Brazil's billion-dollar gym experiment | Hacker News Reader

Brazil's billion-dollar gym experiment

mosaicscience.com

79 pointsakkartik59 comments

As a lot of things here in Brazil, this looks like not very thought through.

"When you consider the fact that Brazilian diets are commonly high in fat – meat is often eaten for all three meals of the day – it’s no surprise that hypertension, diabetes, cancer, obesity and cardiovascular disease are on the rise."

What about all the serious recent research showing little correlation between fat in diet and all the diseases? EDIT: also, I would add that meat is often eaten in upper classes meals. Meat is a luxury for the better part of our population.

Actually, I believe that there is research showing that physical activities has, at the most, an indirect effect on obesity. Although I can't cite any study here.

Another strange passage:

"What really convinces politicians and funders is evidence. "

Not sure this is true, in Brazil or any other democracy. What really convinces politicians are projects that generate good publicity. Which this one proved it can.

Said that, I think this is indeed a good project and it is a good thing that it is running. But I am inclined to say that the answer to "Can a grand vision of 4,000 free public gyms overcome inequality and fight Brazil’s health crisis? " is no.

>>What about all the serious recent research showing little correlation between fat in diet and all the diseases?

Do you mean the few studies coming from the Weston A Price Foundation reverberated by thousands of paleo-fad blogs/books? The ones that have been refuted over and over by the real experts?

Despite all the headlines telling you that bacon is healthy, the lipid hypothesis is still the scientific consensus: http://en.wikipedia.org/wiki/Lipid_hypothesis#Widespread_acc...

>> I would add that meat is often eaten in upper classes meals. Meat is a luxury for the better part of our population.

That's simply not true. I'm originally from Brazil and eating meat is not an upper class thing. Animal products are consumed in luxurious gated communities and in favelas alike. It's part of the culture. Unless you're below the poverty line you eat meat daily in Brazil. And those below the poverty line are not the ones dying from heart disease.

I'm now reading "The Big Fat Surprise" (http://www.thebigfatsurprise.com/ and http://www.amazon.com/The-Big-Fat-Surprise-Healthy/dp/145162...). I have not read the whole book yet but if what is written in it is truth then there is no science I am expecting in lipid hypothesis and that's is very disappointing. I will double check some facts myself after reading this book but it is interesting. 1-star comments in amazon look valuable as well.

Just spent 20 minutes by following comments, blogs and found this:

http://www.foodpolitics.com/2014/03/is-saturated-fat-a-probl...

http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fal...

Listen to Dr. Garth being interviewed by Rich Roll (starting at 13 min) to understand what this nutrition confusion is all about. https://soundcloud.com/richroll/rrp-050-the-rich-roll-podcas...

I have listened to it. It was interesting but it was disappointing at some moments. It is interesting how conspiracy theories work both for and against his position (I will take it as irrelevant for discussion). It is interesting how some of his facts are poorly investigated. E.g. he mentioned EPIC (http://en.wikipedia.org/wiki/European_Prospective_Investigat...) but EPIC found only that regular consumption of PROCESSED meat increases the risk of cardiovascular diseases and death from cancer. There is no correlation between unprocessed meat and those health problems according to EPIC.

BTW I'm from Europe and sometimes I visit USA. Food in USA is usually bad and usually accompanied with bad eating behaviors. You can get good food in USA but it is expensive and hard to find. I can see how changing diet to vegan/vegetarian can improve health if you are living in USA.

I live in the biggest meat-producing province in Canada. People up here love beef, and that includes beef jerky. Expensive beef jerky is made with local beef. Pretty much every supermarket and convenience store carries cheap jerky that is imported from Argentina.

I don't know how much meat is produced in Brazil, but simply being next to Argentina means that their market is flooded with as much cheap beef as they could possibly want.

Brazil produces almost four times as much beef as Argentina.

However, Brazil has almost five times the population, so the Argentines are still ahead on a per-capita basis.

In any case, the Brazilians are not about to run out of beef any time soon.

Anecdotally, Brazilian churrasco could be mistaken for Argentinian beef jerky.

