In Terms Of Longevity & Cardiovascular Health, Fitness Trumps Obesity As Deciding Factor

As reported by the NYT, several new studies show that, for health, the first ingredient is physical fitness. It trumps obesity and the waist line as the prime determinant of health and longevity.
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This from the NYT:

. . . [I]s a person’s weight really a reliable indicator of overall health?

Increasingly, medical research is showing that it isn’t. Despite concerns about an obesity epidemic, there is growing evidence that our obsession about weight as a primary measure of health may be misguided.

Last week a report in The Archives of Internal Medicine compared weight and cardiovascular risk factors among a representative sample of more than 5,400 adults. The data suggest that half of overweight people and one-third of obese people are “metabolically healthy.” That means that despite their excess pounds, many overweight and obese adults have healthy levels of “good” cholesterol, blood pressure, blood glucose and other risks for heart disease.

At the same time, about one out of four slim people — those who fall into the “healthy” weight range — actually have at least two cardiovascular risk factors typically associated with obesity, the study showed.

To be sure, being overweight or obese is linked with numerous health problems, and even in the most recent research, obese people were more likely to have two or more cardiovascular risk factors than slim people. But researchers say it is the proportion of overweight and obese people who are metabolically healthy that is so surprising.

“We use ‘overweight’ almost indiscriminately sometimes,” said MaryFran Sowers, a co-author of the study and professor of epidemiology at the University of Michigan. “But there is lots of individual variation within that, and we need to be cognizant of that as we think about what our health messages should be.”

The data follow a report last fall from researchers at the Centers for Disease Control and Prevention and the National Cancer Institute showing that overweight people appear to have longer life expectancies than so-called normal weight adults.

But many people resist the notion that people who are overweight or obese can be healthy. Several prominent health researchers have criticized the findings from the C.D.C. researchers as misleading, noting that mortality statistics don’t reflect the poor quality of life and suffering obesity can cause. . . .

Part of the problem may be our skewed perception of what it means to be overweight. Typically, a person is judged to be of normal weight based on body mass index, or B.M.I., which measures weight relative to height. A normal B.M.I. ranges from 18.5 to 25. Once B.M.I. reaches 25, a person is viewed as overweight. Thirty or higher is considered obese.

. . . Several studies from researchers at the Cooper Institute in Dallas have shown that fitness — determined by how a person performs on a treadmill — is a far better indicator of health than body mass index. In several studies, the researchers have shown that people who are fat but can still keep up on treadmill tests have much lower heart risk than people who are slim and unfit.

In December, a study in The Journal of the American Medical Association looked at death rates among 2,600 adults 60 and older over 12 years. Notably, death rates among the overweight, those with a B.M.I. of 25 to 30, were slightly lower than in normal weight adults. Death rates were highest among those with a B.M.I. of 35 or more.

But the most striking finding was that fitness level, regardless of body mass index, was the strongest predictor of mortality risk. Those with the lowest level of fitness, as measured on treadmill tests, were four times as likely to die during the 12-year study than those with the highest level of fitness. Even those who had just a minimal level of fitness had half the risk of dying compared with those who were least fit.

During the test, the treadmill moved at a brisk walking pace as the grade increased each minute. In the study, it didn’t take much to qualify as fit. For men, it meant staying on the treadmill at least 8 minutes; for women, 5.5 minutes. The people who fell below those levels, whether fat or thin, were at highest risk.

The results were adjusted to control for age, smoking and underlying heart problems and still showed that fitness, not weight, was most important in predicting mortality risk.

Stephen Blair, a co-author of the study and a professor at the Arnold School of Public Health at the University of South Carolina, said the lesson he took from the study was that instead of focusing only on weight loss, doctors should be talking to all patients about the value of physical activity, regardless of body size.

“Why is it such a stretch of the imagination,” he said, “to consider that someone overweight or obese might actually be healthy and fit?”

Read the entire article.

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Nanny State In Action

I posted below that Britain faces a nation wide crisis over widening obesity rates. Now we see local councils advocating that the State take control of "dangerously" obese children and remove them from their families.
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This from the Sun:

Dangerously fat kids could be taken from their parents and put into care, council chiefs declared yesterday.

They warned that the worst cases of obesity will be increasingly seen as evidence of "parental neglect."

