In Merry Old England

brighton-bus

It’s hard to ignore the fact that the United Kingdom has been something of a hot spot in the controversy over the taxing of sugar products. For purposes of this post, the U.K. comprises Great Britain, Northern Ireland, and Scotland. Wales is also part of the Queen’s realm, but will be covered separately.

As part of a five-year effort, the city of Wolverhampton has put several measures into operation, with others in planning stages. The approach concentrates on increased fitness opportunities, the provision of good information, and the regulating of fast-food menus.

A program called Sugar Smart City has strongly influenced policy in Brighton and Hove (which, despite its conjoined name, is a single city). Its childhood obesity record was pretty good already, but they had been seeing 300 kids hospitalized for tooth extraction every year. The city authorities got together with the widely-known chef and tireless advocate of healthful eating, Jamie Oliver, to promote the idea of a voluntary sugar tax.

Just over a year ago, Brighton and Hove became the first British city to institute the voluntary sugar tax, which apparently involves asking businesses to charge extra for fizzy drinks, but not sending the law after them if they don’t. Any revenue collected goes to charity. The next step would be the abolition of sugary junk food in hospital vending machines.

For The Guardian, Sarah Johnson quoted public health director Dr. Tom Scanlan:

It’s ridiculous if you’re a diabetic, you’re sitting there in the waiting room and there’s a vending machine along the corridor offering you what got you in the problem in the first place.

Another morbidly obese boy

Kardel Wilson became a media sensation as one in a seemingly never-ending series of notoriously obese children. At six years old, he weighed around 110 pounds and was about twice the size a boy his age should be, a condition described by Rebecca Hardy as “frighteningly obese.”

She goes on to say:

In fact, plug his height (3ft 10in) and weight into the NHS’s body mass index (BMI) calculator and Kardel is in the 99th percentile, meaning if you stick him in a room of 100 boys of his age, he’ll be the fattest.

Two years before, a marble slab fell on the little boy’s foot and broke three bones. At first unable to walk, and then unwilling to, he started to get fat, although his mother Sam didn’t notice anything. She told the reporter:

He had a plaster cast and wouldn’t walk. He said it hurt him all the time. So he sat with his colouring books or watching TV and I’d give him sweets, candy floss, popcorn and stuff. He looked so forlorn you wanted to cheer him up.

She overlooked his increasing girth until the school sent a letter home. Sam refused the offer of free healthy parenting classes and told Hardy:

I didn’t go because I do know what’s healthy, what isn’t and what portion sizes to give. I know tinned stuff has a lot of salt and sugar in it.

For a documentary, Sam allowed the reporter to examine the contents of her refrigerator and kitchen cabinets where, Hardy observed, snacks and empty calories abounded, but not so much as a floret of broccoli could be found.

Your responses and feedback are welcome!

Source: “Sugar tax, fat fines and gold coins: new ways cities are tackling obesity,” The Guardian.com, 10/22/15
Source: “A boy aged six weighs EIGHT STONE and his mum says she can’t stop him eating,”
DailyMail.co.uk, 11/02/15
Photo credit: Les Chatfield (Elsie esq.) via Visualhunt/CC BY

Happy Thanksgiving!

Childhood Obesity News would like to wish you a safe and joyful holiday.

We will return tomorrow with a regular post.

Image source: pixelsaway/123RF Stock Photo

All Hail the Lord of Misrule

dragon-street-performance

In many ancient societies, winter was the time to abandon all restrictions, with the excuse or justification of celebrating various holidays like the feast of Saturnalia. A Lord of Misrule would be chosen to preside over a period of time when slaves would act like masters and even take over official government positions. Meanwhile, the rich and powerful had to play the roles of slaves. Orders issued by the Lord of Misrule had to be carried out, no matter how nutty, and regardless of whose dignity was wounded.

There was also a New Year feast day, where children used to go from house to house and give the owner a piece of fruit wrapped in silver foil, receiving a gift in return. This somehow transmogrified into Halloween’s trick-or-treat custom. In other times and places, vagrants and hooligans would group up and surround respectable houses, making hellish noise until the inhabitants tossed them a satisfactory amount of loose change and valuables. In later, more civilized times, this seems to have morphed into the custom of singing Christmas carols.

