Panaceia or Hygeia

immunize yourself against the pandemic of lifestyle diseases

Archive for July 16th, 2008

DIRECT. More obese liars.

Posted by Colin Rose on July 16, 2008

We have already commented on a similar diet study, A to Z. Again with DIRECT (DIetary RandomizEd Controlled Trial) we have another attempt to prove the Atkins diet is better but is really another demonstration of lying by most overweight and obese people. Any study on diet and energy balance that cannot first demonstrate that the First Law of Thermodynamics is obeyed from self-reported data is totally unreliable and unreproducible and should never be published.

While the data as presented are hard to interpret in terms of detailed energy balance because daily energy intake and expenditure is not reported, as it should have been, the subjects claimed to be doing more exercise and eating less but only lost 10 pounds in two years. The prescribed diets contained 1800kcal for men and 1500kcal for women. These values are close to the basal metabolic rates of these mostly obese people. They should have lost weight continuously and markedly during the trial. Let’s see how much they should have lost if they were reporting accurately. They claimed to be eating about 500 kcal less than baseline per day on all diets. Even doing the same amount of exercise they should have lost about a pound per week (one pound of fat is about 3500 kcal) or about 50 pounds per year or 100 pounds in 2 years. Since they claimed to be doing more exercise they should have lost even more. If they had been telling the truth, most participants should have starved to death well before the end of the study! Ergo, most overweight and obese people lie about food intake and exercise; they tell investigators what the investigators want to hear.

Obesity is and always has been caused by junk food addiction. Until we deal with that, the pandemic of obesity and its terrible consequences will only worsen. Unlike most infectious diseases, there is no vaccine against  addictions. We all must make the right choices as to what we put into our bodies. In developed capitalist democracies resisting the self-destructive temptation to consume all manner of cheap addictive substances or to adopt addictive behaviours readily supplied by highly profitable enterprises is the hardest task we have. And how to deal with it is not taught in medical school.

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That obese people lie about food intake was proven beyond doubt by a study using doubly-labeled water to measure true energy expenditure. About 65% of these subjects were overweight or obese. They claimed to be eating only about 1500 kcal/day, about 40% less than they actually ate, but were burning 2500. So, they should have had a deficit of 1000 kcal/day and be losing weight dramatically but their weights were stable. Ergo they were “misreporting”, a euphemism for lying.

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Disney World

Is she on a low-fat or low-carb diet?

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The Spread of Obesity

Posted by Colin Rose on July 16, 2008

The Framingham study is a very detailed picture of the population of a small town in Massachusetts. Below is a series of diagrams showing the relationships between people and their BMI status from a paper in the New England Journal of Medicine. It is the first really detailed picture of the start of the obesity pandemic. Green circles are BMI less than 30 and yellow circles BMI greater than 30, the official definition of obese. The authors were interested in the “transmission” of obesity between friends and relatives but never advanced an hypothesis for what would have initiated the epidemic and what might have fueled it.

In 1975 there was not a single obese person. From 1980 to 1985, the era of the cholesterol-lowering resins, like Questran, the first obese people appear. The LRC-CPPT results were published in 1984. By 1990 after the introduction of statins the incidence of obesity accelerates until by 2003 more than a third of the population is obese. There is no other plausible explanation for this phenomenon. People stopped caring about controlling calorie intake in the belief that lowering blood cholesterol with resins or statins would save them from the well-known consequences of gluttony. This attitude spread in families and between friends in the classical pattern of a transmissible virus or bacterial infection. It was OK to eat anything and to be obese if everyone else was and you took your pills.

If there is a better explanation for the obesity pandemic, we would like to hear it. None of the usual suspects, fast food, cars, suburbs, television, computers, the Internet, dangerous neighborhoods, etc. explain why people just eat too many calories and don’t care enough to control consumption.

See our photo essay on food addiction for a graphical demonstration of the obesity pandemic.

An epidemic of obesity

An epidemic of obesity

United We Stand, Disney World

Disney World. United We Stand. To the outside observer Disney World in Orlando appears to be a social club for the obsese and morbidly obese.

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