Fat and fatter

I’m sure that everyone who has watched TV or read a newspaper over the past couple of days has heard about the new survey showing that Americans are fatter than ever. The Trust for America’s Health (TFAH), one of those ‘think’ tanks loaded with ex-politicians and former government employees of one stripe or another set up to suck money from donor organizations to create meaningless reports while paying its members large salaries issued its 2007 report a couple of days ago. And all the media obliged by rushing the TFAH conclusions into print and onto the airwaves.

The report comes in two forms: the actual big 120 page report filled with the kind of gibberish expected in a document with the touch of the federal employee on it that no one reads; and the press release that everyone reads. Both can be found on the TFAH website.

In sum, the report states that the rate of obesity rose in 31 states last year, no states experienced a decrease, and 22 states went up for the second year in a row.

How did the TFAH find all this out? They used publicly available data from the Behavioral Risk Factor Surveillance System, which was obtained by the self reporting of about 350,000 who were called on the phone. Among other things, these subjects were asked for their height and weight, which was then used to calculate their BMIs. Wait a minute here. We all know that the BMI is a notoriously inaccurate measure of obesity, but what about the self reporting of weight and height? That can’t be reliable, can it?

Nope.

Several studies looking at this very thing have shown that women tend to under report their weight and men tend to over report their height. In both cases, what you will find with self-reported heights and weights is an underestimate of the BMI, and, theoretically, the amount of obesity.

According to the TFAH report, Mississippi led the way with a 30.6% rate of obesity while the other states stratified between Mississippi and Colorado, the state with the lowest rate of 17.6%. I didn’t do any kind of accurate analysis on the data as presented, but with the high at a little above 30% and the low at about 18% you would have to reckon that the overall rates of obesity would fall somewhere in that range, probably around 24%. Looking at the three states with the largest populations and their obesity statistics (California 22.7%; New York 22.4%; Texas 26.3%) would seem to confirm the 24% number.

But according to the CDC in its 2003/2004 estimate, which didn’t rely on self reporting over the phone, 32.2% of the population is obese.

How did the CDC get its height and weight numbers to calculate the obesity rate? The good old-fashioned way: it measured them.

A household interview and a physical examination were conducted for each survey participant. During the physical examination, conducted in mobile examination centers, height and weight were measured as part of a more comprehensive set of body measurements. These measures were taken by trained health technicians, using standardized measuring procedures and equipment.

The actual obesity rate as measured in 2003/2004 is about a third higher than that calculated several years later by asking people for their heights and weights over the phone. So as a nation were not just fat, we’re fatter.

With a report so wildly inaccurate in its statistics, one would have to wonder about the validity of anything else it said. And it said plenty. Sort of.

The one overriding them of the entire report is that the obesity epidemic is with us in large measure because of mass inactivity. The message is that people just don’t exercise enough. And its the government’s fault. Why? Because of inattention to the growing masses of fat people. And what is the solution? You guess it. Government intervention.

What gets me about these kinds of reports is that they are filled with inaccuracies, yet mainstream press people who should know better swallow their idiotic bait hook, line and sinker.

The venerable and hallowed Wall Street Journal reports (subscription required) that

A lack of exercise is a huge factor in obesity rates.

This is reported as fact: ” A lack of exercise is…” Not ‘A lack of exercise may be…’ or ‘some experts believe that a lack of exercise’… or any other kind of iffy business. By God “a lack of exercise IS a huge factor…”

Unfortunately, their certainty isn’t backed up by the scientific data. Exercise has little, if any, affect on whether one gains or loses weight.

As if to prove this, the WSJ goes on to say, and this without batting an eye at the overt inconsistency

Minnesotans led the way when it came to exercise. An estimated 15.4% of the state’s residents did not engage an any physical exercise, the best rate in the nation. Still, the state ranked 28th overall when it came to the percentage of obese adults.

Say what? Let’s think this one through.

People living in Minnesota exercise more than those in any other state. In fact, only 15.4% of Minnesotans did not exercise, which would imply that 84.6% did exercise. And since “a lack of exercise is a huge factor in obesity rates,” then Minnesota should have the lowest rates of obesity, right? Well, uh, no, actually not. The state was about right in the middle of the rankings in terms of obesity. Hmmm.

And this actually made it through the editorial process. Gives one pause.

If the TFAH is wrong about exercise and the Wall Street Journal is wrong about exercise, who has got it right. Well, William Banting for one.