In various societies, the period of misrule lasted as long as a month, and one thing that particularly disturbed some upright citizens was the tendency of manly men to dress up in women’s clothes and speak in falsetto voices. Later, in England during the Tudor era, the season of craziness might last as long as three months, during which the Lord of Misrule arranged and directed all kinds of entertainments, processions, masked balls, stage plays, and banquets.

Today

Here is the point. Human history contains solid precedent for choosing a stretch of time in the winter to toss propriety aside. This tendency seems almost to be imprinted on our DNA, and certainly permeates the social environment. From now until after New Year, it is fully authorized and officially sanctioned binge time, and rather than one Lord of Misrule, we have thousands.

If a person decides to quit eating sensibly, validation is out there. In a single day you can find 20 people who say things like, “What the heck, it’s the holidays,” and “Don’t be so hard on yourself. Live a little!”

Even if people in real life don’t sent that message, advertising certainly does. Merchants want us to feel obligated to throw caution to the winds, spend every cent we own, go into debt for more, eat everything that’s put in front of us, and come back for second helpings.

For many Americans, there are multiple and overlapping social requirements. You have a certain kind of good time with the family, and another sort of celebration with your friends, and yet another with the work crew and another with the church group, and so on. But they all involve either food or drink or both. The numbers on the calorie counter spin wildly, as the device sends up a shower of sparks and a wisp of smoke.

Holiday madness

Psychologically, to stay on a sane path can be brutally difficult. As a host, you feel compelled to buy and serve items you never touch the rest of the year, that you know are not good for people. But (especially if cultural heritage is involved) expectations need to be met, at the risk of causing interpersonal ruptures that could take until next holiday season to heal.

As a guest, you must partake fully or risk giving offense. On a deep subconscious level, people need to prove that they have a lot, and that they are generous with what they have. To validate the abundance and generosity, you have to eat eat eat, or figure out a really smooth exit line.

No matter how well prepared we think we are, some awkward situation always waits to pounce. A successful person who goes back to the old home town might be the only individual in the room under 200 pounds. Deep inside, most humans harbor that little bit of schadenfreude, the resentment that wants to see others fail.

That afflicted person will generously feed you a week’s worth of nutrients at one sitting, as punishment for leaving the old neighborhood and getting skinny. The scenarios vary, but everyone faces challenges.

Childhood Obesity News recommends “Fitting Into the Winter Food Festivals,” which discusses the work of the very interesting Dr. Billi Gordon. “The Day After Thanksgiving” offers a few suggestions on how to cope with the inevitable Diner’s Remorse, and “Clean Up After Thanksgiving” is more of the same. Happy Holidays!

Your responses and feedback are welcome!

Photo credit: mike1727 via Visualhunt/CC BY

Some Morbidly Obese Children

peace-love-and-music-sign

Two years ago a very sad story came out of Australia, concerning the investigation of the death of a hospitalized child four years earlier. The 10-year-old boy (not identified by name) weighed over 70 kg., or nearly 155 pounds. He suffered from sleep apnea, and cardio-respiratory arrest led to fatal brain injury. The narrative is not totally clear, but apparently the youngster was found unconscious, and stopped breathing on the way to the hospital, where he was put on life support and died 12 days later.

When he was hospitalized, the boy had missed 103 days of the current school year, and 101 days of the previous school year. At age 7 he had weighed 110 pounds. Officials who reviewed the case came away feeling that not enough had been done to help. Recommendations were made for the establishment of a “dedicated childhood weight management and child protection units” at John Hunter Hospital, which does not seem to have happened so far.

A news story says:

Deputy state coroner Elaine Truscott […] outlined the litany of failures that led to the death including the parents’ failure to take the child to doctors’ appointments and a breakdown in communication between health officials and the Department of Family and Community Services.

Earlier this year, the United Kingdom’s National Child Measurement Programme found that the heftiest child in its jurisdiction weighed more than 220 pounds, with a BMI of 41.2. In West London alone, 19 children were found to be at risk of morbid obesity.

In all of England, 475 6th-graders were identified as having a BMI of 35 or higher. Kim Roberts, of the anti-obesity charity known as HENRY, expressed concern for the national budget and told reporters:

It is vital that programmes like HENRY that are proven to successfully help families live healthier lifestyles don’t fall victim to local government spending cuts or we will be storing up a ticking time-bomb for the NHS to deal with and pick up the bill once these children have become adults and develop health problems commonly associated with obesity such as diabetes, heart disease and cancer.

