Obese may be denied priority NHS care

[Demi]

The Independent
London, UK

Patients with 'self-inflicted' illnesses face discrimination

By Andrew Grice, Political Editor
Published: 26 December 2006


Smokers, people with alcohol problems and the obese could be denied priority treatment on the NHS (National Health Service) in the UK if they do not try to change their lifestyle.

The Cabinet is discussing the controversial idea as part of a drive by Tony Blair to secure his domestic political legacy by pushing through a final round of public service reforms before he departs next year.

Ministers will confront a panel of 100 ordinary people with some of the "tough choices" facing the Government under a consultation exercise giving the public a direct say in the new policies. One question will be whether people whose lifestyle makes them ill should get the same priority as other patients. This would mean changing NHS guidelines saying that people should not be discriminated against "even if their illnesses are to some extent self-inflicted".

A Cabinet review group on public services was shocked by the scale of the burden caused by people's lifestyles. "Ministers were shocked by the fact that half of all years of healthy life are lost as a result of behavioural factors (e.g. smoking and diet)," a Government source said.

Ministers want a "cultural change" in public services so the state can support and encourage people to change their behaviour to improve their life chances and well-being.

They also want to extend the number of "contracts" between the citizen and the state, such as the £30-a-week education maintenance allowances paid to over-16s who remain in further education.

Experts warned this month that obesity, which costs the NHS £7bn a year, could bankrupt it if left unchecked and predicted that the proportion of obese adults would rise from one in five to one in three by 2010. Smoking-related diseases cost an estimated £1.7bn a year, with the same amount spent on alcohol-related problems. The treatment of alcohol-related harm, such as violent crime and traffic accidents, costs an estimated £20bn.

Downing Street sources said no decisions had been taken on whether to change the guidelines and stressed that the public would be asked their views on the issue first. The suggestion is bound to provoke criticism. Forest, the pro-smoking group, has claimed that some smokers have already suffered discrimination. It argues that tobacco revenues, which bring in £7bn a year for the Government, dwarf the cost of smoking-related illness.

The cabinet group, one of six drawing up the Blair Government's last policies, will also look at how public satisfaction measures can improve state-run services. Ministers will try to learn lessons from retailers like Tesco, which has used the technology behind its Clubcard system to offer a more personalised service.

The 100 people, a representative cross-section of the British public, will be recruited across the regions in the new year and organised lobby groups will be excluded. In February, they will see the papers discussed by the six cabinet groups and, in March, a public services summit will be held in Downing Street at which the "people's panel" will reach decisions. These will be presented to the Cabinet in mid-March.

Hazel Blears, the Labour Party chairman, is looking at other ways in which the public could influence government policy and the way that services are run.

A Blair aide said: "This process of public engagement recognises that politics is changing. The public level of expectations is rising both in terms of the provision which they receive and the right which they have to influence those services. It will identify in more detail the areas which the public want us to focus on and develop a series of radical and progressive solutions."

The cabinet reviews have already provoked controversy. A paper for the security, crime and justice group, leaked at the weekend, suggested that crime could rise for the first time in more than a decade as economic growth slows, and that the prison population, already at a record 80,000, could rise to 100,000 over the next five years.

The Government has promised an extra 8,000 prison places but it is not clear how they will be funded. The Treasury has frozen the Home Office budget in real terms from 2008-11 other than for spending on security and anti-terrorism work.

Yesterday David Davis, the shadow Home Secretary, challenged the Chancellor, Gordon Brown, to address the "chronic shortage" of prison places. He said: "All we have seen from Gordon Brown has been a miserly approach which, as well as putting the public at risk, is short-sighted. The cost of having a serious criminal free on the streets to commit crime far outweighs the cost of imprisoning and rehabilitating that individual."

'Self-inflicted' illnesses

* 114,000 of the 12 million smokers in the UK die each year as a result of their habit.

* 20% of adults in the UK are obese, and one in four children are overweight, making Britain the fattest country in Europe.

* 8,386 people died from drink-related illness in the UK in 2005. Rates have nearly doubled for 35 to 54-year-olds since 1991.


http://news.independent.co.uk/uk/health_medical/article2103722.ece

[kebaldwin]

So the goverment tells people that they should not eat fat, meat, butter, etc -- that they should eat margarine and other hydrogenated oils -- that low fat foods are good for them -- and then when people get obese and come down with type 2 diabetes -- the goverment says they are not responsible ?!?!

[Whoa182]

NHS is a free service, we don't pay to check into an emergency room as you have to in the U.S. Obesity, Diabetes and other self inflicted crap is bankrupting this service...

that they should eat margarine and other hydrogenated oils --

What the hell are you talking about... the government are saying to eat healthy, simple as that.

that low fat foods are good for them --

low fat foods can be good for you ! ! ! Beans, vetables, fruit, oatmeal.

and then when people get obese and come down with type 2 diabetes -- the goverment says they are not responsible ?!?!