Remember what he wrote:

I consulted an eminent surgeon…who recommended increased bodily exertion before my ordinary daily labours began, and thought rowing and excellent plan. I had the command of a good, heavy, safe boat, lived near the river, and adopted it for a couple of hours early in the morning. It is true I gained muscular vigor, but with it a prodigious appetite, which I was compelled to indulge, and consequently increased my weight, until my kind old friend advised me to forsake the exercise.

He exercised on the advice of a physician and developed “a prodigious appetite,” which undid whatever good the exercise did him in terms of weight loss. He realized it and even his physician realized it.

Why is it that a retired undertaker from 19th century London can figure these things out and the people who write the lack-of-exercise-is-a-huge-factor drivel can’t? Perhaps the retired undertaker is eating brain food and these other folks aren’t.

When an average person runs or walks a mile (it doesn’t matter which – calories are burned by moving mass across a distance) that individual burns about 100 calories more than he/she would burn sitting on the couch staring out the window.

Now open any book of nutritional values and look up the amount of food it takes to give you 100 calories. It’s almost nothing. A half an ounce of nuts, an extra bite of pizza, a little extra half and half in your Starbucks throughout the day, a little over an ounce of trail mix, half of a granola bar, a few crackers, a half a bagel, a couple of extra forkfuls of most any casserole dish, and on and on. So, you go out and run a mile in the morning and you make up for it during the course of the day by increasing your intake by virtually unmeasurable amounts. That’s why exercise doesn’t work for weight loss.

But getting back to our report…

What does the TFAH recommend to decrease the rampaging rates of obesity that it so sorely underestimated? Let’s take a look at the 12o page report and find out.

There are five strategies listed.

A. Improving federal leadership: National strategy;

B. Fighting obesity in the workplace;

C. Helping all Americans become more physically active;

D. Helping Americans choose healthier foods; and

C. Accelerate and escalate the research into ways to promote lifestyle changes.

There you have it: The Big Five. Those are pronouncements that any bureaucrat could be proud of.

Here is my take on those five.

First, perhaps we should start by encouraging our federal leadership to abandon price supports on sugar so that more food processors will move away from high-fructose corn syrup, which has been shown to be a major driving force in the obesity epidemic. This would be real leadership because it would cost politicians a lot of Big Sugar money. I suspect you won’t see this happen, but you will hear a lot of talk about how Washington will solve this problem. Remember that talk a few years ago about how the obesity problem would be solved by 2010? And it’s increased every year since.

I’m all for fighting obesity in the workplace. I think every business ought to have an onsite meat store. Geez. Fighting obesity in the workplace…what a nothing suggestion.

We could help all Americans become more physically active. And we would accomplish what? They would be healthier, of that I’m pretty sure. But there wouldn’t be any less obesity.

I’m all for helping Americans choose healthier foods. MD and I have written a number of books on the subject. But somehow I don’t think the TFAH’s idea of healthier foods coincides with mine.

I’m all for more research, but I’m not sure that the best target for funds would be on finding ways to help Americans adopt the lifestyle changes that TFAH thinks they should adopt.

In my opinion there is not a lot of value in this report other than as a blueprint for someone wishing to start a lucrative business. Get letters of intent from a bunch of has-been government blowhards that they’ll sign on if you can pay them a big salary (and make sure they’re from both parties so that it will be bipartisan). Use data that the taxpayers have already paid for once. Mulch it around a little so that it’s slightly disguised. Come up with a handful of inane recommendations. And have the whole thing funded by a large foundation. Release your findings to the press so they’ll run with them as if it’s really big news. Then repeat yearly.

Only in America is there this kind of opportunity.

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34 thoughts on “Fat and fatter

  1. Quick question: is there any significant benefit to using sugar instead of high-fructose corn syrup?

    Dave

    Yep. Sugar has less fructose. Not a whole lot less, but given the amount of sweetener in the typical American diet, the little difference adds up.

  2. Beautifully written, Dr. Mike, as usual. 120 pages! I’m sure it looks very important in its binder on the shelf.

    I’d like to email the link to my brother, but that link seems to be missing in the new blog format. Is that by design?

    Hi Steve–

    No, it’s not by design. I trying to get a new look to my blog, and somehow with the new theme the permalinks got left out. Thanks for bringing it to my attention. I hope to have it fixed within 24 hours, so check back.

    Best–

    MRE

    P.S. I just figured it out. The permalinks are in the black title of the post. In this case roll your cursor over the black title Fat and Fatter; it will turn to blue. If you click on the blue title it will give you the link that you can use to send the post to whomever.

  3. First, perhaps we should start by encouraging our federal leadership to abandon price supports on sugar so that more food processors will move away from high-fructose corn syrup, which has been shown to be a major driving force in the obesity epidemic.