Social workers will have to step in to offer advice to protect the child's welfare.

In the most extreme cases, children could even be taken away from parents.

. . . The dramatic warning was delivered by the Local Government Association, which represents more than 400 councils in England and Wales.

Around one in four people in England are obese, so overweight that it threatens their health.

But experts fear HALF the population will be affected by 2032.

LGA public health spokesman David Rogers said some councils were already taking actions "where parents are putting children's health in real danger.

"Councils would step in to deal with an under-nourished and neglected child so should a case with a morbidly obese child be different?

. . . "There needs to be a national debate about the extent to which it is acceptable for local authorities to take action in cases where the welfare of children is in real jeopardy."

. . . But Mr Rogers said childhood obesity had now become an issue for every council.

Tough action was needed to protect the health of millions of children. . . .

Read the entire article.

Of all the ways that this problem can be addressed, taking a child from his family seems the absolute worst possible decision. Whether a child grows up fat or slim may be a concern of the state, but it is so patently obvious that there is so much more involved in the family unit that bears on what the child will grow into as to make this draconian policy proposal utterly insane. And even besides that, there are a thousand things the state can do to promote health and weight loss, not the least of which is mandating more physical activities for school age children. It is one thing to use the bully pulpit, another thing entirely to use the police powers of the state against a family.

But, sad to say, I am not surprised that this suggestion should arise in the U.K. As a general rule, the socialist left believes in the superiority of centralized power and that those in power - so long as they are reliably socialist - are in a better position to make decisions effecting individuals than individuals can make for themselves. Socialists also tend to have far less respect for the traditional family unit - as the U.K.'s welfare system among others makes clear. Modern Britain is a true laboratory experiement in socialism and multiculturalism transposed on top of a Western democracy.

Cross posted at Wolf Howling.

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Obesity In Britain An Expanding Health Crisis

Cornish Pasties are a thing to be savored, but apparently our cousins across the pond are savoring them in a bit too great a quanity. According to a public health expert quoted on the front page of the Daily Times, given current trends, over half of all people in Britain will be obese in 25 years.
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This from the Daily Times:

Obesity poses as grave a threat to Britain and the NHS as terrorism, a Government adviser has warned.

Public health expert Professor David Hunter criticised ministers for failing to take 'bold action' to tackle the growing crisis.

Experts have already warned that if trends continue, half the population will be obese within 25 years, causing life expectancy to fall for the first time in two centuries.

Professor Hunter, of Durham University, said that since the 1970s governments have done little more than 'tinkered round the edges' of the emerging health crisis.

'They have been talking about it for four decades but that never seems to be enough,' he said.

'The Government was quick to move for things like ID cards or 42-day detention without trial - now it needs to show similar leadership in public health.

'The threat to our future health is just as significant as the current security threat.'

Although Government initiatives were having some impact, he added, these were on a 'piddling' scale.

'Lots of the initiatives are under a voluntary agreement - but it has just come to the point where things like these are simply not working,' Professor Hunter said.

Around 25 per cent of people in England are classified as obese - so overweight it threatens their health - compared to 8 per cent in 1980.

On current trends, half of the population will be clinically obese by 2032, and those with Type II diabetes - which is triggered almost exclusively by being overweight - will rise tenfold to 19million.

Overall, obesity is thought to knock nine years off lifespan. Various cancers, including breast, colon, kidney and stomach cancer, are known to be linked to weight.

The cost to the NHS of treating obesity - already £1billion a year - will also soar.

A spokesman for the Department of Health said: 'We are tackling obesity through awareness campaigns and action in schools.' . . .

Read the entire article. I think that the government is making a tremendous mistake by focusing on what people eat rather than exercise and eating habits. A cursory glance at our activity levels and obesity rates over the past century suggests that exercise and activity levels are the fulcrum of weight loss.

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Sleep - Problems In Quantity & Quality

Lack of sleep is directly linked with obestisty as well as other major health maladies. Step one in weight control is getting control of sleep patterns. An article appears this week in Consumer Reports on the prevelance of sleep problems in the U.S., sleep myths and what we can do to get control over our sleep.
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This from Consumer Reports, reproduced at AOL:

Trouble falling asleep, difficulty staying asleep, and awakening too early afflict a lot of Americans these days. Fifty percent of those we asked about their most recent night of sleep reported those problems, and for many, they occur repeatedly. When asked about the previous month, 44 percent said they had one or more of those issues on at least eight nights, making them "problem sleepers." Our survey was a nationally representative sample of 1,466 adults conducted by the Consumer Reports National Research Center in April 2008.

