More life before death

reposted from: http://commentisfree.guardian.co.uk/michael_blastland_and_andrew_dilnot/2007/12/no_news_of_good_news.html

Something wonderful is happening: people are living longer, healthier lives. So why don't we hear more about it?

All Michael Blastland and Andrew Dilnot articles

About Webfeeds

December 9, 2007 12:00 PM

The past week has brought three pieces of outstanding good news. One received a short grunt of media acknowledgment, the others not even that. Yet they tell us more about human wellbeing than any number of health scares, gone-to-the-dogs jeremiads or nightmare scenarios.

The first piece of news is that we are, yet again, shown to be living longer than ever. What's more, the typical lifespan is not just up, according to the latest data from National Statistics this week, but rising at an accelerating rate: we are adding extra years, faster. Men have taken only about four years to put on their latest year of life expectancy. Astonishing.

Especially heartening for those zipping through middle age is where the gains come from. In earlier periods, it was improved infant mortality: as fewer babies died, the average lifespan increased. Now it derives as much from life extended at the end as sustained at the beginning. A 65-year-old man in 1981 could typically expect to live to 78. A 65-year-old man today will typically make it to 82.

Humbug, say those who feel that more years of life will be life endured, or, as Auberon Waugh almost put it: nothing is worth a couple of extra years in a nursing home in Weston-super-Mare.

But this brings us to the second hallelujah.

On average, the extra years are turning out, for women, to be healthy years, and about three-quarters of them for men. This lengthening of the so-called "healthy lifespan", measured either by the way people report their own health, or by subtracting the number of years of long-term disabling illness, challenges the presumption that longer life must mean decrepit life. We're getting wrinkly, not crumbly.

Source: National Statistics

That could imply more good news about the effect of an ageing population on health costs. Often described as a time bomb, it might be less explosive than suggested by the worst-case scenarios, which simply take the cost of healthcare in the few years before death and assume the line goes on flying upwards as the population wrinkles. The more accurate model might be that costs do go up, but that it is the proximity of death that sends them soaring, not the addition of what turn out to be healthy years before death.

The third piece of news is that, fast as life expectancy is rising for women, it is rising even faster for men. For so long the laggards, they are now closing rapidly. We don't know why, but we can speculate. For example, it may be that fewer men work in industries that, sooner or later, killed them. It could be that more women are in paid work, or enjoying lifestyles more like men's and so becoming more like men in this respect too. But the data suggest that men's progress is speeding up, rather than women's slowing down.

These gains are mightily impressive, and probably reliable. We can measure well enough the ages at which people die. The margin of uncertainty around the figures is tiny, the trends unmistakeable.

Of course, it's always possible there'll be bad news just around the corner, and the trends will reverse. Accelerating gains in lifespan can't go on forever - can they? - or one day the end will be receding faster than our approach. But just for now, we live, and live a bit more, in extraordinary times.

Despite the unrelenting coverage of everything that's wrong with our health service, the toxic soup people supposedly live in, the wretchedness of our diet or the stresses of modern living, something very good indeed is also happening, and on a huge scale; it's just that few talk about it.

We do not argue that all is right with the world, that no one experiences poor standards of welfare, or dies too young. On the contrary, we recognise huge demands for further progress. We know the gains are far from equally shared, and that a healthy old age might still mean a relatively impoverished one. We see that longer lives mean, other things being equal, more people.

But the numbers are a useful glimpse of the bigger picture. They are testament to how much people are continually achieving - and will go on to achieve - to improve wellbeing. Contrast that with how well they recognise this achievement, and one can't help but wonder at the lack of proportion. Longer life doesn't seem to make us grateful.

The authors will be speaking at Wanstead Library, Spratt Hall Road, London E11 2RQ on Thursday December 13 at 7pm. For details email vivian@newhambooks.co.uk.

reposted from: http://commentisfree.guardian.co.uk/abby_oreilly/2007/11/fat_for_purpose.html

The comments are better than this article.

Fat for purpose

Even though they're ridiculed and discriminated against, not all overweight people want to conform to the notion that thin is beautiful

Abby O'Reilly

November 20, 2007 9:00 AM

Fatness has become synonymous with unhappiness. If you are overweight you are not allowed to feel confident: it's against the rules. You're not even supposed to step outside without strapping down your effervescing gut with an elasticated waistband, because fatties don't look or feel attractive. They dress badly. They have greasy hair. They smell like stale chicken wings, body odour and warm fats, and they are lazy. There are no studies to corroborate this, of course. This is the archetypal fat person, the one that would exist should the world spontaneously combust and a superior life force begin to piece together society using the remnants of Gillian McKeith's brain with cuttings from tabloids and women's weeklies.

