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Demi
Fri, Jun-11-04, 02:42
I have just read this fascinating article, and thought I'd share it here:



London Times - 11 June, 2004

A leading US expert has questioned whether there really is an epidemic


FORGET global warming. It isn’t melted polar ice that threatens to engulf the country: Britain, a nation of couch potatoes supersizing themselves to death, is sinking under the weight of a tide of obesity.
That, at least, is the government take on statistics that appear to show that a quarter of adults and 6 per cent of two to 20-year-olds are obese, and the driving fear behind a “stark warning” last month from Sir Liam Donaldson, the Chief Medical Officer, that, unless we all get off our increasingly fat behinds and exercise at least five times a week, “a third of all adults will be obese by 2010 — equal to US levels”.



But what if those statistics are wrong or, at least, have been wrongly interpreted? What if all the time, money and effort being ploughed in by the Government to combat obesity is hopelessly misdirected? Jeffrey Friedman, a Howard Hughes Medical Institute professor at New York’s Rockefeller University, believes it might be. This week Friedman, a leading researcher into obesity, exploded a small bomb under the conventional wisdom in America. Suppose, he said, there was no epidemic? Actually, he did more than suppose. First, he looked around him. You can, too. Take a look at your friends, fellow commuters, or work colleagues. Is one in four of them really obese? Then he took a close look at the statistics for the changes in Americans’ body weight since 1991. His conclusion? There is no nationwide epidemic: “There is this image that everybody’s going to be fat,” he said, “but that’s not what the data say. The problem comes when you reduce all the statistics to a single number.”

Analysis of figures from the National Centre for Health Statistics revealed a substantial increase in weight for the already massively obese — as much as 30lb (13.6kg) since 1991. Yet a little farther down the scale, he found that “mid-range” Americans had gained no more than 7lb in 14 years, while at the lower end there had been no change at all.

Because the body-weight curve has shifted slightly to the right — with more Americans crossing the arbitrary line dividing normal from obese — the headline is that 31 per cent now fall into the obese category, compared with 23 per cent in 1991: a headline-grabbing, government health-spending-generating increase of 30 per cent.

In short, says Friedman, the fat are getting fatter, the lean are staying lean and, as is always the way with these things, there is good news and there is bad news. The good is that the lean will probably stay that way, give or take 10lb or so. And the bad? That the fat really can’t do much about it. It is, like everything else, in their genes. After all, as he recently told Science magazine: “One might ponder why, in our current environment where almost everyone has essentially free access to calories, anyone is thin.”

Friedman told The Times: “Where everyone can eat as much as they like, how can weight vary from person to person by hundreds of pounds? I don’t think anyone can dispute the fact that there is a huge genetic contribution to obesity. It’s a very similar phenomenon to height. Over time, height is increasing — the average Civil War soldier was 5ft 4in (1.6m) tall — and today no one would dispute the fact that tall people have different genetic variants from short people.”

Simply trying to enforce exercise and dietary regimens on the population is misguided, he believes, if we don’t also try to understand the science: “There is an analogy with cancer here: it’s like saying that we don’t need to understand why cells go haywire as long as we know that smoking is bad for us.”

He doesn’t suggest that encouraging the general population to exercise more and to eat more healthily is a bad thing, but while “it is very rational to invest in prevention, it is only research at this point. It is not clear at the moment what remedies would best prevent the development of obesity. Is it a good idea to restrict pre-obese children’s intake, or to increase their exercise? Perhaps, but we can’t take for granted that this will prevent obesity. Let’ s wait for the scientific evidence before we blindly assume that a particular remedy will or won’t work.

“Unfortunately, people want answers now, and the use of the numbers attaches an urgency to the problem that might be somewhat overstated.”

For the past ten years Friedman and colleagues at the Howard Hughes Medical Institute have been on the trail of that science, building on the “thrifty gene” hypothesis first proposed in the Sixties. The hunt has taken them to the Pacific island of Kosrae, where half of the adults are obese and another 30 per cent overweight.

When Westerners stumbled upon them in the 1800s, the islanders were living as primitive, lean hunter-gatherers. It wasn’t until just after the Second World War, and the introduction of a plentiful Western diet, that obesity began to take hold.

Friedman is working on the theory that a “hunter-gatherer” gene that guards against starvation becomes a treacherous liability when the bearer of that gene finds himself in an environment where access to calories is unlimited: in an ironic reversal of inherited fortune, the obese in Western society could be those whose ancestors had it tough, while the lean are the descendants of those who had easy pickings.