The 24/7 nature of today's world, along with continuous access to entertainment and activities, is one reason for the problem, according to the National Institutes of Health. It estimates that as many as 70 million Americans may be affected, with annual health-care expenses of $16 billion.

Another reason: health issues that interfere with sleep. For instance, 57 percent of survey respondents who said they suffered from conditions such as arthritis , back pain , or neck pain said that those ailments disrupted their sleep during the previous month.

People with sleep problems are turning heavily to medications, with some frightening results. Consider our main survey findings:

Almost one in five Americans took prescription or over-the-counter medicines at least once a week to help them sleep better. Although sleep medications are usually recommended for no more than two weeks or so, 14 percent of our respondents took some type of pill on at least eight of the past 30 nights, and 5 percent turned to prescription drugs every night of the month.

Drug side effects occurred in 63 percent of those who took sleep medications; 24 percent became dependent on the medication they used, and 21 percent indicated that repeated use reduced the drug's effectiveness. The most common side effect was daytime drowsiness, noted by more than a third of respondents.

In a parallel survey of 1,093 insomniacs, or those with chronic sleep loss, 7 percent of respondents who took a sleeping pill during the previous month reported bizarre and dangerous behavior such as sleepwalking, sleep driving, and sleep eating. Last year the Food and Drug Administration began requiring prescription sleeping-pill manufacturers to include strongly worded warnings about such possible side effects.

There are better ways to battle sleeplessness. Sound machines were a viable alternative to drugs when it came to treating some cases of sleeplessness, our respondents said. The machines, which emit soothing sounds such as water, wind, or chirping birds, were highly effective most of the time for many people, working almost as well as sleeping pills, minus the dangerous side effects.

What you can do

We all experience occasional restlessness, but the first step need not be a drug. If you have even a short-term sleep problem, examine your routines. Bad habits such as long or late-day naps, watching TV in bed, drinking alcohol or caffeinated beverages close to bedtime, eating large meals at night, allowing pets or children to share your bed, or varying bedtimes and wake-up times can cause problems.

Your bed is one source of sleep problems you might have overlooked. If you've slept on the same mattress for more than eight years, it could be time for replacement. Worn-out mattresses don’t supply the same comfort and support as newer ones. Also, if you're older than 40, your mattress needs might have changed since your previous purchase. As we grow older, our bodies become more sensitive to pressure points, so a cushiony mattress might provide a better night's sleep than a rock-hard bed. You might also try using a sound machine .

If sleeplessness persists several nights a week for at least three months, it's probably time to see a doctor.

One way to change your habits can be learned from a cognitive behavior therapist, who can set up a sleep schedule, help correct poor sleep habits, and teach you to use relaxation, breathing, and mental techniques to help with sleep. Cognitive behavioral therapy has been shown in trials to be effective in treating intermittent and chronic insomnia. About half of the respondents who practiced at least some aspects of the therapy found that it helped most nights.

If your doctor suggests prescription medication, new pills such as Ambien CR , Lunesta , and Sonata aren't necessarily better than the older, cheaper drugs such as estazolam or temazepam for many people who need a sleep aid for just a night or two.

Read the entire article. In a companion article, Consumer Reports looked at the self-reported causes of sleep disorders:

Overall, more than a quarter of our survey population said it took them 30 minutes or longer to fall asleep the previous night, and one quarter awakened in the middle of the night and couldn’t go back to sleep for at least a half-hour. Much of the time, respondents’ sleep was interrupted because they had to use the bathroom. Also, a third woke up much earlier than they had hoped. Such problems weren’t anomalies: Three-quarters of the respondents told us that was a typical night.

Among problem sleepers, 71 percent took at least 30 minutes to nod off; 59 percent woke up in the middle of the night and couldn’t fall back asleep for a half-hour or longer; and 65 percent awoke much too early.

