An hour per week at the gym lowers the risk of metabolic syndrome — ScienceDaily

time to workoutLess than one hour of resistance exercise training per week lowers the risk of developing metabolic syndrome (cardiovascular risk factors such as overweight, high blood pressure and elevated blood sugar). This was shown by a study involving more than 7,000 participants from the Aerobics Center Longitudinal Study (ACLS) in the USA. The beneficial effects of resistance exercise were independent from the amount of aerobic exercise, such as running or cycling. An international team of researchers, led by Esmée Bakker of Radboudumc published these findings on June 13 on the website of Mayo Clinic Proceedings.

Continued at Source: An hour per week at the gym lowers the risk of metabolic syndrome — ScienceDaily

The Ultimate Fat Burning Exercise Guaranteed to Make You Lose Weight

By Jean Kottemann

March 14, 2014

contemplating manIt’s that season again; time to start thinking about how you’re going to get into your bathing suit, going to your high school reunion, attending some June bride, etc. etc. You are naturally panicked about losing as much weight as possible for the big event.  Thank God for the internet and all those helpful exercise gifs bouncing around in your Facebook timeline.

But just which ones work and which ones are too much trouble?  Here’s my ultimate, no holds barred, absolute cannot fail exercise to practice every day between now and the Big Event:

Control.

Exercise control.  Self-control, appetite control, impulse control.

The truth is: EXERCISE IS THE LEAST EFFECTIVE WAY OF LOSING WEIGHT.

I saw my friend’s fitness watch the other day and it told him that because he ran three 10 minute miles, he was burning 530 calories per hour. First, there are too many variables for that to be accurate.  Fitness watches (and other “calories burned” electronica) are designed to sell you the next upgrade of the fitness watch (or treadmill, or bike, etc.).  Think those calorie counts are inflated?

Secondly, a guy his size burns around 120 calories an hour JUST SITTING ON HIS ASS.  So for all his hard work in sustaining a 30-minute run, he burned 410 calories per hour more so than SITTING ON HIS ASS.  His 30-minute run amounts to  205 extra calories burned.  Congratulations!  Here’s your cookie.

There are 3500 calories in a pound.  If my friend ran 30 minutes every day, he would burn 1400 more calories a week than not running at all.  At that rate, it would take him 25 weeks to lose 10 lbs.

Clearly this is an oversimplification, and there are so many important benefits to exercise other than weight control (I mean, I am a trainer, after all).  However, it goes to demonstrate that a more effective way to lose weight, if that is your only goal, is to simply eat fewer calories. Given the above, an explanation why people sometimes lose weight when they start exercising is because that’s an hour a day that they are NOT snacking, for a change.

We are wondrously adaptive.  It’s how we have survived as a species for so long.  Consider that the more you exercise, the more efficient your body gets at burning the least number of calories to perform the same work!  How impossible it would be for the human animal to still exist if we burned calories willy-nilly like our wrist devices tell us.

We’ve persisted through epochs of famine and starvation. Early man thrived on endurance hunts: running prey into the ground.

How could we burn 520 calories an hour running on an endurance hunt, which could last 10 hours long.  That seems excessive; how does that work?  You run the elk down for 10 hours, catch it, kill it, and then share it with EVERYONE IN THE CAVE.  How does burning 5200 calories in a day-hunt justify — what, 150-ish calories per 3 oz. for wild game?  How does that not make a calorie deficit?  The math does not add up.

You and I, we are Priuses, not Hummers. We burn clean and we burn efficiently, and when we add in something mix that throws us off kilter, we adapt to burn efficiently all over again. The way to reduce in size is much more easily achieved by controlling the calories we eat, not what we expend.

So back to the #1 exercise that guarantees you will lose the most weight in the shortest amount of time:

Exercise control.

 

 

 

Pumping iron is good for the heart, researchers show — ScienceDaily

Copyright: dejanj01 / 123RF Stock Photo
Copyright: dejanj01 / 123RF Stock Photo

Date:  January 11, 2017

Source:  University of British Columbia Okanagan campus
Summary:
Just one session of interval weight-training can improve the risk of Type 2 diabetes complications, according to a new study. This is encouraging news for those starting the New Year with good intentions.
Share:

Source: Pumping iron is good for the heart, researchers show — ScienceDaily


FULL STORY

Just one session of interval weight-training can improve the risk of Type 2 diabetes complications, according to a UBC Okanagan study. This is encouraging news for those starting the New Year with good intentions.

Jonathan Little, an assistant professor in the School of Health and Exercise Sciences at UBC Okanagan’s campus, says the study demonstrates that a series of simple leg exercises, involving weights, can improve blood vessel function of people with and without diabetes.

“Individuals with Type 2 diabetes are up to four times more likely to develop cardiovascular disease than those without,” says Little, the study’s senior researcher. “After completion of just one bout of exercise, we saw an improvement in blood vessel function, an indicator of heart health and heart attack risk.