    But HFCS is low in fat, and especially low in saturated fat.

    So is sugar. I know you’re being tongue in cheek, but sugar can be part of a low-fat diet as well as can HFCS without all the other problems.

  4. “When an average person runs or walks a mile (it doesn’t matter which – calories are burned by moving mass across a distance)”

    Are you sure ? Someone who walk 1 mile and someone who sprint this distance (well, sprint one mile…) will burn the same about of calories ?

    Yep, I’m sure. Springing, walking or crawling a mile- it all burns the same number of calories. The difference is in the amount of time it takes to burn those calories. If you can run a four minute mile, then you would burn the calories in four minutes; if it takes a leisurely half an hour to stroll the same mile, you still burn the identical number of calories, but just over a much longer time. It’s the calories per minute burned that changes, not the total calories. So – to belabor the point – if you sprinted for 20 minutes you would burn a lot more calories than if you ambled for 20 minutes, but you would do so because you would move your mass over a whole lot more distance while sprinting.

    Cheers–

    MRE

  5. I had to laugh when I read the bit about “fighting obesity in the workplace.” I work for a massive corporation (a rather BROWN company) and recently one of the departments had “health week” in which employees were given points for doing things like drinking water, having a “healthy” (read low-fat) lunch, walking on breaks, etc.. At the end of the week, the winners were announced and were rewarded … with a pizza and cookie lunch. I literally doubled over in laughter as corporate culture once more missed the Irony Train …

    Ah, yes, it boggles the mind sometimes…

    Sadly, that’s what I expect most attempts to foster healthier lifestyles in the workplace would lead to.

  6. In the article I saw yesterday, they also had this tidbit: ‘included the finding that 81% of Americans “believe that the government should have a role in addressing the obesity crisis,” the authors noted.’

    Ummm, correct me if I’m wrong, but wasn’t government action what got us into this mess in the first place with sugar subsidies and poorly constructed Farm Bills, not to mention the pathetic attempt at setting nutrition standards with the Food Pyramid? I think the last thing we need is government action…they tend to screw things up with bureaucracy and red tape and lobbyists passing money to politicians to make “the official truth” the truth of those that paid the most.

    Great writeup Dr. E. Even if the data is inaccurate, it does show a trend of expanding waistlines and at worst, it’s an underestimate. I’m sure few people actually need any of these reports to prove to us that our nation is getting fatter by the year.

    Scott Kustes
    Modern Forager

    Hi Scott–

    Good to hear from you.

    I agree completely.

    Cheers–

    MRE

  7. I miss your old look-the skulls were just wonderful and the berries were very colorful. Sadly, it now looks like very corporate. Please keep up the good work no matter what the “look.”

    Hi Judith–

    The berries are still there on MD’s blog. I’m trying to do more stuff with mine so I changed WordPress themes. The new theme won’t let me put up the skulls, but it lets me do other stuff the old theme wouldn’t. If it’s any comfort to you, I miss them, too.

    Best–

    MRE

  8. I know you are not big (or even little) into government solutions, but the prevalence of obesity, and the foreseeable tsunami of adult onset diabetes DOES actually require a leadership solution. The problem is not inherently in government, it is in the particular set of government we currently don’t enjoy. If you don’t think a large revision in the USDA recommendations to match with hedonist protein power life plan (just the food and maybe the exercise) would affect a change in the course of the statistics, well, you don’t think it so it must not be true.

    Fact of the matter is that the current government solution is a failure not because government is a waste of time, but rather because their current assumptions are. If you rework the assumptions, maybe you will see the power of an effective government.

    The other thing: don’t you think they know that people under report their weight and overstate their height? The average joe on the street knows this, and as an “insider” I suspect most civil servants and government blowhards do too. They’re really not dumber than the average joe (that’s a low bar, admittedly). I would not dismiss such a study, as it is well on the conservative side of any national estimate. It would almost seem to be by design. Now, don’t get me wrong. I think their recommendations are as pie in the sky as you do, but their finding is, if anything, understated, which I think is not a huge problem, since it’s pretty alarming that something like 28% of DC kids are obese according to an very conservative, likely lowballed report.

    Last thing: Cutting price supports for sugar is a good idea. Not for the HFCS, which is a social goal, but because it’s bad economics. It puts the resources of the many to the benefit of the few (namely sugar beet growers and cane growers in Florida and Hawaii). We should cut this price support on the economics grounds, then reap all the external benefits (reduced HFCS use, which in turn might drop demand for corn, simultaneously dropping prices for factory meat and biodiesel and possibly freeing up some crop for export, which might, if done properly, alleviate some poverty in the world and create a few less kids who grow up to be suicide bombers and child soldiers. Nice). The monetarists have it all wrong. Our economy is a web and all things touch eventually.

