Big Fat Sleep

No, it’s not news that lack of sleep is tied to fat.

What sleep researcher Dr. Orfeu Buxton found is more information on how this occurs.

The resting metabolic rate of the volunteers by the end of the five weeks was 8% lower than where they had started. [...]  That could explain why night shift workers tend to gain more weight and have a higher likelihood of obesity than day workers; such weight gain is linked to an increased risk of diabetes and heart disease.

Wow, it’s like the number of calories burned isn’t standard across all bodies at all times!  Or not just affected by exercise!

The scientists learned something else interesting about another mechanism that put the disrupted sleepers at higher risk of diabetes: the combination of having their circadian clocks reversed (sleeping during the day and waking at night) and the poorer sleep they got as a result had an effect on their insulin levels. After three weeks in the lab, the participants produced about a third less insulin from the pancreas in response to meals; with less insulin available to break down glucose, blood glucose levels started to rise and three of the 21 volunteers showed high enough levels to qualify them as pre-diabetic.

Two things struck me about this.  First is that it occurred after 3 weeks.  Second is that only 3 of the 21 volunteers reached the pre-diabetic range, even though they were all living in the same lab undergoing the same regimen.  Again, it’s like they’re individuals or something.

Not News

The website Fark makes fun of news stories that are not, actually, news.

Example:  Students Discover Desks Have More Germs Than Toilets

Why isn’t it news?  Well, it’s a common story that pops up once a year or two, and relies on people not thinking about which is more likely to get janitorial attention.

Today my Google Health section looked a bit like Fark.

First: Paula Deen has diabetes.  Because she’s fat and publishes “unhealthy” recipes, she’s being blamed for “bringing it on herself” with unhealthy food.  Fat people being blamed for their health problems, gee, where have I heard that before.

( Never mind that Ms Deen is 64 and the American Diabetes Association states that the risk of type 2 diabetes goes up with age —  26.9% of people over 65 have it.   Or that the American Diabetes Association states that “Most overweight people never develop type 2 diabetes” and that eating sugar doesn’t cause diabetes.)

Second:  obesity rates?  Were leveling off in 2010.  And 2007.  Lots of stories about it in the last 4 years.   Um….

 

 

Vitamin B12 in the news

I’ve written about my vitamin B12 absorption problem before.  The NY Times recently posted a good primer on B12 deficiencies, including those at risk:

Natural plant sources are meager at best in B12, and the vitamin is poorly absorbed from them. [...C]hronic users of acid-suppressing drugs like Prilosec, Prevacid and Nexium, as well as ulcer medications like Pepcid and Tagamet, are at risk of developing a B12 deficiency and often require a daily B12 supplement.

Stomach acid levels decline with age. As many as 30 percent of older people may lack sufficient stomach acid to absorb adequate amounts of B12 from natural sources. [...]

Synthetic B12, found in supplements and fortified foods, does not depend on stomach acid to be absorbed. But whether natural or synthetic, only some of the B12 consumed gets into the body. Treatment to correct a B12 deficiency typically involves much larger doses than the body actually requires.

Free B12 from both natural and synthetic sources must be combined with a substance in the stomach called intrinsic factor to be absorbed through the gut. This factor is lacking in people with an autoimmune disorder called pernicious anemia; the resulting vitamin deficiency is commonly treated with injections of B12.

Although most doctors are quick to recommend injections to correct a B12 deficiency, considerable evidence indicates that, in large enough doses, sublingual (under-the-tongue) tablets or skin patches of B12 may work as well as injections for people with absorption problems, even for those with pernicious anemia.

The latter is something I make use of — I appear not to absorb much B12 from food, but the little I absorb of  ”a lot” is enough.  I also like that supplements are over-the-counter and I can take them daily.  Shots would be prescription and often weekly or monthly.  :)

“Light bladder leakage” and Hourglass Pads

Apparently Poise is thinking “light bladder leakage” sounds nicer than “incontinence”, and that framing its products as “feminine” will do better than as “geriatric”.   They are probably correct.