No single reason stood out as a cause of chronic sleeplessness. Our survey uncovered six characteristics that problem sleepers had in common, the most prevalent being high stress levels. Most of the time, respondents were anxious over family or money concerns, health issues, or work woes. Issues most often linked to sleep loss were worries about commuting, personal health, problems with children, and reactions to news events.

Besides stress, problem sleepers had other issues that exacerbated their insomnia. Almost 65 percent suffered from physical pain caused by arthritis or other conditions, 38 percent suffered from a respiratory condition such as asthma or a cold, and 50 percent suffered from mood disorders, including depression.

Other factors associated with sleeplessness are heart disease, Alzheimer's disease, Parkinson's disease, hyperthyroidism, attention deficit hyperactivity disorder, and menopause.

Insomnia can strike at any age, including in childhood. Those 55 and older are more likely to have other illnesses or aches and pains that can disrupt sleep; they’re also more likely to be taking medications that can keep them from falling and staying asleep. Also, as we age our bodies tend to secrete lower amounts of substances that promote deep sleep and regulate our internal body clocks, according to the Mayo Clinic.

Certain activities and behaviors, such as drinking alcohol or caffeinated drinks too close to bedtime, exercising late at night, following an irregular morning and nighttime schedule, shift work, and too much mental stimulation before settling in, can disrupt sleep, too. Traveling, especially shuttling across time zones, can affect sleep. And environmental such as a room that’s too hot, cold, noisy, or bright, can block a good night’s sleep.

Read the entire article. And then there are the nine sleep myths from the AOL site first linked above:

Nine myths about sleep

Think sleeping in will help you catch up on sleep? Are naps a waste of time? Click through this gallery to read findings from the Consumer Reports National Research Center about sleep myths.

Myth No. 1: Getting one hour less sleep per night than needed won't affect you.

Reality: Getting even slightly less sleep can leave you feeling less energetic, hinder your ability to think properly and respond quickly, affect cardiovascular health, and make it more difficult for your body to fight off infections, particularly if the lack of sleep continues.

Myth No. 2: Your body quickly adjusts to different sleep schedules.

Reality: Our biological clocks are programmed so we're more alert during the day and more drowsy at night. Most people can reset their internal clock by one or two hours a day, but it can take a week or longer to adjust to dramatically altered sleep/wake cycles, such as when traveling across time zones or switching from the day shift to working overnight.

Myth No. 3: You need less sleep as you age.

Reality: Older people need just as much sleep as other adults, but they often get less or find it less refreshing because they spend less time in deep, restful sleep and might be easily awakened. They also tend to suffer from aches, pains, and medical conditions that can disrupt sleep.

Myth No. 4: Extra sleep can prevent daytime fatigue.

Reality: It's not just how much you sleep but how well. Some people sleep eight or nine hours but don't feel well rested because of poor-quality sleep.

Myth No. 5: You can make up for sleep loss by sleeping more on weekends.

Reality: This pattern will help relieve part of the sleep deficit, but it won't completely make up for it. Nor will it make up for impaired weekday performance. Sleeping later on weekends can make it more difficult to fall asleep on Sunday night and get up early on Monday.

Myth No. 6: Naps are a waste of time.

Reality: Naps aren't a substitute for a good night's sleep, but they can be restorative. Napping after 3 p.m., though, can make it tougher to fall asleep at night. It can also be difficult to shake off the cobwebs if you nap for more than an hour.

Myth No. 7: Snoring is normal.

Reality: It's common, especially as we age. But snoring on a regular basis might make you sleepy during the day and more susceptible to heart disease and type 2 diabetes, according to growing evidence. Loud snoring could be a sign of sleep apnea, a serious condition in which breathing can stop during sleep for as long as a minute. Untreated, sleep apnea can lead to high blood pressure and other cardiovascular disease, headaches, impotence, memory problems, and weight gain.

Myth No. 8: Children who don't get enough sleep will show signs of sleepiness during the day.

Reality: Unlike adults, children who are sleep-deprived typically become more active during the day, behaving improperly and having difficulty paying attention.

Myth No. 9: The main cause of insomnia is worry.

Reality: Although stress can cause short bouts of insomnia, a persistent inability to fall or stay asleep generally stems from a number of factors: a reaction to medication, depression or anxiety, or asthma, arthritis, or other medical conditions with symptoms that worsen at night.

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