“With further study, this information could provide a new safe and cost-effective tool to help people manage their disease.”

In the study, Little and his research team compared the effect of two types of interval training — resistance (leg press, extensions and lifts) and cardiovascular (stationary bicycle) exercises — on blood vessel function. Both of these alternated periods of high and low intensity effort, in a one-to-one work/rest ratio.

Thirty-five age-matched study participants were assigned into one of three groups; people with Type 2 diabetes, non-exercisers, and regular exercisers without diabetes. Each group performed a 20-minute exercise routine, which included a warm up and seven one-minute, high-intensity efforts with a one-minute rest between each interval.

“All exercisers showed greater blood vessel function improvement after the resistance-based interval training,” says Monique Francois, a UBC graduate student and the co-author of the study. “However, this was most prominent in the Type 2 diabetes group.”

“Resistance training was introduced to this group because it’s relatively easy and can accommodate individuals who are new to exercising. This study shows that resistance-based interval training exercise is a time-efficient and effective method with immediate effects.”

According to the Canadian Diabetes Association, there are 11 million Canadians living with diabetes or prediabetes.

Diabetes is a chronic, debilitating, and sometimes fatal disease, in which the body cannot produce insulin or cannot properly use the insulin it produces. Insulin is a hormone that controls the amount of sugar in the blood.


Story Source:

Materials provided by University of British Columbia Okanagan campus. Note: Content may be edited for style and length.


Journal Reference:

  1. Monique E. Francois, Cody Durrer, Kevin J. Pistawka, Frank A. Halperin, Jonathan P. Little. Resistance-based interval exercise acutely improves endothelial function in type 2 diabetes. American Journal of Physiology – Heart and Circulatory Physiology, 2016; 311 (5): H1258 DOI: 10.1152/ajpheart.00398.2016

Girls with poorer motor skills more likely than boys to be obese — ScienceDaily

60732211_s

Date:December 19, 2016

Source:Coventry University

Girls with poorer motor skills more likely than boys to be obese Date: December 19, 2016 Source: Coventry University Summary: Young girls who exhibit a poor mastery of fundamental movement skills (FMS) are more likely to be obese than boys who have similarly low skills, according to research.

Source: Girls with poorer motor skills more likely than boys to be obese — ScienceDaily

FULL STORY

Young girls who exhibit a poor mastery of fundamental movement skills (FMS) are more likely to be obese than boys who have similarly low skills, according to research led by Coventry University.

The study — which won an award at the recent British Association of Sport and Exercise Sciences conference — assessed among other things the running, catching, and balance skills of 250 girls and boys between 6-11 years, categorising their FMS as either low, medium or high.

Researchers at Coventry University, working in collaboration with Middlesex University and the University of South Carolina, then cross-referenced the kids’ motor skills with their body fatness to investigate the relationship between the two. The children’s habitual physical activity was also taken into account.

The researchers found that:

  • body fatness was significantly higher among girls in the low FMS category compared with boys in the same category;
  • body fatness was higher for girls in the low FMS category compared with girls with medium or high fundamental movement skills;
  • there was no significant difference in body fatness across the low, medium and high FMS categories for boys.

Lead researcher Professor Mike Duncan, an exercise physiologist in Coventry University’s Centre for Applied Biological and Exercise Sciences, said “We know from previous studies that primary school children with a higher body mass index are likely to have poorer fundamental movement skills, but our research is aiming to understand this relationship in more detail — particularly how gender may play a role.

“What we’ve found is significant because it signals a need to review the strategies we have to enhance motor proficiency in girls, and means we should be engaging health practitioners and PE teachers to help explore and understand how additional opportunities or different techniques may be required compared with boys.

“The next big question — which we’re continuing to research — is whether developmental delays in acquiring these motor skills, whether in girls or boys, may actually be the cause of children gaining unhealthy weight status.”


Story Source:

Materials provided by Coventry University. Note: Content may be edited for style and length.

How exercise — interval training in particular — helps your mitochondria stave off old age — ScienceDaily

Date: March 7, 2017

Source: Cell Press

Researchers have long suspected that the benefits of exercise extend down to the cellular level, but know relatively little about which exercises help cells rebuild key organelles that deteriorate with aging. A new study found that exercise — and in particular high-intensity interval training in aerobic exercises such as biking and walking — caused cells to make more proteins for their energy-producing mitochondria and their protein-building ribosomes, effectively stopping aging at the cellular level.

Source: How exercise — interval training in particular — helps your mitochondria stave off old age — ScienceDaily

FULL STORY

 It’s oft-repeated but true: exercise keeps you healthy. It boosts your immune system, keeps the mind sharp, helps you sleep, maintains your muscle tone, and extends your healthy lifespan. Researchers have long suspected that the benefits of exercise extend down to the cellular level, but know relatively little about which exercises help cells rebuild key organelles that deteriorate with aging. A study published March 7 in Cell Metabolism found that exercise — and in particular high-intensity interval training in aerobic exercises such as biking and walking — caused cells to make more proteins for their energy-producing mitochondria and their protein-building ribosomes, effectively stopping aging at the cellular level.