I don't know the meaning churrasco has in the US but it quite literally means barbecue. So you can have a churrasco, you can go to a churrascaria, etc but it has nothing to do with beef jerky.

Then you're eating at the wrong place. What a ridiculous comment.

Every study cited in that wikipedia section is at least 10 years old, and the headline survey is 35-years old.

And? Do you think smoking became all of the sudden healthy again over the last 50 years since they discovered it is a main cause for cancer? Unless there is a reasonable expectation that things have changed, studies are valid and do not get invalidated by age.

Considering that a decent study might take easily a year to run and another year to get through the peer review process, 10 years are actually rather recent. I've seen papers (although in a different field) that in 2013 describe discoveries from the late 199x as "recent".

Your comparison with smoking is completely unfair. The problem is that we have scientific proof that smoking tobacco causes lung cancer (the emphasis is on "causes"). The problem with nutritional science is that we only have correlation data (or at least it looks like so).

For the new research (that haven't been proven over and over again, like the Lipid Hypothesis) go to http://nutritionfacts.org and this Youtube channel: http://www.youtube.com/user/PrimitiveNutrition

>What about all the serious recent research showing little correlation between fat in diet and all the diseases?

I don't think that is the best way to interpret them, the way I read the gist of recent research is roughly:

  0. Calories you didn't eat are better than:
  1. Calories from protein are better than:
  2. Calories from mono-unsat. fat are better than:
  3. Calories from sat. fat are better than:
  4. Calories from poly-unsat. fat are better than:
  5. Calories from complex carbs are better than:
  6. Calories from simple carbs are better than:
  7. Calories from trans. fat are better than:

But nothing is better for then the calorie you didn't eat (assuming you have met your caloric needs for the day).

2. Calories from mono-unsat. fat are better than:
3. Calories from sat. fat are better than:

4. Calories from poly-unsat. fat are better than:

I'm wondering about the reasoning for this particular order. There are different arguments, including the one that sat. fat is the best, as it is the least reactive: it is already fully saturated, while mono and poly have still potential to acquire more hydrogens. This is why some people prefer cooking with animal fat: they assume it is more "inert" under heating.

Anyway, wouldn't it make sense to order them in order of saturation, either sat > mono > poly, or in reverse, poly > mono > sat?

My understanding is monounsaturated fats are known to be cardiovascularly protective and polyunsaturated are less stable, hence the ordering.

"Said that, I think this is indeed a good project and it is a good thing that it is running."

But is it a billion dollars of good?

Especially if the most likely outcome obtains and these turn into 4,000 underused and eventually neglected gyms, eventually resulting in almost all 4,000 being sold at fire sale prices once the government's priorities move on?

The article seems to indicate that the gyms are actually used. Even better, they seem to reclaim previously neglected and unsafe public space. That seems like a good use of public space to me, like a soccer field or a well-maintained park, even irrespective of any health benefits.

Of course, lots can go wrong in the actual implementation (clever uses for public spaces are notoriously tricky and hard to get right), but this doesn’t seem like a bad idea to me.

Investing in a community is a gesture of goodwill. That could be the major legacy of this.

Hard to say, but if I were to bet, I would bet your predicted outcome is pretty accurate.

There isn't much to "sell". They're metal+concrete installations.

I don't know where you live, but here in RS meat is definitely not a luxury.

And I speak as poor person that knows people that gain less than $500 per month.

The RS has historically had more plentiful meat, thus the popularity of churrasco here. Also, while I'm not very well travelled, I've had people from the rest of the country react with shocked gasps when I mentioned that I drink tap water at home, turns out the situation is quite different in the northern areas. As someone once told me: "a relative travelled to the RS once, he told me it is almost like a different country."

> Meat is a luxury for the better part of our population

Yeah, i dont know in what Brazil the OP is living in.. meat is pretty much as "rice and beans" even for the poor ones.. and in no way is a luxury item

Maybe by meat he means "Picanha" and the most noble parts.. which is indeed expensive and not a "everyday meat"..