The front-page report that

almost two thousand people are too fat to work,

according to documents released by the Department for Work and Pensions for 2006-2007, will further fuel the belief that fat people are the scourge of society, addicted to daytime TV and flaky pastry. Despite this being a relatively small percentage of the fat population in the UK, anyone with a spare tyre, whether working or not, will be considered one of the wobbly masses "working the system" and claiming the £4.4bn that rightly belongs to the thin people who earned it.

There were individuals receiving incapacity benefit for a number of reasons, including migraines and acne, but it is the overweight who are considered morally repugnant: fatties have no integrity, their "condition," if it can be called that, is something to be highlighted and shamed rather than sensibly addressed. The article is illustrated with a photograph of the hanging belly of an obese woman, tightly covered in grey sweat pants and a white shirt, inciting the physical revulsion that we are conditioned to feel by the rotund. A lot of fat people work, and work well. What the departmental figures fail to recognise is the number of people actively discriminated against in the job market owing to the fact that they are porkers, and the media prefers to perpetuate the concept that fatties don't work because they don't want to rather than because they can't get employed. It should also be pointed out that to claim incapacity benefit you have to be assessed, and fatness is one thing that you just can't fake.

I am a fat woman and have never resisted that definition. I feel that to do so would endorse the idea that there is something inherently wrong with me, rather than society. I wouldn't say I am particularly insecure about my weight; no more so than someone with a big nose, or oddly shaped head. The greatest problem has always been impolite comments from those who believe that as a fatty I am public property, and owed a verbal pummeling. I refuse to let this influence me, especially since I have no problem with the way I am. This is my biggest crime.

We live in a culture where our ability to adhere to the rules of self-perfection is considered directly proportionate to our success, especially for women. Glossy magazines daily boast images of the emaciated size zero beauties littering celebsville, and while we can't emulate their lifestyles, their look has become achievable, and costs nothing at all (just your health). So being overweight indicates a lack of self-control, something that can only be remedied by substituting your penchant for doughnuts with delicious mung beans.

If you are clinically overweight and not stringing up the noose, you must not admit it. This must be hidden under the bed like a shameful secret, shrouded in years' worth of chocolate wrappers and crisp packets. To raise your bingo wings in the air as a bleary eyed request for help is considered responsible: you exist on the fringes, yes, but at least you realise that you are "aesthetically displeasing" and want to change. However, refusing to allow your weight to impinge on your life means that you will be subject to unyielding pressure from the dieting industry and a media machine intent on making you recognise the error of your ways. To be content when you are different forces society to question its rules of acceptability, and as the anomaly you have to be obliterated before anyone else realises that it's possible to think outside the box. You are depressed being overweight because thin people say so. And if this is not true, then tough luck because everyone still thinks so.

A report last week claimed that those taking the weight-loss drug rimonabant, sold in the UK under the name Acomplia, have an increased chance of developing psychiatric problems. In the study, carried out at the University of Copenhagen, more than 4,000 patients took part in four medical trials. Those taking the drug were 40% more likely to suffer from anxiety and depression. The drug was not licensed in the US over fears suicide rates would increase but in the EU has been approved as a prescription only medicine. Although you may end up eating your own hair, and carving your weight loss along your arms with a butter knife, it is an effective method of shedding those unwanted pounds. People are opting to take this medication because the prospect of becoming mentally deranged is considered far more appealing that living as a "wide load," and so what does this say about the status quo? If a woman has starved herself to the point of death owing to the pressures to be skinny then she is referred to a cognitive behavioural therapist, with the psychological aspects of her condition validated. If someone is very fat, however, the possibility they may have underlying issues that have precipitated their weight problem is ignored simply because, unlike anorexia, the results of obesity are less glamorous. Fatness is considered nothing more than the ugly result of gluttony, and so nobody cares that a weight loss drug could seriously damage a fatty's mental health because they will look better. In many respects it's considered a public service.

Overweight people are not acceptable, an attitude which has permeated the national consciousness. The word "fat" is invested with negativity, considered a derogatory term used as an insult, as opposed to the word "thin" which invokes images of beauty and perfection. Some people are genetically predisposed to be overweight. Others may be miserable, prone to comfort eating. Either way, the claim put forward by Weight Watchers and endorsed by celebrity culture - loose weight and feel great - not only creates, but also enhances existing insecurities, in addition to placing unrealistic expectations on the power of weight control. Yes, many women who loose weight are much happier, but many who choose not to lead perfectly normal and fulfilled lives. You don't have to be thin to be happy, and you don't have to be fat to be unhappy. It is time emphasis shifted from pressurising people to loose weight through public humiliation, to supporting the idea that it is possible to be successful and cheerful even if you are the wrong side of 15 on the scales.

