Does noise make you fat?

“A new study has unearthed some eye-opening facts about the effects of noise pollution on obesity,” proclaimed The Huffington Post recently in another piece or poorly uncritical data journalism.

Journalistic standards notwithstanding, in Exposure to traffic noise and markers of obesity (BMJ Occupational and environmental medicine, May 2015) Andrei Pyko and eight (sic) collaborators found “evidence of a link between traffic noise and metabolic outcomes, especially central obesity.” The particular conclusion picked up by the press was that each 5 dB increase in traffic noise could add 2 mm to the waistline.

Not trusting the press I decided I wanted to have a look at this research myself. I was fortunate that the paper was available for free download for a brief period after the press release. It took some finding though. The BMJ insists that you will now have to pay. I do find that objectionable as I see that the research was funded in part by the European Union. Us European citizens have all paid once. Why should we have to pay again?

On reading …

I was though shocked reading Pyko’s paper as the Huffington Post journalists obviously hadn’t. They state “Lack of sleep causes reduced energy levels, which can then lead to a more sedentary lifestyle and make residents less willing to exercise.” Pyko’s paper says no such thing. The researchers had, in particular, conditioned on level of exercise so that effect had been taken out. It cannot stand as an explanation of the results. Pyko’s narrative concerned noise-induced stress and cortisol production, not lack of exercise.

In any event, the paper is densely written and not at all easy to analyse and understand. I have tried to pick out the points that I found most bothering but first a statistics lesson.

Prediction 101

Frame(Almost) the first thing to learn in statistics is the relationship between population, frame and sample. We are concerned about the population. The frame is the enumerable and accessible set of things that approximate the population. The sample is a subset of the frame, selected in an economic, systematic and well characterised manner.

In Some Theory of Sampling (1950), W Edwards Deming drew a distinction between two broad types of statistical studies, enumerative and analytic.

  • Enumerative: Action will be taken on the frame.
  • Analytic: Action will be on the cause-system that produced the frame.

It is explicit in Pyko’s work that the sampling frame was metropolitan Stockholm, Sweden between the years 2002 and 2006. It was a cross-sectional study. I take it from the institutional funding that the study intended to advise policy makers as to future health interventions. Concern was beyond the population of Stockholm, or even Sweden. This was an analytic study. It aspired to draw generalised lessons about the causal mechanisms whereby traffic noise aggravated obesity so as to support future society-wide health improvement.

How representative was the frame of global urban areas stretching over future decades? I have not the knowledge to make a judgment. The issue is mentioned in the paper but, I think, with insufficient weight.

There are further issues as to the sampling from the frame. Data was taken from participants in a pre-existing study into diabetes that had itself specific criteria for recruitment. These are set out in the paper but intensify the questions of whether the sample is representative of the population of interest.

The study

The researchers chose three measures of obesity, waist circumference, waist-hip ratio and BMI. Each has been put forwards, from time to time, as a measure of health risk.

There were 5,075 individual participants in the study, a sample of 5,075 observations. The researchers performed both a linear regression simpliciter and a logistic regression. For want of time and space I am only going to comment on the former. It is the origin of the headline 2 mm per 5 dB claim.

The researchers have quoted p-values but they haven’t committed the worst of sins as they have shown the size of the effects with confidence intervals. It’s not surprising that they found so many soi-disant significant effects given the sample size.

However, there was little assistance in judging how much of the observed variation in obesity was down to traffic noise. I would have liked to see a good old fashioned analysis of variance table. I could then at least have had a go at comparing variation from the measurement process, traffic noise and other effects. I could also have calculated myself an adjusted R2.

Measurement Systems Analysis

Understanding variation from the measurement process is critical to any analysis. I have looked at the World Health Organisation’s definitive 2011 report on the effects of waist circumference on health. Such Measurement Systems Analysis as there is occurs at p7. They report a “technical error” (me neither) of 1.31 cm from intrameasurer error (I’m guessing repeatability) and 1.56 cm from intermeasurer error (I’m guessing reproducibility). They remark that “Even when the same protocol is used, there may be variability within and between measurers when more than one measurement is made.” They recommend further research but I have found none. There is no way of knowing from what is published by Pyko whether the reported effects are real or flow from confounding between traffic noise and intermeasurer variation.

When it comes to waist-hip ratio I presume that there are similar issues in measuring hip circumference. When the two dimensions are divided then the individual measurement uncertainties aggregate. More problems, not addressed.

Noise data

The key predictor of obesity was supposed to be noise. The noise data used were not in situ measurements in the participants’ respective homes. The road traffic noise data were themselves predicted from a mathematical model using “terrain data, ground surface, building height, traffic data, including 24 h yearly average traffic flow, diurnal distribution and speed limits, as well as information on noise barriers”. The model output provided 5 dB contours. The authors then applied some further ad hoc treatments to the data.

The authors recognise that there is likely to be some error in the actual noise levels, not least from the granularity. However, they then seem to assume that this is simply an errors in variables situation. That would do no more than (conservatively) bias any observed effect towards zero. However, it does seem to me that there is potential for much more structured systematic effects to be introduced here and I think this should have been explored further.

Model criticism

The authors state that they carried out a residuals analysis but they give no details and there are no charts, even in the supplementary material. I would like to have had a look myself as the residuals are actually the interesting bit. Residuals analysis is essential in establishing stability.

In fact, in the current study there is so much data that I would have expected the authors to have saved some of the data for cross-validation. That would have provided some powerful material for model criticism and validation.

Given that this is an analytic study these are all very serious failings. With nine researchers on the job I would have expected some effort on these matters and some attention from whoever was the statistical referee.

Results

Separate results are presented for road, rail and air traffic noise. Again, for brevity I am looking at the headline 2 mm / 5 dB quoted for road traffic noise. Now, waist circumference is dependent on gross body size. Men are bigger than women and have larger waists. Similarly, the tall are larger-waisted than the short. Pyko’s regression does not condition on height (as a gross characterisation of body size).

BMI is a factor that attempts to allow for body size. Pyko found no significant influence on BMI from road traffic noise.

Waist-hip ration is another parameter that attempts to allow for body size. It is often now cited as a better predictor of morbidity than BMI. That of course is irrelevant to the question of whether noise makes you fat. As far as I can tell from Pyko’s published results, a 5 dB increase in road traffic noise accounted for a 0.16 increase in waist-hip ratio. Now, let us look at this broadly. Consider a woman with waist circumference 85 cm, hip 100 cm, hence waist-hip ratio, 0.85. All pretty typical for the study. Predictively the study is suggesting that a 5 dB increase in road traffic noise might unremarkably take her waist-hip ratio up over 1.0. That seems barely consistent with the results from waist circumference alone where there would not only be millimetres of growth. It is incredible physically.

I must certainly have misunderstood what the waist-hip result means but I could find no elucidation in Pyko’s paper.

Policy

Research such as this has to be aimed at advising future interventions to control traffic noise in urban environments. Broadly speaking, 5 dB is a level of noise change that is noticeable to human hearing but no more. All the same, achieving such a reduction in an urban environment is something that requires considerable economic resources. Yet, taking the research at its highest, it only delivers 2 mm on the waistline.

I had many criticisms other than those above and I do not, in any event, consider this study adequate for making any prediction about a future intervention. Nothing in it makes me feel the subject deserves further study. Or that I need to avoid noise to stay slim.

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