This reminds me a type 2 diabetic I was listening to when I went to ge tmy hair cut. He mentioned he just came back from the hospital and was saying (while smirking) that when he was going to get home hes going to have a nice big plate of chips (potato chips), pizza and a beer. Believe me, the NHS does not advise that kind of negligence. He said how he shouldn't be eating it, but he was going to anyway, while laughing. This is an example of peoples attitude to health.

People do NOT NOT NOT listen to any government recommendations. I know not one person that eats 5 fruits and vegetables a day. The only time people usually have vegetables in the UK is on a traditional sunday dinner.

The government are ACTUALLY saying

- Do NOT eat high sugar foods
- Do NOT eat high fat foods
- Eat vegetables and fruits, nuits and healthy fat like olive oil
- Eat fish and lean meats
- Eat enough to maintain a healthy weight *

There is nothing to moan about with those recommendations, because that would translate into less disease and farless sugar, less fat and thus less calories.

Are people following the advice?

No They're NOT


It so confuses me when people around here blame the government(s) for their recommendations when people do not even follow them to begin with. Its complete crap. The food pyramid is not the best it can be, but people in general do not take one bit of notice to it. period.

So before blaming the government for trying to do something about obesity, first understand that people are not even listening to their food advice in the first place. It's NOT the government that got people fat, its peoples own attitude to health and food.

[Nancy LC]

Well, if you eat the US government's recommend 8-11 servings of grains today I can pretty well guarantee you're going to be fat and diabetic at some point in your life.

Food manufacturers NEED us to continue to eat more, otherwise their profits either stagnate or fall. So they enlist the help of the government to push their food products. In the US if they wanted to solve the obesity crisis, they could start by dropping the price supports on corn/wheat most of which goes to industrial food and putting them on meat and vegetables and fruits.

[Whoa182]

Nancy, all I've been hearing from the government in the UK since I was a kid is to eat more fruit and vegetables. That has always been the main point.

I agree that 8-11 servings of grains is quite excessive. But I haven't heard this recommendation before. It's mainly always focused on fruit and veg.

The government has banned all advertisments of junk food before a certain time on T.V here. I think its till after 9pm. Same happened in the US yet?

[kneebrace]

The government are ACTUALLY saying

- Do NOT eat high sugar foods
- Do NOT eat high fat foods
- Eat vegetables and fruits, nuits and healthy fat like olive oil
- Eat fish and lean meats
- Eat enough to maintain a healthy weight *

There is nothing to moan about with those recommendations, because that would translate into less disease and farless sugar, less fat and thus less calories.

IAre people following the advice?

No They're NOT


.

Not just sugar Whoa. Starch also becomes sugar soon after it enters the human body. But then Governments (and it seems you as well) start falling in line with the same low sat fat nonsense this forum seems refreshingly free of. Saturated fat in the context of a low carb diet is perfectly healthy. Dietary carbs above a certain calorie intake, wether sugar or starch, are unhealthy.

There are undoubted health benefits from just eating less food. Governments might as well tell people to breathe less. If you eat the kind and levels of carbs the current medical/dietary paradigm claims are healthy, many people are plunged into a metabolic hunger/bodyfat gain viscious cycle which all too often leads towards obesity. If you eat even more sugary carbs, you're just more likely to end up obese and/or unhealthy. The food pyramid is a criminal mistake.

I personally watched my own highly selfdisciplined high achiever mother swallow the low fat message, eat like a sparrow for fifty years and still spend her entire adult life clinically obese.

Food pyramid carb recommendations tend to put the human body in bodyfat gain mode. It's that simple. To suggest that Governments are then not responsible for the metabolic consequences is disgusting.

[Whoa182]

I personally watched my own highly selfdisciplined high achiever mother swallow the low fat message, eat like a sparrow for fifty years and still spend her entire adult life clinically obese.

I've seen the same thing over and over again with friends and family. They fail on low fat diets... but the reason they fail is because I seen what they eat. Its all pre-packaged, microwave low fat foods but high in sugar and low in fibre. The emphasis is never on fresh whole foods.


But there are still millions of people that do low fat diets and lose weight on them. There are so many studies showing low fat in an environment where its more controlled results in weight loss all the time.


And it is absolutely unrealsitic to expect the world to adopt an extremely low carb diet (like atkins). You can moan and moan about it but it just will not happen. There can be only changes with some realistic approaches.

I think the UK government have been excellent lately in bringing about a healthy change in schools. Which was initially brought to the governments attention by jamie oliver.

[Nancy LC]

I guess the thing that bothers me most is that you can be skinny and be a smoker, have type 2 diabetes, be an alcoholic, have very unhealthy eating habits or have habits that otherwise destroy your health. But the difference is, you don't necessarily have your issues on display like obese people do.