    I like it when you’re pissed about something. You write with more fire.

    And I like it when you write comments like this one that make sense.

    I agree with you pretty much across the board. I, too, think a more perfect government would be a boon to its citizens. The difference between us is that you think a much better government is a possibility; I don’t.

    Given the structure and the outside influences, the USDA is never going to recommend anything close to the PPLP Hedonist program, so why waste time tilting at that windmill.

    Tiger Woods and I are about the same height and weight. He makes $100M+ per year – I don’t. Theoretically, I could practice long and hard and become as good at golf as Tiger Woods, spend my days on the course, and make $100M+ per year myself, and just have a hell of a great life. But, I know it’s never going to happen, so why spend all my time and effort practicing. It’s the same with government. Theoretically it is possible to have the Tiger Woods of governments, but the likelihood of that happening is so low that it’s not worth working for. I would much rather spend my time figuring ways to work around the government to achieve my goals than wasting time trying to make government more to my liking.

    Cheers–

    MRE

  9. I’ve loved your blog for a long time, but I hate the prominence of cheesy weight-loss ads on this new layout.

    Hi Casey–

    I hate them too, but they sure make a difference in my Google ad returns. I’m trying to figure out a way to have this blog at least pay for itself – it costs to host it, have someone do the constant fiddling that I don’t know how to do to keep it working right, etc. – and the Google ads in the new layout look like they’ll do this. I don’t mind (actually, I do, but I do it anyway) writing the material for free, but it’s nice to at least have the hard costs covered.

    Maybe I can figure a way to have them a little less obtrusive.

    Thanks for the feedback.

    MRE

  10. I think you’re overly dismissive of exercises roll in fat loss, and body recomposition. I have seen too many people on various low carb diets with minimal results until they began strength training. Reversing disuse atrophy from a sedentary lifestyle, especially among the over 30 crowd, will produce results an order of magnitude above diet alone. Whether its been scientifically proven or not, I see it on a regular basis.

    I’m in full agreement with you. But we’re talking about different things. The increased activity that most people talk about doesn’t do squat to increase weight loss. If anything it increases appetite and leads to weight gain, just as it did with Banting. Advising people to increase their activity level to lose weight is useless.

    A regimen of resistance training combined with a good low-carb diet is a horse of a different color. It works like a charm to build muscle and markedly change body composition.

    Thanks for pointing this out.

    Cheers–

    MRE

  11. Repeat yearly? More like monthly!!

    I try like crazy to ignore these reports…..but I’m drawn to them…and they make me crazy!!

    On a different note, I found a link to a site called CSPI Scams (http://www.cspiscam.com/index.cfm). While I disagree with some of what they say, like lambasting CSPI for calling soda “liquid candy”, I did find an amusing link. It seems Stephen Colbert recently had CSPI Executive Director Michael Jacobson on his show. The clip, found at the bottom of the page is quite amusing! http://www.cspiscam.com/headline_detail.cfm?id=3429

    Hi Cindy–

    Thanks for the link. The video is hilarious. I liked it so much that I’m going to abandon the post I’m working on now and stick the video with my commentary in its place.

    Cheers–

    Mike

  12. The sad part of this whole report is that it will just generate more ammo for the low fat/ high carb group. It seems that they are already talking (if not already doing) about taking whole milk out of schools and replacing with low fat/skim. It seems that no matter how we try, the government isn’t going to let us raise our children as we want.

    That’s because they know best as evidenced by the food pyramid and all the rest of their schemes to slim us all down. Don’t you know this? If you don’t, just ask them.

    When you talk to individual government employees (and I’m sure their are a handful of exceptions) you usually find them to be idiots. How, then, when these idiots are all grouped together in a committee are they going to come up with better decisions. It’s simply idiocy squared or to the nth power depending on the n of idiots.

    Cheers–

    MRE

  13. Great post. I have to comment on fighting obesity in the workplace. I work at a nice downtown law office in San Francisco where Weight Watchers is constantly promoted in its newsletters and in the kitchen and pantry areas. Yet, every morning the catering service offers employees a selection of food for breakfast, which consists of prominently displayed bagels, muffins (low-fat!), and doughnuts. To be fair, one can also find some hard-boiled eggs and low-fat yoghurt in the fridge, but you can bet the bagels and doughnuts are the most popular items – no one seems to like the low-fat muffins. I hear they are rather tasteless – must be from a recipe from one of Jane Brody’s cookbooks!