Benjamin Judd describes how a 1935 British newsreel…

[…] shows that healthy eating, diets and food awareness has been an issue long before things like Pokemon and Happy Meals were invented and enough of a cause celebre to be the source of sensationalist news.

Leslie Bowles, the heaviest baby in the world, was unable to walk at age 3 because his legs could not hold up the rest of his body. Yet he was said to be in “perfect health,” according to some unspecified standard. His segment was called “A Ten Stone Baby,” which translates to 140 pounds on this side of the Atlantic ocean.

It is not the child’s size that is so disturbing, says Judd, but…

It’s how quickly the narrator’s tone becomes mocking, and even cruel, with Bowles the subject of jokes and innuendos regarding his size. One particularly grim moment towards the end when what is presumably a doctor makes Bowles jump for a chocolate bar and pats him on the head like a pet.

At age 42 Bowles died at his workplace after an accident involving a crane. If he was still obese, this comes as no surprise, because aside from possible difficulty in moving quickly, he might have been afflicted by hearing loss.

Another “World’s Biggest Boy” also disappeared from the news after brief notoriety. One very large teenager, the singer Justin Williamson, seems to be doing well. An October 19 “Saving Justin” Facebook page update written by his mom, Julie Crawford Williamson, thanks a great number of people, and says:

Justin was 580 lbs the day of surgery and today one year later, Justin weighs 384 lbs and is a healthy, happy college student majoring in Music performance.

Your responses and feedback are welcome!

Source: “Coroner calls for childhood weight management after obese boy’s death,” TheHerald.com, 09/26/14
Source: “Morbidly obese at the age of 11: Childhood obesity in west London,” GetWestLondon.co.uk, 03/09/16
Source: “Vintage newsreel shows childhood obesity not only a modern condition,” ninemsn.com.au, 04/08/16
Source: “Saving Justin,” Facebook.com, 10/19/16
Image source: “Saving Justin,” Facebook

A Few Things About Youth and Co-Morbidities

illustration-boys-reading-in-bed

We have been looking at the two different time frames connected with childhood obesity. One is “some day” and the other is “now.” Growing up obese can have all kinds of consequences in later life, including less of that life as measured in years. However, consequences don’t always wait for later.

For instance, JAMA Pediatrics published a report titled “Influence of Obesity on Clinical Outcomes in Hospitalized Children.” This was a meta-study, a survey of 28 other studies of humans age 2-18 years of age, who were hospitalized for various urgent reasons. The researchers, led by Lori J. Bechard (MEd, RD, LDN) were looking for three things: “all-cause mortality, incidence of infections, and length of hospital stay.” Of the studies that mentioned length of stay, almost half showed that obese kids were hospitalized longer.

The team found a meaningful relationship between obesity and infections, and more:

Studies of critically ill, oncologic or stem cell transplant, and solid organ transplant patients showed a relationship between obesity and mortality.

Hospitals are known to be full of infectious agents. For this and other reasons, obese patients do not fare well in the average hospital. In this way they are like newborns. On a related note, births by Caesarean section are losing favor in the eyes of many practitioners, because the baby doesn’t pick up essential microbes from the mother, and instead becomes colonized by the microbiota of hospital workers, other patients, and random strangers.

Maybe this is why siblings can be so different, and not even seem like they come from the same family. It could be that their lives were shaped by, first, deprivation of their rightful share of maternal bacteria; and second, by taking on board a mixture of bacterial species that would not insure optimal health.

The gut microbiome is increasingly recognized as an organ in the human body. A baby literally builds for itself this important, major organ, out of whatever types of gut microbes happen to be available, by whatever means. Even if they are the same bugs you would have gotten from Mom, you’re not getting Mom’s immunities.

Denial

Recently we looked at a study of hearing loss, as related to obesity. At the time of that paper’s publication, it was already known by scientists in other fields that 80% of the adolescents who have hearing loss don’t even realize it. When tested according to traditional protocols, they are surprised to learn that their hearing is not normal.

In many ways and places, lack of awareness is rampant. A 2013 survey asked Americans what they knew about major health risks of obesity, and learned that most people only know about heart disease and diabetes, but are clueless about other co-morbidities such as cancer, sleep apnea, and arthritis.

