told Jane she had responded to a placebo, discussed the implications, and thought he’d helped her understand that her problem was psychological. But as he was leaving the room, Jane asked, “Can I get that new medicine again next time instead of the Demerol? It really worked great!”

A placebo as strong as Demerol?  You bet.  Happens all the time.

I’ve been lambasted by many readers over my comments on the lack of efficacy of HCG treatment for weight loss.  Many have received what they consider to be significant benefit from HCG therapy and can’t possibly believe what they were experiencing is the placebo effect.  However, based on the many studies in which HCG was compared to placebo in double-blind testing, it is no better than placebo.  But that doesn’t deter those who don’t believe.  They know it works because it worked for them.  Which, of course, is how the placebo effect operates.  According to the results of at least 20 double-blind, placebo-controlled studies, these people would have experienced the same weight loss had they been given saline (salt water) injections or drops under their tongues and been told that the therapy they were given would keep hunger at bay and make their excess weight magically disappear as it had worked for thousands of others.  Of course, the 500 kcal/day diet helps, but in the minds of those who have had success with HCG, it is the hormone that does the trick.

Fat cells and adolescence

It has long been thought that fat cell number became fixed at about the time of late adolescence, and now a study using carbon-14 labeling pretty much confirms that hypothesis.

People get fat in childhood and up to late adolescence by increasing the number of their fat cells; people who get fat after adolescence do so not by adding more fat cells, but by increasing the size of the fat cells they already have.

What this difference in method of storing fat means is that it is more difficult to lose weight after a fat childhood than after gaining excess weight as an adult.  Why?  Because obese children have a large number of normal-sized fat cells that they carry on into adulthood.  To lose weight, they must reduce normal-sized fat cells to subnormal-sized ones, a more difficult prospect than reducing the abnormally-enlarged fat cells that are a consequence of adult weight gain back to normal size.  It can be done as evidenced by all the people who were overweight as children who have lost in adulthood, but it’s a tougher row to hoe than for those who got fat as adults.

Exercise and weight loss

Gary Taubes has taken a lot of heat as have I for publishing the idea that exercise doesn’t bring about weight loss.  The body compensates for increased exercise with increased food intake, and it takes surprisingly little food to replace whatever calories were lost by exercise.  Exercise has multiple benefits, and I recommend it to everyone because of those benefits, but, sadly, increased weight loss isn’t one of them.

This concept is one like the placebo effect that many people have difficulty grasping.  I’ve had countless comments from readers who have related their own stories of how they lost weight by a rigorous exercise regimen.  And they may have, but how do they know it was the exercise that did the trick?  How do they know they were losing weight because they were exercising instead of exercising because they were losing weight?  That statement seems ridiculous on the surface because it appears so obvious that the calories expended in exercise are what causes the weight loss.  But how do we know?  Perhaps because of a change in diet the body needs to ditch a bunch of excess calories from fat stores that are being emptied and does so by increasing the desire to exercise or increase fidgeting in an effort to dissipate this energy.  The increased weight loss brought about by this increase in exercise would be perceived as being caused by the exercise whereas in reality the exercise was caused by the need to lose weight.  It’s a difficult concept to grasp, but it has pretty much been shown in controlled studies that simply increasing exercise doesn’t reliably bring about weight loss.

As I wrote above, when people exercise, they generally increase their food intake to compensate.  But it’s not just the exercises itself that increase food intake, it could be simply thinking about exercise.

Researchers from the University of Illinois reported on two studies in which they correlated food intake with advertising encouraging exercise and even with subliminal words that had exercise connotations.  People ate more when simply hearing about exercise or hearing such words as ‘action’ in the context of something else.

Wrote they:

Alarming rates of overweight and obesity in the United States have led to the development of preventive communications and interventions to promote weight loss. As weight loss is contingent on energy expenditure exceeding caloric intake, one popular approach comprises promotion of physical activity. Media and community campaigns often encourage audiences to increase their physical activity by engaging in structured exercise or active routines. The present research was designed to explore potential effects of such campaigns on eating behavior.

Their conclusion:

Overall, the findings from these two experiments are suggestive in demonstrating that exercise messages can exert inadvertent immediate effects on food intake. Such consequences may not be apparent if exercise is the only measured outcome, but could potentially jeopardize weight loss.

The body likes to keep things on an even keel and maintain homeostasis and has all kinds of mechanisms for doing so.  If you walk past a bakery and smell the aroma of freshly baked bread, your pancreas figures there is going to be some carb coming its way soon, so it releases a little insulin in anticipation.  Apparently the same thing happens if you even think about exercise.  You eat just a little bit more to compensate – even before you exercise.

The dark side of fiber

You just about can’t read anything these days without hearing the virtues of fiber extolled.  It seems that fiber is on everyone’s good list.  Even low-carb and Paleo diet advocates go to the trouble of making all aware that their diets contain plenty of fiber.  No one has anything bad to say about it.

Well, I do.  I can’t let one of these odds and ends posts end without linking to one of my own favorite posts from back in the days when I had only three readers.

Take a look here at a post about a pretty good study showing how fiber really exerts its effects.

My slogan has become: Fiber…who needs it?

Video fun
And, finally, I can’t quit without a video.  I saw a guy like the one in the YouTube below on the Johnny Carson Show years ago.  I was stunned back then that someone could do this, and I’m just as stunned now.  It just doesn’t seem possible.  Enjoy.