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Tuesday, 25 March 2008 |
If we're to believe the bad-health ideology of recent decades, we're surrounded by severely overweight people destined to endure physical suffering and premature death. Kids are dieting. Five-year-olds have body image problems. Schools are restricting 'unhealthy' foods. Adults bounce from no-carbs to no-fat to no-food-after-sundown, in fear of looking too much like the common man/woman and not enough like Kate Moss. Food is often associated with fear or guilt.
The population does seem to be getting heavier. Australian Bureau of
Statistics figures show average weight increased for adult males and
females from 1995 to 2005, but while overweight and obesity both rose
somewhat for females, it was the rise in obesity in 25-64yo males which
was most marked. Other studies have shown that child obesity increased
massively (by up to a factor of four) from the early 1980s to the late
1990s, but changes since then have been smaller. This jump in weight
has become a springboard for a wide range of lobbying and social
control initiatives.
Apparently at least 32% of us are overweight and 16% are obese (2004-5
National Health Survey). I've wondered if the threshold for obesity
might be unreasonably low, so I used a body mass index (BMI) calculator
to get a better grip on the dimensions. A BMI of 30 (obese) would
require a 178 cm tall male, like me, to weigh a considerable 96 kg. To
be classed as overweight (BMI 25+), however, I'd only need to weigh 80
kg – less cuddly than I imagined.
The frustration in the figures is that there's very little evidence to
explain the weight increases, and patterns of increase vary from study
to study. Most of what we read is carefully worded to talk about
'links', 'associations' or 'indications' in order to conceal a much
less clear reality. Identified causes are few.
Many health professionals blame modern technology and car-oriented
inactivity. Voices clamour for the purging of TVs, computers and
PlayStations from our lives, forcing everyone (and especially kids) to
abandon sedentary leisure activities. Persuasive ideas, but thin
evidence.
Sitting idly in front of a screen is readily coupled with the notion
that we stuff our faces with high-sugar, high-fat junk. Blaming junk
food is popular and plausible, but it seems that, as a whole, we aren't
consuming more fat or carbohydrate than we were 30 years ago. Junk food
is often more energy dense than other foods, though, and excessive
consumption (as with many things) does lead to weight gain.
Some researchers have sought other food explanations. In the United
States, high fructose corn syrup (HFCS) has been a popular villain, as
its use in food production (replacing sugar) coincides with the rise in
overweight. Unfortunately, similar weight trends in Australia can't be
explained by HFCS because it's rarely used here. Meanwhile, research at
Deakin University, published in 2007, found that fruit drink/juice
consumption correlated with being overweight in children. However, in
one part of the study the researchers downplayed high weight in
children who consumed most fruit and vegetables, and they didn't
differentiate between mildly overweight and obese children.
Michael Gard at Charles Sturt University is a prominent critic of the
misrepresentation of obesity and the causes or solutions. He would tell
you that we quite simply don't know what is happening and what should
be done. An indeterminate amount of exercise is good for you.
Overeating is unwise. The actual population weight trends are unclear.
That's a far less defined picture than the publications of many
official bodies and health lobby groups would lead you to believe.
What is clear is that demographic factors play a strong part in the
occurrence of overweight and health problems, including ethnicity,
socioeconomic disadvantage and age. The trends aren't uniform. A causal
link between overweight and many oft-cited health problems has not been
demonstrated.
Being overweight can be a problem, obviously. It often leads to stress
on the body and a reduction in activity levels. It can also lead to
psychological problems which in turn can lead to eating problems or
further decreases in activity. Some risks commonly associated with
overweight are reduced by non-dieting behaviour: modest improvements in
activity markedly reduce the risk of Type 2 diabetes, for instance,
while healthy eating has benefits too, though it may not contribute
strongly to weight reduction. These principles apply to the entire
population, not just the overweight and obese.
It's difficult to introduce nuance into a complex issue of popular
concern. Although Australians have strongly embraced healthy eating
messages (much to the joy of the dieting industry, food manufacturers
and television quacks) and heeded calls to exercise more (to the
delight of gym entrepreneurs and phys-ed tyrants), there has been no
let-up in aggressive health initiatives. Meanwhile, punitive television
reality shows dole out dubious dietary advice or put fatties into
demeaning (or 'inspirational') bootcamps.
Rational or outrageous, the various attacks on weight, eating and
exercise readily distort normal behaviours and exacerbate unhealthy
ones (healthy food programs in schools, such as Jamie Oliver's in
Britain, are unpopular or undermined). Enjoying food is broadly
stigmatised and the psychological effects of constant negative messages
about eating, body image and lifestyle on kids, parents and the general
population are yet to be fully felt. Good data from good research could
guide health policy more constructively but, for the moment, doomsaying
media releases outweigh positive, constructive action.
(c) Duncan Markham 2008
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