Being obese in middle age lowers a woman’s chance of being alive and free of chronic diseases after age 70 by nearly 80 per cent, according to new data from the landmark U.S. Nurses’ Health Study. The findings suggest every bit of weight gain between ages 18 and 50 lowers a woman’s odds of being a “healthy survivor” – living to age 70 or older, free from 11 major chronic diseases as well as physical, cognitive and mental impairment. For every one kilogram of weight gain since age 18, the odds of healthy survival decreased by five per cent, the study found. The worst odds for a long and healthy life were among women who were overweight at 18 – with a body mass index greater than 25 – and who gained 10 kilograms or more by mid-life. But even a higher BMI at 18 alone was associated with “moderately, albeit significantly” reduced odds of healthy survival at much older ages.
Archive for September, 2009
Posted by Colin Rose on September 30, 2009
Posted by Colin Rose on September 21, 2009
Here is a graphic illustration of the concept of moral hazard as applied to the drug treatment of lifestyle diseases.
Reprinted from AdWatch
Many studies confirm that doctors’ behaviour can be influenced by drug advertising, but many of them are unaware of this.
Not only the advertising text, but also the images play an important part.
For example, see the above image in the Lescol advertisement published in the April 2008 issue of Rivista SIMG (Journal of the Italian Society of General Practitioners).
Lescol (fluvastatin sodium) is one of the statin class of drugs used to treat of high cholesterol when diet and other lifestyle changes don’t work.
The Summary of Product Characteristics states “for best results in lowering cholesterol, it is important that you closely follow the diet suggested by your doctor”.
What kind of advice could the doctor have given the two people on the beach?
They seem to be really happy and relaxed. The pastel colours, the calm sea and the blue sky in the background convey the impression that all is going well and no changes are needed.
The designer must have been influenced by the Colombian painter Fernando Botero, famous for his fat men and women, who generally emanate a sense of calmness and satisfaction.
What I can understand, as a doctor, after looking at this image?
“It doesn’t matter what I advise my patients to eat; it isn’t worth them trying to change their lifestyle behaviours.
Only the pill can make the difference!”
Posted by Colin Rose on September 19, 2009
ScienceDaily (Sep. 14, 2009) — The risk of becoming obese is 2.5 times higher for those who have double copies of the best known risk gene for overweight and obesity. However, this is only true if the fat consumption is high. A low fat diet neutralizes the harmful effects of the gene.
“This means that the critical factor is what you eat. At least in the case of the FTO gene, the most important obesity gene identified so far,” says Emily Sonestedt, member of Marju Orho-Melanders research group at Lund University Diabetes Centre.
She is the main author of a study that is currently being published in the American Journal of Clinical Nutrition. Several studies have found that exercise diminishes the effect of the risk gene but this is the first study where the effect of the gene has been studied in relation to food habits. The risk variant of the FTO gene (fat mass and obesity associated) is common in the general population. 17 percent have double copies, meaning they have inherited it from both parents. Another 40 percent have a single copy.
“It is difficult to calculate how much people eat with any certainty, which is one of the reasons why no one has done this before. But we have good data” says Emily Sonestedt.
The information comes from the large Malmö Diet and Cancer study where food habits were carefully documented using, among other things, an extensive questionnaire, a long interview and a food diaries kept by the participants themselves. When the eating habits of the carriers of the double risk variant for obesity was analyzed the pattern was clear. The risk of obesity was dramatically increased only in the case of high fat consumption.
“Yes, for those who had a diet where less than 41 percent of the energy consumed came from fat, obesity was not more common, in spite of the inherited risk” says Emily Sonestedt.
The FTO genes acts in the hypothalamus, the part of the brain that regulates appetite and satiety, and the risk variant has been connected to an increased energy intake, especially in the form of fat.
“It could be that the carriers of the risk gene don’t feel as full from eating fat and therefore consume more and gain weight” says Emily Sonestedt.
The finding that the harmful effects of the gene can be cancelled by changing eating habits could, combined with mapping of the effects of other obesity genes, lead to better and more individualized nutritional counseling for those that want to avoid gaining weight.
“This shows that we are not slaves to our genes. Even if we are born with an inherited predisposition to obesity, life style is important” says Emily Sonestedt.