I do know I ran into one problem discussed in the industry. The New York Times quotes market researcher Rob Walker:

“[T]he biggest challenge for the industry is that vast numbers of sufferers are too embarrassed to raise the problem of incontinence with their health practitioner, or worse, even buy available products at a retail outlet.”

Or, in my case, to realize they existed. I initially assumed that if you leaked at all, you needed full-on diapers, which of course would not be available in my size.  It did not occur to me to even look for pads designed for stress incontinence.   I ran across Poise pads by accident one day when the local Rite Aid was reorganizing stock.

To address that, Mr. Walker added, “the commercial opportunity here is for the big international hygiene players to humanize (or even Viagra-ize) incontinence, making products as accessible, consumer-friendly and embarrassment-free as, for example, women’s sanitary protection.”

I first wrote about stress incontinence a few years ago in quite a bit of detail.   I haven’t been finding the “wings”, so I’ve been wearing “moderate” pads.  I will probably try the new “hourglass” shape.  FYI, Poise also has samples and coupons available at their site.

Medical Insurance Helps People Feel Better!?

On the one hand, it’s good to have actual research backing this up.  On the other hand, it’s insane that this didn’t exist before.  From the NY Times:

When poor people are given medical insurance, they not only find regular doctors and see doctors more often but they also feel better, are less depressed and are better able to maintain financial stability, according to a new, large-scale study that provides the first rigorously controlled assessment of the impact of Medicaid.

In other news, water is wet?  Not quite.

The study became possible because of an unusual situation in Oregon. In 2008, the state wanted to expand its Medicaid program to include more uninsured people but could afford to add only 10,000 to its rolls. Yet nearly 90,000 applied. Oregon decided to select the 10,000 by lottery.

Economists were electrified. Here was their chance to compare those who got insurance with those who were randomly assigned to go without it. No one had ever done anything like that before, in part because it would be considered unethical to devise a study that would explicitly deny some people coverage while giving it to others.

But this situation was perfect for assessing the impact of Medicaid, said Katherine Baicker, professor of health economics at the Harvard School of Public Health. Dr. Baicker and Amy Finkelstein, professor of economics at M.I.T., are the principal investigators for the study.

In good news, Oregon did end up finding the money to insure the other 80,000 people within 2 years.

QOTD: Fitness and fatness

From Reuters, on a study in patients with coronary artery disease that looked at fitness levels and BMI:

[Heart specialist and study leader Dr. Francisco] Lopes-Jimenez said, the lesson for patients is clear: try to improve your physical fitness. “It is much easier to become fit than it is to become slim,” he said. “Anybody who has gone into an exercise program would agree with that.”

While Lopes-Jimenez seems to presume his patients want to exercise (or otherwise take action to improve their health) it is radical to see a heart specialist stating that a person can improve their fitness without being slim.  Or that exercise doesn’t automagically cause slimness.  Or that it can be easier to become fitter than to become thinner — which has certainly been true in my case.

Heart Risk – BMI Not Useful

Or as Reuters put it: “[T]he best predictors of future heart risk are measures of blood pressure, cholesterol and history of diabetes.”

According to a paper in The Lancet:

BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not importantly improve cardiovascular disease risk prediction in people in developed countries when additional information is available for systolic blood pressure, history of diabetes, and lipids.

Researchers looked at height, weight, hip, waist, blood pressure, cholesterol and other data from more than 220,000 adults — who had no previous history of heart disease – and tracked them over time to see who had heart attacks.   Once they controlled for age, sex, smoking, baseline systolic blood pressure, history of diabetes, and total and HDL cholesterol, they found that BMI or waist-to-hip ratio didn’t add much information.

The headlines and articles focus on how this refutes the notion that “pear-shaped” fat people are at less risk of heart disease than “apple-shaped”.    I wonder if this implies that thin people who have high cholesterol, high blood pressure or diabetes (all of which can be affected by family history) might have their risk factors ignored because they’re thin.