So what can be done with this knowledge, other than returning everyone to the Stone Age? Five years ago Friedman discovered the gene for leptin, a weight-regulating hormone, which a 200lb, nine-year-old English girl was found to lack. After a few injections of leptin, her calorie intake at a single meal fell by 84 per cent, from 1,100 calories to 180; her body weight is now within the normal range for her age.

The bad news here, says Friedman, is that “it appears to work in some people, a minority, and not others. We are trying to understand why most people do not respond.”

Meanwhile, he says, give the obese a break. “If you happen to be lean, don’t judge the obese by an unrealistic set of standards, and to the obese I would say don’t feel a failure if you don’t happen to be as lean as the next person. Obesity is not about gluttony.”

He offers some staggering statistics to reinforce his genetic argument, and to make a case for the more humane treatment of obese people by the rest of us. Over a decade the average Westerner will consume ten million calories with, generally, only a small change in weight. This depends on the miracle of intake matching output within 0.17 per cent over a decade.

“This extraordinary level of precision,” he says, “exceeds by several orders of magnitude the ability of nutritionists to count calories, and suggests that conscious factors alone are incapable of precisely regulating caloric intake.”



http://www.timesonline.co.uk/newspaper/0,,174-1140885,00.html

tholian8
Fri, Jun-11-04, 03:13
http://www.nytimes.com/2004/06/08/health/08cont.html

This link will die in a few days, so here is the article:

The Fat Epidemic: He Says It's an Illusion
By GINA KOLATA

Published: June 8, 2004

Ask anyone: Americans are getting fatter and fatter. Advertising campaigns say they are. So do federal officials and the scientists they rely on.

But Dr. Jeffrey Friedman, an obesity researcher at Rockefeller University, argues that contrary to popular opinion, national data do not show Americans growing uniformly fatter.

Instead, he says, the statistics demonstrate clearly that while the very fat are getting fatter, thinner people have remained pretty much the same.

Let it be said that Dr. Friedman, a Howard Hughes Medical Institute investigator and the discoverer of the gene for leptin, a hormone released by fat cells, is not fat. He is tall and gangly, with the rumpled look of an academic scientist.

As an obesity researcher, he might be expected to endorse the prevailing view that obesity in this country is out of control. But Dr. Friedman said he was outraged by the acceptance of what he sees as a hurtful myth, one that encourages people to believe that if you are fat, it is your fault.

The obesity arena "is so political, so rife with misinformation and disinformation," he said.

Dr. Friedman points to careful statistical analyses of the changes in Americans' body weights from 1991 to today by Dr. Katherine Flegal of the National Center for Health Statistics. At the lower end of the weight distribution, nothing has changed, not even by a few pounds. As you move up the scale, a few additional pounds start to show up, but even at midrange, people today are just 6 or 7 pounds heavier than they were in 1991. Only with the massively obese, the very top of the distribution, is there a substantial increase in weight, about 25 to 30 pounds, Dr. Flegal reported.

As a result, the curve of body weight has been pulled slightly to the right, with more people shifting up a few pounds to cross the line that experts use to divide normal from obese. In 1991, 23 percent of Americans fell into the obese category; now 31 percent do, a more than 30 percent increase. But the average weight of the population has increased by just 7 to 10 pounds since 1991.

Dr. Friedman gave an analogy: "Imagine the average I.Q. was 100 and that 5 percent of the population had an I.Q. of 140 or greater and were considered to be geniuses. Now let's say that education improves and the average I.Q. increases to 107 and 10 percent of the population has an I.Q. of above 140.

"You could present the data in two ways," he said. "You could say that the average I.Q. is up seven points or you could say that because of improved education the number of geniuses has doubled."

He added, "The whole obesity debate is equivalent to drawing conclusions about national education programs by saying that the number of geniuses has doubled."

Not everyone agrees.

"It' s one thing to talk about statistics and another to talk about what's happening to individuals," said Dr. Marion Nestle, a professor of nutrition, food studies and public health at New York University. "Everyone notices that there are more overweight people now."

Dr. Friedman, however, begs to differ. The statistics let scientists get beyond impressions and focus on the evidence.

He is, in a way, an unexpected figure to insert himself into the highly charged politics of obesity. He left clinical medicine in 1980 after discovering that his true passion was the laboratory. By 1981, he had begun his scientific career, and within a few years he was taking on what seemed like an impossibly onerous task, finding a gene whose absence made mice grow massively obese.

He keeps mementos from those days. He still has the purchase order, from December 1986, for the first batch of mice he used for the experiment. Hanging on his office wall is a framed strip of white paper with black blotches, the data that on Sunday morning, May 8, 1994, revealed he had found the gene that he named leptin.

