Thursday, May 16, 2013

How we start being 'fattist' at four: Study finds children would not think of overweight person as a potential friend

This very early emergence of a dislike for fat is consistent with it being genetically inherited.  Fat cavemen could not run fast so were poor hunters and were scorned for that.  The "war on obesity" can be seen then as following an inherited emotional reflex, not any rational judgment.  Only thus can we explain that the war continues even though we now know that  people of middling weight live the longest.  An alleged health crusade is nothing of the sort

They struggle to read or even tie their shoelaces.  But four-year-old children have already learnt to dislike fat people.

A study of 126 boys and girls who had just started school showed they were loath to think of an overweight story book character as a potential friend.

However, they had no qualms about ‘befriending’ the same character when he was of normal weight or disabled.

The Leeds University researchers said it seems that even very young children have picked up on the prejudice against fat people that pervades society.

Professor Andrew Hill read boys and girls who aged between four and six one of three versions of a specially-commissioned children’s book.

The story described a group of children and what happened when Toby, their ‘really naughty’ cat, got stuck in a tree.

In each case, the storyline was the same.  However, the pictures varied, with Alfie, the main character, depicted as being of normal weight, overweight or disabled.

The schoolchildren, who were in reception class and year one, were then asked to rate Alfie’s attributes.

Fat Alfie was less likely to win a race, do well at school, be happy with his looks and get invited to parties than normal-weight Alfie.

The Alfie who was in a wheelchair was also marked down but not to the same extent.

Most tellingly, hardly any of the children said they’d want fat Alfie as a friend.

Only one of the 43 children read the fat Alfie version of the book chose him as a potential pal.

A female version of the story produced a similar result, with just two of 30 children saying they’d want to play with fat Alfina.

The results of the study, the first to show that children of such a young age stigmatise those who are fat, were presented at European Congress on Obesity in Liverpool.

Professor Hill said: ‘This research confirms young children’s awareness of the huge societal interest in body size.

‘It shows that by school entry age, UK children have taken on board the negativity associated with fatness and report its penalties in terms of appearance, school activities and socially.

‘This negativity was shared by another visibly different characterisation, a child in a wheelchair, but to a far smaller extent.

‘But there was some evidence that older children expressed more negative views.’

He said that with parents of obese children saying their youngsters are already socially isolated at the age of five, such views could underpin weight-related bullying and victimisation.

The professor said that he believes the youngsters are picking up on a prejudice towards obesity that is all around them, from the opinions of their parents to TV shows which ‘ridicule’ the fat.

He added: ‘I think we have an underlying social commentary about weight and morals and that the morality of people is based on their shape.

‘I think that is very powerful and kids are sensitive to it.’

Professor John Wilding, of the UK Association for the study of Obesity, said: ‘I think it matters because we know that the social stigma associated with weight problems is quite significant.

‘It is reflected in reduced employment opportunities and all sorts of other aspects of life.

‘If these stereotypes are starting in childhood, it is going to be very hard to reverse them.

‘I guess we need to think about how to change that in society.’


No Benefit Seen in Sharp Limits on Salt in Diet

Nasty of me to say it but I'll say it anyway:  "I told you so"

In a report that undercuts years of public health warnings, a prestigious group convened by the government says there is no good reason based on health outcomes for many Americans to drive their sodium consumption down to the very low levels recommended in national dietary guidelines.

Those levels, 1,500 milligrams of sodium a day, or a little more than half a teaspoon of salt, were supposed to prevent heart attacks and strokes in people at risk, including anyone older than 50, blacks and people with high blood pressure, diabetes or chronic kidney disease — groups that make up more than half of the American population.

Some influential organizations, including the American Heart Association, have said that everyone, not just those at risk, should aim for that very low sodium level. The heart association reaffirmed that position in an interview with its spokesman on Monday, even in light of the new report.

But the new expert committee, commissioned by the Institute of Medicine at the behest of the Centers for Disease Control and Prevention, said there was no rationale for anyone to aim for sodium levels below 2,300 milligrams a day. The group examined new evidence that had emerged since the last such report was issued, in 2005.

“As you go below the 2,300 mark, there is an absence of data in terms of benefit and there begin to be suggestions in subgroup populations about potential harms,” said Dr. Brian L. Strom, chairman of the committee and a professor of public health at the University of Pennsylvania. He explained that the possible harms included increased rates of heart attacks and an increased risk of death.

The committee was not asked to specify an optimal amount of sodium and did not make any recommendations about how much people should consume. Dr. Strom said people should not eat too much salt, but he also said that the data on the health effects of sodium were too inconsistent for the committee to say what the upper limit of sodium consumption should be.

