Showing posts with label Obesity/BMI. Show all posts
Showing posts with label Obesity/BMI. Show all posts

Thursday, March 28, 2013

Hungry Britain


A young man was having a rather agitated conversation, on his mobile, in the lobby of the library:
Yes, I’ve been to the Job Centre ...
No, nothing yet ...I got the food bank thing sorted, though.

The BBC’s Mark Easton reports that since 2011 it has been government policy to allow Job Centre staff to provide any claimant with vouchers for a food bank if they are concerned about their immediate financial problems.

Although these needs may be said to be new, a result of economic recession & changes to the benefit rules, it is worth remembering that, even in better times, many young people went hungry, failed for one reason or another to get properly fed by their families.

Speaking recently on Radio 4 about her experience of friendship with Brixton gang members Harriet Sergeant said that she was surprised to discover how hungry they were. Such lack of sustenance cannot aid good behaviour.

Although obesity in the young is clearly a serious problem, we must not let concerns about this blind us to the fact that the opposite problem also exists.

Links
Mark Easton: Food banks used by thousands of jobless
Harriet Sergeant: Amongst the Hoods
Related post
Where are all the obese hoodies?

Thursday, January 10, 2013

Comfortably healthy


Fuss, alarm & rejoicing met the JAMA paper which reported that those who are overweight (though not the dangerously obese) are healthier than those who are in the so-called desirable range for BMI.

I have not had time to read the whole paper but I wonder if this might not, in part at least, represent the same problem which bedevils alcohol studies, which may also show a U-shaped curve for risk, suggesting that moderate drinking is better than total abstention.

But they say, some people abstain because they are already ill - & not just with alcoholism.

Some people are thin because they are ill & in my opinion a BMI of 18.5 (reduced from 20 in 1997) as the lower limit for ‘healthy’ makes it even more likely that poorly people will fall into this category. I base this purely on my own size – never remotely overweight, but 9 stone is too thin for my height. Conversely we know that many people, who are also not fat but well-muscled, will easily have a BMI of over 30

Link
Association of All-Cause Mortality With Overweight and Obesity Using Standard BMI Categories: A Systematic Review and Meta-analysis

Saturday, May 26, 2012

Origin of obesity


Responses by those experts from whom the press chose to seek a comment on the latest advice (from NICE), that people react badly to being called obese were, as usual, pretty unsympathetic. I remember Sir Liam Donaldson, challenged on the same point (in relation to letters to parents telling them their child was obese), responding with a limp Well there’s nothing we can do about that – it just is the technical medical term.

Well the history of medicine is littered with once-technical terms, such as mongol, which are now deemed offensive; in some cases – like hysteria – one often suspects they were always meant to be, if not offensive, then at least dismissive.

Obese just doesn’t sound very nice – too close to obscene perhaps – but I got a surprise when I went to the OED for its history & derivation. I had always vaguely associated it with oil or lard, without ever going to the bother of looking it up, but it turns out to come from the Latin word edere, to eat, (the same root from which we get the word edible), so it has always been linked with the idea of eating too much.

The OED says that obesity, as a word, was rare before the C19th, that although Dr Johnson included it in his dictionary he provided no illustrative quotations, & dates it as a technical medical term meaning, specifically, a BMI of 30 or more, only to the late C20th.

BMI as a measure is of course less than ideal, not least because it fails to differentiate between those whose heaviness (relative to their height) is explained by a high proportion of muscle rather than body fat.

It is instructive to compare what the OED has to tell us about the word stout, when used as a synonym for obese.

One of the oldest surviving words in the English language, stout’s earliest meaning is anything but offensive: Proud, fierce, brave, resolute. One has to go all the way down to its 12th sense for its appearance (again in the C19th) as a euphemism for fat or corpulent. Charlotte Bronte, describes a woman, in Jane Eyre, as stout but not obese.

Even more interestingly, the Tailor’s Guide : Cutting, published in 1856, asserts that ‘A man is stout when the waist … is large in comparison with the breast … he is not stout because he measures so many inches, but because he is larger  in the waist than in the usual proportion.’