"To me, those data are as beautiful as the Mona Lisa," he said.

Over the years, Dr. Friedman says, he has watched the scientific data accumulate to show that body weight, in animals and humans, is not under conscious control. Body weight, he says, is genetically determined, as tightly regulated as height. Genes control not only how much you eat but also the metabolic rate at which you burn food. When it comes to eating, free will is an illusion.

"People can exert a level of control over their weight within a 10-, perhaps a 15-pound range," Dr. Friedman said. But expecting an obese person to decide to simply eat less and exercise more to get below the obesity range, below the overweight range? It virtually never happens, he said. Any weight that is lost almost invariably comes right back.

The same goes for gaining weight in general, Dr. Friedman argued. A person who has the genes to be thin is not going to get fat because portion sizes increase. It makes no scientific sense, he said.

But isn't it true that we can decide to eat or not, choosing to skip dinner, say, or pass up dessert? Isn't that free will? Not really, Dr. Friedman said. The control mechanisms for body weight operate over months, even years, not day to day or meal to meal.

"People live in the moment," he said. "They lose weight over the short term and say that they have exercised willpower," but over the long term, the body's intrinsic controls win out. And just as willpower cannot make fat people thin, a lack of it does not make thin people fat.

No one, he says, can consciously calibrate their food intake as precisely as the body does naturally. Most people's weights remain steady, within about 10 pounds, year in and year out. But when people count calories, they typically err by about 10 percent. For someone who eats 750,000 calories in a year, that 10 percent error would add up to 75,000 calories, or about 25 pounds.

Obesity, Dr. Friedman says, is a problem; fat people are derided and they have health risks like diabetes and heart disease. But it does no one any good to exaggerate the extent of obesity or to blame the obese for being fat.

"Before calling it an epidemic, people really need to understand what the numbers do and don't say," he said.

lizwhip
Fri, Jun-11-04, 03:33
I have never understood how they judge wether we are heavier now than, say, 50 years ago - were they doing studies and publishing statistics about it then?

A doctor friend of mine mentioned that people (in the west) are living a lot longer now than they used to even when the use of antibiotics and other medical advances are factored out. The reason she claimed is better nutrition. Of course she also reasons that no matter how much healthier people are now, there is always room for improvement! I tend to think that a lot of the research and conclusions being drawn are somewhat skewed.

One woman's opinion!

Liz

nolin nae
Fri, Jun-11-04, 07:17
here's i thread i started a few days ago on the same report:
http://forum.lowcarber.org/showthread.php?t=189883

ceberezin
Fri, Jun-11-04, 19:08
What's all this fol de rol about a thrifty gene! When you shift from a hunter-gatherer protein-based diet to a modern carbohydrate based diet, insulin resistance kicks in and you get obese. What's the mystery. Dr Friedman seems not to have accounted for endocrinology 101.

iceyfire77
Fri, Jun-11-04, 19:44
As a preschool teacher, I would say the most disturbing trend is the upshoot of childhood obesity. We need to start educating at my class's early age (I do a nutrition unit...we discuss fruits and veggies...nuts...meats...calcium) and keep doing so up through high school to really see any change.
I see children come in with an array of junk, from frosted donut minis and poptarts, to sugar laden "milk and cereal" bars and rice krispie treats. I have one little boy who day after day .. brings in almonds, yogurt or string cheese and unsweetened applesauce or some fresh fruit. His grandmother is a nutritionist. It's that kind of dedication within a family to be healthy and educated that will keep the nation the same way.

Just had to run my mouth off...the situation really makes my blood boil!

cc48510
Sat, Jun-12-04, 00:43
I've always believed that the 30s/60s [30-someodd percent Obese/60-someodd percent Overweight] figures that are constantly repeated are wrong. The problem IMHO is BMI. Many times BMI is used to judge if a person is overweight or obese. But, it doesn't take into account body composition. For example, my BMI is about 26.3 [193 lbs ~ 6'0",] and my Brother's is 22.5 [139 lbs ~ 5'6"]...yet we wear about the same size. By BMI, his weight is considered healthy, but I'm considered slightly overweight.

BMI tends to underestimate a healthy weight for men. Take myself for example, at my height, by BMI I should weigh between 136 and 184 pounds [169 lbs being ideal.] Now, I would be fine in the upper end of that range, but the lower end is completely unreasonable. My dad [same height as me] dieted [more like starved himself] down to 149 in the early 1980s, trying to get down to his weight in HS. He was skin and bones. Even at 155/160, he was too skinny. His ideal weight was near the top of that range.