“Based on everything we know, there’s no substitute for these exercise programs when it comes to delaying the aging process,” said study senior author Sreekumaran Nair, a medical doctor and diabetes researcher at the Mayo Clinic in Rochester, Minnesota. “These things we are seeing cannot be done by any medicine.”

The study enrolled 36 men and 36 women from two age groups — “young” volunteers who were 18-30 years old and “older” volunteers who were 65-80 years old — into three different exercise programs: one where the volunteers did high-intensity interval biking, one where the volunteers did strength training with weights, and one that combined strength training and interval training. Then the researchers, led by then-post-doc, now University of Oregon faculty member Matthew Robinson and colleagues, took biopsies from the volunteers’ thigh muscles and compared the molecular makeup of their muscle cells to samples from sedentary volunteers. The researchers also assessed the volunteers’ amount of lean muscle mass and insulin sensitivity.

They found that while strength training was effective at building muscle mass, high-intensity interval training yielded the biggest benefits at the cellular level. The younger volunteers in the interval training group saw a 49% increase in mitochondrial capacity, and the older volunteers saw an even more dramatic 69% increase. Interval training also improved volunteers’ insulin sensitivity, which indicates a lower likelihood of developing diabetes. However, interval training was less effective at improving muscle strength, which typically declines with aging. “If people have to pick one exercise, I would recommend high-intensity interval training, but I think it would be more beneficial if they could do 3-4 days of interval training and then a couple days of strength training,” says Nair. But, of course, any exercise was better than no exercise.

Nair stressed that the focus of this study wasn’t on developing recommendations, but rather on understanding how exercise helps at the molecular level. As we age, the energy-generating capacity of our cells’ mitochondria slowly decreases. By comparing proteomic and RNA-sequencing data from people on different exercise programs, the researchers found evidence that exercise encourages the cell to make more RNA copies of genes coding for mitochondrial proteins and proteins responsible for muscle growth. Exercise also appeared to boost the ribosomes’ ability to build mitochondrial proteins. The most impressive finding was the increase in muscle protein content. In some cases, the high-intensity biking regimen actually seemed to reverse the age-related decline in mitochondrial function and proteins needed for muscle building.

The high-intensity biking regimen also rejuvenated the volunteers’ ribosomes, which are responsible for producing our cells’ protein building blocks. The researchers also found a robust increase in mitochondrial protein synthesis. Increase in protein content explains enhanced mitochondrial function and muscle hypertrophy. Exercise’s ability to transform these key organelles could explain why exercise benefits our health in so many different ways.

Muscle is somewhat unique because muscle cells divide only rarely. Like brain and heart cells, muscle cells wear out and aren’t easily replaced. Functions in all three of those tissues are known to decline with age. “Unlike liver, muscle is not readily regrown. The cells can accumulate a lot of damage,” Nair explains. However, if exercise restores or prevents deterioration of mitochondria and ribosomes in muscle cells, there’s a good chance it does so in other tissues, too. Understanding the pathways that exercise uses to work its magic may make aging more targetable.

Nair and his colleagues hope to find out more about how exercise benefits different tissues throughout the body. They are also looking into ways that clinicians may be able to target the pathways that confer the most benefits. However, for the time being, vigorous exercise remains the most effective way to bolster health. “There are substantial basic science data to support the idea that exercise is critically important to prevent or delay aging,” says Nair. “There’s no substitute for that.”


Story Source:

Materials provided by Cell Press. Note: Content may be edited for style and length.


Journal Reference:

  1. Robinson et al. Enhanced Protein Translation Underlies Improved Metabolic and Physical Adaptations to Different Exercise Training Modes in Young and Old Humans. Cell Metabolism, 2017 DOI: 10.1016/j.cmet.2017.02.009

Hold That Pose: Yoga May Ease Tough Depression: MedlinePlus Health News

Study finds weekly sessions, plus deep breathing, helped ease cases when medications failed

Source: Hold That Pose: Yoga May Ease Tough Depression: MedlinePlus Health News

By Mary Elizabeth Dallas

Thursday, March 9, 2017

HealthDay news imageTHURSDAY, March 9, 2017 (HealthDay News) — The calming poses and meditation of yoga may be just what the doctor ordered when it comes to beating depression, new research suggests.

Researchers found that weekly sessions of yoga and deep breathing exercises helped ease symptoms of the common condition. They believe the practice may be an alternative or complementary therapy for tough-to-treat cases of depression.

The intervention seemed helpful for “people who are not on antidepressants and in those who have been on a stable dose of antidepressants [but] have not achieved a resolution of their symptoms,” study lead author Dr. Chris Streeter said in a news release from Boston Medical Center. He’s a psychiatrist at the hospital and an associate professor of psychiatry and neurology at Boston University.