It comes down to discrimination based on how people look and that should offend everyone.

You don't know if someone is obese because they have a genetic or endocrine abnormality or if they inject twinkies introveneously. But because you can see obesity you can easily lump everyone into the same category.

[kneebrace]

I've seen the same thing over and over again with friends and family. They fail on low fat diets... but the reason they fail is because I seen what they eat. Its all pre-packaged, microwave low fat foods but high in sugar and low in fibre. The emphasis is never on fresh whole foods.

Ah the 'fresh whole foods' mirage. What utter nonsense. Sure it's healthier than processed food. But the carb level will determine whether you are putting your body in fat burning mode, not the 'quality' of the carbs. My Mum was chillingly selfcontrolled about not eating processed junk. She was and still is extremely healthy. But at 82 she is still (and still unwillingly) clinically obese. She's the first to admit that her admittedly remarkable life would have been even more enjoyable if she hadn't been carrying around all that flab for all those years.


But there are still millions of people that do low fat diets and lose weight on them. There are so many studies showing low fat in an environment where its more controlled results in weight loss all the time.

I don't doubt it. And every single one of those favourable low fat diet results would have been more easily and more healthily achieved with a low carb dietary approach. The simple fact is the nutritional establishment was (and still is :q: ) just too dense (and these days just too proud) to admit they were approaching bodyfat loss with their metabolic hands tied behind their backs.


And it is absolutely unrealsitic to expect the world to adopt an extremely low carb diet (like atkins). You can moan and moan about it but it just will not happen. There can be only changes with some realistic approaches.

Well it's certainly unrealistic when the very authorities who are charged with disseminating dietary advice get it wrong ;) . Low carb is easy and endlessly enjoyable. If even a tiny fraction of the effort that has gone into whingeing about saturated fat consumption had gone into recommendations about controlling carbohydrate intake you'd soon find what was 'realistic'. It's so much easier to control hunger when carbohydrate is restricted. Suggesting that people just 'eat less' is where reality has really taken a holiday ;) . A high (even 'healthy' ) carb dietary approach is for most people (natural undereaters, like you Whoa, a notable exception :) ) a free lifelong ticket to a hunger rollercoaster, the middle and end of which is usually bodyfat storage. Hunger is a very compelling imperative. Carb induced hunger almost always exceeds normal bodyfat calorie needs. When it doesn't, it's because the poor weight loss battler is using it up in the gym.



I think the UK government have been excellent lately in bringing about a healthy change in schools. Which was initially brought to the governments attention by jamie oliver.

Yes of course some carbs are healthier than others. Nobody here contests that. Nevertheless our evolutionary design is best suited to a much lower level of dietary carbohydrate (even choosing from the very 'best' sources) than is currently recommended. But the low saturated fat recommendation is still just plain wrong.

Nobody has ever suggested on any low carb forum I've ever seen that a twinke is as healthy as a (modern) banana. The point is they are both innappropriate fare for human beings. Eat a few berries after your bunless burger (eg.) and learn to really look after your metabolism.

[Whoa182]

But the low saturated fat recommendation is still just plain wrong.

Why bring saturated fat into the equation? Why not a diet high in olive oil? It just seems you're trying to be rebellious. Olive oil offers more protection that saturated fat and imprves lipids, inflammation and cancer risk.

It still be be irresponsible to suggest te government to do an instant U-turn and say to everyone... "go gorge on saturated fat foods". I think that will just make the problem even worse. There was a study in 2001 in clinical diabetes journal showing that in fact the group with the highest body fat and BMI was the group who ate least carbs <30 %, while the group with the highest carbs > 55% + had the lowest BMI.

You make it sound so simple but its not. Good epidemiological evidence suggests that those you follow high carb low fat low protein high in vegetable diet are the healthiest and live the longest... This is where the evidence for following these kind of diets are coming from.

Even with the recent evidence showing that high fat low carb diets don't increase heart risk and is the same as low fat, this doesn't at all mean they can just say "go and eat all the fat you want". There isn't even much data on the long term health effects of an atkins diet. How the hell can they recommend everyone go on it.

the word 'diet' is just horrible... peoples attitide to leading a healthy lifestyle need to change. Natural foods and we wouldn't be in this mess. I'd love to see someone actually try to get fat on eating vegetables like broccoli.

I personally think a diet high in vegetables, low gi fruits, olive oil, nuts, seeds would save a lot of people from obesity. But not only that, people need to adjust food intake for their OWN metabolic rate. Not everyone can eat the same amount of calories. The critical point is that people need to alter their own food inake to MAINTAIN a healthy weight. So if you ended up obese, then you clearly never followed that bit of advice.

And if you say calories do not matter. Then I completely DISAGREE with you.

