OK TO BE FAT IF YOU ARE OLD

The journal article abstracted below is a lot of fun. It starts out admitting that among older people your weight has little or no bearing on how long you will live. Being greatly dissatisfied with that pesky truth, however, they say that maybe fatties are sicker, even if they don't die. But even their findings there were pretty pesky. What they found is in fact the usual finding: That people of MIDDLING weight are the healthiest! Both the skinnies and the real fatties had slightly more illness

The Effect of Obesity on Disability vs Mortality in Older Americans

By Soham Al Snih et al.

Arch Intern Med. 2007;167:774-780

Background: The association between obesity and mortality is reduced or eliminated in older subjects. In addition to mortality, disability is an important health outcome. The objectives of this study were to examine the association between body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, and subsequent disability and mortality among older Americans, as well as to estimate the effect of BMI on life expectancy and disability-free life expectancy among older Americans.

Methods: We studied 8359 non-Hispanic white Americans, 1931 African Americans, and 2435 Mexican Americans 65 years or older who were not disabled at baseline from 5 sites of the Established Populations for Epidemiologic Studies of the Elderly. Measures included BMI, medical conditions, activities of daily living, and demographic information. Cox proportional hazards regression analysis was used to estimate the hazard ratios (HRs) for subsequent disability and mortality during 7 years of follow-up. Total life expectancy and disability-free life expectancy were estimated using the interpolation of Markov chain approach.

Results: The lowest HR (1.02; 95% confidence interval [CI], 0.94-1.10) for disability was at a BMI of 25 to less than 30. Subjects with BMIs of lower than 18.5 or 30 or higher at baseline were significantly more likely to experience disability during the follow-up period. In contrast, the lowest HRs for mortality were seen among subjects with BMIs of 25 to less than 30 (HR, 0.78; 95% CI, 0.72-0.85) and 30 to less than 35 (HR, 0.80; 95% CI, 0.72-0.90), with subjects with BMIs of lower than 25 or 35 or higher experiencing higher hazards for mortality. Disability-free life expectancy is greatest among subjects with a BMI of 25 to less than 30.

Conclusion: Assessments of the effect of obesity on the health of older Americans should account for mortality and incidence of disability.





ARE STOMACH ULCERS GOOD FOR YOU?

If you followed the usual crazy logic in these matters you might think so. The study below shows that kids who were infected with the bug that causes ulcers are slightly less likely to get asthma and allergies. The prevailing theory of asthma is that it is an autoimmune disease caused by insufficient exposure to mild pathogens. So it follows that ANY infection with ANY bug in early life would reduce your chance of getting asthma. So the findings are probably right and serve only to show how careful we should be in drawing policy conclusions from small group differences. This is a good absurd case to bear in mind for the next outburst of hysteria about such differences

Inverse Associations of Helicobacter pylori With Asthma and Allergy

By Yu Chen et al.

Arch Intern Med. 2007;167:821-827

Background: Acquisition of Helicobacter pylori, which predominantly occurs before age 10 years, may reduce risks of asthma and allergy.

Methods: We evaluated the associations of H pylori status with history of asthma and allergy and with skin sensitization using data from 7663 adults in the Third National Health and Nutrition Examination Survey. Adjusted odds ratios (ORs) for currently and ever having asthma, allergic rhinitis, allergy symptoms in the previous year, and allergen-specific skin sensitization were computed comparing participants seropositive for cagA- or cagA+ strains of H pylori with those without H pylori.

Results: The presence of cagA+ H pylori strains was inversely related to ever having asthma (OR, 0.79; 95% confidence interval [CI], 0.63-0.99), and the inverse association of cagA positivity with childhood-onset (age ~15 years) asthma was stronger (OR, 0.63; 95% CI, 0.43-0.93) than that with adult-onset asthma (OR, 0.97; 95% CI, 0.72-1.32). Colonization with H pylori, especially with a cagA+ strain, was inversely associated with currently (OR, 0.77; 95% CI, 0.62-0.96) or ever (OR, 0.77; 95% CI, 0.62-0.94) having a diagnosis of allergic rhinitis, especially for childhood onset (OR, 0.55; 95% CI, 0.37-0.82). Consistent inverse associations were found between H pylori colonization and the presence of allergy symptoms in the previous year and sensitization to pollens and molds.

Conclusion These observations support the hypothesis that childhood acquisition of H pylori is associated with reduced risks of asthma and allergy.

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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.

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