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Wednesday, October 6, 2010

Obesity is NOT a public health burden

Which removes the major rationale for government intervention. The comments below by economist Ross Gittins are based on conventional assumptions -- which are in turn based on dogmatic interpretations of epidemiological findings -- but if those findings are usable to condemn obesity, it seems equally reasonable to use those findings to exonerate it. What's good for the goose is good for the gander

I have bad news and good about the O-word. Although there has been a suggestion in some quarters that the media got over-excited about the "obesity epidemic", a report from the Organisation for Economic Co-operation and Development - unlikely to be a purveyor of faddish enthusiasms - has confirmed the seriousness of the problem.

The report says obesity is worsening throughout the developed world and becoming the top public health concern. One in two people is now overweight or obese in almost half the developed countries. In some, two out of three people will be in trouble within 10 years.

In Australia, 61 per cent of adults are overweight or obese, making us almost as fat as the Americans. In 20 years, our overweight rate has risen faster than in any other developed country. It is projected to rise another 15 per cent in the next 10 years.

And the good news? It's saving taxpayers money.

Although healthcare spending for obese people is at least 25 per cent higher than for someone of normal weight, and increases rapidly as people get fatter, severely obese people are likely to die eight to 10 years earlier, so their shorter lives mean they incur lower healthcare costs over their lifetime. It's even greater than the saving on smokers.

If you don't like that, try this. As measured by gross domestic product, obesity is a win-win-win situation. The more you eat the more you add to GDP and the profits of businesses. If the messages of advertising and marketing make you self-conscious about your overweight, everything you spend on fancy diets, gym subscriptions etc adds to GDP.

And then when you damage your health, everything you, the government and your health fund spend on trying to keep you going adds to GDP. Even when you die prematurely that won't count as a negative against GDP, although the absence of your continued consumption will be missed.

Two of our greatest campaigners on obesity are Garry Egger, the professor of lifestyle medicine at Southern Cross University and the founder of GutBusters, and Boyd Swinburn, professor of population health at Deakin University.

They've written a book, Planet Obesity, which takes a rather different tack. Since obesity is endemic, it can't be dismissed as the product of gluttony and sloth on the part of a few individuals.

Obesity has been rising since the 1980s. Before then it was rare. Clearly, it's a product of our modern lifestyle, of the way we organise our society.

We're getting fatter for a host of interacting reasons. According to the OECD report, the supply and availability of food altered remarkably in the second half of the 20th century, brought about by big changes in food production technologies and an increasing and increasingly sophisticated use of promotion and persuasion.

The price of calories fell dramatically and convenience foods became available virtually everywhere, while the time available for traditional meal preparation from raw ingredients shrank as a result of changing working and living conditions.

"Decreased physical activity at work, increased participation of women in the labour force, increasing levels of stress and job insecurity, longer working hours for some jobs, are all factors that, directly or indirectly, contribute to the lifestyle changes which caused the obesity epidemic," the report says.

See what this is saying? The rise in obesity is a product of the success of capitalism and the technological advance it fosters and exploits.

People in developed countries have been getting taller and heavier since 1800. For almost all that time, our weight gain has made us healthier but in recent decades it's greatly accelerated and is now making us unhealthy.

Until fairly recently, economic growth was making us unambiguously better off. Making us more secure, more prosperous and, because of scientific advances, improving our health. But now we've overshot the sweet spot and continued economic growth is starting to worsen our health.

SOURCE





Another bit of conventional wisdom bites the dust

Skipping 'kiss' during kiss of life may be better: research

Skipping the kiss when giving the "kiss of life" could help save more lives, doctors have discovered. People who suffer a cardiac arrest in the street are more likely to survive if bystanders carry out chest compressions without stopping to give "mouth-to-mouth".

The study found that the survival rate of people who received conventional CPR, including the kiss, was 7.8 per cent. This compared with 13.3 per cent for those who were given compression-only CPR.

It is thought the decline in blood circulation when people stop chest compressions to give rescue breaths causes some resuscitation efforts to fail.

The time taken to get adequate blood low going again after the pause is also detrimental.

Several other studies have also shown compression-only CPR may be better than the traditional method and experts say bystanders may be more willing to attempt it if no rescue breaths are required.

The study by the Arizona Department of Health Services in Phoenix was published in the Journal of the American Medical Association.

Dr David Cone, of the Yale University School of Medicine, wrote in an accompanying editorial that further research should be conducted in this area.

International organisations on resuscitation are currently reviewing guidelines.

SOURCE

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