    I’m sure you’re right. They must come from a recipe of Jane’s. Especially if they’re tasteless.

    Cheers–

    MRE

  14. I miss the skulls and cave drawings, too! The other thing missing is the top level navigation that leads to MD’s blog and the other areas of your Protein Power site. Are they coming back? Regarding the Google ads, maybe they can be put in the right hand column (?). I think you can put the code anywhere.

    Your recent articles have been great. Thanks!

    Hi Barbara–

    Thanks for the feedback. I’m working on getting the navigation stuff back in place. You change what you think is one little thing and the whole shebang gets altered in ways unexpected.

    Cheers–

    MRE

  15. Re the exercise piece: what do you think about the premise in Rob Thompson’s “Low Glycemic Load” book, that a subset of the population has an extra-deep “sleep” mode for slow twitch muscle. That is, if they are sedentary, they use far less fat for fuel than others in the background as it were.

    This makes sense to me as part of the whole “thrifty gene” theory that says some people are extra special when it comes to fuel management – on the glucose side with higher insulin response to carbs, and on the fat side with great conservation when there’s no need.

    Hi Connie–

    I’ve never read Rob Thompson’s book, so I can’t really comment on it without seeing his explanation. Like all things biological, there is I would imagine an individual variation in the rates at which muscle fibers consume nourishment. I don’t know if it makes a big difference or not, however.

    Ah, the ‘thrifty gene’ story again. This idea was come up with by James Neel, the so-called father of modern genetics, many years back in a paper everyone has read. In a later paper, that almost no one read, he decided that he had been mistaken on the first go round, and that there was no such thing as the ‘thrifty gene.’ But somehow the name has stuck and you see it used all the time with a reference back to Neel’s early paper. (I have Gary Taubes to thank for pointing this out to me. It’s all in his new book.)

    Cheers–

    MRE

  16. The thing that I always fear when people start clamoring for the government to “do something” about the obesity problem, is that, as long as everyone (well, almost everyone) believes that dietary fat is the culprit in obesity, what the government will do to combat obesity will be to start taxing things such as butter or other full-fat diary, fatter cuts of meat, etc., or funding scientists who tamper genetically with animals to make them carry less and less fat on their bodies; in short, the government will “do something” that will only make the obesity problem worse and will punish those of us who eat fat from real food, and make it even more expensive or difficult to purchase real food. As long as people refuse to listen to those asserting that over-consumption of wheat, corn, soy, and sugar products is the cause of obesity, there’s little hope, especially considering how disruptive it would be to the economy for the government and the medical establishment to switch gears and starting telling everyone to avoid or greatly reduce these foods in the diet. A whole lot of people would have to 1) realize they have been wrong about what we should eat, then 2) they would have to exercise the virtue of admitting publically that they have been wrong, and finally 3) face the ire of a public that has been misdirected into becoming fat and sick by following their former advice.

    One of the underlying causes of many of the problems in our society, not only but certainly including the nutritional ones, is a total lack of ability and desire to think critically. We are not trained to do so in school, so few of us have any ability to think critically or to recognize or eschew the use of logical fallacies, and, in a culture that enshrines My Personal Opinion = Truth, there’s no desire to think critically about any objective external truth. If I believe it, it’s true for me. (Jane Brody comes to mind.) Unfortunately, our bodies could not care less about our beliefs about what makes them fat or sick, and they go right ahead and get out of whack despite our dogmata about what we should eat to be healthy.

    Hi Ethyl–

    Very valid points all. I hope someone wises up before it gets to the taxing stage.

    Cheers–

    MRE

  17. Thank you for the article, informative as always.

    It would be interesting to compare obesity in Canada verses the USA. I live in Ottawa, Canada.

    Very anecdotal, but… there seem to be a lot more fat people in the USA than in Canada and we basically eat the same food with the same culture. At my son’s school I have noticed very few fat kids, no obese ones, primarily normal or skinny. A cubby kid at the pool is an oddity. When I see real Americans on TV (verses actors), I am always struck by the numbers of people including children. I have yet to see a truly obese person at my company of 500+, sure lots of varying overweight people, most look normal weight and we all sit at computers all day. I am probably a fatter person with a BMI of 27. Sure 24% of adults are obese (BMI > 30) but there are very few severally fat people (BMI > 35) and morbidly obese (BMI > 40) is almost non-existent.

    Whenever people I know visit the U.S., they are always struck by how much food is served in restaurants. It’s always the same comment that that much food could feed two or three people. I wonder if there is a culture of overeating. Combine that with a culture of carbs and you would have an obesity epidemic.

