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Old 03-15-2015, 10:48 AM   #41
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I was going to bring up the studies that show that overweight and slightly obese people have longer life spans, but I see Ron beat me to it. So obviously I don't think BMI is the most important test. However, based on BTravlin's statement about food intake and all the conditions that are tied to it, I started to wonder what we're defining as health? Is it a longer life span (without requiring live in care or a nursing home)? Or is it the ability to do semi-athletic activities without popping a blood vessel?

I've been coming to the viewpoint that Dr. Kendrick espouses, that nobody is going to get out alive, and life should be lived and enjoyed. Having said that, I would like to lose some more weight and be a bit more flexible and balanced so I can do things like get in and out of my kayak easier. Obviously, at nearly 60 I'm going to feel aches and pains doing things I used to do without them. But I can minimize that with things like diet, and maybe keeping up my Qi Gong and Tai Chi classes.

So I guess my definition of health is the ability to do most of the activities you enjoy. My definition of happiness is doing most of the activities I enjoy, including eating and drinking and smoking things that are blacklisted in today's society. I know I'm going to die at some point, and I'm hoping all my diseases and conditions help make it fast when it happens. But in the meantime I'd like to enjoy my life.

So I have to chime in with the people who are saying the one test they think is most important is getting out of bed in the morning. Or early afternoon, depending on how fun the night was.
To me quality of life is more important than longevity, within reason of course. DW and I have some good married friends who are obese. We would love to do more things with them but their obesity prevents them from participating. We can't travel with them because they can't walk the cities or museums. We scuba dive, bike ride, walk and paddle board regularly but they aren't up to it due to their weight. They spend their time watching TV, eating out at restaurants and soaking in the pool. That's not enough to keep us happy and we're glad we're physically able to pursue more varied interests.
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Old 03-15-2015, 02:32 PM   #42
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To me quality of life is more important than longevity, within reason of course. DW and I have some good married friends who are obese. We would love to do more things with them but their obesity prevents them from participating. We can't travel with them because they can't walk the cities or museums. We scuba dive, bike ride, walk and paddle board regularly but they aren't up to it due to their weight. They spend their time watching TV, eating out at restaurants and soaking in the pool. That's not enough to keep us happy and we're glad we're physically able to pursue more varied interests.
There is a difference between being overweight and obese. Folks who are simply overweight, or maybe just edging over into the obese class I category can be very, very active with no problem. Folks who are in the higher obesity categories do have lower longevity and do seem to have much more trouble with mobility/living an active life.
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Old 03-15-2015, 02:36 PM   #43
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Thanks RonBoyd and Harley. SomeHow I missed that important little nugget.

The Problem With All of This 'Overweight People Live Longer' News — The Atlantic
I had a little problem with this, the blurb at the beginning of the article -

Quote:
Yes, to some degree, having a higher BMI has been associated with a lower risk of death. But interpreting these new findings to mean anything more than that, and precisely that, is dangerous.
What else could it mean? Did the article after that imply that if you were "obese" due to being a body builder or pro basketball player you would live longer, but not if you were just a fatty? I didn't really understand her point. I don't think there are enough people who's BMI is high due to being highly muscular to skew the studies.
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Old 03-15-2015, 02:50 PM   #44
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I had a little problem with this, the blurb at the beginning of the article -

What else could it mean? Did the article after that imply that if you were "obese" due to being a body builder or pro basketball player you would live longer, but not if you were just a fatty? I didn't really understand her point. I don't think there are enough people who's BMI is high due to being highly muscular to skew the studies.
Yes - that is silly (warning against interpreting the study results to be anything other than what they are, LOL!) At points the article does attempt to "explain away", like some others, why folks perhaps shouldn't be too enthusiastic about the findings. But the "dangerous" part seems to be more of a dogma problem.

I found this part quite amusing:
Quote:
For some health advocates, the implication is downright offensive. Walter Willett of the Harvard School of Public Health, for example, lost his cool this morning on NPR, declaring, "This study is really a pile of rubbish and no one should waste their time reading it."

But the study's author, Katherine Flegal of the Centers for Disease Control and Prevention, mounted a solid defense: "It's statistically significant." Those three words carry weight -- if an association has been found to be significant, it tells us that if nothing else, we need to acknowledge that the results are in some way legitimate and warrant our attention.
Of course people will always feel compelled to warn others that they haven't been given permission to go gain a lot of weight.
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Old 03-15-2015, 03:27 PM   #45
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"It's statistically significant." Those three words carry weight
No pun intended.
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Old 03-15-2015, 05:59 PM   #46
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Heh, heh. They're limiting the scope of medical problems from a higher BMI to death only.

I suspect that there is an interaction here not being controlled for.

A person with a higher BMI might be prone to medical issues that would not impact a person with a lower BMI. That could be anything from assorted chronic difficulties in the legs and lower back, to things like sleep apnea, all ailments that could have someone seeing a doctor regularly. They are more likely to be medically monitored or examined periodically, and receive medical intervention for other problems that might arise.

A person with normal weight might not see a doctor outside of an annual checkup, if they bother with that. There is no medical monitoring. Their first indication of a medical problem such as hypertension could be that fatal stroke.

