Wednesday, April 20, 2005

What's the Deal with: The Today Show

I can say today started with a suprise. We got Simone to go to bad at about 10pm last night, and she didn't wake until 7am. A new personal best for Simone! So despite getting up at about 7am and feeling quite good about the day, I still got to work around 9am, since I sat down and held the baby while Ellie had a bowl of cereal and watched the "Today Show." So now I'm going to have my little rant about it to release frustration about it.

Perhaps I'm becoming an intellectual elitist, but I'm having a very difficult time tolerating the news media lately. I was complaining to one of my coworkers that I was already tired of hearing "there was black smoke from the Vatican, so a new pope has not been elected." Give me a break, just tell us when they pick one, not when they don't. Not an hour after I complained I heard a new pope had been selected. Guess I wasted my breath on that one.

Next the new food guide pyramid. So they tailored it to age and activity level. My prediction: it won't make a bit of difference in what people eat. People eat what they like, and they like frozen ding-dongs and New York style pizza.

They give something like a minute of time on the subject of a new CDC study finding being overweight is not significantly greater risk for death than being normal weight. I have a feeling they are refering to a study recently published in the Journal of the American Medical Association (Flegal et al 2005, JAMA voluem 293, pages 1861-1867). The study examines data from the three NHANES studies (these were national health surveys, very comprehensive in nature). Looking at the figures, my interpretation is if there is an actual increase in risk from being fat, it doesn't kick in until a population has a BMI over 30 (it really shows for BMIs over 35 are at risk), and the older the population the less "relative risk" is associated with higher BMI. In fact, for people over 70, BMIs over 35 are not significantly most risky than having a "normal" BMI of 18.5-25. Without a doubt there study shows that having a BMI below 18.5 is a greater health risk than others. One should also keep in mind that the risk is 1.0 for "normal BMI" and 1.83 for BMI more than 35 when looking at the population ages 25-59, while for the population that is more than 70 the relative risk is 1.0 for "normal BMI" while it is 1.17 for BMIs over 35! That is quite small when taken in the context that relative risk of mortality from malignant neoplams of the respiratory tract use goes from 1.0 in male non-smokers to 23.26 for malesmokers(from the CDC)! I'd call obesity, even defined by a BMI greater than 35, is a modest increase in risk in comparison.

I actually found it rather humorous that they partially attributed the observation in improvements in cardiovascular care, despite saying elsewhere in the study that their study did not examine deaths caused by cardiovascular disease, but rather all cause mortality. It's also interesting to note that they associated "111,909 excess deaths" with obesity, where previous estimates that got a great deal of media attention had estimates of 400,000 deaths from "poor diet and physical inactivity" were touted (Mokdad et al 2004, JAMA vol 291, pages 1238-1245)! Where did the 300,000 deaths go?

I'll take the opportunity to share some snippets from a newswire I found though Google News.
* May 2004 Science magazine reports on the 400,000 deaths figure: "Some researchers, including a few at the CDC, dismiss this prediction, saying the underlying data are weak. They argue that the paper's compatibility with a new anti-obesity theme in government public health pronouncements -- rather than sound analysis -- propelled it into print."
* December 2004 A follow-up story in the Wall Street Journal reports that due to additional problems based on the "authors' scientific approach": "The number of obesity-related deaths could be less than half of the 400,000 estimated in the flawed CDC study, according to some scientists familiar with the debate."
* January 2005 The CDC admits that its 400,000 deaths figure was exaggerated due to mathematical errors.

Oi! Where was the Today Show when that was coming out? I think the bottom line is people want to believe obesity is a bigger problem than the facts are telling us, for what misguided reasons we can only guess at.

My personal feeling is the attribution of risk to obesity is pointless. Obesity is simply a symptom of an imbalance between caloric consumption and caloric expenditure, often the result of a poor diet in conjunction with physical inactivity. I think I've written enough on that today though


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