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AFP - Life expectancy is shorter in the United States compared with other wealthy nations because of its health care system -- and not obesity, smoking, homicide or vehicle accidents, according to a study.
Smoking and obesity, the two most important behavior-related risk factors for health in the United States, were ruled out as culprits in the US drop in the rankings.
"The prevalence of obesity has grown more slowly in the United States than in other nations while smoking prevalence has declined more rapidly in the United States than in most of the comparison countries," the study says.
The U.S. Equal Employment Opportunity Commission has filed suit against Resources for Human Development, Inc., for firing an employee because of her obesity, in violation of the Americans with Disabilities Act. The case arose from the charge of a former RHD employee, Lisa Harrison, who claimed that RHD fired her from a New Orleans facility because of her disability.
RHD fired Harrison in September of 2007 because of her severe obesity, the suit alleges. The EEOC alleges that, as a result of her obesity, RHD perceived Harrison as being substantially limited in a number of major life activities, including walking. Harrison was able, according to the lawsuit, to perform all of the essential functions of her position. Before the EEOC filed suit, Harrison died. Her private interests will be represented in the lawsuit by her estate.
WEIGHT DISCRIMINATION FOUND AS PREVALENT AS ETHNIC & GENDER BIAS
SVETLANA SHKOLNIKOVA, USA TODAY - Weight discrimination, especially against women, is increasing in U.S. society and is almost as common as racial discrimination, two studies suggest. Reported discrimination based on weight has increased 66 percent in the past decade, up from about 7 to 12 percent of U.S. adults, says one study, in the journal Obesity. The other study, in the International Journal of Obesity, says such discrimination is common in both institutional and interpersonal situations -- and in some cases is even more prevalent than rates of discrimination based on gender and race. (About 17 percent of men and 9 percent of women reported race discrimination.)
More evidence that the prejudice shown against large people is just that: prejudice
NEW SCIENTIST A team of Swedish researchers has found that humans determine their total number of fat cells in childhood. New cells spring up and old ones perish, but their numbers change little after adolescence. By measuring radiation absorbed after nuclear bomb tests in the 1950s and 60s, researchers found that our fat cells quickly regenerate.
But obese people turn over far more fat cells than others, says Kirsty Spalding, a biologist at the Karolinska Institute in Stockholm. The difference could explain why people battle to keep weight off after a diet.
STUDY FINDS DISCRIMINATION AGAINST BIG PEOPLE RAMPANT
ABC NEWS It's illegal to discriminate against someone because of race or gender, but our culture condones a bias against people who are overweight. There are no federal laws that prohibit discrimination on the basis of weight, and only Michigan has such a law, according to a new study from Yale University. As a result, the researchers contend, weight discrimination is spiraling upward. . . Weight discrimination "occurs in employment settings and daily interpersonal relationships virtually as often as race discrimination, and in some cases even more frequently than age or gender discrimination," the researchers report in the current issue of the International Journal of Obesity. Overweight women are twice as vulnerable as men, and discrimination strikes much earlier in their lives, the report states.
STUDY FINDS 77% OF DIFFERENCE IN TWINS' BODY MASS ARE GENETIC
BBC - Becoming overweight as a child is more likely to be the result of your genes than your lifestyle, claims a study. University College London researchers examined more than 5,000 pairs of identical and non-identical twins. Their American Journal of Clinical Nutrition study found that differences in body mass index and waist size were 77% governed by genes. . . Identical twins have exactly the same genes, while non-identical twins are genetically different, like brother and sister. However, because they were born at the same time, and raised in the same household, they can be assumed to have roughly similar upbringing in terms of food
SCIENTIFIC BLOGGING - Genetics Researchers from the Monell Chemical Senses Center have attempted to count the number of genes that contribute to obesity and body weight - and it isn't a pretty number. The findings suggest that over 6,000 genes, almost 25 percent of the genome, could help determine an individual's body weight.
