Posted by: Chris Maloney | September 10, 2011

A Cardiologist Gives a History of How We Got So Fat And Sick.

Weightloss pyramid.

Image via Wikipedia

In lovely reading, MSN has posted a finger-wagging cardiologist’s take on how we got where we are.

I thought the most interesting aspect was blaming 1873 and the invention of the steel roller mill for producing cheap refined grains.

Another highlight was renaming my generation from generation X to generation S for the sickest generation.  I guess we’ll never get a break.  Will I miss the days when we were briefly pandered to with OK cola?  It’s bad enough that the 80’s songs are now elevator Muzak or played on the golden oldies shows.  Hello?  We’re the backbone of the workforce now, not retired yet.  (oh, that’s why we’re in trouble.  See what happens when you depend on the slacker generation?)

I guess I shouldn’t be surprised.  I just finished watching Fat, Sick and Nearly Dead, which was about guys my age.  The only difference is that everyone in the movie wants to be dead at 55 or so, and I figure I’ll just be hitting my stride about then.

So is our cardiologist friend right?  Was it really 1873?  I think not.  I think it’s 2011, when we continue to subsidize every unhealthy aspect of our lives and leave things like fruits and vegetables too expensive to afford.  Below is a stunning review that resolves that healthy obese individuals are at no increased risk of illness or shorter lifespan.  It looks pretty conclusive, but if you look who wrote it, it says it’s from the Sugar Bureau.  Hmmm…statistics.  I notice now that the “unhealthy obese” do actually get some benefit from losing weight.  I’m also starting to see surgeons talk about the “super obese” like it was some kind of superpower.

Nutr Res Rev. 2009 Jun;22(1):93-108.

A review and meta-analysis of the effect of weight loss on all-cause mortality risk.


The Sugar Bureau, London WC2B 5JJ, UK.


Overweight and obesity are associated with increased morbidity and mortality, although the range of body weights that is optimal for health is controversial. It is less clear whether weight loss benefits longevity and hence whether weight reduction is justified as a prime goal for all individuals who are overweight (normally defined as BMI>25 kg/m2). The purpose of the present review was to examine the evidence base for recommending weight loss by diet and lifestyle change as a means of prolonging life. An electronic search identified twenty-six eligible prospective studies that monitored subsequent mortality risk following weight loss by lifestyle change, published up to 2008. Data were extracted and further analysed by meta-analysis, giving particular attention to the influence of confounders. Moderator variables such as reason for weight loss (intentional, unintentional), baseline health status (healthy, unhealthy), baseline BMI (normal, overweight, obese), method used to estimate weight loss (measured weight loss, reported weight loss) and whether models adjusted for physical activity (adjusted data, unadjusted data) were used to classify subgroups for separate analysis. Intentional weight loss per se had a neutral effect on all-cause mortality (relative risk (RR) 1.01; P = 0.89), while weight loss which was unintentional or ill-defined was associated with excess risk of 22 to 39 %. Intentional weight loss had a small benefit for individuals classified as unhealthy (with obesity-related risk factors) (RR 0.87 (95 % CI 0.77, 0.99); P = 0.028), especially unhealthy obese (RR 0.84 (95 % CI 0.73, 0.97); P = 0.018), but appeared to be associated with slightly increased mortality for healthy individuals (RR 1.11 (95 % CI 1.00, 1.22); P = 0.05), and for those who were overweight but not obese (RR 1.09 (95 % CI 1.02, 1.17); P = 0.008). There was no evidence for weight loss conferring either benefit or risk among healthy obese. In conclusion, the available evidence does not support solely advising overweight or obese individuals who are otherwise healthy to lose weight as a means of prolonging life. Other aspects of a healthy lifestyle, especially exercise and dietary quality, should be considered. However, well-designed intervention studies are needed clearly to disentangle the influence of physical activity, diet strategy and body composition, in order to define appropriate advice to those populations that might be expected to benefit.


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