Thorkild Sørensen

Yesterday, at the ongoing XI International Congress on Obesity, the 2010 ICO Award for Population Science and Public Health was awarded to Thorkild Sørensen from the University of Copenhagen. His studies from the early 70’s found early signs of the impending obesity epidemic in young Danish military recruits as far back as the 1960s.

His studies further suggest that this increase in obesity was related to “birth cohort” effects and can likely be traced to perinatal environmental factors rather than to influences acting on school age kids or adults. Indeed, based on his findings, Sørensen strongly recommends that we take a careful look at the historical dimension if we hope to identify the root causes of the current obesity epidemic.

As it so happens, I also had the pleasure of attending the launch of the new Wadd Society for the History of Obesity, with presentations from Professors George Bray, Stephan Rossner, and David Haslam at this meeting. The aim of the society is to promote interest in the history of obesity ranging from medical and pharmacological aspects to those of fashion, culture, art, and literature.

As all of this perhaps serves to remind those of us working in the field of obesity, that we must be very cautious before jumping to conclusions regarding whether or not recent environmental changes such as sedentary lifestyles, fast food, sugary soft drinks, television, or any of the many other factors that are being discussed are truly the root causes of the epidemic. While none of these development would be considered “healthy”, conclusive evidence as to their actual role in the epidemic of obesity is far from conclusive.

AMS
Stockholm, Sweden

For more posts on ICO 2010 click here

From time to time the media loves to write stories on the Obesity Myth.

These stories come in two flavours - the first one denies the very existence of an obesity epidemic, attributing the rise in obesity statistics to moving definitions that “suddenly” make everyone obese simply by shifting the goal post.

The second flavor of obesity myths acknowledges the increase in people with excess weight but states that carrying a few extra pounds or even having more severe obesity is not really detrimental to your health, ergo this whole obesity thing is vastly overblown.

Last week, news media around the world once again splashed Obesity Myth headlines on their front pages, this time of the second flavor - yes obesity exists, but it is really not a health risk.

These reports were based on a study by Brant Jarrett and colleagues from the Brigham Young University, Provo, UT, published in the International Journal of Obesity.

The researchers examined data from the 1988-1994, 2003-2004 and 2005-2006 US National Health & Nutrition Examination Surveys (NHANES) to determine the relationship between BMI, age, gender and current medication in 9071 women and 8880 men. Current medication (or medication loads) were considered a surrogate measure of current health status.

In both the 1988-1994 and 2003-2006 data sets, with few exceptions, medication loads did not increase significantly in overweight compared with normal-weight people, a finding that prompted the news headlines.

However, the paper did find increased medication load in people who were clinically obese (BMI>30), especially if they were 40 years of age or older.

In fact, the authors themselves conclude:

“Although obesity does not substantially affect current health in young people, it is likely that the increased medication loads in obese compared with normal-weight older people originates at least in part from an increased BMI starting at a younger age. Thus, age, gender and onset of high BMI all require consideration when using BMI to assess current health status.“

Given these findings, one can only wonder why the media chose to propagate the Obesity Myth based on this study, given that the authors themselves clearly found a relationship between excess weight and health status.

While the authors do emphasize that BMI is not a good measure of health risk, this is nothing new.

Regular readers of these pages will recall several previous posts on the limitations of BMI as an indicator of health and it were indeed these limitations that prompted us to develop the Edmonton Obesity Staging System as a more clinically relevant measure of obesity.

So, while moderate excess weight may not cause apparent health problems in the young, obesity remains a significant risk factor for poor health in middle-aged adults.

AMS
Vancouver, BC

Jarrett B, Bloch GJ, Bennett D, Bleazard B, & Hedges D (2010). The influence of body mass index, age and gender on current illness: a cross-sectional study. International journal of obesity (2005), 34 (3), 429-36 PMID: 20010903

Looks like the Europeans may be onto something here. The following is from the European Obesity Day website:

It’s estimated that over half of the European population is overweight or obese. Whilst it is often seen as something that affects body image and confidence, being overweight is extremely detrimental to health, causing huge personal and public health issues across Europe.

We’re not just talking about feeling sluggish and unfit. Being overweight or obese increases the risk of developing serious life-threatening illnesses such as type 2 diabetes and heart disease – two of the leading causes of preventable death worldwide.

However, what many people don’t know is that if you’re overweight, losing 5-10% in body weight can significantly improve your health.

That’s right – gradual, steady weight loss which results in a 5-10% decrease in body weight can help you feel fitter, healthier and reduce the likelihood of you suffering from high blood pressure, type 2 diabetes and stroke.