"Reports describing the discovery of a new 'obesity gene' have become common in the scientific literature and also the popular press," notes Monell behavioral geneticist Michael G. Tordoff, PhD, an author on the study. "Our results suggest that each newly discovered gene is just one of the many thousands that influence body weight, so a quick fix to the obesity problem is unlikely.". . .Tordoff comments, "It is interesting that there are 10 times more genes that increase body weight than decrease it, which might help explain why it is easier to gain weight than lose it."
THE MYTH OF DIETING
NY TIMES - The researchers concluded that 70 percent of the variation in peoples' weights may be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease. The results did not mean that people are completely helpless to control their weight, Dr. Stunkard said. But, he said, it did mean that those who tend to be fat will have to constantly battle their genetic inheritance if they want to reach and maintain a significantly lower weight.
The findings also provided evidence for a phenomenon that scientists like Dr. Hirsch and Dr. Leibel were certain was true - each person has a comfortable weight range to which the body gravitates. The range might span 10 or 20 pounds: someone might be able to weigh 120 to 140 pounds without too much effort. Going much above or much below the natural weight range is difficult, however; the body resists by increasing or decreasing the appetite and changing the metabolism to push the weight back to the range it seeks.
SUBURBAN KIDS HEAVIER THAN URBAN ONES
REUTERS - Using data from a national health survey, researchers found that teenagers living in sprawling suburbs were more than twice as likely to be overweight as teens in more compact urban areas. The findings echo those of a 2003 study by the same researchers that focused on U.S. adults. The researchers believe the same factors may be driving the link between suburban living and teenagers' weight -- the major one being reliance on cars. . . By contrast. . . people in cities are often forced to be active in their daily lives -- walking to stores and public transportation, carrying groceries up the stairs to their fifth-floor walk-up apartment.
STUDIES SHOW IT'S MORE THAN CALORIES
ELIZABETH WEISE, USA TODAY - You are what your microbes eat. Two new studies show that there are different colonies of bacteria in the intestines of the obese than there are in the innards of the slim. The research, published in today's edition of the journal Nature, finds that the microbes in an overweight body are more efficient at extracting calories from food.
"Not everyone sitting down to a bowl of cereal will necessarily absorb the same number of calories from it," says Jeffrey Gordon, lead author of the papers and a professor of medicine at Washington University in St. Louis. . .
NY TIMES FINALLY DISCOVERS THAT THE BMI DOESN'T WORK
[Although interestingly, the Times still doesn't notice that BMI absurdly uses a two-dimensional formula for a three dimensional object, i.e. you.]
NY TIMES - By the revised standards, nearly 55 percent of the American adult population in 1998, was considered overweight or obese, according to the N.I.H. (Today, 66.3 percent of adults are overweight or obese, according to the Centers for Disease Control and Prevention.)
The index also didn't distinguish between body fat and muscle mass, so athletes and bodybuilders like Arnold Schwarzenegger, whose rating was 33 when he was Mr. Universe, were technically obese.
PHRAUD TO GAIN FROM OBESITY OBSESSION;
BRITISH MEDICAL JOURNAL - New guidelines on obesity in the US may end up harming children, says an article in this week's BMJ. And an accompanying article goes on to question the financial links between the organization promoting these proposals and the pharmaceutical industry. If implemented, the proposals would see many more children classified as overweight or obese - and thus eligible for treatment with obesity drugs.
The article outlines how an influential expert committee of the American Medical Association has "tentatively decided" to reclassify obesity definitions. This will result in healthy children being categorized as medically overweight or obese, says the author, and mean that approximately a quarter of toddlers and two fifths of children aged 6-11 in America will be classed as having the disease.
SCHOOLS' WEIGHT OBSESSION CAN HURT KIDS
DONALD MACLEOD, GUARDIAN, UK - Screening the weight of four and 10-year-olds in schools could be psychologically harmful to children and result in some developing eating disorders, researchers from Loughborough University warned today. The government has proposed tests in schools in England to measure children's body mass index as part of a drive against childhood obesity, but the academics say the initiative could lead to overweight children being misinformed about the state of their health and being bullied. "If translated into policy and practice in schools, this latest measure will certain damage the health of some children," they warn. . .