Note: i was born in the south, raised be "churrascos".. and now live in northeast.. considered by the south brazillians like low-income.. but the reality.. is far from truth..

This country is very big, and we need to know ourselves better.. the old rules and believes no more applies..

(Northeast is now in a constant uprise economically while south and southeast are pratically economically frozen)

Meat is not a luxury in Recife, one of the cities mentioned in the article. Here, even low income families eat meat every day, despite being low quality meat. Red meat is more expensive, but chicken is very common.

As a foreigner who was once earning R$500/mo ($250 at the time) in rural Brazil, I support this message.

it’s no surprise that hypertension, diabetes, cancer, obesity and cardiovascular disease are on the rise.

Did Brazilian diets change recently to include a bunch of meat? If not then "on the rise" should be surprising. If there was no change in diet and no change in diet related disease levels then it would be unsurprising. But changes in diet related diseases without a change in diet should be somewhat surprising or at least hint that some other factor has changed.

> Did Brazilian diets change recently to include a bunch of meat?

Yes, for some values of "recently" (past 20 years).

We had a sort of economic renaissance in the 90s, when the government finally managed to control hyperinflation amongst other reforms (slashing tariffs, privatization of several state companies, etc).

One of the consequences is that people started eating more meat. The chart in this page shows the chicken consumption per capita (in kg):

http://revistaepoca.globo.com/Revista/Epoca/0,,EDG51460-6009...

Do you have statistics for pork and beef. Red meat statistics is more interesting and relevant than poultry.

It's the same as has happened in other places: processed foods and restaurants have taken over. Brazilians are bigger, fatter, and more sedentary than they used to be (just like Americans, Chinese, etc).

> I believe that there is research showing that physical activities has, at the most, an indirect effect on obesity.

Whether an effect is "indirect" or not is an orthogonal consideration to whether it is significant. Most effects are indirect on close enough analysis (gunshot wounds other than those inflicting direct trauma to the central nervous system only indirectly produce death, but that's doesn't mean getting shot in the heart has an insignificant effect on your chance of dying.)

One more data point, this one from Santa Catarina, where my gf lives with her single mom, they're definitely not upper class but eat meat about twice a day.

Yes, I've had personal experience with a lot of different types of Brazilians, in different parts of Brazil, and I'd say eating meat is no longer a middle-upper class thing as it might have been a decade ago.

>When you consider the fact that Brazilian diets are commonly high in fat – meat is often eaten for all three meals of the day – it’s no surprise that hypertension, diabetes, cancer, obesity and cardiovascular disease are on the rise.

I'm sad to report that I downvoted most of the comments replying to this line because they are not constructive: they fail to provide support for their claims, but their only claim is that other claims are unsupported. It's just short of trolling.

I'd really, really like not to argue this point in this thread, though. TFA is about a gym construction project, not a dietary intervention, and in any case, the role of "meat" -- which includes many, many different foods -- in the human diet is a complex scientific question which cannot be given a satisfactory treatment in a paragraph.

Instead, I hope to provide here useful, accurate resources that allow interested HNers to learn more about the topic. I preemptively acknowledge that I am not a qualified expert and there are considerable differences of opinion among experts. Let's start with "the problem":

http://www.sciencedirect.com/science/article/pii/S0002822304...

"Dietary patterns and health outcomes": "A systematic review of the literature on dietary patterns [...] was conducted. [...] Both of the currently used approaches for extracting dietary patterns have limitations, are subject to dietary measurement errors, and have not generated new diet and disease hypotheses."

Unfortunately, it turns out nutritional science is hard. Arguing about the age of studies on Wikipedia doesn't help us learn much. The largest study ever conducted on red meat consumption was the European Prospective Investigation into Cancer and Nutrition:

https://www.biomedcentral.com/1741-7015/11/63/abstract

I'm not going to post the result here: read for yourself. The fulltext is freely available. Red meat probably increases the risk of colon cancer:

http://preventcancer.aicr.org/site/PageServer?pagename=recom...