Europe’s obesity epidemic is already here – and we need to take the right action now!

Losing weight is really tough and helping people lose weight (not just preventing weight gain) is key. Governments are taking steps to prevent people becoming overweight, but we believe that to truly create a healthier Europe today, more effort is needed to help those who are already overweight or obese.

Through our campaign, 5-10 for a healthier Europe, we want to harness support and backing to help overweight and obese citizens lose 5-10% of their overall body weight, collectively improving the health of our nations and enriching the lives of people across Europe.

We want to raise public awareness of the need for action by all – from Governments to individuals –to make genuine and practical steps to help people reach a healthy weight in order to reverse Europe’s obesity epidemic.

What you can do?

Help our European friends by joining their citizens’ initiative petition, where they are hoping for 1 Million signatures!

Click here to sign the petition

Do you think it is time for our own petition here in Canada?

AMS
Frankfurt, Germany

Yesterday, I had the pleasure of spending a beautiful warm and sunny day ( in Whitehorse. Located around two flight hours north-east of Vancouver, Whitehorse is the capital of Canada’s north-western most territory. A city of roughly 22,000, Whitehorse is home to roughly two-thirds of the territory’s population.

I was invited by the Yukon Health and Social Services to meet with dietitians, physicians and other health professionals to discuss obesity management in the Yukon. My visit followed in the tracks of a recent visit by the Edmonton Weight Wise staff, a few weeks ago. Currently, the Whitehorse General Hospital, the only hospital in the Yukon, does not have the capacity to provide bariatric services although there is clearly an increasing recognition of the need for a local obesity program.

In the past years, many patients from the Yukon have been referred for bariatric assessment and surgery to our program in Edmonton, but the distances (especially for bariatric patients) make this a most expensive and ineffective endeavor. The aim of my visit was therefore to provide input into the possible creation of bariatric assessment and management services in Whitehorse itself.

Given the attendance and level of discussion, I have no doubt that there is an increasing recognition for the immense need for such services for the local population. Particularly given the large local aboriginal population, which appears particularly prone to obesity and its complication, there is no doubt that serious consideration of developing obesity management locally will in the end be cost-saving and likely the only feasible route to managing the obesity problem.

During my visit I not only visited the only long-term bariatric suite in Whitehorse but also saw, what I was told, was the only bariatric wheelchair in the city (I understand it is in high demand).

I am grateful to my most generous hosts for their kind hospitality and very much look forward to working with my new Yukon friends to help address this pressing and growing health issue in Canada’s North.

AMS
Edmonton, Alberta

Indigenous populations in most Westernised countries are well known to be particularly susceptible to obesity - the same can be certainly be said for Canada’s high Arctic Inuit population.

In a study just published online this week in the International Journal of Circumpolar Health, Tracey Galloway and colleagues from the University of Toronto and Montreal’s McGill University present results from the Nunavut Inuit Child Health Survey, a study in preschool-aged Canadian Inuit children.

As part of a larger study of population health across the Canadian High Arctic, the survey collected growth and nutrition data on 388 children aged 3 to 5 years.

While mean height-for-age was comparable, body mass index z-scores were significantly greater than a standard US reference population for all age and sex categories.

The overall prevalence of overweight was 50.8%, with significantly more boys (57.1%) than girls (45.2%) in the overweight category.

Although, the researchers could not find a definite explanation for the increased obesity risk in any of the biological, socio-economic and dietary factors, including birth weight, breastfeeding, day care attendance, traditional and market food consumption and sweetened beverage consumption in this population, they concede that their sample size may have been too small to detect such associations.

Nevertheless, a recent separate report from this survey, published in CMAJ, shows a high degree of food insecurity and a high prevalence of poverty indicators, both of which have been related to obesity in other populations.

In fact, the data on food insecurity are shocking: nearly 70% of Inuit preschoolers resided in households rated as food insecure. Children from severely food-insecure households experienced times in the past year when they skipped meals (75.8%), went hungry (90.4%) or did not eat for a whole day (60.1%).

In households in which children were moderately food insecure, primary caregivers reported experiencing times in the past year when they worried food would run out (85.1%), when they fed their children less expensive food (95.1%) and when their children did not eat enough because there was no money for food (64.3%).

Whatever the drivers of the childhood obesity epidemic, these new numbers certainly do not spell out a healthy future for Canada’s Northern-most inhabitants.

AMS
Edmonton, Alberta