[potatofree]

If the government decides who gets treatment or not, then they also get to decide what constitutes a "self-inflicted" condition or not. It's that simple.

What if you don't live to be 100 eating CR? What if you get rubber-stamped by your health system as having an eating disorder based on your BMI and denied medical coverage? After all, if they see obesity and alcoholism as things brought on by behavior, surely brittle bones and other delights that can be blamed on undereating (And NO, I'm not trying to start a debate about whether or not there's evidence to back that up, just like they have insufficient proof that Atkins will kill you. ;) ) had better be off the list as well...

How about people who come down with smoking-related issues from spending their lives with a smoker? Is that their own darn fault, too? Birth defects or prematurity? FInd a good way to blame the mother, and get out of covering those conditions too!

Slippery slopes could save the government a lot of money in the end! :rolleyes:

[kebaldwin]

Whoa

I hope you grow up soon.

[Whoa182]

just like they have insufficient proof that Atkins will kill you. ;) ) had better be off the list as well...

There is also insufficient evidence to say to everyone go on atkins. When all successful populations eat a high vegetable carb diet. There is no lie in this, it is a fact. Americans, british eat a high GI carb, high fat, excessive protein, and most importantly high calorie, processed food based diet. They do not eat a high plant based high carb diet. So using US as an example that carbs are not good is absolutely WRONG and pointless.

Whoa

I hope you grow up soon.

What I'm saying is true.

http://forum.lowcarber.org/showthread.php?t=318562

[potatofree]

Whoa-- in your zeal to promote CR, you're missing the point... that the Government gets to decide what healthy eating is, whether it meets my approval, your approval, or even makes sense. They then get to deny you health coverage based on that.

That scares me.

Luckily, I have health insurance, but even without a government-run system, my insurance company could decide on a whim that I have to eat the way they say or my coverage is gone...

[Whoa182]

Stop talking about CR. I'm talking about a healthy diet in protecting against obesity. What i'm only saying is actual facts... nothing less.

[potatofree]

You're talking about YOUR definition of a healthy diet.

[Whoa182]

You're talking about YOUR definition of a healthy diet.

NO, i'm talking about populations that have diets that are making them healthy. watch these videos! Decades of evidence behind these diets.

http://forum.lowcarber.org/showthread.php?t=318562

[potatofree]

So, how do you propose changing the way the population in general EATS? Who should set the standard, and how should it be enforced?

[MyJourney]

The government deciding what anyone should or should not eat is a scary thought in and of itself. While one may be in agreement that the diet the government picks today coincides with their personal view of what is healthy, it is setting a precedent for the government to decide about the nutritional importance or lack thereof of other foods etc. While today it might be eat more vegetables, tomorrow it might be eat more grains or cut all the fat or who knows what and people, at least obese people, would have to comply or risk not getting treatment.

Obese people pay into this system too and yet they are treated as second class citizens and told that their problem is self inflicted.

What about athletes who put themselves at high risk for sports injuries? Are they also going to be denied treatment for broken bones or other problems that they get because its self inflicted?
Of course not. The government can pick and choose and discriminate at will.

[Lisa N]

What about athletes who put themselves at high risk for sports injuries? Are they also going to be denied treatment for broken bones or other problems that they get because its self inflicted?

Let's not forget those that are injured participating in high risk activities such as bungee jumping, parachuting or reckless driving. Had an accident because you were driving too fast? Too bad. Got hit by a car because you weren't paying attention? Tough. Attempted suicide? That's self-inflicted; can't treat those folks, either. Eating disorders? Below standard BMI? Got AIDS, STDs or Hepatitis B? Whoops! Better do something about those lifestyle choices or you don't get medical care.
It'll be interesting to see if and where the line is drawn. If they play their cards right, they can wind up not treating most people for one reason or another and save themselves buckets of money. That whole citizen satisfaction with the government thing is overrated anyway.... ;)


NHS is a free service, we don't pay to check into an emergency room as you have to in the U.S. Obesity, Diabetes and other self inflicted crap is bankrupting this service...

Gosh, like Medicare and Medicaid in the US isn't having its share of problems with those who are sick because of lifestyle choices, not to mention skyrocketing medical care costs and health insurance premiums for the same reason.

[potatofree]

Of course, with all the people they deny treatment dying early, there would be fewer paying IN.... ;)

[Angeline]

No one should be denied medical care for any reason whatsover. That's going back to the Dark Ages. Might as well return to stepping over dying people on the street while holding a perfumed handkerchief over your mouth.

However, it would make more sense to ask people to contribute to health care, according to a slidding scale that's determined by your general health and lifestyle habits. Factors like weight, # of drinks, smoking, sports (i.e. extreme sports) could influence the rate. Just like your driving record can affect your insurance rates. Not a perfect system, but a better alternative to bankrupting the medicare system. Then we'd have to go back to an american style system where your pocketbook determines how good your medical care is. Not that I'm blind to the fact, that's pretty much the case anyway. You don't find rich people crammed on stretchers in hospital hallways.

