jeudi 17 octobre 2013
HEALTHY OVERWEIGHT VS UNHEALTHY OVERWEIGHT: PROCESSED FOOD MAY PLAY A ROLE
TROUBADOURS OF TRAGEDY: THE LOSS OF TRUST IN EPIDEMIOLOGISTS
Epidemiologists are bureaucrats of Western Medicine. They are usually male, middle aged; White and lack people skill or communications skills but brilliantly hide behind numbers, which they crunch, using tools they or their colleagues invent. They do not do field studies, nor are they clinicians who have to take care of sick people. Epidemiologists not only are ignorant of sicknesses affecting the individuals but are experts in creating sicknesses by manipulating numbers, one such thing being, Pre-Hypertension, Metabolic syndrome etc.
They can predict and given the responsibility to do so by the governmental agencies so that health policies for the societies could be drawn up. What a pity!
During my career I have seen them come up with “patch work” causes of one single physical manifestation, Obesity, which was recently got into the hall of fame as a Disease. One would study would show that single mothers were overweight, as if it is the fact that they are single mothers is the primary cause or association.
(a very successful north american export)
Having now seen 97 causes or associations why a person becomes OBESE, I am convinced that further epidemiological studies are not to be trusted. Lately studies are emerging to say that what they said earlier is not true. Such is life.
On the other hand, scientifically oriented, clinically minded researchers are coming up some good answers or solutions. An excellent paper from Finland on twins could show that there are metabolically healthy and metabolically unhealthy overweight and obese people. Fatty liver was the distinguishing feature there.
Of course we all know what causes NAFLD, non-alcoholic fatty liver disease. The epidemiologists will tell you that it is associated with Type 2 Diabetes but more and more scientific research is pointing the other way, it is the fatty liver that may be causing the type 2 Diabetes.
So we now have metabolically healthy overweight and metabolically unhealthy overweight categories (MHO vs. MUO?). It is also an explanation of why only a very small percentage of Overweight or Obese people ever get Type 2 Diabetes.
Of course no one wants to take on the food industry (McDo is a sponsor at International Diabetes Federation meetings and how many of these mavens who would be speaking at IDF in Melbourne in December 2013 are on speaking trips for food industry or drug companies, I would guess upwards of 59%)(I have become so sensitive to this issue that if ever I see the name Fonseca or Groop on a panel or an article, I don't read it or listen to them)
There is no doubt that the so-called nouveau western diet: high is processed food is the cause of Fatty Liver, not the carbohydrate or protein or fat but the quality of these ingredients. If ever you saw what they do to cattle in the “farms” in the state of Nebraska you may never want to eat meal again, because of the high infiltration of antibiotics, growth hormones and other plastic in the cattle feed.
So the recent issue of JAMA Surgery journal had the news that BMI (the measure of obesity or overweight) had the least predictive risk factor for mortality rate over 10 years in obese patients.
First of all, I looked up the original article, not “readers digest” kind of free medical literature sent to the doctors on a daily basis by the drug company supported journalists.
Before reading the article, I checked out the lead author, Dr Padwal. He is a practising physician, not an office-based epidemiologist without any contact with patients and this doctor actually looks after the illness in obese people.
Next to see their affiliations. The authors are university-affiliated people but the main support for their research comes from the State Government and the University. They do have some commercial ties but it does not seem to be with any of the heavy weights (sorry for the pun).
Conclusion was simple and straightforward: In patients who are obese, all cause 10 year mortality can be estimated using a simple 4 variable prediction based on age, sex, smoking and diabetes mellitus. BODY MASS INDEX WAS NOT AN IMORTANT MORTALITY PREDICTOR.
Ah, well. Another one of the trumpets of the troubadours of tragedy, the Epidemiologists, is silenced.
One of the axioms I have learned from the Oppressed First Nation/Aboriginal/Native people
Try to be Healthy in the Body you have..