Plus-Sized Athletes (with heads)

There’s a story making the rounds on “plus-sized athletes” reacting to the US “Let’s Move” campaign.

The fitness community has embraced the first lady’s ‘Let’s Move’ program, but many health experts balk at equating improving health with lowering weight.

Fat aerobics instructor Sandy Shaffer and physical trainer GeMar Neloms are interviewed.  Dr Kenneth Cooper, a longtime supporter of measuring fitness independent of body weight, comments.  All suggest that body size is a poor measure of health. One bit of wording I found curious was “a robust body need not mean poor health”. Robust is an adjective meaning:

1. (of a person, animal, or plant) Strong and healthy; vigorous.
2. (of an object) Sturdy in construction.

What does it say that “strong and healthy; vigorous” or even “sturdy” is assumed to mean poor health?

The Age in Australia went a step further and paired the story with a photo of plus-size women (with heads) doing aerobics.

Image from The Age

Sex or Thinness?

Obviously it takes a certain kind of mind to ask 2,400 women if they would sacrifice a full year of sex to be skinny.  In this case, the mind works at  Fitness magazine.

51% of the 2,400 women said “Yes”.

Now, I’m sure that some of those women interpreted “sex” to mean “sex with a partner”, are single, and figure they aren’t getting any anyway, so why not?  However, I submit that if you’re having orgasms then some kind of sex is happening … and I don’t see a reason why orgasms require the presence of another person. (Yes, the right partner absolutely adds a lot to the experience. The wrong one —and I’ve had a few — reminds me of why I was thrilled to discover Babeland (NSFW).)

Even so, I’m sure there were some women for whom this question caused some soul-searching.   Sexual pleasure, with its attendant health and emotional benefits?  Or societal approval, making life easier in hundreds of ways (even if it doesn’t measure up to your dreams)?

But I’m wondering, really, what this question being asked and it getting 51% says about our society.

Of course, other thoughts are welcome in the comments.

Ban Fat Marriage?

Yes, I know that Dan Savage’s screed on banning fat marriage is trying to illustrate the point that gay marriage bans are ludicrous.   Fellow Stranger writer Lindy West has already responded with a solid “why fat hate doesn’t work” aimed at those who don’t want to get it, and I don’t disagree with it.

However.

I do think Dan seriously missed the boat bringing up the silly “fat is contagious” thing.  It totally weakens his argument!  No, the better argument is this:

1. Fat is frequently inherited, even among children who are raised by thin adoptive parents or twins raised separately.
2. As anti-gay legislatures are constantly reminding us, only married heterosexual people have children.
3. Therefore, to prevent fat people from passing on their fatness to children, we should not allow fat people to marry.

See?  Much more logical!

See also:  Parents-to-be shouldn’t diet.

PS: Brian at Red No 3 has a good post on this as well.

Culture Affects Science Reporting

The bare facts in this piece on breakfast size are simple:

German researchers studied the food intake of 280 obese adults and 100 of normal weight. The subjects kept records of everything they ate over two weeks, and were carefully instructed about the importance of writing down what they ate as soon as they ate it.

For both groups, a large breakfast simply added to the number of daily calories they consumed. Whether they ate a large breakfast, a small one or none at all, their nonbreakfast calorie intake remained the same.

What struck me as interesting was that the same results were seen in both groups.  Both the fat and thin groups contained people that ate breakfasts of varying sizes, or not at all.  Both found their nonbreakfast calorie intake remained the same.   (It’s almost like fats are people!)  But the idea that breakfast is “added calories” is seen as the primary news, because it contradicts the “eat like a king at breakfast and a pauper at dinner” advice.

Personally?  Maybe it’s strange, but I try to match my breakfast to how hungry I am.  I also decide whether my breakfast was good or not based on things like mood and energy levels.  I know, it’s crazy.

Fat Discrimination Research

Rebecca Puhl, director of research and weight stigma initiatives at the Rudd Center, is quoted on studying weight bias in The Toronto Star:

[It's] one of the easiest [bias] fields to research as the prejudices are so widespread and socially acceptable that people easily admit to them.