[hummelda]

In the end, many many things are self-inflicted if you search hard enough.

Pregnancy and birth? Your choice so why should you be covered for the delivery?
Any kind of accident? Someone should have been more careful about something.
etc etc etc.

It is alarming that the NHS would choose to limit coverage to certain groups of people. For most of us, if it were as simple as just changing a lifestyle and foregoing foods that are harmful to us with no other strings attached whatever they be -- emotions, addictions, food sensitivites -- I'm sure most of us would have kicked our issues many years ago.

But I am neither young enough nor unrealistic enough to think that we will solve all the food-related problems overnight simply by the government declaring it so.

Prohibition was a big success, wasn't it?

Having worked in the insurance industry in Ontario for over 25 years, I know there has been immense controversy about what factors are used to determine rates, so much so that the government has it tied up with heavy legislation including the rates that can be charged. Applying this to medicare would be much more difficult and controversial. Maybe the start should be made by shutting down Timmy's drive-throughs. Now that would cause complete panic in the land.

[Whoa182]

they can wind up not treating most people for one reason or another and save themselves buckets of money.

Well since the NHS is in a deficit, sure... they need to be more selective. Education needs to play a massive role if most of the western world are going to change. The problem is that now there are a bunch of uneducated parents that have gone passed the education system without much knowledge about nutrition, they have kids and then feed their kids junk food everyday.

What about the people that DO take care of their health and have an accident. It's not like they're breaking bones on a weekly basis is it? A broken bone in a young person isn't normally a chronic problem and it heals without prolonged medicine like is given out for diseases caused by bad lifestyle.

The healthy people that eventually do need treatment for something that they couldn't prevent have to wait months in line because people that can't be bothered to look after their own health are clogging up the system.

I've only ever broken one bone in my life and I've been a very active person. I skateboard, played football everyday for 10 years, played roller and ice hockey, boxing, karate, judo and other things. And I only ever broken 1 bone in my wrist in 22 years... I'm hardly clogging up waiting list times am I?

Sports persons that are engaging in running, going to the gym are improving their health. They should be praised for their efforts to lead a healthy lifestyle but if it results in a broken bone then so what? At least they're trying something that will help keep their mind and body active. On the other hand there is plenty of information out there to eat vegetables, fruits, nuts, legumes and all healthy foods but people ignore it. That is negligence and is a whole different attitude to health than the sports persons. Obese people know they're obese, and are told the risks over and over again.

Do not blame people engaging in health promoting activities for clogging up the system, it is people that develop chronic diseases because they do bad things to their bodies and mind.

Damn right i'd take a hard line approach

The first one I'd do is put smokers at the back of the line. I know I want to go into medicine, but even half of the medical community has the same feelings.

[hummelda]

Funny, I broke a bone while visiting the U.K. I was treated well with an ambulance coming to get me from a canal somewhere, drive me to Bath, and having my collarbone x-rayed and put into a sling. While I offered to pay for my treatment since I had full health coverage (actually, double coverage, since I have government-funded Canadian insurance as well as out-of-country coverage), I never paid a cent. I wonder how the accounts are handled in the NHS? As a Canadian, I was not entitled to NHS coverage.

Good thing I am not a smoker ... with my broken collarbone, going to the back of the line would sure have been painful.

Oh, by the way, bedside manner is really important in medical personnel.

[potatofree]

The healthy people that eventually do need treatment for something that they couldn't prevent have to wait months in line because people that can't be bothered to look after their own health are clogging up the system.

I've only ever broken one bone in my life and I've been a very active person. I skateboard, played football everyday for 10 years, played roller and ice hockey, boxing, karate, judo and other things. And I only ever broken 1 bone in my wrist in 22 years... I'm hardly clogging up waiting list times am I?

Sports persons that are engaging in running, going to the gym are improving their health. They should be praised for their efforts to lead a healthy lifestyle but if it results in a broken bone then so what? At least they're trying something that will help keep their mind and body active. On the other hand there is plenty of information out there to eat vegetables, fruits, nuts, legumes and all healthy foods but people ignore it. That is negligence and is a whole different attitude to health than the sports persons. Obese people know they're obese, and are told the risks over and over again.

Yeah, that helps. So you have only broken one bone in 20-something years. Good for you! A lot of your age group neglect helmets, go bungee jumping, race cars, drink and drive...if you lump all obese people together, you get lumped in with your own demographic by most government standards, regardless of your personal luck avoiding accidents.

Government doesn't really deal well with individuals, they need trends and statistics to go by... :rolleyes:

As for your "get to the back of the line" attitude, I think I know a future nurse you might like to set up practice with. ;)

[potatofree]

By the way, have you ever visited a brain-injury ward? Lots of fine young people in there who might not be covered if it was their own fault the didn't wear a helmet...