I've also talked to a few folks who are not overweight, but have been told they needed to lose weight based on their BMI. As a result, I believe that BMI overestimates the percentage of persons who are overweight/obese. I'm not saying there isn't a problem. There is...but, its most predominant among children. When I look around, maybe 10-20% of adults I see would appear overweight. For children, the numbers are much closer to the Govt's figures for the entire population. I see more and more Overweight, Obese, and even Morbidly Obese children everyday.

The problems are numerous. School food is now and has always been crap. When I was in school, we got Lucky Charms, Trix, or some other Sugar-Laden Cereal for Breakfast; lunch was Fried Meat, Pizza, or Spaghetti served with Tater Tots [fried potatoes,] overcooked spinach which noone ate, and a Fruit Juice Bar. But, at least in Elementary School, we had Recess. We could go outside and play. And, we did. Also, back then, it was still reasonably safe to play outside, so we would play ball after school. Plus, an Atari 2600 and even the original NES just didn't have the same ability to turn a kid into a couch potato, Playstation does nowadays.

In Middle School, my first year they let us play ball outside when we finished lunch. But, it got too rough, and some kid got his head split open on the Basketball Court. So, we couldn't go outside after lunch anymore. We had Gym one quarter out of the year, and it was pretty much worthless. The class was 50 minutes, and 3/4 of it was wasted in the Locker Rooms [due to having to change into and out of a gym uniform,] where the unpopular students [such as myself] would get pounded by Bullies. In the end we got at most 20-30 minutes of class, and it was wasted doing useless crap that noone liked. They could have gotten alot more done if they'd just let us have the whole 50 minutes [no need to change into a gym uniform] to play Basketball, Baseball, Football, Dodgeball, or whatever game we felt like.

High School was even worse exercise wise. We had Gym for one quarter during the first year only. Again, most of the hour was wasted in the locker room and the remained was wasted on useless exercises which noone liked. It would have been nice if we could have played ball or something of that nature instead of useless crap like running around a track, doing situps/chin-ups, and such...

watcher16
Mon, Jun-21-04, 10:29
Body weight, he says, is genetically determined, as tightly regulated as height. Genes control not only how much you eat but also the metabolic rate at which you burn food. When it comes to eating, free will is an illusion.

"People can exert a level of control over their weight within a 10-, perhaps a 15-pound range," Dr. Friedman said. But expecting an obese person to decide to simply eat less and exercise more to get below the obesity range, below the overweight range? It virtually never happens, he said. Any weight that is lost almost invariably comes right back.
The first statement seems in great contradiction to images of streets full of 1000-pounders. This is from the last decades. So it can´t be genetically determined. :lol:

The second is contradicted by members of this forum??

wbahn
Mon, Jun-21-04, 17:33
I have never understood how they judge wether we are heavier now than, say, 50 years ago - were they doing studies and publishing statistics about it then?

Actually, quite a bit of data is available from even before that. Aside from researchers and doctors, insurance companies have had a long vested interested in knowing the correlations between a person's weight (and other factors) and how long they live. Generally, the have tended to use the data more or less rationally - using it to describe large populations and set premiums accordingly. But they also tend to abuse it and apply it to individuals as well.


A doctor friend of mine mentioned that people (in the west) are living a lot longer now than they used to .... I tend to think that a lot of the research and conclusions being drawn are somewhat skewed.

More skewed than you might imagine. If you look at the life expectancy for someone that is 30 years old a century ago it is almost the same as today. In fact, the age at which someone could expect to die of "old age" hasn't changed much in thousands of years.

What has changed enormously is the infant mortality rate. If half of kids die before their fifth birthday - which was the case in Chicago as late as 1870 - it's going to be hard to have a very high average lifespan. Even if everyone who didn't die by age five lived to be 105 you would still only have an average of less than 55. But from 1870 to 2000, the infant mortatily dropped from over 300 per 1000 live births to only 10.

In the early 18th century the average lifespan in New England was about 40. People draw the conclusion that someone that was 40 was therefore near the end of their life. Yet the U.S. Constitution states that a person can't run for president unless they are at least 35.

In Roman times the life expectancy was barely 30, yet Jesus is never described as an old man when crucified at the age of 33 - with his mother present!

Lisa N
Mon, Jun-21-04, 17:42
In Roman times the life expectancy was barely 30, yet Jesus is never described as an old man when crucified at the age of 33 - with his mother present!