SOCIAL BIGOTS AND HEAVY PEOPLE
REBECCA M. PUHL AND KELLY BROWNELL IN WASHINGTON POST - With colleagues, we recently completed a study of more than 2,000 people enrolled in a weight loss program. . . . Participants told us that when they are stigmatized because of their weight they respond with such strategies as eating more food and just giving up on dieting. Eating more in response to discriminatory treatment was reported by 79 percent of the participants, and 75 percent refused to diet. A smaller number, 63 percent, said that they had at one time or another used dieting to cope with such discrimination, but dieting doesn't work very often.
Other studies have shown that overweight girls and boys who are teased because of their weight are more likely to engage in unhealthy weight control and binge eating than are overweight youth who are not teased. It has also been shown that overweight young people avoid physical activities in which peer victimization frequently occurs.
The data are quite clear: Stigmatizing overweight people contributes to unhealthy behavior that only adds to the problem of obesity..
RESEARCH SHOWS WEIGHT LOSS PLATEAUS DESPITE DIET AND EXERCISE
RESEARCH AUSTRALIA - Researchers frm Queensland University of Technology say that our bodies have a much easier time gaining weight then losing it Research confirming the human body is designed to strongly resist attempts to lose weight will be presented at an international gathering of obesity experts hosted by QUT.
Queensland University of Technology appetite regulation and energy balance researcher Dr Neil King. . . said our bodies have strong mechanisms to defend attempts to lose weight but very weak mechanisms to prevent weight gain. Dr King's weight loss intervention studies demonstrate the "plateau effect", whereby weight loss from exercise and calorie restrictions stops at a certain point. He conducted two studies on weight loss following induced energy deficits in two different groups of overweight and obese people.
REUTERS - Body Mass Index, the standard measure of obesity, is badly flawed and a more accurate gauge should be developed, according to doctors in the United States. Writing in Friday's Lancet medical journal, the researchers from the Mayo Clinic College of Medicine, Rochester, Minnesota, found that patients with a low BMI had a higher risk of death from heart disease than those with normal BMI. At the same time overweight patients had better survival rates and fewer heart problems than those with a normal BMI.
This apparently perverse result, drawn from data from 40 studies covering 250,000 people with heart disease, did not suggest that obesity was not a health threat but rather that the 100-year-old BMI test was too blunt an instrument to be trusted. . .
APRIL 2005. . .
THE SOCIOLOGY OF WEIGHT
GINA KOLATA, NY TIMES - The idea of an epidemic, some critics say, is in the financial interest of weight loss centers, supplement makers, drug companies and purveyors of diet books and diet programs. And the alarm can also benefit many scientists, who get research grants to study the problem and who often serve as consultants to drug companies or run weight loss centers at their universities. A sense of crisis can also help government agencies get additional funds from Congress.
In fact, epidemiologists say, while Americans are fatter than they used to be, they also are healthier by every measure than they were in the 1960's and 1970's, when the average body mass index was lower. In the ensuing years, even as the public has grown heavier -15 percent more, on average - heart disease rates have plummeted, cancer mortality has fallen, many fewer people smoke and death rates from auto accidents are down. People also live longer than back then, and when they do develop chronic illnesses, they tend to get them later in life. . .
HE AIN'T HEAVY; HE'S MY REVISED LONGEVITY FIGURE
THE GIGANTIC error in CDC obesity stats has been given less coverage than it should. We can't recall a similar public health statistic found to be so far wrong. Further, the original research, listing obesity as the number two cause of death, has undoubtedly spurred the misallocation of millions, if not billions, in public and private funds.
Instead of worrying about blogs and who gets into White House news conferences, the media nannies would do better to examine the way the press covers health issues, how it routinely accepts data from questionable sources like drug companies without adequate investigation, and how it serves as a transmitter of mass hypochondria.
