Tuesday, September 09, 2008

It's official: you can be fat and fit

Contrary to the government hysteria, being obese is not an indicator of ill-health, and it's far from a death sentence.

One of the more depressing things about the constant talk of an obesity epidemic that is killing us all, and most particularly our children, is the media's constant readiness to give room to almost any nonsense so long as the word fat appears in it, while ignoring significant research that fails to fit the now-conventional wisdom that `being fat = death'.

Recently this trend has been on display in the way in which the British press has uncritically reported the views of Professor David Hunter of Durham University. Described by the Daily Telegraph as a `leading public health expert', Hunter has claimed that the UK National Health Service (NHS) will become unaffordable due to the costs of treating obesity-related diseases, opined that obesity requires `strong action' from government, and demanded that the government require tobacco-like warnings on foods that are high in fat, salt or sugar. Claiming that the obesity epidemic posed as significant a threat as terrorism, Hunter derided the official response as nothing more than `piddling'. According to Hunter, half the British population will be obese by 2032 (1).

Yet just days before Hunter's outburst, the quality dailies, with the exception of the Telegraph, which published a small piece deep inside the paper, failed to cover two new studies published in the same issue of Archives of Internal Medicine which give the lie to a good many of today's doomsday scenarios as well as to much of the government's propaganda about overweight and obesity, not to say its `obesity strategy'.

The studies come from Germany and the US. The US study found that despite claims, such as Hunter's, about the dangers of obesity and the risks of the diabetic obese overwhelming the NHS, roughly half of overweight people in the US - about 36million people - do not have raised blood pressure or cholesterol levels. The same applies to about a third of the people - 20million - who are categorised as `obese'. Moreover, about a quarter of normal-weight individuals have high blood pressure or problematic levels of cholesterol. As the authors concluded, `the present data suggest a high prevalence of cardiometabolic abnormality clustering among normal-weight individuals, as well as a high prevalence of obese individuals who are metabolically healthy.' The conclusions were based on a representative sample of over 5,400 adults surveyed in the National Health and Nutrition Examinations from 1999 to 2004 (2).

The German study found that insulin sensitivity was not statistically different in obese individuals compared with normal weight individuals. In effect, the image of hordes of fatties with metabolic problems leading to high levels of heart disease and diabetes is a myth. As the German research team put it, a `metabolically benign obesity that is not accompanied by insulin resistance and early atherosclerosis exists in humans' (3).

This is indeed unwelcome news to the obesity crusaders, for it shows just how scientifically unjustified their claims are, how generally untruthful the government's claims about the dangers of being overweight are, how compromised is their health advice about overweight and obesity, and how unwarranted are the calls for draconian government interventions such as tobacco-like warnings on so-called unhealthy foods. As MaryFran Sowers, one of the co-authors of the US study, told the New York Times: `We use "overweight" almost indiscriminately sometimes. But there is lots of individual variation within that, and we need to be cognizant of that as we think about what our health messages should be.'

Of course, none of this should come as a surprise since there is considerable evidence that `fat-and-fit' is not an oxymoron. For instance, last December the Journal of the American Medical Association published a study which followed 2,600 American adults aged over 60 for 12 years. Two striking findings emerged from the study. First, as in other studies, the overweight - that is those with a body mass index (BMI) of 25 to 30 - had slightly lower death rates than those of `normal' weight. Second, levels of fitness, not BMI, was the most reliable predictor of death. Those with the lowest levels of fitness were significantly more likely to die, regardless of body weight.

Despite the incessant claims that the government's obesity strategy is `evidence-based', don't expect to hear about any of this research from anyone connected with the Department of Health. After all, having invested so much time and money in spreading fears, it would be a shame now to have to stop picking on the overweight and obese and find a genuine health problem on which to focus.


Cancer cell suicide research

TOUGH cancer cells would be stopped with a drug designed to flick the death switch, says an eminent scientist. Professor Peter Colman, best known for the world's first anti-influenza drug, trained at the University of Adelaide. He made his prize-winning anti-influenza discovery in Melbourne at the CSIRO. Prof Colman now works in medical biology at the Walter and Eliza Hall Institute. He says his work involves taking photos of molecules using X-ray crystallography "to see what it is, at the level of the atom, that makes molecules stick together".

The anti-influenza drug sold under the trade name Relenza stops the virus from spreading by interfering with a protein at the surface. Now Prof Colman is trying to find a way to stop cancer cells spreading by causing them to commit suicide. Deep inside every cell lies the machinery for programmed cell death or "apoptosis".

Normal cells know when it is time to go, but Prof Colman says the cells of many cancers are "seriously screwed up". "The machinery in every cell - which it uses when it needs to die - has somehow been corrupted," he said. By using X-ray crystallography to look at the structure of the death switch, Prof Colman realised a drug could be designed to flick the death switch. "There are some medicines useful against certain tumors, but none of them work this way, by getting their hands on the death switch of every cell," he said. The drug is likely to be most useful in cases that do not respond to chemotherapy or radiotherapy.


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