Major depression is common and often persistent and disabling, Streeters’ team noted. Up to 40 percent of people taking medication for this form of depression won’t see their depression go away, according to the researchers.

However, prior studies have shown that the ancient practice of yoga may be of help.

“The mechanism of action is similar to other exercise techniques that activate the release of ‘feel good’ brain chemicals,” explained Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City, who reviewed the new findings.

He added that exercise, especially yoga, may also “reduce immune system chemicals that can worsen depression.”

Then there’s yoga’s meditative quality, as well, Manevitz said.

“It has been demonstrated that ‘mindful’ movement — conscious awareness — has a much more beneficial impact on the central nervous system,” he said.

But would this bear out in a rigorous study? To find out, Streeter’s team tracked outcomes for 30 people with major depressive disorder. All were randomly assigned to partake in either a “high-dose” or “low-dose” yoga intervention. The high-dose group had three 90-minute yoga classes each week along with home practice, while the low-dose group engaged in two 90-minute yoga sessions each week in addition to home practice.

The participants practiced Ilyengar yoga, a method that focuses on detail, precision and alignment in posture and breath control.

The study found that both groups had significant reductions in their depression symptoms. Those who took three weekly yoga classes had fewer depressive symptoms than those in the “low-dose” group, but Streeter’s team said even two classes a week was still very effective in improving people’s mood.

Streeter noted that this intervention targets a different neurochemical pathway in the body than mood-altering medications, suggesting that yoga may provide a new, side effect-free avenue for treatment.

For his part, Manevitz called the study “practical and well-designed.” He believes the findings support yoga as a treatment “that can help the millions of people suffering from major depressive disorders around the world.”

Dr. Victor Fornari is a psychiatrist at Zucker Hillside Hospital in Glen Oaks, N.Y. He agreed that the new study “supports the use of yoga for the treatment of depression… Yoga, like regular exercise, is good for most people for health maintenance as well as to treat what ails them.”

The study was published March 3 in the Journal of Alternative and Complementary Medicine.

SOURCE: Alan Manevitz, M.D., clinical psychiatrist, Lenox Hill Hospital, New York City; Victor Fornari, M.D., psychiatrist, Zucker Hillside Hospital, Glen Oaks, N.Y.; Boston University Medical Center, news release, March 3, 2017

HealthDay
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.

Kathleen Settoon: a Flow Yoga Teacher full of youth and wisdom

By Jean Kottemann

“Kathleen Settoon took her first yoga class in 2011 in attempt to heal her mind and body from cancer treatment.”  That’s the first sentence in Kathleen’s bio, and it contains a whole lotta info.

kathleen-1

Kathleen Settoon

My friend once told me he would never take yoga from a young, healthy person because they have nothing to teach him. There is a maturity that comes to people who have lived through some stuff. Especially if that stuff came young. Kathleen has that maturity.

I met Kathleen a mere couple of months ago when she was recommended to me to teach yoga at Crescent City Strength. Before I knew the first sentence of her bio, I liked the way she ran her class: she’s very hands on, attentive, and is pretty individualizing considering its a (small) class.So to get to know her a little better, I posed 6 fairly general questions:

            1.         How did you get started in yoga?

I took a few yoga classes in high school and college, and I enjoyed it but it never really took.  I became more interested and committed during and after my cancer treatment.  I started practicing from YouTube videos!  When I went to a class with a teacher, so many things clicked.  A led class with adjustments makes a big difference.  I started practicing vinyasa flow yoga regularly in 2013.  In 2016, I wanted to further commit to my practice and yogi lifestyle, so I enrolled in the Shanti Yoga Shala 200 hour teacher training.

2.         How has yoga affected your life?

Yoga is about connection! It has connected me to my body but also to my spirit.  And it has given me connection to a whole new community outside of the one I knew before.

It has also helped me with physical symptoms I was previously experiencing, like peripheral neuropathy, problems with balance, and chronic fatigue.

3.         Who has been most influential to you in terms of your yoga practice?

So many people! I enjoy many different yoga studios and teachers in New Orleans.  My brother was the first one who dragged me to a class after my treatment.  My teacher Nathalie Croix at Shanti Yoga Shala.  My friends that I have practiced with over the years.  And of course my students, we always have so much to learn from each other.

4.         What do you still want to achieve through yoga that you have not yet conquered?

So much!  I want to continue my studies with my teacher at Shanti Yoga Shala.  I want to continue to connect to myself and my community.  And of course I am always working on my breath, my alignment, my meditation practice, and a fun inversion or arm balance!

As a teacher, I want to connect to my students and serve their needs.

5.         What do you want your students to get from practicing yoga with you?

A sense of connection to body and spirit, an understanding of breath, alignment, and postures, and a good feeling when we are done with class.

6.         What is your yoga philosophy?

Practice consistently and purposefully, but keep it fun!