Last year, researchers in London questioned 5,000 kids between ages 13 and 15. Among overweight and obese adolescents, around 40% of them figured they were at “about the right weight.” How to cure this delusion without causing even more harm is the eternal question.

Your responses and feedback are welcome!

Source: “Influence of Obesity on Clinical Outcomes in Hospitalized Children,” JAMANetwork.com, May 2013
Source: “Obesity survey suggests many Americans don’t know fat can cause cancer, infertility,” CBSNews.com, 01/07/13
Source: “Overweight teenagers in denial about obesity at risk of up to 10 different types of cancer,” Telegraph.co.uk, 07/09/15
Photo credit: Internet Archive Book Images via Visualhunt/No known copyright restrictions

Youth, Obesity, and the Senses

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Here is a frightening headline: “Childhood obesity increases likelihood of a cranial disorder that may cause blindness.” Kaiser-Permanente researchers looked at the medical histories of 900,000 children ages 2-19 and unearthed 78 cases of a condition called idiopathic intracranial hypertension, or IIH. It happens inside the skull, and when it happens to children the word “pediatric” is attached to the front of the phrase.

The idiopathic part of course refers to the fact that the cause is unknown, but it creates misery, in the form of headaches, blurred vision, nausea, and abnormal eye movements. In maybe one out of 10 cases, it can lead to blindness. The risk of getting IIH is, for an extremely obese child, multiplied by 16 times, compared to a normal weight child.

Still, it is a rare disease with an even more rare dreadful end result, but the pertinent information is:

The condition occurred most frequently in overweight or obese, non-Hispanic white teenage girls — 85 percent of the children with IIH were girls 11-19, nearly half were non-Hispanic white, and 73 percent were overweight or obese.

Sight is not the only sense that can be adversely affected. A 2013 study, the first of its kind, found that obese teens experience sensorineural hearing loss all up and down the frequency spectrum, and also tend to suffer from a unilateral loss of the low frequencies. The hairs of the inner ear sustain damage, possibly because of the inflammation associated with obesity.

Not long afterward, the Harvard Nurses’ Health Study determined that one out of six subjects experienced hearing loss during the 20-year study period. Brenda Goodman wrote:

Those with a higher body-mass index (BMI) or larger waist circumference faced a higher risk for hearing problems compared to normal-weight women…

Women who were obese, with BMIs between 30 and 39, were 17 percent to 22 percent more likely to report hearing loss than women whose BMIs were less than 25.Women who fell into the category of extreme obesity (BMIs over 40) had the highest risk for hearing problems — about 25 percent higher than normal-weight women.

The study author, Dr. Sharon Curhan, suggested that obesity, especially paired with high blood pressure, can obstruct blood flow. In the “metabolically active” ear, perhaps the cochlea, when damaged, is not able to heal because of that diminished blood flow.

And let’s not leave out the sense of smell. Florida State University scientists fed a high-fat diet to a bunch of mice, and found “major structural and functional changes in the olfactory system.” The report says:

It was the first time researchers had been able to demonstrate a solid link between a bad diet and a loss of smell… Mice exposed to high-fat diets only had 50 percent of the neurons that could operate to encode odor signals.

Confusion arises from this, because four years before, a University of Portsmouth study of human subjects found that overweight people have a greatly enhanced sense of smell, at least where food is concerned. Dr. Lorenzo Stafford hypothesized that “this keener sense of smell might compel the individual to carry on eating, even when they are full.”

On the other hand, after describing the more obvious causes for olfactory malfunction, the American Rhinologic Society says:

The loss of smell can also present as a signal for other health problems including obesity, diabetes, hypertension, malnutrition, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and Korsakoff’s psychosis (a dementia caused by severe malnutrition or alcoholism).

The fact that obesity is mentioned first must be meaningful.

Your responses and feedback are welcome!