In the mid-20th century, there were concerns that things like phytate might be bad for you by sequestering nutrients. This one-time dietary "villain" turns out to prevent colon cancer:

http://www.ncbi.nlm.nih.gov/pubmed/8383315

These effects are both suspected to relate to mineral availability in the small intestine, or, as the researchers state, "Phytic acid forms chelates with various metals and suppresses damaging iron-catalyzed redox reactions." Red meat contains a lot of iron, hence, cancer.

Be careful reading nutrition studies, they can report strange things which may be spurious correlations. This Harvard School of Public Health study finds that chicken without skin is correlated with bladder cancer, but chicken with skin is not:

http://ajcn.nutrition.org/content/84/5/1177.full

I don't understand it either.

It is common informally to conflate the constellation of diseases represented by "cardiovascular disease" and that represented by "diabetes and metabolic syndrome". While there is a great deal of literature regarding the relation of meat consumption to the former, it is almost never even mentioned in connection with the latter:

http://en.wikipedia.org/wiki/Metabolic_syndrome#Etiology

Quick, do these studies contradict each other?

http://www.dur-a-avaler.com/wp-content/uploads/2013/02/Red%2...

http://ajcn.nutrition.org/content/94/4/1088.full.pdf

Answer: no. Whether red meat is healthier than "X" (here "nuts, dairy, and whole grains") is not the same question as whether it is healthy "in isolation", which really means "relative to other dietary constituents", which often include plenty of sugar and refined grains. Nuts, in particular, are known to be very healthy:

http://scholar.google.com/scholar?q=nut+consumption+health&b...

It's very, very easy to throw things like this at each other without really understanding the research you're looking at.

As for obesity, it turns out that fat both causes and prevents obesity:

http://ajcn.nutrition.org/content/68/6/1157.short

http://inspire.stat.ucla.edu/unit_15/NEJM2082.pdf

http://portalsaudebrasil.com/artigospsb/obes078.pdf

http://phdres.caregate.net/curriculum/pdf-files/nejm2k3-2074...

Note from the second study: "Adherence was poor and attrition was high in both groups." The most effective diet is the one you actually follow. It should also be noted that the pro-fat studies tend to be experimental, while the anti-fat studies tend to be longitudinal.

The recent prevalence of large nutritional experiments represents, in my opinion, increased attention (and concomitant funding) directed towards nutrition research as obesity and associated metabolic syndrome have become a pandemic.

Shit be up in the air, yo. Anyone who claims to understand nutrition is a liar.

There are, however, low-hanging fruit: sugar is bad, vegetables are good, nuts are good, bologna causes cancer. There are various psychological analyses of diet patterns, but a common theme is that if you are constantly hungry you will give up on your diet or start eating more. I hope this is not too controversial: hunger causes eating. Try to pick foods that generate satiety.

Thank you for the time and effort invested in this comment. A mere upvote is not enough to express my gratitude. :)

What really convinces politicians are projects that generate good publicity.

I used to think that counted, but then I noticed that most politicians regularly support projects that generate appalling publicity, so what really convinces politicians most of the time is probably just bribes and prostitutes.

A "model politician" in this day and age seems to refer to one Silvio Berlusconi

Completely agree. As usual most people blame meat rather than the processed sugar content.

It’s also cheaper to eat badly because processed foods that are high in fats and sugars are often cheaper than fresh produce.

This is just like the US, where it's cheaper to eat BAD fats and sugar-laden food.

I thought the good/bad fat controversy had been laid to rest? Fat is good for you, insofar as it doesn't contribute to obesity which is the real demon.

...obesity which is the real demon.

I've heard that, but then I've also heard that moderate obesity (obviously not 2x "normal" weight, but say 1.25x) is actually associated with longer lifetimes than normal weight. There doesn't actually seem to be much consensus in these areas.

I thought there were multiple tentative results showing that starvation (to the degree that menstruation etc. stops) increases life expectancy. Anyway, the consensus is that obesity is very bad, but I'm not sure if 1.25x is obese.

It seems that the low-carb/paleo alliance is turning that controversy on on its head by theorizing that the polyunsaturated vegetable oils (e.g. corn, canola, peanut, soybean) are really bad for you. http://www.fathead-movie.com/index.php/2013/02/07/surprise-s...