Kathleen teaches flow classes that link movement to breath, creating body awareness and a sense of calm. Her classes feature long warm ups with fun sequences that are accessible to all levels and bodies. She is excited about teaching and bringing more yoga into her life and community.

Why intensity is not a bad word: Optimizing health status at any age.

Author information

 CutAbstract

Age-related declines in health and function make locomotion increasingly difficult leading to reductions in non-exercise activity thermogenesis (NEAT), skeletal muscle size and strength, and increased adiposity. Exercise is an important strategy to attenuate loss of function through the life cycle. Despite claims to the contrary, high-intensity exercise is important for the prevention of obesity and sarcopenia with advancing age. Therefore, the purpose of this mini-review is to present literature supporting the contention that low volume, high-intensity aerobic and/or resistance training can slow sarcopenia, sustain ease of movement, stimulate NEAT, and attenuate the accretion of fat mass.

KEYWORDS:

Energy expenditure; Exercise economy; High-intensity exercise; Physical activity; Resistance training; Sarcopenia

How eating less can slow the aging process

ScienceDaily

Date:February 13, 2017
Source:Brigham Young University
Summary:New research shows why calorie restriction made mice live longer and healthier lives.
FULL STORY

“When you restrict calorie consumption, there’s almost a linear increase in lifespan,” Price said.
Credit: © Steven R Breininger / Fotolia

There’s a multi-billion-dollar industry devoted to products that fight signs of aging, but moisturizers only go skin deep. Aging occurs deeper — at a cellular level — and scientists have found that eating less can slow this cellular process.

Recent research published in Molecular & Cellular Proteomics offers one glimpse into how cutting calories impacts aging inside a cell. The researchers found that when ribosomes — the cell’s protein makers — slow down, the aging process slows too. The decreased speed lowers production but gives ribosomes extra time to repair themselves.

“The ribosome is a very complex machine, sort of like your car, and it periodically needs maintenance to replace the parts that wear out the fastest,” said Brigham Young University biochemistry professor and senior author John Price. “When tires wear out, you don’t throw the whole car away and buy new ones. It’s cheaper to replace the tires.”

So what causes ribosome production to slow down in the first place? At least for mice: reduced calorie consumption.

Price and his fellow researchers observed two groups of mice. One group had unlimited access to food while the other was restricted to consume 35 percent fewer calories, though still receiving all the necessary nutrients for survival.

“When you restrict calorie consumption, there’s almost a linear increase in lifespan,” Price said. “We inferred that the restriction caused real biochemical changes that slowed down the rate of aging.”

Price’s team isn’t the first to make the connection between cut calories and lifespan, but they were the first to show that general protein synthesis slows down and to recognize the ribosome’s role in facilitating those youth-extending biochemical changes.

“The calorie-restricted mice are more energetic and suffered fewer diseases,” Price said. “And it’s not just that they’re living longer, but because they’re better at maintaining their bodies, they’re younger for longer as well.”

Ribosomes, like cars, are expensive and important — they use 10-20 percent of the cell’s total energy to build all the proteins necessary for the cell to operate. Because of this, it’s impractical to destroy an entire ribosome when it starts to malfunction. But repairing individual parts of the ribosome on a regular basis enables ribosomes to continue producing high-quality proteins for longer than they would otherwise. This top-quality production in turn keeps cells and the entire body functioning well.

Despite this study’s observed connection between consuming fewer calories and improved lifespan, Price assured that people shouldn’t start counting calories and expect to stay forever young. Calorie restriction has not been tested in humans as an anti-aging strategy, and the essential message is understanding the importance of taking care of our bodies.

“Food isn’t just material to be burned — it’s a signal that tells our body and cells how to respond,” Price said. “We’re getting down to the mechanisms of aging, which may help us make more educated decisions about what we eat.”


Story Source:

Materials provided by Brigham Young University. Note: Content may be edited for style and length.


Journal Reference:

  1. Andrew D. Mathis, Bradley C. Naylor, Richard H. Carson, Eric Evans, Justin Harwell, Jared Knecht, Eric Hexem, Fredrick F. Peelor, Benjamin F. Miller, Karyn L. Hamilton, Mark K. Transtrum, Benjamin T. Bikman, John C. Price. Mechanisms of In Vivo Ribosome Maintenance Change in Response to Nutrient Signals. Molecular & Cellular Proteomics, 2017; 16 (2): 243 DOI: 10.1074/mcp.M116.063255

A surrealistic mega-analysis of redisorganization theories

This is scientific writing at its finest.  Please read.


Logo of jrsocmed

Link to Publisher's site
J R Soc Med. 2005 Dec; 98(12): 563–568.
PMCID: PMC1299350

A surrealistic mega-analysis of redisorganization theories

Abstract

Background We are sick and tired of being redisorganized.

Objective To systematically review the empirical evidence for organizational theories and repeated reorganizations.