This is a form of bias that is so prevalent, society accepts it unchallenged [...] It’s a social justice issue and a public health problem …

A few years ago the ABC News piece ‘Weight-ism’ More Widespread than Racism discussed both Puhl’s research on fat bias and that it’s not easy to just “stop being fat”:

“We place a lot of emphasis on personal responsibility for body weight,” [Puhl] said. [...] “But that does not reflect the current state of science. We know from hundreds of randomized clinically controlled trials that it’s very difficult to sustain weight loss over time with our existing treatment methods.”

“That has compelled a number of expert panels, like the National Institutes of Health, to conclude that we really can’t expect you to lose more than 10 percent of your body weight and be able to keep that off.”

For a 300-pound man, she notes, that’s a mere 30 pounds, and he’s still overweight, unless he’s nearly seven feet tall.

For much more detail on the state of fat bias research, check out the The Stigma of Obesity: A Review and Update, co-authored by Puhl. It discusses weight bias research in employment, healthcare settings, education, the media, and the consequences of weight stigma.   It discusses both perceived bias in surveys of fat people and experimental research.

Typically, experimental studies ask participants to evaluate a fictional applicant’s qualifications for a job, where his or her weight has been manipulated (through written vignettes, videos, photographs or computer morphing). Roehling and colleagues recently conducted a meta-analysis of 32 experimental studies investigating weight discrimination in employment settings. [...] Across studies, it was demonstrated that overweight job applicants and employees were evaluated more negatively and had more negative employment outcomes compared to nonoverweight applicants and employees.

The Fatosphere is well aware of fat bias in healthcare.  We know it can be hard to dress professionally as a fat person, especially in extended sizes.   But I’m not sure we realize how much we lose in other ways, and we’re so used to it that it can be hard to see it.  (Are fish conscious of water?)

More information: The Canadian Obesity Network and The Rudd Center provide good information and are working against fat bias, but I can’t help feeling that they’re handicapped by their own pro-weight-loss attitudes.   Naafa’s FAQ is all about weight bias.

MLK Day

I was born in 1966, in a state which entered the Union in 1889, and thus had always been a “free” state; some of the founders came here because they couldn’t legally own land in other states.  Yet state history included two of the most prominent counties being named in honor of the pro-slavery President Pierce and Vice President King.

I learned about the Reverend Martin Luther King, Jr and the Civil Rights movement in school, along with the internment of Japanese-Americans during WWII.   The internment had a lot more “hometown punch” because I attended school with kids whose parents and grandparents had  been interned, many of them losing everything in the process.   Toss in that my town was overwhelmingly white and the Asian-Americans outnumbered African-Americans by a large margin, and it was easy to view Jim Crow as from another world. (It wasn’t.)

As an adult I discovered A Knock at Midnight, which is a collection of sermons preached by the Reverend King. In that book I discovered a persuasive and powerful voice, and the kind of preacher I wish I had known.  Much of the memories of him today focus on his social justice work, but he was a Christian minister first, and his leadership came from that tradition.  A Knock at Midnight is also online here. If you would like to discover the Reverend King in a different way, this might appeal to you.

Oh – in 2005 Washington’s King County was “renamed” in honor of Martin Luther King, Jr.

Dawn French, “Happy In Her Skin”

In a recent interview tied to her new novel (not yet out in the US), Dawn French mused about how most articles about her mention her weight.

“Sometimes it’s done in a mean way, but I do find it strange because it’s not as though it’s a new thing, I’ve been this size for a long time, you would think people might not feel the need to talk about it, that it would be old news by now,” she says.

Her tone is more incredulous than irritated. [...]  Her weight is a source of fascination, she believes, because some people find it impossible to believe that as a larger woman she can be confident and comfortable in her skin. “There are people who think I must be in some really, really deep denial . . . so much so that I’ve sometimes had to stop and ask myself whether they are right and is it really a front, and then I realise that no, actually I really am happy and it’s their problem, not mine.”

More from Ms French here.