Some medics & nutritionist would of course prefer that waistline  be used as the indicator of when fat is truly a health issue in a patient; objections include that it is hard to define precisely what is meant by waistline (perhaps especially in corpulent men), & that measurement may include getting too close & personal.

We should always remember that not everybody accepts that thin is beautiful & that there are many who would prefer to sleep in a bed with a pillow rather than a bag of bones – common everyday experience shows you this, including plenty of men who are clearly both pleased by, & proud of, their wife’s size.

Collaboration with tailors & dressmakers & artists experienced in drawing the human body (which involves learning to look really closely), as well as with others whose business is the human form, might well be the best way for medical scientists to make real progress in learning how to classify & describe the human figure, to talk to people about their (or their child’s) shape with sympathy & without causing offence & in a way that might actually help inspire those, who really need to do so, to comply with what the doctor says.

Whatever we call it, obesity is important – we need all the insights we can get.

Links


Wednesday, March 07, 2012

Don't just sit there

Experts now realise that for many of us what is missing from our lives is the kind of incidental activity that one used to take for granted – performing household chores, pram pushing, stair-climbing – indeed just moving – the lack of which is having a more profound effect on our waistlines & health than any failure to attend the gym.


So The Times advised us yesterday.

Future historians of medicine & science my have a fine time working out how scientists & others were so long obsessed with the need for exercise as sport.

In part it stems from what is both the strength & a drawback of ‘science’ or rather the scientific method: the need to isolate one particular factor & to eliminate confounders or interactive terms, any other thing which may affect our search for underlying universal ‘laws.’ To work with phenomena– inputs & outcomes - which can be measured reliably & in a controlled way, one which does not depend upon who is doing the measuring.

It is a kind of paradox that, although we know real life just is not like that, that it is messy & in constant flux, with nothing fixed, we could make no scientific progress without behaving as if some things can be ‘fixed’ – one at a time.

A slow process.

One which extends over more than the lifespan of one generation of humans.

So what are we supposed to do while we are waiting for The Truth to emerge?

Keep calm & carry on.


Friday, February 24, 2012

Knowing wherof

The World Cancer Research Fund has found a new cause for worry: we don’t know much about the calorie content of foods we eat.

Well, apart form one brief period – about which more anon – I have never paid any attention to the calorie content of the food I eat or prepare for the family, nor can I see that there is any use or need in doing so unless you have some specific problem which needs adjustment to your diet, & specifically your calorie intake. But that’s because I think that my old fashioned nutritional education, from school, Guides, womens magazines & most of all family, gave me a much more solid & sensible set of rules to go by. I don’t doubt that things are different today.

Just to show willing I have been trying to take note of the calorie content of foods that I have been eating – just those that are prepared by others, I am not going to go down the road of using food tables to work out the calorie count of meals prepared at home.

The results have surprised me a bit. Mainly because there is so little relationship between the calorie content of food & how full it makes you feel.

Exhibit A: 1 cup latte + 1 chocolate muffin = 655 calories
Exhibit B: 1 cup tea + 1 crispy chicken & bacon wrap = 505 calories

There is no doubt which would leave me feeling more like I had had a proper meal, one that will easily last me through to teatime without flagging. I would count myself (not in a good way) as having skipped lunch if all I had had was coffee & cake.

The simple calorie comparison hides the important difference – that higher quantities of protein & (non-sugar) carbohydrates are offered by the more filling food.

The thing is, though I have never tried it, I don’t think even 2 lattes & 2 chocolate muffins (which would provide more than half my GDA for calories) would assuage my hunger & make me feel full; just sick & needing to lie down for a bit rather than get on with some work.

Saturday, January 15, 2011

Obesity biography

I have just started to read Obesity: The Biography, a short but important account by Sander Gilman of the medical & social history of fat, whether as a sign of disease or, sometimes, of health, from Hippocrates to the present day.

One of my first acts was to check the index. Quetelet has no place in this history.


Thursday, December 09, 2010

Buprestogenesis

Listening to yet another expert in public health explaining how the only way to combat the obesity epidemic is to change our obesogenic society.

But what if whatever it is that generates the obesity in some also generates long legs in others? Are we sure that short legs are a price we are willing to pay for universal slenderness?