Look out for hidden assumptions and uncovered cases. Oversimplified models (BMI vs death) can produce pretty odd results.
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Old 03-15-2015, 11:13 PM   #47
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I have to say I do kind of like the explanation: "Well, overweight people must be seeing the doctor more often. So they are more likely to have early detections of disease".

It doesn't change the outcome. If that's really the reason, it turns out to be a significant benefit/survival advantage.
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Old 03-15-2015, 11:44 PM   #48
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DW was just commenting on that this morning. She was looking at old family photos from 1960's on and even with casual friends the obesity so common now just isn't there. All the kids are rail-thin, some of the adults might have a bit of a paunch but no one was obese.

So what happened? Can't blame it all on potato chips as we certainly had those then - just not much of it. Too many restaurant meals and meals out of boxes? Is it realistic to blame it on fast food? We so rarely eat out that I have little idea of what is "normal" for eating out.
This is one of those that is, IMO, an intersection of factors. A great deal of this relates to changes in the overall food environment. It is easy to say it is individual portion control and that is a factor but there is no reason that couldn't be a factor 50 years ago. I actually did a blog post a week or so ago talking about how eating was different "then" as opposed to now. Some of the factors:

1. Highly palatable food designed to cause overeating. I used to think this wasn't a major factor. I know think it is. A couple of books that are interesting on this are Salt Sugar Fat and The End of Overeating. These books are really fascinating about how. Here is a NYT article by the author of Salt Sugar Fat that talks about some of this: The Extraordinary Science of Junk Food.

The point is that food is scientifically designed to appeal to people through the use of sugar (especially), fat and salt. There is discussed a concept of manufacturers spending lots of money to decide the "bliss point" of food which is the exact amount of sugar that people find the most appealing.

When we look back to 40 or 50 years ago, the techniques are crude in comparison to what they do now. Some of the stuff talked about in Salt Sugar Fat is how even some people in the food industry feel that they have designed food to be so appealing that this has led to the obesity crisis.

I am not saying this is the only factor. I'm not saying that personal responsibility isn't a factor. I would perhaps compare this a bit to smoking. Not smoking does involve personal responsibility and stopping can be very difficult. But, we also recognize that there is some responsibility on the part of cigarette manufacturer's so we put a lot of restrictions on tobacco (ie, warning labels, advertising restrictions, age limits, etc.). Those kinds of restrictions largely don't exist for unhealthy food that promotes obesity (such as sugared soft drinks for example).

2. Portion sizes. Back in the 1960s I was allowed to have a 6 1/2 oz. Coke a day, occasionally a 10 oz. Even when we rarely ate out, drink sizes were small and no free refills. A "Jumbo Jack" seemed huge then and would be tiny under the standards now.

3. More sophisticated advertising of food. The ads for food on TV now compared to how they were in the 1960s -- no comparison. Also more ads while out and about. Even the smells from the food court all make food very appealing.

4. People eating out more. A lot of this is because people are busier and more women are in the workforce and so more people eat out more often. Another factor, though, is that food eaten out is more appealing than it used to be. Back in the 1960s restaurant food was more like the food eaten at home and wasn't so appealing. In the End of Overeating there is a lot of discussion about restaurant food and how it is often way higher in calories than similar food made at home. It is often fried in a factory somewhere then frozen and sent to the restaurant and then fried again. The result is a food much higher in calories than most people would suspect.



Edit: On the issue of overweight people living longer than normal weight people, I read an interesting article that separated out stats based upon whether people were smokers or not. The gist was that smokers were more likely to be thinner, but would die earlier due to their smoking. So the presence of smokers skewed the data.

If you looked only at people who had never smoked, it looked like the lowest death rates were associated with being normal weight rather than overweight.

All right here it is - http://www.runnersworld.com/weight-l...ing-overweight
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Old 03-16-2015, 12:35 AM   #49
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There was a thread about this sitting-rising test a few years back. I just did it, and also asked DW to do it.

Result: same as the 1st time a few years ago. We could do it with no hand support, but were a bit wobbly when standing up, and not perfect like the woman in the yellow shirt in the video.

What does this mean? I also have perfect blood test results, and BMI of less than 24.

Two years ago, I was diagnosed with a disease that would put me 6 feet under if it weren't for modern medicine.
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Old 03-16-2015, 02:02 AM   #50
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Since heart disease is our #1 killer, I'm surprised no one said a coronary angiogram.

If the test were free and could be almost guaranteed of no further complications, I'd love to know what the inside of my coronary arteries look like.
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Old 03-17-2015, 03:33 PM   #51
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Since heart disease is our #1 killer, I'm surprised no one said a coronary angiogram.

If the test were free and could be almost guaranteed of no further complications, I'd love to know what the inside of my coronary arteries look like.
Statistically speaking:
List of preventable causes of death - Wikipedia, the free encyclopedia

So, a colorectal cancer test. Alternatively, a medical competency test for the doctor treating me (does that exist)?

A coronary angiogram indeed, once I'm 50 years old. Before that a generic cancer test (early stage - also doesn't exist?).
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