Source: “Childhood obesity increases likelihood of a cranial disorder that may cause blindness,” ScienceCodex.com, 05/24/16
Source: “Obesity is associated with sensorineural hearing loss in adolescents,” Wiley.com, 06/17/13
Source: “Obesity May Be Hard on Your Hearing, Study Says,” HealthDay.com, 12/10/13
Source: “New research links bad diet to loss of smell,” ScienceDaily.com, 07/21/14
Source: “Obesity’s Link to Sense of Smell,” BBC.com, 11/15/10
Source: “Disorders of Smell & Taste,” American-rhinologic.org, undated
Photo credit: John Snape via Visualhunt/CC BY-SA

Globesity, Co-Morbidities, and the Young

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One of the main characteristics of childhood obesity is its tendency to hang on, which underlines the importance of efforts to either stop it early, or prevent it from ever starting. Overweight and obese kids tend to become overweight and obese adults, with the associated risk of a shortened life expectancy. Age 70 is reckoned to be normal; anything before that is considered premature. The four major killers are coronary heart disease, stroke, respiratory disease, and cancer, all of which are multifactorial.

In the summer of this year, The Lancet published a meta-study that examined 189 studies from all over the world. Amazingly, they were able to find 3.9 million subjects who neither smoked nor suffered from a long-term illness at the beginning of their respective studies. Both heavy smoking and serious illness can cause weight loss, so those were unwanted variables.

Naturally, no study of this kind can be unerringly precise. A lot of those people probably started smoking later, or came down with a serious illness. A certain amount of self-reporting is involved. Science attempts to be rigorous, but those nearly 200 studies will not all have been constructed with the same parameters.

Sometimes it is difficult to make comparisons that line up acceptably. Also:

The authors note that one important limitation is that their only measure of obesity was BMI, which does not assess fat distribution in different parts of the body, muscle mass, or obesity-related metabolic factors such as blood sugar or cholesterol.

Despite all these caveats, it is apparent that, overall, obesity is very much associated with unnecessarily early death, and the effect is much more pronounced in men. As summed up by BBC.com:

Overweight and obesity now cause about one in seven of all premature deaths in Europe and one in five of all premature deaths in North America.

Even though exact numbers are difficult to pin down, the basic truth of this had been widely assumed, and the meta-study confirmed it. Fat can make you die too soon, but some day, off in the distance. We got that — and meanwhile, other research showed that fat can seriously mess you up and maybe even kill you, while you’re still young.

A UCLA study was titled “Childhood obesity linked to more immediate health problems than previously thought,” and immediate means now. This study encompassed data on more than 43,000 subjects, derived from the 2007 National Survey of Children’s Health, and was described as providing “the first comprehensive national profile of associations between weight status and a broad set of associated health conditions, or co-morbidities, that kids suffer from during childhood.”

ScienceDaily.com said:

While a great deal of research on childhood obesity has spotlighted the long-term health problems that emerge in adulthood, a new UCLA study focuses on the condition’s immediate consequences and shows that obese youngsters are at far greater risk than had been supposed.

The University’s message points out another important facet of the big picture — the ongoing need for two entirely different kinds of surveys:

The researchers add that while the strength of the current study lies in its large population base, future studies need to examine better longitudinal data to tease out causal relationships that cannot be inferred from a cross-sectional study.

Again, the elusive nature of precision in these matters is underlined by lead author Dr. Neal Halfon:

Obesity might be causing the co-morbidity, or perhaps the co-morbidity is causing obesity — or both might be caused by some other unmeasured third factor… An understanding of the association of obesity with other co-morbidities may provide important information about causal pathways to obesity and more effective ways to prevent it.

Your responses and feedback are welcome!

Source: “The Lancet: Obesity linked to premature death, with greatest effect in men,” EurekAlert.org, 07/13/16
Source: “Obesity ‘puts men at greater risk of early death’,” BBC.com, 07/14/16
Source: “Childhood Obesity Linked to More Immediate Health Problems Than Previously Thought,” ScienceDaily.com, 01/14/13
Image by Elliott Brown on Flickr

Instant Karma — Obesity and the Brain

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In discussing the co-morbidities that can accompany obesity and presage an early death, we often think far ahead. In the mind of a child or teenager, however, the long-term effects are inconsequential, because — who knows? They may not live that long, or by the time they are middle-aged, a cure might be discovered. But the side effects of obesity can be immediate, affecting young people right here, right now.

In 2012, the journal Cerebral Cortex published a report titled “The Negative Association of Childhood Obesity to Cognitive Control of Action Monitoring” which revealed that obesity may relate to a child’s decreased ability to think quickly or as well in some circumstances. Inhibition, working memory, and cognitive flexibility are recognized to be the core cognitive processes. Success math and reading definitely requires these higher-order cognitive processes.