Wednesday, November 03, 2010

Height, health care & IQ

Just came across, via the Economix blog, this really interesting piece on Height, health care and I.Q. There is lots to ponder in this, with links to even more meaty articles.

The odd thing is that Americans seem to have stopped growing taller around 1955 & have been overtaken as the worlds tallest.

It is being argued that the lack of good health care for all, from conception onwards, is the main explanation.

Saturday, July 03, 2010

Baby BMI

I was startled to hear on the radio someone report the birth of a baby weighing over 8lbs – on the 82nd percentile. That means something like 1 baby in every 5 these days is more than 8lbs?

In my youth everybody knew that a normal full term baby weighed in at 7 lbs. One of the less attractive attributes of my mother & her friends – indeed of all the other women in the town - was the eager way in which they awaited the birth of a newly wed's first child – usually, or at least often, within a year of the wedding. Then the ‘Well, they say it’s a honeymoon baby, but it’s barely 8 months & it weighed 7 lbs!

News of an eight pound baby made everybody’s eyes water.

I had noticed that babies born to readers of The Times – at least those whose birth is announced in the expanded version of the column which now comes complete with photo of the new arrival & too much information (what the mother was doing when her waters broke, for heavens sake) – often weigh in at closer to 9 lbs, but these are the most affluent & well nourished section of the population. The mothers are also much older, taller & heavier than those of my mother’s generation.

I found figures for 2005 in Table 5 of Birthweight and gestational age by ethnic group.

Looking just at the category White British (the sort that my mother's generation would have been thinking of) I was slightly relieved to see that the average for a full term baby is still under 7 ½ lbs, but still almost one baby in eight weighs in at a wince-inducing 8.8lbs.

We are used to hearing that low birthweight is a Bad Thing, but does anybody even try to calculate the BMI for a baby & make pronouncements as to what is the healthy number? Is there any evidence that White British babies are getting longer as well as heavier? Are the heaviest babies born to the tallest women? Does obesity start in the womb? I think we should be told.

Related post
More long legs

Monday, May 04, 2009

Not all BMIs is equal

Not all BMIs are the same

BMI, or the equivalent ‘acceptable’ weight, can vary quite a lot, depending on who, when, where & how it is calculated

In this country we tend to think of our height in feet & inches, our weight in stones. BMI needs meters & kilogrammes if it is to be checked against the familiar 20, 25, 30 yardstick

So conversion is required

In every day life we tend to think that 1 inch = 2½ centimetres, which is perfectly adequate for most purposes. But it makes you out shorter than you really are – the correct conversion factor should be 2.54

Then there is the question of rounding. Do we carry all the decimal points through at every stage of the calculation, or round, or truncate to meaningful ‘real’ numbers at certain points

Using my own height as an example (5ft 10in) I might be branded obese at 12 stone, or not until I get to nearer 12½

At the level of the individual it may not matter too much – whatever the detail, I am getting to be very heavy

Actually I would start to get a bit worried if I got near to 11 stone, more than I have ever been in my life before

But in any box ticking, performance monitoring or statistical exercise comparing populations or changes in a single population over time, or calibrating the relationship between BMI & health, these biases could matter





Related post
BMI confusion

Thursday, April 30, 2009

The modern Quetelet

I just recently came across a very interesting paper Adolphe Quetelet (1796–1874)—the average man and indices of obesity by Garabed Eknoyan published in Nephrology Dialysis Transplantation in 2007

It gives some of the history of the BMI since it was ‘rediscovered’ in the 1960s, & its use particularly in the Framingham study & has a particularly useful bibliography


Frustratingly (for me) I still have not found where the magic numbers 20, 25 & 30 come from, but I shall keep working on it

I was amused to see that the author found it necessary to point out that “Quetelet analysed data from both genders and highlighted differences where they existed; despite his exclusive use of the singular masculine in the title of his book and writings


Clearly in the world of American nephrology in the Noughties the male most definitely does not embrace the female







Tuesday, April 14, 2009

BMI confusion

Sara Buys wrote an interesting piece about Marilyn Monroe’s costumes in The Times Magazine on Saturday


