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Author: VWheelock

14.Do You Really Want to Lower Your Cholesterol?

  We are repeatedly told that we must have low levels of blood cholesterol (TC) if we wish to reduce our risks of developing heart disease. In fact this is the rationale which underpins a key element of the NHS policy. This means that if your TC is considered to be too high (above 5.0Mmol/L) you may well be prescribed drugs in order to reduce it. So it not in the least surprising that many people have been advised to take TC lowering drugs such as statins. There is little doubt that these drugs are effective in lowering TC but the critical question which has to be addressed is: “Does this medication actually improve health?” In BLOG 8 I referred to several research reports which conclusively demonstrated that death rates due to all causes increase as the TC goes down. What is more there is no reliable evidence that there are significant increases in the all-cause mortality rate at relatively high levels of TC. In fact there are very strong indications that in those over 60, especially in women, the higher the TC value the greater the life expectancy. In the light of this information it is evident that the fundamental justification for lowering TC levels just does not stand up to critical evaluation. Nevertheless it is still possible that the statins may be beneficial. The key factor to...

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13.Yet Another Report on Obesity and What to Do about It

  At the beginning of this week The Academy of Medical Royal Colleges released the latest report entitled: “MEASURING UP: THE MEDICAL PROFESSION’S PRESCRIPTION FOR THE NATION’S OBESITY CRISIS” There are 10 key recommendations which it is believed are necessary if progress is to be made in tackling the obesity crisis in the UK.   Unfortunately it trots all the same arguments which not only exaggerate the dangers of people being overweight/obese but also continue to proclaim that the problems will be solved by applying the approach which has manifestly failed to deliver the results expected.   I will just deal a selection of the flaws contained in this report which apparently is supposed to represent the views of almost the entire medical profession. According to the report: “Obesity is one of the largest public health threats facing many of the wealthiest nations in the 21st century. Every day doctors treat people, young and old, who are facing the health consequences of being overweight or obese, such as high blood pressure, type 2 diabetes, heart disease, strokes, depression, and some major cancers. These illnesses are putting our nation’s health – and the budget of the NHS – under strain, and the contributions of overweight and obesity are growing.” It is simply not true that people who are overweight have serious health problems. There are several reliable and comprehensive studies which...

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12. Fitness not Fatness is the Issue

Despite all the emphasis on BMI as an indicator of health status/risk of dying the fact remains that for any given body weight/BMI there is a wide variation in health because many others factors can come into play. A recent study conducted in the USA has analysed the impact of various demographic and behaviour-related factors likely to affect all-cause mortality. 3,617 men and women were monitored between 1986 and 2005 during which time there were 1,409 deaths. The results confirmed earlier findings that low income is a predictor of mortality when allowance is made for major health risk behaviour. By contrast, physical activity – even at relatively low levels – provided a protective effect against mortality. Those with little or no physical activity had a 60% higher mortality rate than those who were reasonably active. The risk of death was not associated with obesity or overweight. For those over 55 at the start of the investigation, mortality rates were significantly reduced for those who were overweight or obese(1). The levels of physical fitness for different BMI values were compared in 2603 men and women aged 60 years and over. 450 deaths were recorded over the 12-year follow-up period. The participants who died were older, less fit and had higher cardiovascular risks than those who survived.  The results in Table 1 show that there is very little difference in the death...

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11. Relationship between BMI and Death Rates from Different Diseases

  The official approach to obesity is based on the fact that there is an increased incidence of diabetes, heart attacks and certain cancers as the BMI increases. But there are many other causes of death and to obtain a comprehensive perspective we need to consider all the different diseases/conditions which contribute to ill-health and death. Katherine Flegal’s team, whose detailed work (BLOG 10) provided convincing evidence that those in the BMI “overweight” category had a lower death rate than those with a “normal” BMI has analysed  the causes of death in the different BMI categories(1). The results are shown in Table 1. TABLE 1 RELATIONSHIP BETWEEN BMI AND EXCESS DEATHS (1000s)                                                                BMI Cause of death <18.5 18.5-25 25-30 >30 Coronary heart disease +3 0 -12 +6 Other   cardiovascular +8 0 -5 +36 Lung   cancer 0 0 -10 -7 Obesity   related cancer 0 0 -3 +20 All   other cancers +3 0 +3 +2 Diabetes/kidney   disease 0 0 +15 +34 Chronic   respiratory +16 0 -30 -6 Acute   respiratory/infectious +8 0 -8 -3 Injury +2 0 -32 -13 Other   causes +6 0 -52 +13 ALL +46 0 -134 +82   The findings for the “overweight” category confirm that there is an increase in the deaths from diabetes but that the reductions in deaths from a variety of other causes are...

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10.What is the Evidence that being Overweight or Obese as Determined by BMI is dangerous?

  In 2005 the authoritative Journal of the American Medical Association published the results of a study conducted by Katherine Flegal and colleagues at the respected Center for Disease Control (CDC).  This work is an analysis of data derived from the National Health and Nutrition Examination Survey (NHANES) conducted in the USA. It was started in the 1970s and has continued until the present day. Large numbers of people are involved. Participants report regularly to a centre where various measurements are taken by professional health workers to ensure that the quality of the data is absolutely first class. The normal BMI range has been taken as the benchmark and given a value of 1.00. The results are shown in Table 1. TABLE 1 CDC STUDY RELATIVE RISKS ALL-CAUSE MORTALITY BMI 25-59 Years 60-69 Years >70 Years <18.5 Underweight 1.38 2.30 1.69 18.5-25 Normal 1.00 1.00 1.00 25-30 Overweight 0.83 0.95 0.91 30-35 Obesity Class I 1.20 1.13 1.03 >35 Obesity Class II 1.83 1.63 1.17   These results show that risks of dying are slightly smaller in the ‘’Overweight’’ category than in the ‘’Normal’’ one.  The risks of those in ‘’Obese (Class I)’’ are only marginally increased, especially those aged over 70 years(1). In Canada 11,326 men and women aged 25+ at the outset were monitored over a 12-year period commencing in 1994/1995 as part of the National Population...

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    about 27 mins ago
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