[StLouisTom]

NO, i'm talking about populations that have diets that are making them healthy. watch these videos! Decades of evidence behind these diets.

http://forum.lowcarber.org/showthread.php?t=318562

Whoa182,

I watched the videos, and they don't prove that a vegetarian/vegetable based diet is what is making them healthy. Here are some of the things they found about long lived societies:

1. They eat an almost vegetarian diet with a lot of beans.
2. They are spiritual.
3. They are very family oriented.
4. The younger people respect and take care of the elderly.
5. They handle stress well.
6. They have a positive attitude.
7. They have a "purpose" in life.
8. They don't smoke.
9. They don't eat pork.
10. They go to church at least 4 times per month.
11. Those in the U.S. are Seventh Day Adventists.

Keep in mind this is just a partial list that I picked up from watching the videos. It doesn't even take into account literally hundreds of other things that MIGHT affect longevity. So from all of these things, your conclusion is that it's the DIET that causes them to live long?

The problem with all of these epidemiological studies is that there is simply no way to single out one factor as "the" reason a population lives longer than others. Maybe if all of the above factors were in place but the diet was replaced with a healthy low carb diet, the people would live even longer! How do you know?

I would also venture to guess that these populations have fewer car accidents (at least outside the U.S.), industrial accidents, murders, suicides, etc. which would also affect the statistics.

[potatofree]

Excellent points, Tom.

[Lisa N]

I've only ever broken one bone in my life and I've been a very active person. I skateboard, played football everyday for 10 years, played roller and ice hockey, boxing, karate, judo and other things. And I only ever broken 1 bone in my wrist in 22 years... I'm hardly clogging up waiting list times am I?

Well...other than the 3 times I've given birth, I've never been hospitalized in 45 years and I see my doctor, on average, twice a year. WOW! I'm seriously plugging up the health care system! :lol:
You know...some of the 'skinny' people in my office sure seem to see the doctor a lot more often than I need to. Come to think of it, Whoa, you're always going on about how you get checkups and bloodwork, etc.. to be sure that you're doing okay on your CR. How often do you see the good doctor, anyway, and wouldn't it be better for those time slots to go to someone who is actually ill? Seems to me that your healthy lifestyle necessitates more visits to the doctor and labwork than my diabetes. :lol:
Come to think of it, the one time I needed surgery, it was for a gallbladder removal for stones caused by a LOW FAT diet! :p
I also take it that the NHS doesn't care about (or is conveniently ignoring) the studies showing that it's quite possible to be both fit and fat? Wouldn't want the facts interfering with their prejudice, now would we? ;)

BTW, Whoa, it's not about you and it's not about me. It's about discriminating against groups of people based on government determined standards of what constitutes a healthy lifestyle. I wonder why it is that the Dutch government can legalize prostitution, provide checkups and health care for the prostitutes and provide safe houses for their heroin addicts and they aren't whining about the cost of those lifestyle choices?

[ysabella]

Lisa N, there is not much increased cost. The prostitutes have a union (of sorts) and are able to get private health insurance (the Netherlands has a two-tiered system much like the US). And, the Netherlands has a much lower rate of heroin addicts (per capita) than most countries. I can dig up some statistics if you like. (My husband is Dutch, and I lived there for a couple of years. :) )

I'm sure there are a few things we can all agree are unhealthy...but personally I would rather see less government decisions in health care, not more.

[potatofree]

Yet another illustration of who gets to draw the lines, and why. There's such a moral judgement attached to "your own fault" kind of thing.

IMO, some sort of reward system in place for those who adopt healthier habits would go a lot farther than denying care to those deemed at fault for their own condition... as has been said, if you look hard enough, you can find a way to blame the patient for a LOT of health problems.

[MyJourney]

My boyfriend and I were discussing the other day about how difficult it is to get health insurance in the US. The people who need it the most, the sick, cannot withstand underwriting and get denied while those who are healthy and dont need/use it are the ones who are able to get it.

It sounds like whoa is proposing the same thing. Treat the healthy and let the sick die.

It doesnt matter that the sick and the healthy all have to pay into the system.

[Lisa N]

Education needs to play a massive role if most of the western world are going to change.

Whoa, even you don't believe that to be effective because in the same post, you go on to say...

On the other hand there is plenty of information out there to eat vegetables, fruits, nuts, legumes and all healthy foods but people ignore it. :idea:

[Whoa182]

I think it depends when the education is given, at what age. Older kids seem to be more rebelious against changes. Hence why schools are having problems with secondary schools rather than primary schools in school dinner uptake.

[potatofree]

..and primary school kids have WHAT control over what they get served, and the sudden burst of memory as they grow up with all the easy fast-food choices and crap available?

