Saturday, January 27, 2007

"Obesity" confusion in Britain

Plans to halt the rise in childhood obesity are confused, poorly co-ordinated and lack clarity and forcefulness, according to an influential Commons committee. In 2004 the Government set a target of 2010 to halt the year-on-year rise in obesity in children under 11, but there are still no ring-fenced funds nor any specific programme to bring this about, the Public Accounts Committee says in a scathing report.

Particular anger is directed at the Department of Health's plans to weigh and measure children in all primary schools but not tell parents the results. This policy provoked one of the briskest exchanges in a public hearing in the Commons as the committee chairman, Edward Leigh, accused three Whitehall permanent secretaries of "talking drivel".

Yesterday Mr Leigh said: "If a primary school finds that a child is overweight then the parents must be informed. To do otherwise would be to keep parents in the dark about health risks to their children. "A campaign aimed at parents, children and teachers is supposed to be launched this year, three years after the target was set. When it appears it must bring home all the risks of being obese and show that obese children can make small changes to their behaviour that help them lose weight."

Responsibility for the childhood obesity strategy is divided between three departments - Health, Education and Skills, and Culture, Media and Sport - and 26 bodies or groups of bodies, the report says. This leads to confusion over roles and responsibilities. Mr Leigh said that it was "tricky territory". That made it all the more urgent that the departments involved should work together to set a clear direction. "It is lamentable that long after the target was set there is still so much dithering and still so little co-ordination," he said.

Departments had been slow to react and efforts to work with the food industry to change the way that unhealthy products were marketed had failed, the committee said. It also called for the appointment of a high-profile figure to champion the battle against obesity. Parents were still not being engaged, and a public information campaign was finally being launched only this year. The report found that "the departments' strategy of working alongside the food industry to influence its approach to the marketing of foods and drinks that are high in fat, salt and sugar has not been successful in changing the way the majority of unhealthy foods are marketed".

Meanwhile, the Department of Health has no idea if the strategy is working because there was a delay of two years in getting data on childhood obesity from the Health Survey for England. The attempt to measure obesity in primary school children ended in failure when fewer than half turned up, although the committee does not report this. The results of the exercise were meaningless because the parents of fatter children opted them out, as they were allowed to do.

Caroline Flint, the Public Health Minister, claimed that a lot had been achieved since the evidence on which the report was based had been gathered. She said: "There are no easy answers or quick-fix solutions. Changing behaviour requires long-term action on a number of fronts and that is what we are putting in place. People's awareness of the importance of healthy eating and exercise had increased significantly, she said, and food labelling had become the norm. Ofcom had made recommendations about food advertising on television; there had been "a transformation in school food" and the target of 80 per cent of children doing at least two hours of school sport a week had been beaten, she said. But Andrew Lansley, the Shadow Health Secretary, said: "Conservatives share the committee's alarm at the dramatic increase in childhood obesity and the apparently uncoordinated way in which the Government is dealing with it."


Doctors hope to switch off brain’s craving for tobacco

Smokers who suffer damage to a particular part of the brain can give up quickly and easily without feeling any urge for a cigarette, according to research that promises new approaches to treating nicotine addiction.

A study of smokers who suffered strokes has shown that part of the brain, the insula, appears to be intimately involved in their addiction, indicating that it could be targeted to help people to give up the habit. Patients who had strokes that damaged the insula, which is thought to be involved in emotions and cravings, lost the urge to smoke immediately, and many have not touched a cigarette since.

The findings suggest the possibility of helping smokers to give up by manipulating the insula to kill their addiction, without causing the extensive brain damage of a stroke.

Drugs could be developed to alter its activity, or it could be disrupted using magnetic fields. Another technique called deep brain stimulation, in which electrodes are implanted in the brain to switch off particular areas, has already been used successfully to treat Parkin-son’s disease and depression.

Such treatments, however, will require much more research into exactly how the insula affects smoking and other addictions before patient trials could begin; it will be important not to disrupt other activities in which the region plays a critical role.

The insula lies in the centre of the brain and is thought to translate information from other parts of the body into feelings such as hunger, pain or cravings for a drug.

“The insula also carries out lots of normal everyday functions, so we would want to make sure we only interfere with functions that disrupt bad habits like smoking but not something vital like eating,” said Antoine Bechara, of the University of Southern California (USC) and the University of Iowa, who led the research.

Nevertheless, the work is exciting because damage to the insula appears to break many smokers’ habits instantly; their brains seem to forget that they are supposed to crave cigarettes.

“There is a lot of potential for pharmacological developments,” Dr Bechara said. “One of the most difficult problems in any form of addiction is the difficulty in stopping the urge to smoke, to take a drug, or to eat for that matter. Now we have identified a brain target for further research into dealing with that urge.”

Antonio Damasio, Professor of Neuroscience at USC, who first suggested the insula’s role in feelings, said: “It’s really intriguing to think that disrupting this region breaks the pleasure feelings associated with smoking. It is immediate. It’s not that they smoke less. They don’t smoke, period.”

The study, pubished today in the journal Science, was inspired by a patient who smoked 40 cigarettes a day before having a stroke that damaged his insula. He quit immediately, telling doctors that he “forgot the urge to smoke”.

The scientists then turned to a database of stroke patients held by the University of Iowa and identified 69 who had smoked at least five cigarettes a day for at least two years before they suffered brain damage. They found that 19 of these patients had damage to the insula and 13 of them had given up smoking, 12 of them quickly and easily. The other six continued to smoke — possibly reflecting damage to different parts of the insula.

Of the 50 patients who had strokes that did not disrupt the insula, 19 also gave up smoking, but only four did so instantly and without any cravings.

The difference in the two groups’ experience of quitting suggests that the general stroke patients gave up in standard fashion because of the health risks. The insula-damaged patients, however, gave up because it no longer occurred to them to smoke.



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.

The use of extreme quintiles (fifths) to examine effects is in fact so common as to be almost universal but suggests to the experienced observer that the differences between the mean scores of the experimental and control groups were not statistically significant -- thus making the article concerned little more than an exercise in deception


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