It could also examine the public record better. For example, the JAMA story in question contains interesting information not mentioned in most stories, such as the fact that the effect of weight is significantly different depending on one's age.
And it could examine the basis of most of these stories about weight: the mathematically absurd body mass index, in which humans are treated like paper cutouts when most of them have three dimensions. If, in high school math, you tried to compute the size of a cube the way we compute BMI - squaring things that should be cubed - you would flunk.
And it shouldn't pretend there isn't a controversy when there is. For example Stephen Blair of the highly respected Cooper Institute has been arguing that fitness is much more important than weight but has gotten little press attention.
Finally the media should read its own copy. If, as one story reported, the CDC had "found people who are modestly overweight actually have a lower risk of death than those of normal weight," then shouldn't the latter really be called underweight or perhaps even morbidly thin? This is a small but useful example of how in the media past assumptions survive new facts.
ADMITS HUGE ERROR IN WEIGHT STUDY
WEIGHT, HEIGHT MATTER IN JOB PROMOTION
FINDS HEAVY MOMS HAVE HEAVY KIDS
CHART SHOWS CHANGE IN MENTIONS OF OBESITY IN BRITISH ARTICLES AND ADS (BLUE & RED) VS. MENTIONS OF POVERTY (YELLOW)
SOCIAL ISSUES RESEARCH CENTER, UK - Amidst disoriented casting around for culprits and simple solutions, driven hard by media hype, it was refreshing to read in the Observer a thoughtful article by David Smith that for once dealt with some of the real issues underlying the rise in obesity - poverty and disadvantage. It has become fashionable to believe that in the modern Blairite Britain such features of British society are no longer with us - that we are all now 'middle class' and that the old social and economic distinctions that were once an intrinsic feature of our culture have been consigned to history. Not so, sadly, for the people of Glasgow's East End where life expectancy is around 60 and falling and where the average diet is about as unhealthy as it can get. Obesity is but one of the symptoms of the impoverishment that plagues their lives.
For those directly concerned with stemming the declining health of the population, the middle-class food and health philosophies generated in Westminster seem almost obscenely irrelevant. A local GP, Dr Gerry Spence, for example, comments:
"A lot of people are on benefits, living from week to week, relying on convenience foods and eating out of the chippy. Give people jobs and the ability to be masters of their own destinies and they will make healthy decisions about their lives. You bring employment into here and I guarantee the pubs will empty, the kids will stay at school and the place will flourish. You can't blame the people when they are victims of circumstances. It's not really a medical problem, it's something for the politicians to sort out. I hope the drop in life expectancy is a turning point and the politicians are called to account. They should hang their heads in shame."
Bob Holman, who quit academia to work on projects in socially deprived areas, is similarly unimpressed with current initiatives to combat obesity.
"This is not rocket science. Poor health is a well-known feature of deprivation. Mothers are not daft and they do know fat and crisps are bad for children but they can't afford the alternative. The government has to give them the means. Initiatives are not going to change anything unless you've got the cash in your pocket. If you buy a salad at Sainsbury's, it's still very expensive."
The Observer article is, unfortunately, a rarity. Most journalists and editors seem to prefer to crank up the attacks on soft targets - the unlovable McDonald's or Coca Cola - rather than expose the dirt that has been swept under the carpet of many parts of urban Britain. The data show quite clearly that lower income families and those living in socially deprived neighborhoods are far more at risk from becoming obese than the middle and upper classes. A report from the National Statistics office notes:
"Obesity is linked to social class, being more common among those in the routine or semi-routine occupational groups than the managerial and professional groups. The link is stronger among women. In 2001, 30 per cent of women in routine occupations were classified as obese compared with 16 per cent in higher managerial and professional occupations."
Researchers at the Department of Social Medicine at Bristol University have also concluded that:
"Social origins may have a long term impact on obesity. Whether this operates through the early establishment of behavioral patterns, such as diet and exercise, or through metabolic changes associated with early deprivation, is still to be determined."