One thing startled me. Since I got into a bit of a tiswas with the calculations I am going to show my workings in full, as they used to say on the exam papers

“Monroe was 5ft 5in”

5ft 5in = 65inches
x2.54 = 165cm
÷ 100 = 1.65 metres
Squared = 2.72

“Monroe was just over 8 stone”

8 stone x 14 = 112 lbs
÷ 2.2 = 50.9 kgs

So BMI = 50.9/2.72 = 18.7

which is distinctly underweight

But “she had a respectable BMI of 21”

So start with BMI =21
Assume height is correctly given as 5ft 5 in
Then weight = 21 x 2.72
= 57.1 kg
= 126 lbs
= 9 stone

I am not bothering to write all this here just to pick nits. I suspect the mistake might have been to assume that there are 16 lbs in 1 stone – easily done, I have done it myself

Since Monroe was American her weight would usually be quoted in pounds, but on this side of the water we still tend to think in terms of stones, despite years of metric-only education. So if people then multiply by 16 on the way to kilogrammes BMI will be overstated, which could explain some of the odder assertions we sometimes read

Sunday, February 08, 2009

It’s the way that you see ‘em




Stephen Anderton thinks there is “something of Denis Healey”, though thinner, about the face of Giles Coode-Adams, the president of the Royal Horticultural Society, but when I saw the photo I thought it was Dick Francis, though plumper
Related post

Tuesday, December 23, 2008

What do they look like?

One of the complaints about our current parliamentarians is that they do not look like us

Too male, too white, too middle class

As a bit of fun, I am wondering how like us they look in other respects too

Height – they always say the tall man beats the short one in elections. What about the women? Do we have any parliamentary Napoleons or Naomi Campbells?

Baldness – say no more

Blondeness – bottle or otherwise

Fatness – it would actually be a public service to publish the BMI of all MPs since they lecture the rest of us so much about this

Glasses – or are contact lenses de rigueur?

Intelligence – how many qualify to speak for the 50% of the population who have an IQ below 100?

Age – how many MPs qualify for a bus pass? How many use them regularly?

I also find myself wondering whether there was ever a time when the Lords was younger than the Commons

Saturday, December 20, 2008

Off the reins

You hardly ever see a child under 3, or even 4, walking around much these days. The buggy is never far away. Toddlers do not toddle any more

There must be many reasons for this – not least the motor car, which makes walking along almost any pavement hazardous for a toddler who may, in a moment’s inattention, step off the curb

There is also the issue of stranger danger – we all saw, in this country at least, repeated cctv footage of just how easy it can be to walk away with a toddler from a shopping centre

And so children ride around in their palanquins like little mini caesars. And today’s models come equipped with trays & hooks so that all sorts of comforts are at hand to keep the little blighter quiet – they can drink whenever they like & disturbing numbers of children have buns, crisps, biscuits or chocolate laid out on their tray

And yet children of that age always used to seem to need to let off a tremendous amount of steam - a fact which used to puzzle me. At an age when you would have thought that they needed all their energy for growth & development, any toddler used to walk at least twice as far as the accompanying adult and, when space allowed, took great delight in running round in circles

I wonder if the new research, which showed that a child’s tendency to excess weight is well established by the time they reach school age, looked at whether this was in any way related to whether the family had a garden.

As Hogben wrote in the 1930s Planning for Human Survival,

5 children in a house surrounded by its own garden in a locality where there is
little traffic are far less trouble than one child in a London flat … Every mother of 4 knows that a garden surrounded by a wall is worth all the labour saving devices yet invented … You may provide crèches, school feeding, family allowances, holidays with pay for expectant mothers, & 1001 other inducements. If you do not give people space you will not make parenthood endurable


Saturday, November 22, 2008

Moderation in diet

Another poem from Charles & Mary Lamb

After conceding that there is no need to warn a child of the dangers of the demon drink, since, thankfully, nobody offers alcohol to a child, the poet goes on:

... there’s a vice
That shares the world’s contempt no less;
To be in eating over- nice
Or to court surfeits by excess

...