    Hi George–

    I’m sure you’re right. Portion sizes are huge here in the US at many restaurants, especially those where people in lower- and middle-income categories dine. Not only large, but very carb-rich, to boot. And since more and more people are eating out here than ever, it makes sense that these large, carb-laden portions are having an effect.

    Unlike in the 16th-early 20th centuries, obesity these days is a disease of the poor much more so than a disease of the rich. I had the opportunity a while back to play golf at one of the premier country clubs in the world, often described as summer camp for rich men, and while there I noticed that not a single person was obese, or even much overweight, for that matter. Compare what I saw there with golfers on any public course, many of whom are obese, and you’ll see what I mean about the difference in body sizes of the rich and the middle and lower incomers. In watching the rich eat as in comparison to watching the poor or moderate income people eat, it’s easy to see why the former are thin and the latter obese.

    Cheers–

    MRE

  18. There should be no food allowed in the workplace except what you actually bring in for yourself, not bring in for others to share. My office has stretched so far overboard with this “bring in goodies every day” thing that it’s turned into an all day smorgasborg, with people grazing all day. It wouldn’t be bad if it were in a separate location that I could avoid, but I cannot avoid passing by the nasty stuff in my regular line of duty or if the definition they use for healthy weren’t diametrically opposed to what I think is healthy. I remember bringing in a tray of herring, sardines, cheese and olives one day and letting them smell up the office to try and make a point but it just flew by their noses.

    The most asinine thing I heard here is that “the government is looking after us in their recommendations for what is considered healthy eating. They would never recommend stuff that is unhealthy.” There you have it folks.

    Albert Einstein said it best: ““Unthinking respect for authority is the greatest enemy of truth.”

    I am also having trouble navigating with this new format, but I suppose eventually I’ll get used to it.

    My sentiments precisely.

    And I’m having some trouble navigating myself with the new format, but I’m working through it. Thanks for hanging in there.

    Cheers–

    MRE

  19. ” . . . one of those ‘think’ tanks loaded with ex-politicians and former government employees of one stripe or another set up to suck money from donor organizations to create meaningless reports while paying its members large salaries issued its 2007 report a couple of days ago.”

    c’mon Doc. Don’t sugar-coat it. Tell us what you really think!

    Was I that obvious?

  20. Hi Doc –

    I watched the video at “CSPI Scams”, and was prepared to see Jacobson come off really, really badly ( based on the lead-in ), but I have to say that, with the huge and ever-present exception of the low-fat/High carb initial assumption mistake they all fall prey to, I don’t think he came off all that bad. Certainly NOT humorless. I think the CSPI Scam folks are not keeping in mind the caution from “Stumbling on Happiness”. We tend to need very little evidence to see what we want to see, especially if it something negative about our “enemies”.

    But, I’ll await your post on the video.

    Best,
    John

    Hi John–

    You’re certainly right that I always look for the worst in Jacobson, and I’m very rarely disappointed.

    Cheers–

    MRE

  21. Great post again. As Thomas Sowell once said, you solve a problem by not doing the things that created the problem in the first place. Junk the food pyramid, and end corporate welfare for the sugar and corn industries. (I love how Michael Pollan, in the Omnivore’s Dilemma, lays out how much corn and corn products are in the typical American diet, and how this came to be. Worth the price of the book.) As it is, eating healthy food takes more time, money, and willpower than most Americans seem able to muster. To see the results all you have to do is some people watching at a mall or airport.

    If Thomas Sowell said it, it must be true. Most of the problems we are having today can be laid at the doorstep of our friends in government. Don’t even wait for Gary Taubes’ book to come out. Read about the government finagling with things in his article from a few years ago titled “The Soft Science of Dietary Fat.”

    Cheers–

    MRE

  22. After reading your blog the last couple of days, I was struck by this article found on Runner’s Worlds’ Ask the Doctor.

    “But one recommendation is incontrovertible from our study: Keep exercising. Healthier low total cholesterol profiles are unequivocally associated with some of the healthiest people among us—marathon runners and their friends.

    So what about people with cholesterol levels 200 and above who eat “right” and exercise? Well, you just can’t pick your parents! Heredity is the most important factor in your being able to get your level within a “good range.” The new statin drugs like Lipitor and Crestor are excellent at controlling your cholesterol with minimal side effects.”

    Not only does exercise “incontrovertibly” equal good health, but if you add some statin drugs with it, now you’re really smokin’ and with “minimal side effects!” AAAARRRRRRGGGGGHHHHH!

    Idiocy abounds. What can I say.