Even the connection between exercise and weight loss can be questioned. I highly doubt that gyms will solve the obesity problem. That said, I'm sure the Brazilian people will appreciate the gyms.

Wow, what's up with all the negative comments on HN?

Brazil has $2.5 trillion annual GDP, according to the World Bank it spends 9.3% on health. That's over $200B. Even if this project costs $1B annually, IMHO spending .5% on effective preventation is a great idea.

1. More than 10 per cent of Brazilians live on just two US dollars a day, despite the fact that the country ranks fifth in the world for its number of billionaires.

2. I'm for anything that helps the poor.

3. In America, I'm not asking for a gym membership, but it would be nice to have Public restrooms? Yes--just a restroom. "No--we have no restroom!" "The closest restroom is in that hotel, but you have to sneak in the back door" "Why do the Homeless defecate in the pristine park?" "Mom--did you bring your Detrol--there will probally be no restrooms." Yea--It's a problem. And I don't want to hear if you build it, they will come. Exactly who will come--99% of the people will be there because they need to use the toilet, and wash their hands.

WalMart. Everywhere.

I know that exercise doesn't make that much of a dent in the overall obesity epidemic by itself, but I wonder how much of just exercising influences one's diet. For instance, if I run 3 miles today, am I more or less likely to eat a salad for dinner? Or a pizza? Am I more likely to watch my diet if I'm exercising, or am I more likely to splurge? Is there a trend in either direction?

If exercise influences diet positively, then this is absolutely worth it. If it doesn't affect diet at all or if it affects diet negatively, then that's another story. While exercise is great in and of itself, it doesn't solve an obesity epidemic. Even people who exercise every day can have cardiac problems if they don't eat well.

Nice idea, and I wish them well, but I suspect it will take more than a free gym for every 50,000 people to put a significant dent in Brazil's inequality and health problems.

Indeed; a reminder that crony capitalism is not isolated to the US.

what most people miss is that this term applies to about every government known to man. Oh sure many countries would never call their government capitalist but they sure do the same thing, politicians and private or appointed owners of production work together to protect their status usually with little concern for others.

In places like Brazil and Italy it is normal and expected in the US it is not.

I'm a Brazilian and I've seem near my home those 'open gyms' coming up in the latest years.

I never see any instructor, but there is this square just across the street of my house that got some 'gym equipment' for everyone to use.

It's a lovely idea, but (IMHO) this move solely doesn't do much towards better health results. It's nice to bundle some equipment to do better workout where we already exercise, but in the end I feel like it would be more efective to make more of those areas. There is really few good places to workout around here or take a long walk for instance.

I would love to move around in the city in a bicycle. But there is almost no bicycle path, and facing the transit with buses passing centimeters to you is just for the brave.

I live in Porto Alegre and it has some bycicle path... but to be really useful it would have to cover most of the way between A and B.

(Also its very obvious that flat and colder cities are much better for cycling-as-transportation... you can ride in your office clothes)

Why not try it out on one city before spending a billion on the whole country? Too many large scale leaders insist on the grand "I'm sure it will work" idea before bothering to try it out on the small scale first.

I used to study at the church mentioned in the article when I was a kid, they had a school too. I used to live at the mentioned neighborhood too.

I wonder how much India is investing in health and fitness. Hope we do something similar seeing the current fitness levels of the Indian youth.

I don't get what's new about this. From what I've been told (never been to Brazil), they always had free public gyms:

http://timclayton.photoshelter.com/image/I0000dmFBPB1xZuQ

http://timclayton.photoshelter.com/image/I0000cCIgGINK7MA

http://timclayton.photoshelter.com/image/I0000DVoSvWJxumY

Is the novelty the presence of free lady classes?

So would you all have happily paid for all those fat people's gyms? If they want to exercise they could put some walking/running to their daily programme. You only need a pair of legs to do so. But slackers always find excuses, and bureaucrats always find ways to spend the money of the economically illiterate with the smart and naive minds, as it seems.

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