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Saturday, April 23, 2011

Three Inches!

Because of a lousy three inches I am obese? Because of just three inches I am at risk of a host of health problems and probably early death. At six feet three inches tall and 255 pounds I am classified as obese according the government’s body mass index calculator. If I had the genetic good fortune of being six feet six, merely three inches more I would have a BMI of 29.5 and have a bright future full of health and longevity. But alas I have missed the mark by three inches.

If that sounds absurd that’s because it is. Furthermore it is just one of the many issues I have with generic government imposed standards of health measurement. That term generic could not be more appropriate in discussing the BMI as that is exactly what it is.

The Body Mass Index was devised by Belgian mathematician Adolphe Quetelet in 1832 as a measure of a “normal man”. The arbitrary calculation became the accepted formula for health when it was adopted into wide use in the 1970’s by famed obesity researcher Ancel Keys. If not for a growing body of contradictory objective evidence the BMI might be an acceptable calculation but that is simply not to the case.

For example consider the findings of Dr Steven Blair at the Cooper Institute for Aerobic research in Dallas Texas. Since 1970 Dr Blair has studied the effects role physical fitness in reducing mortality rates in over 30,000 men and women. Findings from those years of ongoing studies have shown that being heavy did not increase the risk of dying early and in test subjects with adequate levels of physical fitness being overweight seemed better than being underweight. In other words a high BMI is not a death sentence as we are so often told.

My real issues with generic broadly stated health measurements are one they do not account for individual markers of health. Two they illogically assume that because someone is born short they are doomed to poor health and an abbreviated lifespan. And three in the face of clear contradictory evidence no amendment to those markers is made.

As usual our government with its minions in the health establishment continually attempt to look at us as nameless and faceless statistics. The truth is that we are individuals in every way. Although based on the generic BMI measure I am classified as obese and at risk I have no health issues. I assume that issues are coming in the future but will they be directly related to those three inches that I don’t have? Could it simply be the case that people get sick not matter what they weigh or how tall they happen to be?

Sunday, April 17, 2011

Is it ok to ask these question?

Our own Centers for Disease Control states that there has been a “Dramatic increase in the prevalence of obesity over the last 20 years”. This sure sounds alarming and gives the impression that we are rapidly approaching the end of our existence.

A little more reading from the CDC website tells me that obesity is measured by the Body Mass Index or BMI and that a BMI greater than 30 indicates obesity. Furthermore the BMI is said to be a reasonable indicator of body fatness and weight categories that may lead to health problems. Such verbiage seems to leave a certain amount of gray area in the obesity discussion.

The spike in obesity numbers as measured by the BMI is as reported by the CDC an estimate based on phone interviews where random people self report their height and weight. This estimated obesity epidemic based on self reporting causes the Centers for Disease Control to dole out millions of tax payer dollars each year to fight the self reported problem.

The reasons for the prevalence of obesity across various ethic groups are per the CDC complex and not well understood. Despite being not well understood 25 of the fattest states are given funding to provide evidence based programs to combat the “growing” problem. How you can have an evidence based program for a problem that is not well understood is a mystery to be addressed in a later post. Meanwhile based on what I have learned I have a few questions of my own.

In addition to the issue of obesity the subject of hunger is purported to be one of the major issues we face as a nation. Some statistics say that 1 in 8 people have issues related to food security or not having adequate food on a daily basis. At the risk of sounding cold and uncaring what is the obese group doing that the hungry group isn’t?

If there is a growing epidemic of obesity in the United States shouldn’t we be hearing of less and less hunger? At some point shouldn’t hunger be a thing of the past if in fact more and more are becoming obese? One of the primary reasons the CDC cites as contributing to the obesity epidemic is over eating of calorically dense foods. At some point in the future it only seems logical that these two issues will intersect, obesity will triumph and hunger will disappear once and for all.

Another thing I wonder about how the Centers for Disease Control is addressing the issue of obesity is when will they conclude that what is being done is not working? Since the late 70’s the USDA, CDC and many other government agencies have promoted the idea of eating a healthy diet spending millions of dollars in the process. Given the amount of time and money used to educate the population most could have a PhD level education in the finer points of nutrition and health. In fact most I talk with do have a good working knowledge of what it means to eat a healthy diet according to government recommendations. Yet there is an epidemic of obesity among the same population that should be fairly well versed in how to eat right.

Could we conclude based on this observation that knowing and doing are two very different things? Just because someone knows how to eat right doesn’t necessarily mean they will always desire to eat that way. This of course wades into the pond of freedom of choice, the very freedom we value as American citizens. For example what to eat, how much to eat, body image et al are largely determined on an individual level. At least they are determined by norms acceptable to ones own family or cultural heritage. In other words just because someone is obese based on the CDC BMI measurement may be irrelevant to certain people.

If weight, body image and diet are individual choices almost naturally then why should the CDC spend untold millions to cure what is a non issue to many people? Bear in mind that those are our dollars first and could be spent in smarter ways all too often.

What also strikes me as obvious in the discussion of health and nutrition is that no matter what your weight or BMI is illness and disease is a part of life. Then following that for 100% of us is death. Forgive me for sounding macabre but these are the facts of life. Given the facts wouldn’t it be simpler to just be left alone and live as we choose rather than always having some ominous government statistic stalking us? Assuming that the employees and staff of the Centers for Disease Control and every other health related government agency have the best intentions and motives I still want to live my life on my terms fat or thin. Is that too much to ask?

Tuesday, April 5, 2011

Science has been wrong before....

On September 6 1492 the Nina, Pinta and the Santa Maria along with their crew and captain Christopher Columbus set sail from the Canary Islands. Some scientists of that day warned that Chris would sail off the edge of the flat earth, they were wrong.
In the mid 1800’s Louis Pasteur posited his germ theory to the leading scientists and doctors of the day. Pasteur insisted that tiny invisible microorganisms were causing the spread of death and disease. His solution to this problem, wash your hands, he was right and the great scientific minds of the day were wrong.
Today scientists tell us all sorts of things. For example it has been thought for many years that high cholesterol was a major contributor to heart disease. In fact a recent review of patient records admitted to the hospital for a first time cardiac event revealed that nearly half had LDL or bad cholesterol levels well within the normal range. In other words these people had no indication that a heart attack was coming solely based on cholesterol level.
Ignoring these findings which are not the first to indicate that cholesterol is not a major risk factor for heart disease the scientific community continues to push medication to solve the problem. Statin drugs are used by over 13 million Americans as a means of lowering cholesterol and reducing the risk of heart attack. However of all those who take this type of medication only a fraction benefit in fact one study showed that a sugar pill was just about as effective as the cholesterol lowering medication in preventing heart disease.
Another popular scientific theory is that losing weight can lead to better health and a reduction in risk factors for heart and other diseases. As one who works in this area of nutrition science I heartily agree that this is in fact true weight loss can lead to better health. However 95% of those who lose weight gain it back within five years with a little extra on the side. Moreover this yo-yo type dieting and weight loss then gain can have a negative impact on the body especially the heart. So what then?
Accepted science does not always have the correct answer and this has been true throughout history. Perhaps time will reveal that the whole issue of high cholesterol as related to health has more in common with the flat earth theory that actual truth. Perhaps it is time for us the patients and targets for these scientific interventions to apply a little critical thinking when it comes to our own health. We may find a New World of health far beyond what the mad scientists of the day tell us is possible.