  23. I was first referred to this site from some exercise sites that I read, and I enjoy getting your perspective on issues. I realize that this is not an exercise site, but I have to question some of your comments regarding exercise. First, your use of the Minnesota data to discount the value of exercise for weight loss is a bit disingenuous. A few paragraphs before this you questioned all of the obesity data in the news reports due to the way in which the data was acquired, namely, through self reporting. I assume that the exercise data from Minnesota was also obtained through self reporting, so the most you can say is that this data is also likely not valid and has no bearing on the value of exercise for weight loss.

    Second, running a mile consumes more calories than walking a mile. This is due to the up and down motion of running vs. walking. If you view a person walking and focus on the center of mass, you can see that the center of mass stays a relatively fixed distance from the ground. For a person running, the center of mass moves up and down since running consists more of a bound (cm moves up) and a catch (cm moves down), thus leading to somewhat greater calorie expenditure.

    Third, I was going to point out how exercise can change underlying metabolism and body composition, but I see that this point was already raised. I would like to emphasize the value of high intensity interval training in addition to weight training as an effective form of exercise. Tabata intervals, only four minutes in duration (20 seconds hard, 10 seconds easy for eight cycles) give a particularly good bang for the buck.

    Hi Elmer–

    I wasn’t really being disingenuous. First I discussed how inaccurate self-reported weights and heights are by comparing the TFAH data to data obtained by actually weighing and measuring subjects. Second, I was demonstrating how invalid their presumptions were even if based on their own flawed data. (And you’re correct – they did obtain exercise data along with all other data via phone interviews.) In other words if their data were correct, they couldn’t really draw the conclusions they did from it. IF lack of activity were the main driving force behind the increased rates of obesity, and IF the vast majority of Minnesotans exercised regularly, THEN Minnesota should be at the bottom of the obesity charts. Instead Minnesota is buried somewhere in the middle.

    Second, I figured I would hear from a hair-splitter on the calories-per-mile issue. Okay, there is a tiny difference in calories expended because of the up and down motion of running verses walking, but not enough to spit at.

    Finally, I do agree that exercise is good and healthful, especially resistance exercise. But, based on my experience with a whole lot of patients and based on the medical literature, there is no weight loss benefit to simply increasing activity. It’s got to be done in conjunction with diet, and even then, the diet does most of the heavy lifting.

    Cheers–

    MRE

  24. The low fat movement will never die as long as you have people like Dr. Mehmet Oz spouting its benefits in front on 50 million people on the Oprah Winfrey Show and on 5 different programs on the Discovery Health channel. Not to mention his books. This guy is everywhere. He is a cardiothoracic surgeon but also believes himself to be a nutrition expert and is constantly tells us to reduce our saturated fat and eat more whole grains. Today on one of his programs he showed an overweight woman examples of real plaque-filled and damaged arteries – the result of years of high cholesterol levels he said. He pop quizzed the woman by asking her the origin of the high cholesterol. She said “a diet high in fat and saturated fat”. He nodded and smiled in approval. If a “top-rated” and “world-renouned” cardiac surgeon (and clearly a marketing genius as well based on the way he markets himself) is saying that low fat is best, who are we to dispute it?

    But what if the “top-rated” and “world renowned” cardiac surgeon is a moron when it comes to nutrition? Which is obviously the case, so you ignore him.

    Cheers–

    MRE

  25. The cardiothoracic surgeon is a great example of what I believe is called eminence based medicine. Wish I’d thought of that one first!

    Hey Neil–

    Beautiful! I wish I had thought of it first, too. I’m certainly going to add it to my arsenal of pithy comments.

    Cheers–

    MRE

  26. I took the “Real Age” test from the website of Drs. Michael Roizen and the aforementioned Mehmet OZ. What a joke. I am 45, the test said that my “real age” is 43. I could be doing a lot better if I ate less red meat and more whole grain!

    Jesus wept.

  27. I just took that real age test. I didn’t know my cholesterol numbers so I just lied and said my total was 200 and my Hdl was 70. It gave me advice about how to get my raging cholesterol numbers under control. Does that sound right?

    No, it sounds like a moron giving medical advice.

  28. Thoughts:
    I think I’m more of an idealist (though working for the government is slowly crushing the impulse), when it comes to government. I used to have hope for large reform to the civil service due to the exit of many baby boomers with retirement, but think the culture is too crystalized, at least at Labor where I perform work like activities. That said, rewriting the farm bill on the economics is more likely than on the side benefits (I would advocate turning back to what it looked like during WWII, only with thoroughly liberalized trade, but that’s a wonk discussion for another day). But neither is particularly likely with the morons we call an electorate. Ditto for reform of the flat tax (what we essentially have currently, despite “progressive” income taxes, another story for another day).

