Solution to obesity, pollution, congestion and social issues is ‘glaringly, frighteningly simple’ says Boardman

Jimmy Ray Will wrote:

If I look at my kids, they are both lean, but they both enjoy a MacDonalds, a KFC, chocolate, sweets etc.... the reason they're not fat is because there is an awareness that these foods are the exception and not the rule when it comes to nutrition. That is, as said above, hardly rocket science.

And I hope they stay that way and healthy.
But as said above, it may not be rocket science but it is complex biochemistry and diabetes is now affecting more and more people who have never been obese, because of the food we eat. Even so called healthy food (ie low fat) is in many cases more of a health risk than their full-fat equivalents. Believe in the simplistic calories in vs calories out message at your peril - its way more complicated than that and the dieticians are only just now waking up to the research that is turning the old certainties on their heads, over the last decade.

andybwhite wrote:

Jimmy Ray Will wrote:

If I look at my kids, they are both lean, but they both enjoy a MacDonalds, a KFC, chocolate, sweets etc.... the reason they're not fat is because there is an awareness that these foods are the exception and not the rule when it comes to nutrition. That is, as said above, hardly rocket science.

And I hope they stay that way and healthy.
But as said above, it may not be rocket science but it is complex biochemistry and diabetes is now affecting more and more people who have never been obese, because of the food we eat. Even so called healthy food (ie low fat) is in many cases more of a health risk than their full-fat equivalents. Believe in the simplistic calories in vs calories out message at your peril - its way more complicated than that and the dieticians are only just now waking up to the research that is turning the old certainties on their heads, over the last decade.

Hmmm, I'm not too sure that suggesting the occasional McDonalds etc may generate diabetes in otherwise healthy, lean people is the right are of focus.

For me that is chapter 3 or 4. First up surely, is addressing the extreme ends of the spectrum... you want to change mindsets, saying that everyone can only ever chew on root vegetables is only going to generate resistance to change.

A moderate, varied diet is good enough for the UK I am sure.

Low carb diets do work for short term weight loss, but at a cost:

http://nutritionfacts.org/video/low-carb-diets-and-coronary-blood-flow/

http://nutritionfacts.org/video/atkins-diet-trouble-keeping-it-up/

Except if you do it this way:

http://nutritionfacts.org/video/plant-based-atkins-diet/

IanW1968 Why don't you write the driver a nice polite note pointing out the error of their ways preferable with a set of keys across the bonnet

Ush wrote:

I think some skepticism on the simplistic "exercise more and eat less" meme is probably required. Stephane Guyenet is worth reading on the idea of the "adipostat".

http://www.ncbi.nlm.nih.gov/pubmed/22238401

Poor storage of glucose in early stage (even subclinical) T2 diabetes where insulin resistance and the resultant hyperinsulinemia cause dietary glucose (carbs) to be stored as fat instead of in the muscles as glycogen is one mechanism - it causes weight gain and simultaneously reduces available energy disincentivising exercise.

There also seems to be some tie in with leptin signalling which provides a more direct feedback loop for adipose homeostasis (http://en.wikipedia.org/wiki/Leptin).

I've done a lot of reading about various aspects of health and nutrition over the last year and I have shifted considerably from my original "calories in calories out" and "it's just willpower" stance to one where I think we have both a complex and a serious problem and we need to attack it from several angles at once - encouraging cycling is an important part of that but it's just a part

FatFreddie wrote:

I've done a lot of reading about various aspects of health and nutrition over the last year and I have shifted considerably from my original "calories in calories out" and "it's just willpower" stance to one where I think we have both a complex and a serious problem and we need to attack it from several angles at once - encouraging cycling is an important part of that but it's just a part

Agreed. What has become more obvious (in no small part due to the work that Gary Taubes has done) is that this is an extremely complex area and that anyone running around telling other people that they know (preferably in capital letters) what is good for them is at best woefully under-informed. Confidence of ignorance and all that.

bigshape wrote:

i blame greggs.