Methods We did not find anything worth reading, other than Dilbert, so we fantasized. Unfortunately, our fantasies may well resemble many people’s realities. We are sorry about this, but it is not our fault.

Results We discovered many reasons for repeated reorganizations, the most common being ‘no good reason’. We estimated that trillions of dollars are being spent on strategic and organizational planning activities each year, thus providing lots of good reasons for hundreds of thousands of people, including us, to get into the business. New leaders who are intoxicated with the prospect of change further fuel perpetual cycles of redisorganization. We identified eight indicators of successful redisorganizations, including large consultancy fees paid to friends and relatives.

Conclusions We propose the establishment of ethics committees to review all future redisorganization proposals in order to put a stop to uncontrolled, unplanned experimentation inflicted on providers and users of the health services.

INTRODUCTION

HARLOT1 was commissioned by PSEUD (an international organization for the Preservation of the Status-quo through Evasion, Unreason, and Diversion) to systematically review the literature on reorganization. We were offered not much money and 10 days to respond. After spending 8 days developing four strategic plans, undergoing three reorganizations, and going to a concert, we got started. Our preliminary search yielded 2526 organizational theories, 2 600 000 links (Google: organization theory; accessed 20 July 2005), 1309 books (Amazon: organizational theory; accessed 20 July 2005), 1811 hits in MEDLINE (PubMed: organizational theory; accessed 20 July 2005), and one empirical study. Not having time to sort through all this garbage, we considered several different methodologies for synthesizing this ‘literature’, including meta-analysis, best-evidence synthesis, qualitative synthesis, chaos synthesis, ethnographic synthesis, vote counting, random sampling, focus groups with 18 month olds, and realist synthesis. Given the amount of money we were offered and the boring nature of the topic, we elected to use surrealistic synthesis, a term that we coined to highlight the innovativeness of our venture and hide the fact that we do not know what we are talking about, nor it seems, does anyone else.

METHODS

We used the following inclusion criteria for our review:

  • Population: We considered restricting our review to healthcare personnel, but there was no point in doing so in light of the predominant conceptualizations of healthcare workers as assembly line workers (in modern theories), entrepreneurs (in post-modern theories), and as galactic hitchhikers (in theories that go beyond postmodernism into new realms of reality)
  • Interventions: Anything that anyone has ever done to anyone (particularly to us) in the name of reorganization, reengineering, modernization, effectivization, revitalization, transformation, devolution, centralization, strategic planning, risk management or crisis maximization, regardless of whether it was well intentioned or not
  • Outcomes: The consequences had to make us either laugh or cry or both (depending on how seriously we took them)
  • Study design: Story telling. We used the standard for research in this field: at least one organizational consultant has to have been paid at least once for having said whatever the study concludes. We included studies that generated reorganizational recommendations that we could not understand (99.99%). We excluded studies that did not offer a reorganization plan (0.01%).

Search methods

We browsed the web a bit, sat around and chatted for an enjoyable weekend, asked a few people who are actually interested in the topic what they think, circulated drafts of this article to a few buddies, and made up the rest. We recorded interviews and focus groups between organizational consultants and reorganized health workers, managers, ministers of health, and academics. Unfortunately, a recently reorganized company (DILBERT plc) produced the batteries for our recorder and we later discovered that our tapes were blank. None of us can remember much of what was said, so we have faked that part of our review.

Data collection

We used a large trash bin on wheels.

Analysis

We measured the heat:light ratio of consultants’ recommendations when they were raised to Fahrenheit 451. We also used some fluorescent colours in our data summaries because bright colours increase credibility and statistical power.

RESULTS

We discovered that the literature is almost impenetrable due to creative jargon and the meaningless terminology generated by a variety of cults adhering to different beliefs and led by competing gurus. An abridged glossary decoding some of these terms is attached to this report (Box 1). Each cult has its own theory (Table 1), none of which is particularly coherent. These theories all use complicated diagrams called organograms (Figure 1) and support the OFF theory of research utilization. OFF can be summarized as follows: ‘you don’t need a theory’.2 Although thousands of articles and books have been written about these theories, the concepts they contain are remarkably simple and overlapping. These concepts are summarized here.

Figure 1

HARLOT plc Organogram. Organograms rarely have fewer than 22 boxes and can have as many as 1012. As a rule they should have a minimum of 2n+1 lines connecting the boxes (where n=the number of boxes). The organogram employed in generating this paper is
Table 1

Organizational theories and their diagnostic signs

Box 1 Glossary of redisorganizational strategies

Centralization (syn: merging, coordination): When you have lots of money and want credit for dispensing it

Decentralization (syn: devolution, regionalization): When you have run out of money and want to pass the buck (i.e. the blame, not the money) down and out

Accordianization: When you need to keep everyone confused by instituting continuous cycles of centralization and decentralization. Best example: the NHS

Equalization: When you have not (yet) sorted out which side is going to win

Interpositionization: When you need to insert shock-absorbing lackeys between patients and managers to protect the latter from being held accountable (this strategy is often misrepresented as an attempt to help patients)