There are health implications to being overweight, and of course, support should be accessible to those who want and need it. We shouldn't encourage people to be fat, but it is counterproductive to claim that the only way you can be happy and get the promotion you want is by banishing your muffin top, because some of us just cannot do it. Considering that many people are overweight, shouldn't we foster an all-inclusive society, rather than making every fat person feel like a grotesque beast of burden and assuming they are trapped in a neverending cycle of binge eating and depression? What will this do other than foster generations of teenagers and adults who lack the confidence to even step outside without being shrouded in a black cagoule?

'Taking control of your weight' from British Heart Foundation

reposted from:http://www.bhf.org.uk/idoc.ashx?docid=dde3a040-6034-409c-9ed7-2b4bd6856130&version=-1

'Taking control of your weight' from British Heart Foundation (pdf)

Top tips to cut the saturated fat

reposted from: http://www.bhf.org.uk/keeping_your_heart_healthy/top_tips_to_keeping_healthy/tips_to_cut_the_saturated_fat.aspx

Top tips to cut the saturated fat

Eating too much saturated fat can increase blood cholesterol levels, which in turn is a risk factor for coronary heart disease.

The healthier type of fat to choose is unsaturated fat (monounsaturated or polyunsaturated), which can actually improve cholesterol levels. But don’t forget all fat is high in calories, so if you are watching your weight, you should limit your overall fat intake.

Here are our tips to help you cut down on saturated fats:

• Not so good fats…
  
  

  Butter, lard, palm oil, coconut oil/cream and ghee (clarified butter) are all rich sources of saturated fat and are best limited. Replace with small amounts of unsaturated fats such as olive oil, rapeseed oil or corn oil.
• 
  

• Choose your meat wisely
  
  

  Have chicken or turkey without skin, lean cuts of meats and trim off any visible fat. Cut back on fatty meat pies, sausages, sausage rolls and breaded meat or chicken etc. Did you know a grilled chicken breast without skin contains a third less saturated fat than with skin?
• 
  

• Spreads
  
  

  Use spreads thinly and go for lower fat spreads with the lowest amount of saturates. Avoid butter or hard margarines and choose spreads that mainly contain monounsaturated or polyunsaturated fats.
• 
  

• Check the labels
  
  

  Cut down on takeaways, ready meals and processed foods. Opt for lower fat versions; check and compare nutrition labels and pick foods with a lower amount of saturated fat.
• 
  

• Look at your cooking methods
  
  

  Grill, bake, steam, boil or poach foods instead of frying in lots of oil. Did you know a portion of cod fried in batter has 2.9g of saturated fat and 445 calories, but an average portion of baked cod has just 0.4g of saturated fat and only 115 calories! Rather than adding extra fat like cream or sour cream to recipes why not swap with low-fat yoghurt or fromage frais.
• 
  

• Dressings and sauces
  
  

  Make your own low fat salad dressing using ingredients such as low fat yoghurt, lemon juice, herbs, etc rather than shop brought ones. If you do buy dressing or sauces, pick lower fat varieties, e.g. low-fat salad dressing or lower fat mayonnaise.
• 
  

• Milk it up…
  
  

  Use semi-skimmed or skimmed milk rather than full fat or condensed milk. For example, swap a 200ml glass of full fat milk for semi-skimmed milk and cut your saturated fat intake by 2.9g and 40 calories.
• 
  

• To measure or spray
  
  

  Measure your oil out with a tablespoon rather than just pouring straight out of the bottle. Then you know how much you are using. Or why not use a spray oil to cook.
• 
  

• Cheesy choice
  

  
  Check out the nutrition label and opt for cheeses that are lower in fat and saturated fat such as cottage cheese, ricotta and half-fat cheddar. Did you know that a 30g portion of hard cheese is the size of a small matchbox?
• 
  

• Eat more oily fish
  
  

  Oily fish, such as salmon, mackerel, fresh tuna and sardines are rich in omega 3 polyunsaturated fat; which can help to protect against heart disease.
• 
  

• Snack attack
  
  

  For a tasty and nutritious snack, have a handful of unsalted nuts, seeds or dried fruit rather then reaching for fatty snacks such as crisps, pastries, or bombay mix. For those with a sweet tooth choose sugar free jelly or sorbets instead of cakes, biscuits or ice-cream.
• 
  

• Bulk up
  
  

  Add less meat to casseroles, stews and sauces and replace with fibre-rich vegetables, beans or pulses.

Now Doctors Say It's Good to be Overweight

reposted from: http://www.alternet.org/healthwellness/67692/?page=entire

Now Doctors Say It's Good to be Overweight

By David Usborne, The Independent UK. Posted November 13, 2007.

After years of anti-obesity public health advice, a major new study causes an outcry by concluding that the moderately overweight live longer.

A startling new study by medical researchers in the United States has caused consternation among public health professionals by suggesting that, contrary to conventional wisdom, being overweight might actually be beneficial for health.