FOUR PASSENGERS ON EVERY BIG JET TRIP SUFFERS THROMOBIS
BRITISH MEDICAL JOURNAL - A report on the front page of The London Times today warns that around three to four passengers on every jumbo jet are likely to develop deep vein thrombosis. Researchers from New Zealand studied 878 people who took long-haul flights over a six-week period. Some of the passengers wore compression stockings or took aspirins to reduce the risks of DVT. The researchers identified four cases of pulmonary embolism and five of DVT, amounting to 1 per cent of the total. High-risk patients were deliberately excluded from the trial. The study is published in The Lancet today.
EVEN SHORT FLIGHTS CAN BE DANGEROUS TO LEGS
BRITISH MEDICAL JOURNAL - A study of people flying between Italy and London's Stansted airport has found that deep vein thrombosis is a threat on short flights, as blood clots develop in the first two to three hours of a flight. Previously it was thought that DVT was only linked to the cramped conditions on long-haul flights. Ultrasound tests were performed on 568 people making the short journey between the UK and Italy, and researchers found clots in 4.3 per cent of higher risk passengers (women on the pill or HRT, those who have had surgery recently, and mothers to be). Professor Gianni Belcaro, leading the study, advised all passengers to try to exercise, avoid alcohol, and drink lots of water.
PITTSBURGH POST GAZETTE - The number of people worldwide who are officially regarded as overweight or obese may increase by 600 million -- almost 50 per cent -- as scientists move to adopt a new definition of abnormal body weight. Dr. Philip James, chairman of the London-based International Obesity Task Force, will describe the revision in a lecture being delivered at a medical seminar. The task force is part of the International Association for the Study of Obesity, which includes 10,000 scientists, physicians, and other and health professionals in 44 countries. It is doing research on obesity's role in disease for the World Health Organization (WHO), a United Nations agency headquartered in Geneva.
BIG FAT MYTHS ABOUT OBESITY
[While improving the quality of food offered kids in school is a worthy cause, it is being supported by some shaky theories and bad science. Among the problems are these:
- The widely touted Body Mass Index only measures mass; it does not discriminate between fat and muscle; it assumes that everyone in the United States should be average despite broad genetic or physical development differences; and it is an unproven indicator of health or longevity and reflects the anorexic cultural bias of our society.
- At the very least, the decline in exercise programs in our school system is as important in diet in contributing to great weight among students, yet it is getting only a fraction of the media attention. Further, there is the possibility that the lack of physical activity in today's bureaucratized education is a contributor to other problems such as hyperactivity.
- The widely touted 300,000 deaths due to obesity is a faulty extrapolation from a computation that 300,000 heavy people die each year. What they die of is another matter. This is a highly complicated matter for which there is at least some good evidence that both lean people and heavier people who lose weight are more at risk.
- At least part of the increase in average weight may have been due to the purported cure proposed to a recent generation of Americans: a high carbohydrate diet, which has been found to cause some of the very problems associated with weight including diabetes.
- The high carb bias of recent years has also been a boon to one of the most powerful lobbies in the country: the sugar industry. Not only is sugar specifically associated with some of the problems often charged generally to weight - again such as diabetes - but has been found to have a drug-like ability to affect the working of the brain.
- A good health program at schools would emphasize fitness and healthy eating, rather than a puritanical attack on children who - many for unalterable genetic reasons - do not fit our culture's stereotype of health. These kids have enough social problems with their weight - such as teasing from other children - without being harassed by adults and media as well.
Instead of stigmatizing the young as "obese" or decrying the crisis, our emphasis should be at dealing with more specific problems such as sugar, high carbohydrates, lack of exercise at school, corporate hustling of the young, planning public space to encourage more exercise (such as building bikeways and designing communities where services are within walking distance) and finding appealing alternatives lying on a couch watching some model disguised as a reporter decrying the obesity crisis.]
