The House of Lords to save us from obesity? Maybe not…
Today’s insight into popular exercise literature and culture comes courtesy of that bastion of health, wellbeing, and physical par excellence that is the House of Lords. Tory Peer Lord Macoll of Dulwich was able to single-handedly provide us with a solution for the growing obesity in our country. His insight? Simply for us all to eat less. There you have it, although heaven knows how they will fill the remaining years of a dietetic degree now that has been revealed. Not content with enlightening us all as to the real reason so many people are overweight, he went on to say that politicians are in fact misleading you all by stressing that exercise is the solution.
I am sure Lord Macoll means well, indeed he has served a long and very distinguished career so this is in no way an ad hominem pop at him. I do though take a few issues with this rather facile and trite mantra, which is perhaps a little disappointing coming from someone who must understand the complex issues behind the challenge of tackling obesity. We must get to grips with why people get overweight rather than just how if we are to find a solution to this problem. Simply telling people to eat less will not work and in this short post I’ll try to explain why.
Let’s take smoking as an example, which has been absolutely and positively linked to causing lung cancer. The International Agency for Research on Cancer also states it can cause cancers of the pancreas, liver, kidney, bladder, in fact stick a pin in an anatomy chart and there is a good chance smoking can be linked to developing cancer there. If you smoke you’re also twice as likely to have a heart attack.
Cigarettes are widely recognised as being bad for your health. They have for years carried many explicit and evocative health warnings on their packaging to that effect and have been the target of multiple media campaigns to target both adult and child smokers. Tobacco companies have been banned from advertising or sponsoring sports and been liable to increasingly higher rates of taxation. Even social media is being used to try and combat smoking as a socially undesirable risk to health.
Yet, despite all this, around 1 in 5 adults in the UK smoke, which is only marginally less than the amount of adults who are obese (gender differences for smoking are now virtually non-existent while 2% more women are obese according to BMI). Despite all the evidence, death, illness, and proven risks that smoking carries, the advice to ‘smoke less’ or ‘stop smoking’ still goes unheeded by the same amount of people who are currently obese.
Perhaps the futility of these strategies combined with a fear of a ‘nanny state’ is why we have so far not seen levies on junk food or health warnings on crisp packets? It may help explain in part why the worlds biggest* McDonald’s will be opening on the site of the London 2012 Olympic games as well? Commercial interests of major food retailers will make legislating against less healthy food very difficult, a topic often written about by the excellent Felicity Lawrence.
* Overtaking the McDonalds in Orlando, Florida. It seems we have finally super-sized America.
The fact is that many overweight and obese people are very aware that they eat too much, but the reasons why they do this are far more complicated and in truth are still not really clear. They are also aware that the food they eat is not conducive to reducing bodyweight. It is hardly news that pizza, chips, and sugary drinks make you fat after all. Eloquent writers such as Gary Taubes will argue that calories are almost an irrelevance causally and that the over-consumption of fattening carbohydrates is the issue, while the dieticians will continue to promulgate the calories in/calories out theory, which they cling to despite it clearly being far too simplistic to explain why obesity is rising or how to fix it. It is likely that this debate will continue to clog up numerous blogs and websites for many moons to come. What is clear is that simply telling people to eat less is about as effective for treating obesity as telling an alcoholic they should drink less.
I don’t have a lot of room to comment on the exercise aspect, which is where Taubes gets it wrong in my mind and where Macoll follows suit, dismissing exercise as an almost pointless endeavour despite astonishing amounts of data to the contrary. It is though both proven and pertinent to say that those who combine exercise with a weight loss nutritional strategy achieve the following:
- Greater success in maintaining weight lost*
- Better retention of muscle mass and increased amounts of fat lost
- Improvements in many markers of disease risk whether or not any weight was actually lost
These reasons alone are powerful arguments for the inclusion of some form of exercise as part of any intervention aimed at reducing obesity.
So, there you have it. Next time you are at a dinner party debating the complex reasons behind the London riots and how they could have been prevented, you will be able to succinctly end any debate with the advice that people should simply riot less. Alternatively you could try advising an alcoholic that they should drink less or a gambler that they should bet less. Good luck with that approach.
Of course, the debate in the House of Lords went on to point out that we also eat too much saturated fat (another nutritional pariah still vilified despite the considerable weight of evidence against the flimsy data presented many decades previous), too much salt (despite the Cochrane Collaborations conclusions that reducing salt intake wasn’t worth the effort), and too much sugar (the elephant in the room perhaps?). You may well also contend that it really isn’t the role of politicians to try and tell us how to eat. Indeed many of them could take a look at their own health before advising others. Instead the advice on nutrition and health should come from an independent body free from lobbying by food suppliers or political interests, and garnered from a group of people who have an understanding of the complexity of the issue and the evidence around it.
* Many fitness and nutrition writers, both web and print, continue to declare exercise (in particular the use of aerobic or ‘cardio’ work) redundant for obesity, choosing to cherry pick evidence that supports their product, certification, or personal training beliefs. This blatant selection bias is often delivered with such derision and vehemence that few would dare to dispute it lest they are labelled ‘haters’ or some other perjorative term. Ad hominem attacks are the typical go-to response of many of those who typify this approach.
The evidence however tells a different and entirely more complex story. As with nutrition, the responses to exercise are individually widely variable. Many authors blithely disregard the many health benefits, which seem consistent irrespective of actual weight loss, and look at only mean results for weight loss where the individual variations are lost in data. Despite this the Cochrane Collaboration certainly support the inclusion of exercise as part of any weight loss/health improvement strategy and is an example of why I recommend you look to the evidence along with the anecdote.
http://www2.cochrane.org/reviews/en/ab003817.html
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Phil Hawksworth
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Graeme