By temperance meat is best enjoyed;
Think of this maxim when you dine

Prefer with plain food to be fed,
Rather than what are dainties styled;
A sweet tooth in an infant’s head
Is pardon’d, not in a grown child.

If parent, aunt, or liberal friend,
With splendid shilling line your purse,
Do not the same on sweetmeats spend,
Nor appetite with pamperings nurse.

Go buy a book …

Purchase some toy …

Go see some show …

That may the youthful mind expand.

And something of your store impart,
To feed the poor & hungry soul;
What buys for you the needless tart,
May purchase him a needful roll

And so we have what were to become the great Victorian virtues, self improvement & philanthropy

What I find intriguing about this, from a modern perspective, is how much responsibility (and choice) a child was expected to have for his own behaviour in 1809 when these poems were first published


But then I remembered the story of Sir Elkanah Armitage. Born in 1794 to a family of weavers, he went to work in a factory when he was 8 years old because there was not enough work at home for him & all his brothers. With 20 years experience of business behind him he set up his own firm when he was 28. He became wealthy & was a powerful figure in Manchester politics. He died aged 82 in 1876

And somehow I doubt that the prime minister in 1809, William Henry Cavendish Cavendish-Bentinck, third duke of Portland, felt that it was any part of his job to give advice on, still less issue regulations to prescribe or proscribe the content of diet of the nation's children


Friday, October 24, 2008

Obesity & alcohol

A fat boy had to be rescued by the fire brigade in an alcohol-related incident in Cornwall last week

He fell into a swimming pool while trying to steal further supplies of his favoured tipple

The health police were not required to attend, & social services will not be taking any action

Fat Boy is a pony who had eaten too many cider apples

Saturday, September 20, 2008

Swollen shires

There has been a rumpus over Rupert Maas, who used the phrase Shropshire ankles on tv to describe thick ones

There used to be a swelling called Derbyshire neck – in fact a goitre caused by lack of iodine in the water. Cerebos used to sell Table Salt in a special iodised form which was always used in our family

It seems to have disappeared entirely from the market now – I expect even ordinary Table Salt is banned now anyway

But where, I wonder, do we get our iodine from?

Perhaps Shropshire ankles indicated a similar local lack of a particular trace element which led to dropsy, poor circulation & swollen ankles

Monday, September 15, 2008

Out of touch

The great majority of people – sitting down to their Sunday lunch today ...

So said the Chief Whip on Radio 4 news

It may be just one of those phrases – like blue rinse brigade - that summons up an image long departed from real life, it may even br true of the majority of Radio 4 listeners

Some might find it more akin to John Major’s spinsters on bicycles – nostalgic but out of touch with modern life

Sunday, September 14, 2008

More corn

“Will no one speak up for popcorn?” asked Giles Smith recently, when it was reported that some cinemas are banning the stuff

Well, I will - though not for the wilting gooey version in super-size-me bags, the profits from which are relied upon to keep some multiplexes in existence

Popcorn should be a Friday, Saturday or Sunday evening treat for all the family

All you need is a bag of un-popped corn (surely available in all good supermarkets) & a good sized pan – preferably a heavy one, but certainly one with a tight fitting lid

Pour a little oil into the pan. Scatter corn so it covers the bottom in a single layer. Apply lid firmly. Put over the lowest possible heat

The noise, as the corn begins to pop, provides amusement for all the family. When it starts to subside, turn off the heat, but wait until you are certain the noise has stopped before lifting the lid

It is such a simple process, it could be left to the children – except that small boys particularly need close supervision. They find it hard to resist the temptation to remove the lid & cheer as corn bullets fly around the kitchen

We used to eat it with just a light sprinkling of salt, but I expect Demerara sugar would suit the sweeter tooth. Or perhaps some Indian spices, now chicken tikka is the national dish. Cumin, fennel or fenugreek (or even all 3 together) might work. I do not guarantee it, but since you will still have plenty of unpopped corn left in the bag, you could just bin the disaster & start again

For the scientifically minded family, the eating could be enlivened by a discussion of what makes popcorn pop, & how (if at all) this relates to what is currently going on under the Franco-Swiss border