- Sonestedt, Emily, Roos, Charlotta, Gullberg, Bo, Ericson, Ulrika, Wirfalt, Elisabet, Orho-Melander, Marju. Fat and carbohydrate intake modify the association between genetic variation in the FTO genotype and obesity.American Journal of Clinical Nutrition, 2009; DOI:10.3945/ajcn.2009.27958
Posted by Colin Rose on September 13, 2009
Great article, Joe. We appreciate there are those that are confused. But there are also large numbers who know what is healthy to eat, but easily blind themselves to reality; they are junk food addicts. That “food” that the cruise passengers are piling on their plates is specifically formulated to appeal to addictions to sugar, salt and the mouth feel of fat. Unfortunately, treating junk food addiction is just as hard as treating addictions to tobacco, cocaine or heroin. Doctors are not trained to and not paid to treat addictions. They are paid to “treat” the symptoms of junk food addiction, like hypertension, Type 2 diabetes and “cholesterol” and do futile gastric bypasses. “Treatment” of these symptoms deceives the addict into believing that s/he can avoid the consequences of the addiction and makes the addiction worse. Americans are inundated with direct-to-consumer (DTC) drug advertising, claimed to be a First Amendment right by corporations with $billion ad budgets, promoting this deception and doctors are paid to prescribe those drugs. Canada is catching up fast. Obesity rates are rising and there is pressure from the media to allow DTC in Canada, presumably guaranteed by the Bill of Rights.
The solution? Each individual has to balance the transient pleasure of addiction against the long term disastrous consequences of the addiction. In our society this is the hardest thing most people have to do 24/7/52 for a lifetime and doctors must avoid aggravating addictive behaviour.
WHAT YOU EAT MAKES YOU FAT
13 Sep 2009
Occasionally, I like to spy on people. Only for the sake of science, of course. And what better opportunity to do that than on a cruise ship? I like cruising. Besides outstanding entertainment, impeccable service, interesting ports, activities galore…read more…
Posted by Colin Rose on September 12, 2009
No professional should take any benefits from any industry for which s/he makes recommendations to clients. Medical licensing bodies should de-license any doctor who does so.
FREE LUNCHES COME AT A PRICE
ALEX ROSLIN SPECIAL TO THE GAZETTE
12 Sep 2009
Adam Hofmann is used to getting teased about his lunch. It’s not because his mom gave him something uncool to eat. It’s because he paid for it. Hofmann is a doctor and fifth-year medical resident at McGill University. Lunchtime is often when residents…read more…
Posted by Colin Rose on September 10, 2009
Here is a classic example of Big Pharma controlling what doctors get to hear during “continuing medical education”. Big Pharma pays big money to have their logos appear below that of McGill, a presumed institute of higher learning that is tacitly approving of their drugs and the methods they use to promote them.
There is always the meaningless disclaimer about how the grants are “unrestricted”. Just try inviting a speaker who is at all critical of Big Pharma and see how fast the grant disappears.
How much does the McGill Faculty of Medicine receive? How much of the money goes into undergraduate education? Is the money also influencing what gets taught to medical students?
Write to the Dean of the Faculty of Medicine, Richard Levin, and try to get his answers. Lots of luck.
Posted in cme, continuing medical education, drug marketing, professionalism | Tagged: Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Faculty of Medicine, Family Physician, GlaxoSmithKline, mcgill, Merck-Frosst, P&G Pharmaceuticals, Pfizer, Refresher Course | Leave a Comment »
Posted by Colin Rose on September 6, 2009
Another very common scam is the seeding trial; doctors are paid to enroll patients in a “study” that involves prescribing a drug and recording some data on the response to it. Doctors get used to writing prescriptions for the drug. Such data is scientifically useless but gets reported in some medical journal which is itself largely dependent on drug advertising.
Many ways to land doctors’ orders
05 Sep 2009
Canada’s pharmaceutical firms invest up to $3 billion a year in marketing, drug-policy expert Alan Cassels says. That works out to $50,000 in marketing per doctor. In addition to ghostwriting, the industry relies on many other tactics. Among…read more…
Posted by Colin Rose on September 6, 2009
TAKING THEIR MEDICINE
AARON DERFEL GAZETTE HEALTH REPORTER
05 Sep 2009
The title of the article was so dryly scientific, it was impossible to arouse suspicion at the time: Published in the Journal of the American Geriatrics Society in April 2000, the paper hailed estrogen in the treatment of memory loss in older…read more…