Indecisionization trees: When you are massively uncertain and incompetent, picking numbers out of the air and placing them in diagrams. Also used as a party game at management retreats

Matrixization structure: When your indecision tree has been exposed as meaningless twaddle, the introduction of a second indecision tree at right angles to it

Obfuscasization: When you need to hide the fact that you have not a clue what is really going on, or what you should do about it. Makes heavy use of phrases such as ‘at this moment in time’ instead of ‘now’, and transforms things that are simple and obvious into complicated and impenetrable muddles

R&Dization: When you have been exposed as a power-mad fraud and are offered a compensation package just to get you out of town. Employs the ‘Rake it in and Disappear’ ploy

Black hole effect: When a reorganization absorbs large amounts of money and human resources without producing any measurable output

Honesty: When your corporate conscience urges you to admit that when you say, ‘It’s not the money it’s the principle’, it is the money. A dangerous and abandoned strategy, included here for historic purposes only.

Why reorganize?

We identified several over-lapping reasons for reorganizations, including money, revenge, money, elections, money, newly appointed leaders, money, unemployment, money, power-hunger, money, simple greed, money, boredom, and no apparent reason at all. Because we wanted to muscle in on this consultation market, we attempted to estimate the extent of financial incentives for reorganizations. To our delight, the advice business is booming. Estimated income rose from around 20 billion dollars per year in 1990 to over 100 billion in 2000.3 Of course, nobody seems to know quite what the business is, let alone whether it delivers value for money. Consultants typically refuse to provide any evidence on the efficacy of their recommendations by pleading client confidentiality and hiding behind opaque terms such as ‘value propositions’ and ‘service offerings’.

We were unable to find any reliable estimates of how often newly elected governments, new academic deans, and other newly appointed leaders reorganize, so we unblushingly guessed at it. Based on a non-systematic survey of our own painful experience, we estimate that ‘regime change’ results in reorganization roughly 99% of the time.

The benefits of reorganization in terms of consultant employment are undeniable. The largest consulting companies (such as Earnest & Old, McOutley and CostDirthouse) each have over 50 000 employees and there are tens of thousands of smaller companies. Almost a third of MBA graduates go into consulting, lured by starting salaries for top graduates of $120 000 a year (plus tuition reimbursement and bonuses). Consulting companies are getting worried that they are drawing too heavily on business schools, and are now tapping new sources of recruits, such as PhD programmes, medical schools, and art courses.3

Beyond the hundreds of thousands of people who are gainfully employed as consultants, the amount of time that employees in virtually every modern organization are forced to spend on strategic and organizational planning is astounding, even to us at HARLOT. A conservative estimate of 1 day per year per employee spent in strategic planning and at organizational retreats (not to mention leadership courses and team building adventures) would suggest that trillions of dollars are being spent on these activities each year. This figure does not include cost-centres in the hotel, restaurant and travel industries.

The internal justifications for reorganizing identified in our mega-analysis include:

  • You need to hide the fact that an organization has no reason to continue to exist
  • It has been 3 years since your last reorganization
  • A video conferencing system has just been purchased out of your employees’ retirement fund
  • Your CEO’s brother is an organizational consultant
  • The auditor general’s report on your organization is about to be released.

The external justifications for pushing for a reorganization of someone else’s organization include:

  • You are threatened by their organization
  • You discover that their organization is functioning effectively
  • You would like to direct attention away from your own organization’s activities.

These justifications must never be made public. The fundamental rule is: ‘Never let on why—really—you are reorganizing’.

Leading in vicious circles of redisorganization

New leaders typically take up their posts intoxicated with the prospect of transformation and radical revision. This triggers an avalanche of constant and hectic activity. Repeated redisorganizations4 result in exhausted managers who rush from one meeting to another with no time to step back and reflect. By the time the organization decides to saddle somebody with the blame for the resulting chaos, the leader has left to foul up some other organization. The end result is a perpetual cycle of redisorganization.

While all new leaders feel compelled to redisorganize, it is nonetheless possible to distinguish among several breeds of leaders based on their canine redisorganization behaviour:

  • Mutts The most common type of leader: self-focused, with a need to piss all over everything to mark territory
  • Bulldogs Well meaning, but incompetent, and dangerous when aroused
  • German Shepherds Bureaucratic, commonly suffer from anal retentiveness, which makes them irritable
  • Poodles Ideological, focused on a specific peculiar aim derived from a specific peculiar way of looking at the world, to the exclusion of empirical evidence, practical experience and common sense.

These four breeds display, to varying degrees, the eight ‘secrets of success’: meet a lot, sniff a lot (yes, they can smell fear), talk a lot, listen infrequently, change a lot, delegate (particularly responsibility without authority), disappear and move on. These ‘secrets’ seem to be in the genetic make-up of the common breeds of leaders since there is high concordance in monozygotic twins.