This study focused on action monitoring, which is a person’s ability to recognize and correct a mistake, a necessary trait if a person is to carry out goal-oriented behaviors. Leaving school aside, the ability to respond to stimuli quickly can save many situations, up to and including life-threatening ones. The authors explain how…

[…] individuals must continuously monitor their correspondence between intended and executed actions, and correct response errors during subsequent environmental interaction for the maintenance and adaptation of successful performance.

This research built on previous studies indicating that childhood obesity might be inversely associated with cognitive control, defined as “the ability to orchestrate thought and action in accord with internal goals.” But other studies seemed to go the opposite way, so empirical evidence was scarce and inconclusive.

In 2014 researchers from several universities in the United Kingdom published what was said to be “the first comprehensive study to look into the association between obesity and academics in teens.” It found that obesity is negatively related to academic achievement, which is a formal way of saying that obese teenagers get worse grades.

For unknown reasons, the harmful effect appears to be stronger on girls. MedicalNewsToday.com says:

To conduct their study, the team assessed data from nearly 6,000 children who were part of the Avon Longitudinal Study of Parents and Children (ALSPAC). Overall, the results revealed that girls who were obese at age 11 had lower academic achievement at ages 11, 13 and 16 years, compared with those of a healthy weight.

As with any scientific study, the researchers considered other factors that might skew the results. But even after accounting for such variables as “socio-economic status, mental health, IQ and age of onset of the menstrual cycle,” the conclusion held.

Another report in the same year showed that childhood obesity correlates with learning disorders and academic underperformance, as well as attention-deficit and hyperactivity disorders. Is this merely coincidence, or could weight reduction and the healthier living that goes along with it actually alleviate those other problems?

Your responses and feedback are welcome!

Source: “The Negative Association of Childhood Obesity to Cognitive Control of Action Monitoring,” OxfordJournals.org, 11/11/12
Source: “Teen girls: obesity linked to lower academic performance,” MedicalNewsToday.com, 03/11/14
Source: “Rules of thumb: Three simple ideas for overcoming childhood obesity,” MedicalXpress.com, 05/01/14
Photo credit: wecometolearn via Visualhunt/CC BY

Tolerance, Obesity and Co-Morbidities

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Several international bodies combined their data and expertise to estimate the proportions of the obesity epidemic 15 years down the line. The “Background” and “Conclusion” sections of the report, published in September by the journal Pediatric Obesity, convey the gist:

Member states of the World Health Organization have adopted resolutions aiming to achieve “no increase on obesity levels” by 2025 (based on 2010 levels) for infants, adolescents and adults… The 2025 targets are unlikely to be met, and health service providers will need to plan for a significant increase in obesity-linked comorbidities.

The researchers were particularly interested to know what to expect in the way of co-morbidities, including hypertension, impaired glucose tolerance (which leads to metabolic syndrome), heart disease, type 2 diabetes, and fatty liver disease, as well as less threatening conditions that serve as precursors to co-morbidities. The report indicates that we should not be surprised if, by 2025, somewhere around 90 million of the world’s school-age children experience one or more of those problems.

Even five years ago, the increase in morbid obesity was noticed by pediatricians to a point that Dr. Pretlow called “alarming.” But why? He noted the tendency, in some quarters, to jump to a solution like bariatric surgery, and rhapsodize about what an acceptable safe effective treatment alternative it is, without ever examining the underlying reasons for the obesity.

Reasons for obesity

Probably the most frequent reason is addiction, an idea that has gained traction despite being hard to understand in some ways. Is it the food, or the overeating? Is it a substance addiction or a behavioral addiction? But like the “nature vs. nurture” debates that occupy sociologists, the precise roles played by the food itself and the individual’s psychology are difficult to pin down.

Undoubtedly, some foods taste better than others, and we have a very persuasive flavor receptor for “umami.” There is also no question that millions of dollars are poured into research to make foods irresistible. To the greatest possible extent, addictiveness is deliberately engineered.

On the other hand, an enormous amount of evidence points to the same kinds of emotional difficulties so often found in people who become addicted to substances. Links also exist with behavioral addictions like gambling, that have nothing to do with food. Tolerance is both a result and a cause of addictive behavior.