The study, published yesterday in the respected Journal of the American Medical Association, runs counter to almost all other advice to consumers by saying that

carrying a little extra flab -- though not too much -- might help people to live longer.

Struggling dieters, used to being told that staying thin is the best prescription for longevity, are likely to be confused this morning if not heartily relieved. While being a bit overweight may indeed increase your chances of dying from diabetes and kidney disease -- conditions that are often linked with one another -- the same is not true for a host of other ailments including cancer and heart disease, the report suggests.

In fact,

scanning the whole gamut of diseases that could curtail your life, being over weight is, on balance, a good thing. The bottom line, the scientists say, is that modestly overweight people demonstrate a lower death rate than their peers who are underweight, obese or -- most surprisingly -- normal weight.

The findings will be hard to dismiss. They are the result of analysis of decades of data by federal researchers at the Centres for Disease Control and Prevention (CDC) in Atlanta, Georgia. This is not a study from a fringe group of scientists or sponsored by a fast-food chain.

Being overweight, the report asserts in its conclusions, "was associated with significantly decreased all-cause mortality overall".

"The take-home message is that the relationship between fat and mortality is more complicated than we tend to think," said Katherine Flegal, the lead researcher. "It's not a cookie-cutter, one-size-fits-all situation where excess weight just increases your mortality risk for any and all causes of death."

That the CDC has even published the report and thus threatened to muffle years of propaganda as to the health benefits of staying slender has enraged some medical experts.

"It's just rubbish," fumed Walter Willett, the professor of epidemiology and nutrition at the Harvard School of Public Health. "It's just ludicrous to say there is no increased risk of mortality from being overweight."

Not that the CDC results are an invitation to throw caution to the winds and take cream with everything. The scientists are careful to stress that

the benefits they are describing are limited to those people who are merely overweight -- which generally means being no more than 30 pounds heavier than is recommended for your height -- and certainly do not carry over to those who fall into the category of obese.

Obesity has been declared one of the main threats to health in the US, including among children. Those considered obese, with a body mass index (BMI) of more than 30, continue to run a higher risk of death, the study says, from a variety of ailments, including numerous cancers and heart disease. It said that being underweight increases the risk of ailments not including heart disease or cancer.

The scientists at the CDC first hinted at the upside of being overweight a few years ago. Since then, however, they have expanded the base of their analysis, with data that includes mortality figures from 2004, the last year for which numbers were available, for no fewer than 2.3 million American adults.

Highlighting how a bit of bulge might help you, the scientists said that in 2004 there were 100,000 fewer deaths among the overweight in the US than would have been expected if they were all considered to be of normal weight.

Put slightly differently, those Americans who were merely overweight were up to about 40 per cent less likely than normal-weight people to die from a whole range of diseases and risks including emphysema, pneumonia, Alzheimer's, injuries and various infections.

Aside from escaping diseases, tipping the scales a little further may also help people recover from serious surgery, injuries and infections, Dr Flegal suggested. Such patients may simply have deeper bodily reserves to draw on in times of medical crisis.

Not everyone in the medical profession was surprised or angry about the study. "What this tells us is the hazards have been very much exaggerated," said Steven Blair, a professor of exercise science and biostatistics at the University of South Carolina, who has long argued that the case for dietary restraint has been taken too far.

"I believe the data," added Elizabeth Barrett-Connor, a professor of family and preventive medicine at the University of California, San Diego, who believes that

a BMI of 25 to 30 -- roughly the the so-called overweight range -- "may be optimal".

Critics, however, were quick to point out that

the study was concerned with mortality data only and did not take account of the quality of life benefits of keeping your weight down. The study "is not about health and sickness"

, noted the obesity researcher Barry Popkin of the University of North Carolina.

The report "definitely won't be the last word", said Dr Michael Thun of the American Cancer Society, who pointed out,

in a report released last week by the World Cancer Research Fund and the American Institute for Cancer Research, that staying slim was the main recommendation for avoiding cancer.

Others in the American medical community, while a little bemused, were withholding judgement. "This is a very puzzling disconnect," said Dr JoAnn Manson, the chief of preventive medicine at Harvard's Brigham and Women's Hospital.

The suggestion that a bit of extra weight may assist patients recovering from an infection or surgery was of no surprise to Dr Flegal. "You may also have more lean mass -- more bone and muscle," she said. "If you are in an adverse situation, that could be good for you."

In their conclusions, the authors of the study note:

"Overweight ... may be associated with improved survival during recovery from adverse conditions, such as infections or medical procedures, and with improved prognosis for some diseases. Such findings may be due to greater nutritional reserves or higher lean body mass associated with overweight."

Those of us mostly likely to benefit from a little bulge beneath the belt, the study adds, are between 25 and 59 years old, although there were also some advantages for people over 60.