[PHNUTR-L] Head to head: Is the obesity epidemic exaggerated?

[Kathrynne Holden]

Colleagues, the following is FYI and does not necessarily reflect my own
opinion. I have no further knowledge of the topic. If you do not wish to
receive these posts, set your email filter to filter out any messages
coming from   @nutritionucanlivewith.com    and the program will remove
anything coming from me.
---------------------------------------------------------
ublic release date: 31-Jan-2008
http://www.eurekalert.org/pub_releases/2008-01/bmj-ito013108.php

Contact: Emma Dickinson
edickinson at bmj.com
44-020-738-36529
BMJ-British Medical Journal

Is the obesity epidemic exaggerated?

Head to head: Is the obesity epidemic exaggerated?

Last week, the UK health secretary declared that we are in a grip of an 
obesity epidemic, but does the evidence stack up? Researchers in this 
week’s BMJ debate the issue.

Claims about an obesity epidemic often exceed the scientific evidence 
and mistakenly suggest an unjustified degree of certainty, argue Patrick 
Basham and John Luik.

For example, the average population weight gain in the United States in 
the past 42 years is 10.9kg or 0.26kg a year. Yet, between 1999-2000 and 
2001-2002, there were no significant changes in the prevalence of 
overweight or obesity among US adults or in the prevalence of overweight 
among children.

Furthermore, they say, the categories of normal, overweight, and obese 
is entirely arbitrary and at odds with the underlying evidence about the 
association between body mass index and mortality.

For example, the study on which the bands for overweight and obesity in 
the US are based found that the death risks for men with a body mass 
index of 19-21 were the same as those for men who were overweight and 
obese (29-31). Other studies have shown negligible differences between 
body mass index and death rates.

The association of overweight and obesity with higher risks of disease 
is equally unclear, they write. And, despite supposedly abnormal levels 
of overweight and obesity, life expectancy continues to increase.

They suggest that some public health professionals may have deliberately 
exaggerated the risks of overweight and obesity, and our capacity to 
prevent or treat them on a population wide basis, in the interests of 
health. They warn that this has unwelcome implications for science 
policy and for evidence based medicine.

But Robert Jeffery and Nancy Sherwood argue that a large body of 
scientific evidence shows that obesity is a major global health problem.

In the US, the prevalence of obesity in 1976-80 was 6.5% among 6-11 year 
olds and 5% among 12-17 year olds. In 2003-4 it was 19% and 17% 
respectively. Europe can also expect to see the numbers of overweight 
and obese children rising by around 1.3 million a year by 2010.

The risks of obesity on many serious health conditions including high 
blood pressure, diabetes, heart disease and some forms of cancer, are 
also serious and well established, they write.

Most health economists and epidemiologists agree that the contribution 
of obesity to current healthcare costs is high and that it is likely to 
get much higher. Some have argued that we may even see real falls in 
life expectancy within a few decades, they add.

In summary, a large body of evidence documents that over-nutrition and 
obesity are a major global health problem, say the authors. With the 
continuing rise in obesity and limited treatment efficacy, options for 
averting a poor public health outcome seem to rest either on the hope 
that scientists are wrong in their projections or speedy investment in 
the development of more effective public health measures to deal with it.

They think the second option a more prudent scientific and policy choice.
-- 
Kathrynne Holden, MS, RD
"Ask the Parkinson Dietitian"  http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
http://www.nutritionucanlivewith.com/