A large amount of anecdotal evidence suggests that individuals are different, and there may be a spectrum. Some people have a personal chemistry, quite possibly generated by the microbiome, that lends itself to cellular-level addiction. For others, the quality of the food is less important than other considerations, like availability and quantity.

Dr. Pretlow describes another kind of spectrum:

The observation that the children in this study struggled to lose weight proportional to their BMI percentile suggests that dependence on the pleasure of food may be on a continuum: overweight children may be only partially dependent (addicted); obese children may be fully dependent (addicted); and morbidly obese children may be in addictive tolerance mode. Thus, they eat larger amounts and higher pleasure-level foods to obtain the same degree of comfort.

Tolerance seems to be universally found in addiction, where escalation is the name of the game. On the most practical level, anything that can interrupt the seemingly inevitable march toward ever-increasing use of the addictor is a very useful intervention.

Your responses and feedback are welcome!

Source: “Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025,” Wiley.com, 09/29/16
Source: “Qualitative Internet Study,” tandfonline.com, 06/21/11
Image by @JackTayBarton

The CDC-Coke Scandal and Beyond

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Just when everybody was catching up on the less-than-optimal activities and connections of Dr. Michael Pratt, there was a new development. In June, while still employed by the Centers for Disease Control, he also began working for the University of San Diego’s School of Medicine. The Division of Global Health hired Dr. Pratt to advise on physical activity and non-communicable disease policy.

In other words, different boss, same gig. His job is to preach the gospel of “Energy Balance,” and convince the World Health Organization and anyone else who will listen that physical activity is the sovereign cure for the non-communicable disease of obesity. Consequently, according to this doctrine, corporations that manufacture, advertise, and sell sugar-sweetened drinks bear zero responsibility for the global obesity epidemic.

In that area, Dr. Pratt’s experience is extensive. According to the San Diego Union Tribune, he has co-authored several papers whose research was funded by the Coca-Cola Company. Journalist Morgan Cook mentions a dicey-looking recent study which found no relation between obesity and the substances that pre-adolescent children put into their bodies:

Physical activity, sleep, and time spent watching television were identified as more important predictors of obesity than whether the children ate mostly vegetables or diets dominated by processed food and soda.

And then, there is ILSI, the industry-funded (so-called) nonprofit charity organization which Dr. Pratt advises on science, and on (surprise!) liaising with government bureaucracies. He was, and perhaps still is, a member of the ILSI Board of Trustees. Many of the expenses for his jaunts to conferences and other gatherings sponsored by Big Soda, have been paid for by Big Soda.

As Dr. Pratt segues out of the CDC job, the university is not concerned with any appearance of impropriety in his former position. When the conduct of CDC colleague Dr. Barbara Bowman was questioned for conflicts of interest, she resigned within days. Others in a similar situations appear less worried about anything catching up with them. The school’s spokesperson says the new employee is also cutting his ties with ILSI, and assures critics that Dr. Pratt’s work has not been influenced at all, ever, by Coke money.

This is all a big problem for several reasons. The Centers for Disease Control is a tax-supported institution that has one job: to improve the health of Americans including obese children. To advance the interests of the beverage industry is not part of that job description. Like the CDC, the research facilities of a university are also, ideally, expected to produce science unfettered by ties to industry.

Also, whether governmental or educational, we are expected to trust the institution to make policy and help us understand the reasons for it. When relations between these bodies and the very persuasive corporate lobbyists become all cozy-like, it is, as the kids say, “not a good look.” U.S. Right to Know put it like this:

ILSI is partnering with the UCSD to hold a forum related to “energy balance behavior,” planned for November 30 to December 1 of this year. One of the moderators is another CDC scientist, Janet Fulton, Chief of the CDC’s Physical Activity and Health Branch.

In other words, yet another CDC official seems to be involved in this questionable alliance, raising the possibility that further chapters of the story might be forthcoming.

Your responses and feedback are welcome!

Source: “UCSD hires Coke-funded health researcher,” SanDiegoUnionTribune.com, 09/29/16
Source: “Dr. Michael Pratt,” USRTK.org, 10/20/16
Photo credit: Kevin Dooley via Visualhunt/CC BY

Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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