They are only a company supplying what is wanted. Ditto McDonalds, Marlboro, cocktail bars etc etc. Why should they be expected to set the agenda? They would change instantly if their customers stopped eating the shit they serve and asked for something healthier.

oozaveared wrote:

The obese ones will be the poorer folk that are not paying for healthcare and are covered by either the state or federal programmes.

Lots of seriously overweight professional types in USA. While being defined as obese might seem to be a working class condition there are lots of well-paid fatties too. I also know of plenty of well paid people in the UK who are very overweight, just look at the shape/BMI of our MPs.

I also can't see how you can effectively tax people for being overweight. I'd prefer to tax products, not consumers. Having said that, it appears that charging a premium for cigarettes hasn't deterred many smokers. Binge drinking has been increasing for some time now despite the fact that alcohol is not cheap.

Simon E wrote:

I also can't see how you can effectively tax people for being overweight. I'd prefer to tax products, not consumers. Having said that, it appears that charging a premium for cigarettes hasn't deterred many smokers. Binge drinking has been increasing for some time now despite the fact that alcohol is not cheap.

I think airline ticket prices should be based on total weight of passenger+luggage. Not a tax I agree, but sending out the message that if you weigh more some things cost more.

Simon E wrote:

Lots of seriously overweight professional types in USA. While being defined as obese might seem to be a working class condition there are lots of well-paid fatties too. I also know of plenty of well paid people in the UK who are very overweight, just look at the shape/BMI of our MPs.
.

Both the reported statistics I've seen (which might be out of date) and my personal observations, seem to show that that being obese is correlated with being poor/working class/low-SES (whatever you want to call it) for women, but not for men. For men it doesn't correlate to class or wealth at all, though overall men are slightly fatter than women I think (though there's very little in it).
I don't think this is at all surprising, if you think about it.

(Who deals with the food in poorer families, who is more likely to be out-and-about vs being stuck at home? For men, being broke is as likely to require _more_ physical activity than less, more manual labouring jobs, more walking to work, more keeping fit as a source of status, and, er, possibly more running away from the police. Whereas poorer women are probably stuck in the home dealing with child-care, while posh women seem very keen on staying thin in part to emphasise they aren't poor).

In the US the most overweight group, I think, are black women.

bigshape wrote:

i blame greggs.

I do aswell, after I cycle into town about 10 miles, I treat myself to a warm sausage roll

Simple solution, fat fookers get off your arses(I used to be one) and do some physical exercise, eat less. Told you it was simple.

fenix wrote:

I dont think its carbs or fat or protein or whatever....

I think the problem is the availability of cheap food.......

You can eat very healthily and still get fat. Look at cows. HUGE and they eat salad all day long...

Its willpower and knowledge. You have to know how many calories you're eating and how many you're burning. If theres a difference - you'll get fat. .........Its really not rocket science. ..

To answer you fenix:

I agree cheap food is the problem. It's mostly carbohydrate based and produced using lots of additives which you wouldn't want to eat if you knew what they did to you.

As for cows - they may be big but they're not fat - fatty meat doesn't sell so they're pumped full growth hormones (in the USA at least) to bulk them up.

Knowledge. Yes it is all about knowledge. It may not be rocket science but it is biochemistry and its way more complicated than calories in vs calories out. its that simplistic approach beloved of political soundbites which is stopping us from getting out of this mess.

Martyn_K wrote:

It makes you wonder if the NHS is such a good thing. I wonder what peoples attitudes to healthy living would be if they HAD to pay for their own healthcare instead of having a state funded service.

The NHS should be a safety net, not something relied upon and the first port of call to resolve self inflicted problems.

That argument doesn't hold water. People choose to buy their own booze and fags but that doesn't stop them trying very hard to kill themselves with one or both of these extremely toxic products.

Simon E wrote:

Martyn_K wrote:

It makes you wonder if the NHS is such a good thing. I wonder what peoples attitudes to healthy living would be if they HAD to pay for their own healthcare instead of having a state funded service.

The NHS should be a safety net, not something relied upon and the first port of call to resolve self inflicted problems.