ARIZONA DEPARTMENT OF HEALTH SERVICES - The 1998 Arizona Behavioral Risk Factor Surveillance Survey found that almost 60% of all Arizonans do not "exercise" regularly. National studies of youth, such as the Centers for Disease Control and Prevention Youth Risk Behavior Survey, indicate exercise levels are decreasing, especially among teens. Among children and teens, lack of physical activity is considered to be the primary cause of the rising childhood obesity rates. . . [Our goal is to] increase the number of 4th - 8th grade youth in participating schools who accumulate 30 to 60 minutes of daily, moderate-intensity physical activity.
AMONG THE LEGIONS of young people in every age group who fail to get enough exercise, the biggest decline in physical activity occurs when students reach high school, according to CDC's 1999 Youth Risk Behavior Survey. The report showed that more than one-third of high school students do not regularly participate in vigorous physical activity (at least three 20-minute sessions per week). And only one-half of high school students regularly engage in stretching and strengthening exercises. The survey also showed that physical activity declines sharply as students get closer to graduation, and that the amount of physical activity is lower among high school girls, particularly among African-American and Hispanic girls.
ONCE CUSTOMARY for children at nearly every grade level, gym class, in recent years, has been steadily scaled back. Just during the past decade, the number of U.S. high school students attending daily physical education classes dropped from 42 to 29 percent. Currently, nearly half of all students and 75 percent of high school students do not attend any physical education classes, according to the National Association for Sport and Physical Education, the nation's largest organization for physical education teachers. Judith Young, executive director of NASPE, maintains that schools cut gym classes for lack of funding, but more often cuts result from time constraints that develop with the addition of new curriculum. "Standards-based reform has been detrimental to physical education," said Young.
PAUL CAMPOS, NEW REPUBLIC - According to the government, you're "overweight" (that is, your weight becomes a significant health risk) if you have a BMI figure of 25 and "obese" (your weight becomes a major health risk) if your BMI is 30 or higher. A five-foot-four-inch woman is thus labeled "overweight" and "obese" at weights of 146 pounds and 175 pounds, respectively; a five-foot-ten-inch man crosses those thresholds at weights of 174 pounds and 210 pounds. Such claims have been given enormous publicity by, among other government officials, former Surgeons General C. Everett Koop--whose Shape Up America foundation has been a leading source for the claim that fat kills 300,000 Americans per year--and David Satcher, who in 1998 declared that America's young people are "seriously at risk of starting out obese and dooming themselves to the difficult task of overcoming a tough illness.". . .
ARE THE SCALES WRONG?
GUARDIAN, UK - The BMI, a method used worldwide to determine how healthy a person's weight is, is based on the relationship between an individual's height and weight. At a reading of 25 or above, you are overweight. But so, according to the calculations, is Mel Gibson. And at 30, you become obese; but so are Arnold Schwarzenegger, Jonah Lomu and Sylvester Stallone.
The simplicity of the BMI makes it a godsend for looking at trends. But it is also something of a broad-brush tool. It takes no account of age, sex or race; it makes no allowance for your fitness. Most importantly, it does not measure how much fat you are carrying or how that fat is distributed.
[Now that the atrocious seating space provided passengers by airlines has come to public notice, the following are worth recalling]
JOHN SWEENEY, OBSERVER, LONDON, January 14, 2001 - British airline companies ignored warnings for more than three decades about the deadly effects of blood clots on passengers during long-haul flights, The Observer can reveal. Despite being warned as long ago as 1968 by leading medical experts about the problems of so-called 'economy-class syndrome', the airlines played down the dangers and gave no advice to passengers on how to minimize the risks. Hundreds of people are feared to have died as a result . . .
Three doctors working at a hospital near Heathrow - Yvonne Hart, D. J. Holdstock and William Lynn - wrote: 'Working in a hospital on the perimeter of London Airport we see a steady stream of illnesses which have developed in flight. The major manifestation of the illness may not occur until after disembarkation. We have seen several patients with thromboembolism presenting in this way, with a near-fatal outcome in one case.'