    On the data, self reported, regarding exercise: Unless we believe that there is some reason why Minnesotans tell taller tales of their exercise habits than Idahoans, New Hampshirites, and everyone else in the Union, then we can take it at something like face value. They may not exercise as much as they say they do, but neither does anybody else, so it should even out. I think it’s pretty clear than Flat Cardio is worse than useless when it comes to weight loss for most people. I think it’s reasonably clear that lifting in a structured manner and HIIT are considerably better than ass on couch.

    Real Age: Hrm, I do LC, I eat tons of meat, no whole grain, and not enough veggies and I’m 11.6 years under my 34.6 years of age. It’s stupid, but in my first year of PPLP, I increased my under from 3 to 11.6. Not bad. Course, it’s the cholesterol, weightloss and exercise (plus I’m a year beyond moving, being unemployed, having grave financial worries, etc).

    On low fat going out of style: It doesn’t not work for everyone, so there will always be role models. The meme is too simple to be wrong (Fat makes you Fat). I think it’s gonna be here a long time, even without Oprah, Roizen, Oz, or even Ornish. Look at how many people think the earth is 6000 years old and in basic creationism or the watered down version, design. Yeah, you need pushers, but when it comes to science versus mumbo jumbo, MJ seems to win a lot.

    I’m interested in your statement that you “used to have hope for large reform to the civil service due to the exit of many baby boomers with retirement…” What I find amazing about this statement – that no doubt is true – is that the baby boomers were the hippies, and anti-war activists, the first generation in who knows how long who bucked the system and demanded change. They brought down a presidency, yet are now a cause of stasis in government. One would think that the most activist ones of them all would gravitate to government where they could ‘make a difference,’ but it seems that they are just there putting in their time.

    Cheers–

    MRE

  29. Here is a real life example for how ingrained the “move more” meme is. My ex-brother-in-law sported a huge gut. He was obese for sure. Then one Christmas, I saw him again, and he had melted away. When I asked what happened my sister explained he had changed job. He was now a forklift operator and “moved more”. Fair enough. Except that his previous job (which he did for many years) was delivering pizza. One of the perks of the job, was free food and free pizza. I think it would be more correct to attribute his weight loss to cutting out the daily carb-laden lunches and suppers.

    Hi Angelyne–

    I’m sure you’re correct.

    Cheers–

    MRE

  30. “One would think that the most activist ones of them all would gravitate to government where they could ‘make a difference,’ but it seems that they are just there putting in their time.”

    I suspect that a lot of these people were once upon a time very active in the way that makes one an activist. You join the government because JFK inspires you to. Back when folks really believed in big Gov. You maybe enjoyed working under LBJ. But then Nixon wages his war on the Civil Service. Ford not a big friend either. Carter, I dunno. Reagan modernized the benefits and did a great sales job on it, so that the unions bought in, and people given the choice of opting out of the old system (CSRS) for the new system (FERS) actually did it (even though it makes no practical sense to do so whatsoever for anyone who was a civil servant). And the Reagan years were no picnic for feds either. So, it’s probably a case of hard reality crushing the activism out of them.

    But there’s the other thing. When it’s the 60’s and 70’s, and you’re having fun in your twenties, marching on the capitol and changing things, maybe you feel great about everything. Then, you marry that hippie guy/girl, move out to NoVa or Maryland, buy a house, crank some kids, get your fed job so you can change things from the inside. You get a steady paycheck, a retirement plan, health insurance, etc. And the status quo seems a lot more attractive.

    Last thing: Because of low pay for middle/senior management (don’t mind the studies that say Civil Servants make more than others. Average MBA, class of 2005 makes $90K in base salary. Average MBA, Dept of Labor, class of 2005 makes under $70K, and gets no bonus), clotted culture and maybe a feeling that inside activism doesn’t work, most of the sharpest leave the profession early. It’s Jack Welch in reverse.

    I have great hope for Government solutions when they’re run with good economics and the heart in the right place. I have lost some hope for this government’s ability to craft those solutions in the face of:
    1- The rules that run the civil service
    2- The great incentives provided by the political donor class
    3- A setup where you have to be a millionaire to run for national political office.
    4- A lot of little stuff that also provide improper incentives.

  31. I was at a lecture given by Dr Joel Fuhrman last winter and Dr Oz was brought up.
    Dr Fuhrman stated that actually Dr Oz and his family have been on his diet for quite
    a long time and what Dr Oz advocates is for the masses, but what he eats is totally
    vegan. This is true….Just saying!

    Interesting.