Two behaviours are common to all of these breeds. The first is a preoccupation with SWOT (Scandalously Wasted Opportunities and Time) analyses. The second is a natural talent for self-promotion. Leaders belonging to these breeds are masters of self-citation (exaggerating their credentials), and adept at ‘spinning’ negative feedback into testimonials (such as ‘We were never the same again’). Their reputations resemble creative fiction more than genuine accomplishment. According to Tom Chalmers, by the time people have earned their reputations they do not deserve them (personal communication). Common breeds of leaders are good at moving on before their reputations can catch up with them.

Two other breeds of leaders are now so rare that it is not possible to characterize them in any detail: golden retrievers (inspiring) and saint bernards (facilitative).

Indicators of successful redisorganization

We found many useful indicators of a successful redisorganization, including:

  • All the good people have left, or become catatonic
  • Inept people have been given tenure, or its equivalent
  • Important decisions have been postponed, or are being made on a whim-to-whim basis
  • Resolutions are being mistaken for solutions
  • The number of administrators has more than doubled
  • In healthcare redisorganizations, vast resources have been diverted from patient care, research and education and spent on relocating and refurnishing executives’ offices and supplying them with the flashiest business machines
  • Administrators’ office windows point toward, not away from, nearby mountains, lakes, and oceans
  • Large consultancy fees have been paid to relatives by blood or marriage (hence HARLOT’s recruitment programme).

The generation of these indicators can niftily be summarized as the ABCD of any successful redisorganization:

  • A minimum amount of thought has gone into a maximum amount of change
  • Brownian motion has been mistaken for progress
  • Coincidence has been mistaken for cause
  • Decibels have been mistaken for leadership.

IMPLICATIONS FOR PRACTICE

We have discerned four key lessons from our mega-analysis of redisorganization:

  1. For leaders and consultants who feed on cyclical redisorganizations: Be loyal to organizations always, and to people never
  2. For victims of redisorganizing leaders and consultants: Remember that the best-laid plans of mice and managers can be disrupted by creative imagination. Exploit the chaos for more worthy goals
  3. For those in well-functioning enterprises who want to avoid being redisorganized: Fake it. Make it look like you are redisorganizing already: Schedule (but don’t hold) countless meetings; plagiarize, photocopy and distribute (on coloured paper) strategic plans lifted from out-of-town victims; rename traditional sporting and social events ‘team-building’; and get on with doing your job
  4. For perpetrators of perpetual redisorganizations: Why don’t you just go… reorganize yourselves.

IMPLICATIONS FOR RESEARCH

The requirement for ethics approval of anything labelled ‘research’ spells trouble for advocates of redisorganization. If they are going to continue to label as ‘research’ the anecdotes that pass for incontrovertible evidence in this area they are going to need ethics approval for the uncontrolled, unplanned experimentation that they inflict on organizations, including the health services and users of the health services (i.e. all of us). The alternative is to admit that the emperor has no clothes and that they are just messing around with us. To get around this, we at HARLOT are establishing special ethics committees, which, for a price, will review the ethics of plans for redisorganizations.

The answers to five simple questions will determine whether we approve any redisorganization proposal. The first three questions must be answered NO, and the last two YES:

  1. Is it possible for the new leader proposing the redisorganization to get his/her jollies in some other way?
  2. Is it possible for the organizational consultants to earn an honest living?
  3. Does the organogram used to illustrate the new organization have fewer than 22 boxes and 45 connecting arrows?
  4. Is the organizational theory justifying the redisorganization lifted from a paperback best seller, written by a guru with good anecdotes and catchy phrases, and available in airport bookshops?
  5. Will HARLOT get a piece of the action?

Redisorganization proposers who initially fail this review are invited to resubmit. If they are smart, they will then avail themselves of HARLOT’s ‘redisorganization-in-a-box’ recovery service. Mind you, if they had been really smart, they would have come to us in the first place.

CONTRIBUTIONS

ADO, IC, and DLS conceived the idea during a pleasant afternoon stroll on Port Meadow, in Oxford. DLS, IC and ADO went to the concert while TEP was working. All four authors enjoyed the fun of iterative redisorganizations of the manuscript. SA was invited to illustrate the article, but politely declined.

Notes

Competing interests Lots.

References

1. Sackett DL, Oxman AD. HARLOT, plc. An amalgamation of the world’s two oldest professions. A new niche company specializing in How to Achieve positive Results without actually Lying to Overcome the Truth. BMJ 2003;327: 1442-5 [PMC free article] [PubMed]
2. Oxman AD, Flottorp S, Fretheim A. The OFF theory of research utilization. J Clin Epidemiol 2005;58: 117-18 [PubMed]
3. Anonymous. The advice business. The Economist 22 March 1997
4. Smith J, Walshe K, Hunter DJ. The “redisorganisation” of the NHS. BMJ 2001;323: 1262-3 [PMC free article] [PubMed]