You can't teach children with words, but by example, and that comes from the adults down, I'm afraid.

[Lisa N]

I think it depends when the education is given, at what age. Older kids seem to be more rebelious against changes. Hence why schools are having problems with secondary schools rather than primary schools in school dinner uptake.

I can't speak for Europe, but in the US, the food pyramid is taught in primary school and has been since I was in that age group. It's on boxes of cereal and even the milk they are served at lunch. Truth is, kids don't particularly care about what's healthy; they want what tastes good to them and when given a choice between cookies/candy and fruits/veggies, the fruits and veggies lose out. ;) You can blame their uneducated parents all you like but the fact is, kids have taste buds and it doesn't take them long to figure out that junk food tastes good and no matter how careful you are as a parent, eventually your little darlings are going to get their hands on something you'd rather they didn't eat and decide that they like it. Once that happens, you can't unring the bell. My kids eat healthier than most, but I'd be lying if I said that they preferred brussels sprouts or spinach (two veggies they really like) to chocolate chip cookies; I'm not that naive.
If you're really going into medical school, it might be a good idea to reconcile yourself with the idea right up front that lots of patients are not going to heed a word you have to say and will leave and do as they please the second their fanny walks out of your office much like the man you overheard not long ago; obviously he had the knowledge that such foods weren't the best choice for him, but that didn't seem to make much difference, did it?
You can educate people until the cows come home and in the end they are still going to do what suits them; you cannot force someone to follow your advice no matter how sound it may (or may not) be, nor how dire you paint the consequences to be. If education was the key, doctors would be the healthiest folks around since they, in theory, know all about how to keep themselves healthy. In reality, doctors are often just as unhealthy as their patients. Same thing goes for a lot of scientists and researchers.
So...what are you going to do when faced with a non-compliant patient? Lecture them? Yell at them? Shame them? Threaten not to treat them? Lots of luck with that; let me know how it works out. ;)

[Mutant]

Why bring saturated fat into the equation? Why not a diet high in olive oil? It just seems you're trying to be rebellious. Olive oil offers more protection that saturated fat and imprves lipids, inflammation and cancer risk.

Part of the problem with having the government dictate things like 'healthy' eating is that they are often ignorant and do a diservice to those they are supposed to be serving. You provide a good example by remaining willfully ignorant about saturated fats; they support important signalling and stabilization processes in the body including the immune system and hormone production which are both adversly affected with low saturated fat intake. In men it's well known that testosterone production correlates strongly with saturated fat intake (warning: boys that want to suppress sexual desire, function and secondary male sexual characteristics will want to stay far away from saturated fats!) Stearic acid is strong anti-oxidant and the most prevalent saturated fatty acid in beef; another reason for selecting that fatty beef cut (being delicious is the number one reason!).

Combatting bad nutritional advice for over 30 years!

[kneebrace]

Why bring saturated fat into the equation? Why not a diet high in olive oil? It just seems you're trying to be rebellious. Olive oil offers more

Protection against what?



It still be be irresponsible to suggest te government to do an instant U-turn and say to everyone... "go gorge on saturated fat foods". I think that will just make the problem even worse. There was a study in 2001 in clinical diabetes journal showing that in fact the group with the highest body fat and BMI was the group who ate least carbs <30 %, while the group with the highest carbs > 55% + had the lowest BMI.

You make it sound so simple but its not. Good epidemiological evidence suggests that those you follow high carb low fat low protein high in vegetable diet are the healthiest and live the longest... This is where the evidence for following these kind of diets are coming from.

Well if you define 'good' epidemiological evidence as being plenty of it regardless of the mental and statistical gymnastics required to reach the conclusion, then I guess you'd have to call it good.

Look Whoa, surely you've learn't something in your time on this forum. It's useless recommending ad lib saturated fat consumption unless it is concomitantly recognized and recommended that dietary carbohydrate be also restricted.

Even with the recent evidence showing that high fat low carb diets don't increase heart risk and is the same as low fat, this doesn't at all mean they can just say "go and eat all the fat you want". There isn't even much data on the long term health effects of an atkins diet. How the hell can they recommend everyone go on it.

Well, perpetuating the historical anti sat fat mistake would seem to be pretty counterproductive too. Actually there's about five million years of evidence that a low carb dietary approach is the healthiest, but I can't help remembering a classic Whoaism - 'I couldn't care less what my remote ancestors ate' ;) .

A good start would be to recognize that carbohydrate makes most people ( Whoa I know you don't find it that difficult to eat starvation calories, but you are in a minority) unnaturally hungry. Restricting carbohydrate makes it so much easier to eat moderately.

the word 'diet' is just horrible... peoples attitide to leading a healthy lifestyle need to change. Natural foods and we wouldn't be in this mess. I'd love to see someone actually try to get fat on eating vegetables like broccoli.

