Airline Seats Revisited

BEST HEALTH BLOG FINALIST: The second round of voting is on – please vote AGAIN for your favourite health blog by clicking here Last week I blogged about the recent Supreme Court ruling mandating that airlines accommodate oversized passengers. This ruling was picked up by international media, especially in the US, where in light of their own obesity epidemic, this ruling attracted substantial attention. In fact, I was interviewed by MSNBC for my take on this, especially with regard to the question how airlines should determine who would qualify for an extra seat and who would not. My simple solution, as reported by MSNBC was as follows: “You can’t bring it down to a BMI. People’s body shapes are different.” Instead, the chair of obesity research at the University of Alberta suggests a solution inspired by the baggage sizers already in place at many airports. Instead, Sharma would like airlines to place an airplane seat in the terminal — “somewhere that offers travelers a bit of privacy.” Then, if it’s not obvious that a traveler won’t fit in one seat, they can sit in the sample seat. “If they don’t fit in the seat, then they’re too big and they’ll need to have that extra seat. At no cost. It’s not rocket science.” Obviously, other “experts” had other suggestions including bringing in doctors’ notes or simply increasing the seat sizes for everybody. For a full report on this story click here. If readers of this blog have any other suggestions – I’d love to hear them. AMS Edmonton, Alberta

Full Post

Severe Obesity is Not a Choice!

Last week, the Supreme Court of Canada passed a ruling that would entitle severely handicapped individuals to be accommodated on airlines and specifically extended this ruling to include individuals, who were severely handicapped because of excess weight. This ruling resulted in a flood of raves and rants on why the Supreme Court would promote obesity by accommodating rather than punishing obese people for their laziness and indulgence. The Globe & Mail commentator went as far as to imply that by extending the ruling to obese individuals, the Supreme Court was in fact undermining the case for people with “real disabilities”. In light of this ridiculous and discriminating accusation, I could not help but write the following letter to the Globe & Mail: As Medical Director of one of the largest medical obesity programs in the country, I am appalled at the notion that including obesity in the recent Supreme Court judgement on accommodation of disabled people on airline flights, should be considered by the Globe & Mail commentator as anything but fair. To be clear, this ruling does not provide free rides for anyone with a few pounds excess weight – this ruling is specific in that it addresses the issues of individuals, who suffer from a condition so disabling that they require help with even the most basic functions. The idea that someone with such severe disabling obesity, has gained that amount of weight (often several hundred excess pounds) simply by lack of willpower or sheer laziness rather than some underlying genetic, mental heath or medical issue is not only naïve but also reflects the prevailing negative stereotyping, prejudice and discrimination toward obese individuals, that appears to be perfectly acceptable even to otherwise compassionate and reflective individuals. But that is not even the point. The point is that the Globe & Mail commentator, unlike the Supreme Court, uses causality as a criterium for judging which disability is deserving of special accommodation and which is not. By those standards, it would be fair to ask if the person claiming disability due to a spinal cord or brain injury from a motor vehicle accident was in fact observing the speed limit at the time of the accident or if the person who suffered a disabling stroke always religiously took her blood pressure medications and passed on the salt. Singling out individuals disabled by severe obesity as the only group undeserving of special accommodation… Read More »

Full Post

Obesity and Oil Prices Fuel Bike Sales

Regular reader of this blog know of my passion for utilitarian biking – while you’ll never catch me on an exercise bike, I’m happy to ride my bike if it gets me where I need to go. But there’s a chance that with increasing rates of obesity and higher oil prices, I soon won’t have the bike paths to myself anymore. According to an article in this week’s ECONOMIST, Giant Manufacturing, the world’s largest bicycle-maker (Taiwan), sold a record 460,000 units last month. For many models, buyers now put down deposits months before their bikes come off the assembly line (reminds me of the current situation with hybrid cars). Apparently since 2004, wholesale prices of bikes have gone up by 23% in Europe, 45% in America and almost 50% in Asia, even as thousands of low-cost factories churn out boatloads of cheap bikes. For more on the economics of the bicycle check out the full article in the ECONOMIST. AMS Edmonton, Alberta

Full Post

Will Active Commuting Solve the Obesity Crisis?

Yes, we live in a society that is designed for and continues to be dependent on the automobile. This may well be an important variable in the multitude of factors that are believed to be driving the obesity epidemic (no pun intended). So how much would active commuting (i.e. walking or biking to work) help reduce the burden of obesity? This question was now reviewed by Roy Shephard from the University of Toronto in a paper just out in Sports Medicine. According to Shephard, while children and adolescents prefer cycling, for adults issues of safety, cycle storage and company dress codes make walking the preferred option, particularly in North American cities, where urban design and weather conditions often do not favour cycling. Nevertheless, active transportation is more frequent in some European countries with dedicated cycle and pedestrian paths, but in most developed societies, active transportation has declined in recent years. Attempts to increase walking behaviour in the sedentary population have had only limited success to date. A weekly gross energy expenditure of at least 4 MJ (~1000 KCal) is recommended to reduce all-cause and cardiovascular mortality. This can be achieved by walking 1.9 km in 22 minutes twice per day, 5 days per week, or by cycling at 16 km/h for 11 minutes twice per day, 5 days per week. When engaged in level walking, this intensity of effort may be adequate for cardiovascular benefit in older adults, but in fit young workers, it is necessary to either increase the pace or choose a hilly route in order to induce cardio-respiratory benefit; in contrast, cycling is likely to provide an adequate cardiovascular stimulus even for young adults. Empirical data to date have yielded mixed results: a reduced all-cause and cardiovascular mortality has been observed more frequently in cyclists than in walkers, and more frequently in women and older men than in young active commuters. More information is needed concerning the typical weekly dose of activity provided by active commuting, and the impact of such commuting on overall attitudes towards physical activity. It is also necessary to find better methods of involving the sedentary population, through both counselling and changes in urban design. So while I have no illusions that we are going to solve the obesity epidemic by active commuting anytime soon, I for my part, am glad to see that my daily 7 KM (24 min) bike ride to… Read More »

Full Post

Gas Poor

So yesterday, I blogged about the fact that nothing short of a catastrophic crisis is likely to reverse the obesity epidemic any time soon. I used the example of $4/litre gas prices. Today, I heard a term for the first time that kind of addresses this issue: “gas poor”. I’ve previously heard of “house poor” and “divorce poor” but “gas poor” – to me that was a new one. So how is being gas poor going to affect obesity? Here are some scenarios: 1) You decide to continue driving your truck or SUV no matter what – and save on foods – i.e. no more expensive fruits and veggies – more cheap junk food. 2) You decide to switch to the rather ineffective public transportation – your commute to work is now twice as long – you have even less time to exercise or prepare a healthy meal. 3) You decide to work from home – your risk for boredom, loneliness, snacking and even less physcial activity goes up. 4) You decide to walk or ride a bike to work (if you’re lucky enough to live close enough) and you get fitter and healthier (even if you don’t lose weight). But seriously, how many of us actually have option 4? There may be other options like car pooling, moving closer to work, getting a smaller car or Vespa, no idea how those will impact your health. Interestingly, this week truck drivers in Spain went on strike against the high gas prices resulting in a nation-wide shortage of fresh fish, meat, fruits and vegetables – my guess is people are turning to conserves, chips and (salt-laden) frozen meals. Perhaps even hope in a “catastrophic” event like astronomic gas prices to prevent and reduce obesity may be futile after all. AMSEdmonton, Alberta

Full Post