Until about 2006, almost all studies on salt and health outcomes relied on the well-known fact that blood pressure can drop slightly when people eat less salt. From that, and from other studies linking blood pressure to risks of heart attacks and strokes, researchers created models showing how many lives could be saved if people ate less salt.

The United States dietary guidelines, based on the 2005 Institute of Medicine report, recommend that the general population aim for sodium levels of 1,500 to 2,300 milligrams a day because those levels will not raise blood pressure. The average sodium consumption in the United States, and around the world, is about 3,400 milligrams a day, according to the Institute of Medicine — an amount that has not changed in decades.

But more recently, researchers began looking at the actual consequences of various levels of salt consumption, as found in rates of heart attacks, strokes and death, not just blood pressure readings. Some of what they found was troubling.

One 2008 study the committee examined, for example, randomly assigned 232 Italian patients with aggressively treated moderate to severe congestive heart failure to consume either 2,760 or 1,840 milligrams of sodium a day, but otherwise to consume the same diet. Those consuming the lower level of sodium had more than three times the number of hospital readmissions — 30 as compared with 9 in the higher-salt group — and more than twice as many deaths — 15 as compared with 6 in the higher-salt group.

Another study, published in 2011, followed 28,800 subjects with high blood pressure ages 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming fewer than 3,000 milligrams of sodium a day.

There are physiological consequences of consuming little sodium, said Dr. Michael H. Alderman, a dietary sodium expert at Albert Einstein College of Medicine who was not a member of the committee. As sodium levels plunge, triglyceride levels increase, insulin resistance increases, and the activity of the sympathetic nervous system increases. Each of these factors can increase the risk of heart disease.

“Those are all bad things,” Dr. Alderman said. “A health effect can’t be predicted by looking at one physiological consequence. There has to be a net effect.”

Medical and public health experts responded to the new assessment of the evidence with elation or concern, depending on where they stand in the salt debates.

“What they have done is earth-shattering,” Dr. Alderman said. “They have changed the paradigm of this issue. Until now it was all about blood pressure. Now they say it is more complicated.” The report, he predicted, “will have a big impact.”

But Bonnie Liebman, director of nutrition at the Center for Science in the Public Interest, an advocacy group that has taken a strong position against excessive salt consumption, worried that the public would get the wrong message.  “It would be a shame if this report convinced people that salt doesn’t matter,” Ms. Liebman said.

The American Heart Association agrees with her. Dr. Elliott Antman, a spokesman for the association and a professor of medicine at Brigham and Women’s Hospital n Boston, said the association remained concerned about the large amount of sodium in processed foods, which makes it almost impossible for most Americans to cut back. People should aim for 1,500 milligrams of sodium a day, he said.

“The American Heart Association is not changing its position,” Dr. Antman said. The association rejects the Institute of Medicine’s conclusions because the studies on which they were based had methodological flaws, he said. The heart association’s advice to consume 1,500 milligrams of sodium a day, he added, is based on epidemiological data and studies that assessed the effects of sodium consumption on blood pressure.

The Institute of Medicine committee said it was well aware of flaws in many of the studies of sodium, especially ones that the previous Institute of Medicine committee relied on for its 2005 recommendations. Much of that earlier research, committee members said, looked for correlations between what people ate and their health. But people with different diets can differ in many ways that are hard to account for — for example, the amount of exercise they get. And relying on people’s recall of how much salt they consumed can be unreliable.

Even the ways previous studies defined high and low sodium consumption varied widely.

“In one study, it was high if it hit 2,700 milligrams a day. In another study, it was high if it hit 10,000 milligrams a day,” said Cheryl A. M. Anderson, a committee member who is an associate professor of family and preventive medicine at the University of California, San Diego.

The committee said it found more recent studies, published since 2005, that were more careful and rigorous. Much of the new research found adverse effects on the lower end of the sodium scale and none showed a benefit from consuming very little salt.

Although the advice to restrict sodium to 1,500 milligrams a day has been enshrined in dietary guidelines, it never came from research on health outcomes, Dr. Strom said. Instead, it is the lowest sodium consumption can go if a person eats enough food to get sufficient calories and nutrients to live on. As for the 2,300-milligram level, that was the highest sodium levels could go before blood pressure began inching up.

In its 2005 report, the Institute of Medicine’s committee said that sodium consumption between 1,500 and 2,300 milligrams a day would not raise blood pressure.

That range, Dr. Strom said, “was taken by other groups and set in stone.” Those other groups included the Department of Agriculture and the Department of Health and Human Services, which formulated dietary guidelines in 2005.

But those dietary guidelines will soon be revised, with new recommendations to be issued in 2015.


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