Interesting that you give one of the most popular low carb vegetables as an example of non fattening foods. You probably don't know how much better it tastes smothered in butter.

I personally think a diet high in vegetables, low gi fruits, olive oil, nuts, seeds would save a lot of people from obesity. But not only that, people need to adjust food intake for their OWN metabolic rate. Not everyone can eat the same amount of calories. The critical point is that people need to alter their own food inake to MAINTAIN a healthy weight. So if you ended up obese, then you clearly never followed that bit of advice.

But you are still missing the point that eating a high carbohydrate diet (wether processed or not) tends to make most people unnaturally (ie more than their energy in = energy out homeostasis dictates) hungry. Such a diet does so for absolutely compelling evolutionary reasons. Mix that with the proliferation of absolutely delicious high calorie/carb food (modern selectively bred fruit being a prime example, twinkies being another ;) ) and you've got the makings of a metabolic catastrophe. That anyone could even suggest that Governments should abandon the victims of this disaster is just one more example to me that human beings probably just aren't up to the job. Selfishness has certainly served it's evolutionary purpose thus far. Perhaps it's time we all recognized it's a bit of an anachronism. As if both obesity and premature degenerative disease weren't a sad enough consequence of the agricultural revolution , now you're supporting a move to punish the victims further by denying them societal funded medical care.

So Whoa wether you are inclined to or not, you should care what your ancestors ate. You talk about dietary 'shoulds' and 'shouldn'ts' as if human will was more than a match for hunger. It's not, never has been, never will be.

Btw. I think few low carbers still think that calories don't matter. They certainly matter less on a low carb than a high carb dietary approach (in terms of fat burning/storage). But of course they still matter.

[ReginaW]

There is also insufficient evidence to say to everyone go on atkins. When all successful populations eat a high vegetable carb diet. There is no lie in this, it is a fact. Americans, british eat a high GI carb, high fat, excessive protein, and most importantly high calorie, processed food based diet.

Whoa - you've been here quite some time and you still don't understand that a low-carbohydrate diet IS a high vegetable diet?

Secondly, the data betrays your assumption that the US and UK diets are excessive in protein - we eat LESS protein than the two countries at both extremes for dietary fat...Japan and France....both of those countries eat MORE protein, especially MORE animal protein than we do or the UK does. Interestingly, both Japan and France also consume LESS sugar - significantly less - more vegetables (real veggies, not corn and peas) - and LESS vegetable oils than we do!

[Lisa N]

NHS is a free service

Whoa, you do realize, don't you, that there is no such thing as a 'free lunch'? Last I checked, goverments need money to fund these programs and since it doesn't grow on trees or appear out of thin air, they get their money to fund such programs from....the people of their country.
It's not a 'free' service when the people are funding it through taxation; the very people, in fact, that they are now talking about not providing care to.
It would be fair, IMO, that if they are going to deny care to certain people under the guise of 'self inflicted disease' to refund the money that they have paid into the system and let them seek medical care elsewhere. Of course, that leaves less funds to care for the healthy, but if they're healthy, they don't need much care, do they? ;)

[Whoa182]

I watched the videos, and they don't prove that a vegetarian/vegetable based diet is what is making them healthy. Here are some of the things they found about long lived societies:

It is their diet, please watch this small flash video and it explains whats going on

click on "begin your journey"
http://www7.nationalgeographic.com/ngm/0511/sights_n_sounds/index.html

[hummelda]

It is their diet, please watch this small flash video and it explains whats going on

I watched this flash ... stronger than diet was the socialization. There was no suggestion of caloric restriction in Sardinia. I didn't see a strong CR theme in that clip at all.

[StLouisTom]

It is their diet, please watch this small flash video and it explains whats going on

click on "begin your journey"
http://www7.nationalgeographic.com/ngm/0511/sights_n_sounds/index.html

I watched, and once again, the diet was only one factor mentioned...and it wasn't even stressed. They seem to stress family, social network, stress reduction, etc. ahead of food. And when they did mention food, they made a point to say that the people grew their own food.

With the SDA, they specifically mentioned exercise and abstinence from tobacco and alcohol.

As for any influence their diet does have on longevity, just the fact that they stress "real food" over processed food may be the important piece of information. The fact that it is vegetarian may be immaterial, or may even be working against them. As I said before, give these people all the same variables except substitute a healthy low carb diet consisting of real, unprocessed food, and you may find they live even longer.

[sublime]

Obesity, Diabetes and other self inflicted crap is bankrupting this service...

So only the good little boys and girls get medical care? Give me a f%cking break already. :rolleyes: What about a child who develops diabetes from their diet? Its probly their parents fault, but should they be denied medical care also? Should someone who drank too much be denied medical care as they are dying of liver cancer? Are they not still human? I better stop here cause I'm getting mad. This subject just became WAY to personal. Later