Way Outside the Bell Curve

Per the US CDC’s Anthropometric Reference Data (PDF) 5% of adult, non-pregnant women in the US weigh less than 111lbs, and 95% weigh less than 250lbs.   90% of US women weigh between 111 and 250lbs.

This is why I consider myself a statistical outlier, weight-wise.  As I’ve noted before, in some ways I’m a freak of nature — most humans simply can’t weigh as much as I do.   And most adults can’t weigh less than 111lbs.

This article from the German newspaper Der Spiegel profiles a woman who is also far outside the average, but on the other side.   Lizzie Velasquez weighs 62lbs and was born with neonatal progeroid syndrome (NPS); she has zero body fat.   Not low body fat – zero.  Most children born with the NPS die within the first year or suffer mental retardation.  In Lizzie Velasquez’ case, her brain developed normally.  The lack of fat reserves affects her appearance, but also her stamina — she gets hungry much more frequently than other people, and shows starvation symptoms (listlessness, immune resistance) if she doesn’t eat when hunger pangs hit.  Ms Velasquez reportedly averages 8,000 calories throughout the day.

I don’t envy Ms Velasquez her NPS.  Nor do I think it’s something to joke about, any more than anorexia.   But I am glad that she seems comfortable with herself, not pining for a cure.

Oh, CNN

This blog post got my hopes up with “Dieting gets you nowhere” and then dashed it with the “but it works for kids!” ending.  No, people, turning off the TV or passing up a Happy Meal will not automagically turn a fat kid into a slender one.  Sorry.

Things to Read: Scandals That Aren’t

This bit on Fast Food Restaurants Not Single-Handedly Ending Child Obesity is hysterical.   Yes, some fast food restaurants pledged to make “healthier” choices available, and yes, they make some “healthier” choices available.  Is it really a surprise that you might have to, gasp, order the milk and apple slices instead of pop and fries?

Hey, here’s another one: Instead of whining about TV ads, why not minimize watching them?  Unlike the world of 1984, televisions can be turned off; commercials can be muted, programs can be recorded and commercials fast-forwarded.   Teach the kids to help you make dinner or with the dishes — that’s teaching the kid an important life skill AND spending quality time together.   Or play a board game or read with the kids or watch a DVD or mute/fast-forward through commercials or, heck, let the kid watch the commercials and tell them “No” if that’s what you’ve decided.  I realize it’s radical to pretend you’re the one raising your own kid, but I won’t turn you in, I promise.

(Not that I think that turning off the TV or passing up a Happy Meal will automagically turn a fat kid into a slender one.  But it’s a lot easier to start learning to cook or do the dishes or handle “No” or amuse oneself without TV before you’re 25 or 30, so why not do your child a favor and teach them?)

Also in the “this is a surprise?” is  that the US Dept of Agriculture is promoting American-made cheese.  The Dept of Agriculture was founded with the aim of promoting US agriculture and has maintained multiple roles through its history — it regulates and markets US food, it promotes good nutrition and runs the Forestry Service.  It isn’t, in fact it really can’t, be a monolith.  Maybe I worked too long in a large (50,000+ employees) company, but it’s reasonable that people in the group that works to market the US dairy industry is not necessarily going to be worried about limiting dairy intake.  It’s also reasonable that the people who are worrying about ideal nutrition are in a different group from the ones marketing various types of food.   Yes, they have a point that the USDA is talking out of both sides of its mouth with “eat more cheese” and “eat less saturated fat, including less cheese” as messages, but — hello — the USDA didn’t stop subsidizing tobacco production until 2005 (and is still paying tobacco farmers to help them transition to a free market).   There is big money encouraging Congress to help market US agriculture, and don’t you forget it.

Now, if the NYT is looking for a scandal, the fact that the Dairy Marketing group continued their “dairy helps you lose weight” campaign despite the research they funded disproving it is a better target, I’d think.  Especially since the Federal Trade Commission got involved.  Or maybe it’s just that nobody really expects diet ads to have any basis in fact?