Wednesday, March 07, 2012

Nothing Will Ever Prevent Childhood Obesity


I know, a cheap headline to draw you in. I apologize.

What I mean to say is,
"No ONE thing will ever prevent childhood obesity",
or any obesity for that matter.

In order for any single public health intervention to have an impact on any sort of obesity, it would mean that whatever target the intervention manipulated would have to in and of itself be responsible for a large and significant percentage of the problem.

And therein lies the rub. Our struggle as a society with weight and/or healthy living has more to do with the accumulation of dozens, if not hundreds, of environmental changes where the end result is an environment where the unattended consequence of spontaneously living is weight gain. Simply put, the current pushes us there.

The reason it's important to always keep this in mind is that the likelihood there'll ever be a singular intervention that makes a demonstrable impact is exceedingly low, and that fact is going to bedevil policy makers, researchers and analysts because it's going to be tough for them to make the case, "Yeah, sure, that didn't do much, but we've got to keep doing it anyhow even if there was no demonstrable benefit".

It's that whole twig thing. Effortless to break one. Easy even to break two, three, four, five and more, but get a large pile of small twigs together and eventually you'll get to a point where despite each twig being laughably snappable itself, together they might as well be a log.

Keep that in mind before you pass judgment the next time on the futility of a particular intervention after you read about how a study on intervention "X" didn't seem to make a demonstrable difference on obesity rates, weight changes or eating behaviours.

It's David Katz's single sandbag phenomenon, and if you're surprised that a single sandbag wasn't enough to stop the flood, I think perhaps some remedial Flooding 101 is in order.

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6 comments:

  1. Anonymous5:37 am

    Parents cooking whole foods for their kids and bagging lunches and not letting them eat the fast food that schools give them will go a long way to stopping their childrens obesity. It won't fix society as a whole, but you can have your kids avoid obesity.

    I see many non-obese kids, and their parents push activity and don't eat fast food every meal. They just don't participate in the trend that is sweeping the world

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  2. Childhood obesity is actually childhood hormonal imbalance which is associated with but not caused by inactivity and excessive caloric intake(1). It's caused by consuming the sort of food components that promote overeating, emotional discomfort, and sluggishness(2); added sugars and omega-6 industrial seed oils.

    Most everyone is aware of the added sugars problem, finally(3). But what of the omega-6 hazard? Where are the admonitions to consume less of products laced with polyunsaturated seed oils(4)? And why do the American Heart Association and the Harvard School of Public Health(5) still advise replacing saturated fats(6) with polyunsaturated oils(7) we're already getting too much of? When are government(8) and academia going to stop demonizing saturated fats and acknowledge that it was a mistake to assume that saturated fats cause clogged arteries(9).

    References
    1. http://articles.latimes.com/2002/mar/13/food/fo-52-13
    2. http://www.cannabis-med.org/english/bulletin/ww_en_db_cannabis_artikel.php?id=367
    3. http://www.businessweek.com/news/2011-11-11/fatty-foods-addictive-as-cocaine-in-growing-body-of-science.html
    4. http://www.psychologytoday.com/blog/evolutionary-psychiatry/201103/your-brain-omega-3
    5. http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-full-story/
    6. http://rdfeinman.wordpress.com/2012/02/22/saturated-fat-on-your-plate-or-in-your-blood/
    7. http://articles.orlandosentinel.com/2003-09-28/news/0309270148_1_overweight-or-obese-women-were-overweight-south-africa
    8. http://freepressonline.net/content/what-has-government-done-our-health
    9. http://www.nutritionjrnl.com/article/S0899-9007%2811%2900314-5/abstract

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  3. Bobbini10:08 am

    I think the above two responses illustrate your point very well--acknowledging that something is multifaceted and that there is no single, clear cause hurts our brains. We scramble to find the One True Solution not so much to solve the problem for everyone, but to find a way to make sure it won't happen to us (or our kids).

    ReplyDelete
    Replies
    1. Anonymous11:11 am

      Well, realistically the problem will never be solved in a free society. Witness other addiction issues. I assume the medical "cure" rate will be similar to the "cure" rates for alcoholism and/or drug use, which is to say fairly pathetic.

      All you can do is raise your own kids and take care of yourself. May as well focus on what you can actually do, and not waste too much time on insoluble problems.

      Delete
  4. Since childhood obesity is defined by percentile and since the natural and healthy size of human beings is a bell curve, not confined to a narrow band, then it's literally true that nothing will ever prevent childhood obesity, and that's fine. We don't all need to have identical bodies.

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  5. I meant to comment yesterday on this post, Yoni, first to thank you for all your efforts re the Disney exhibit fiasco. But also wanted to point out just what dee.calarco did -- we'll never "prevent" childhood obesity also because some kids are genetically made to fall within that BMI range even with the healthiest behaviors.

    One of the most heartbreaking comments I've heard re this is highlighted in the Association for Size Diversity & Health's efforts toward this issue. When we asked larger kids what they thought of the effort to prevent childhood obesity, they said it sounded like people wanted to get rid of them.

    ReplyDelete