And, taking that a bit further, since it's estimated that Mary was between 14 and 16 when Jesus was born, that would make her a ripe old 47-49 years old at the time of his death...nearly 20 years past the average life expectancy. ;)

arkie6
Mon, Jun-21-04, 21:19
I seem to recall reading somewhere that a 50 year old in 1980 has less of a chance of making it to 80 than a 50 year old in 1930 would have had making it to 80 years old. Its primarily the reduction in infant mortality and deaths during childhood as a result of disease that accounts for increase in life expectancy since the early 1900's.

CindySue48
Mon, Jun-21-04, 21:45
Well as a nurse for over 25 years, I have to say I see a lot more elders now than I did when I first graduated. 25 years ago people didn't live as long OR as well as they do today. Just my 2 cents.

cc48510
Mon, Jun-21-04, 23:44
Well as a nurse for over 25 years, I have to say I see a lot more elders now than I did when I first graduated. 25 years ago people didn't live as long OR as well as they do today. Just my 2 cents.

Maybe its just that more of them are getting more Medical Care nowadays. My Great-Grandmother lived most of her life in the backwoods. She raised her own livestock, which she killed and ate. She cooked with Lard and made her own Butter. She lived that way until she was in her mid to late-80s, when she moved in with my Grandparents. She was in fairly good health until just before she died at the ripe old age of 93. That was 15 years ago. I knew her for a few years [in the her late-80s/early 90s] before she passed away, and she was in a hell of alot better health than most of the people I see nowadays in their 60s/70s.

She wasn't the only one either. I saw a picture of my 2nd Great Grandfather [her father,] which was purportedly taken in the late 1950s or early 1960s and he looked in good shape...for how old he would've had to have been. He had his kids in the 1880s/1890s. So, to have still been around in the late 1950s/early 1960s, he had to have been in his 80s or 90s himself.

But, then we have my Father's Side of the family...which is the only one I've been able to get information from more than 4 generations back:

Relative: Age at Death (Cause of Death if Known)

Uncle: 50 (Hypertension)
Grandparents: 65/79 (Infection while Hospitalized for Heart Disease/Pneumonia)
1st Great-Grandparents: 55/72 (Heart Attack/Unknown)
2nd Great-Grandparents: 65/?? (Unknown/Child Birth ??)
...
6th Great-Grandparents: 63/?? (Siblings: 0 Days/1M+13D/25/29/31/44/49/59/63/74/75/83/83/??)
7th Great-Grandparents: 29/64 (Siblings: 29/32/43/83/??/??/??)
8th Great-Grandparents: 71/74 (Siblings: 38/57/71/??)
9th Great-Grandparents: 59/60

wbahn
Tue, Jun-22-04, 00:14
But are you seeing more elders now because they are living longer or because we are treating them for ailments that use to either be untreatable or were left untreated in elderly people?

I'm not saying that the age at which someone can expect to live to and die of "old age" hasn't increased - it has. I'm saying that the life expectancy figures that everyone bandies about and frequiently interpret as being the average age that people die from "old age" at is bogus.

From the National Vital Statistics Report:

Life expectancy at birth (the number generally used):
1900 - 49.2
1930 - 59.2
1960 - 69.8
1990 - 75.4

A 25 year increase over that time span.

Now how about the expected number of years remaining for someone that is 50 years old?

1900 - 21.2
1930 - 22.1
1960 - 25.3
1990 - 29.0

Less than an 8 year improvement over the same time period.

How about someone that is 75?

1900 - 7.1
1930 - 7.3
1960 - 8.7
1990 - 11.0

Not quite a 4 year increase.

BTW - Remaining life expectancy for a 50 year old in 1930 was 22.1 years while for a 50 year old in 1980 was 27.9 years.

Now, these numbers are for the U.S. for all races/genders/social class.

You can really see the impact of infant mortality by noting the following entries:

1900: Expected life remaining:
Age 0: 49.2
Age 1: 55.2
Age 5: 55.0

1990: Ex[ected life remaining:
Age 0: 75.3
Age 1: 75.1
Age 5: 71.2

If every child made it to age five, then the first number would be one greater than the second number which would be four greater than the third number. Presently, this is almost the case.

You can actually calculate the infant mortality rate from these numbers. For 1900 it is 125 per 1000 live births and for 1990 it is slightly under 11.

The mortality rate from 50 to 80 in 1930 was 40% while the mortality rate from 50 to 80 in 1980 was only 27%.

Now, some of these values are still going to change because the actualy life span of some of the people involved is not known, only projected. For instance, we don't know exactly how many people that were 50 in 1980 will reach the age of 80 and we can't know that for another 6 years.