That argument doesn't hold water. People choose to buy their own booze and fags but that doesn't stop them trying very hard to kill themselves with one or both of these extremely toxic products.

I think he's talking about a more direct and less aggregated connection between what we pay for healthcare and how we regard it. I think there is something in that but not necessarily a straighforward mapping.

Basically if you paid a personal premium to the NHS and not an aggregated one and if it went up 50% for being a smoker and another 30% for being a fatty based on your risk /cost to the NHS then some people might amend their behaviour. Difficult in practice mainly because the ultimate sanction of refusing healthcare to people that abuse the system and refuse to pay premiums isn't available.

but there is plenty that could be done to make the connection stronger such as an annual account of your costs and contributions.

Martyn_K wrote:

It makes you wonder if the NHS is such a good thing. I wonder what peoples attitudes to healthy living would be if they HAD to pay for their own healthcare instead of having a state funded service.

The NHS should be a safety net, not something relied upon and the first port of call to resolve self inflicted problems.

Indeed, this works great in 'murica... O Wait.

TheHound wrote:

Martyn_K wrote:

It makes you wonder if the NHS is such a good thing. I wonder what peoples attitudes to healthy living would be if they HAD to pay for their own healthcare instead of having a state funded service.

The NHS should be a safety net, not something relied upon and the first port of call to resolve self inflicted problems.

Indeed, this works great in 'murica... O Wait.

Well 'murica does kind of prove his point. People that essentially pay for their own health care in America do tend to take it rather seriously. It's a big expensive bill and matters like smoking, obesity, alcohol abuse whack your premiums right up. But if the state or Fed is picking up the tab as it does for poor people then there does seem to be a disregard.

I think there's a generally held urban myth that if you can't pay the hospital or doctor in America then you don't get one and then you die. All that actually happens in practice is that the state pays the bill. In so doing it sends you to doctors you don't choose in hospitals it specifies and gives you the treatment it deems to be the most cost effective. Instead of your own room, you get put on a ward with others and essentially you get what you're given and you're expected to be grateful. A bit like the NHS in fact.

It's not so very different as it is here. If you go private it's all nice hospitals and a choice of surgeon at a time that suits you. If you use the NHS you get a good medical service but no nice bells and whistles.

oozaveared wrote:

People that essentially pay for their own health care in America do tend to take it rather seriously. It's a big expensive bill and matters like smoking, obesity, alcohol abuse whack your premiums right up.
.

America - one of the fattest nations on the planet with massive problems of obesity, heart disease, diabetes and obesity related cancers.... and private health care ... sure they take their own health seriously - NOT!

It the country that invented industrial carb based cheap food and they and the rest of us that follow are paying the price.

andybwhite wrote:

oozaveared wrote:

People that essentially pay for their own health care in America do tend to take it rather seriously. It's a big expensive bill and matters like smoking, obesity, alcohol abuse whack your premiums right up.
.

America - one of the fattest nations on the planet with massive problems of obesity, heart disease, diabetes and obesity related cancers.... and private health care ... sure they take their own health seriously - NOT!

It the country that invented industrial carb based cheap food and they and the rest of us that follow are paying the price.

not reading what I said eh. There is massive inequality in America. They also have some of the fittest and most health conscious people on the planet as well.

The ones that pay for their own healthcare do tend to be quite health conscious because the premiums directly reflect their lifestyle choices among other things.

The obese in America are almost certainly not paying for their own healthcare because no private healthcare insurer would even quote them. Obesity maps very strongly in the UK and the USA on to income.

So if you are well enough off in the USA that you're outside state or Fed health programme eligibility then you pay for your own healthcare usually by insurance. So if you're one of those people then you do take your health seriously because if you are obese you won't get either insurance or be allowed on state or federal programme. So if you get ill you can be bankrupted.

Most what we might term "middle class" America (Middle class means something different over there ie not super rich or super poor ie the vast mass) but well paid professionals do not tend to be obese.

The obese ones will be the poorer folk that are not paying for healthcare and are covered by either the state or federal programmes.