Monday, 13 January 2014

Misinformation, ignorance and prejudice masquerade as a serious article about obesity.


A friend of mine at university once described articles written by the likes of Enoch Powell or Tony Benn as superficially works of logical completeness and coherence that, on closer examination, reveals a huge leap of what can only be faith half way through the article.

This article on obesity lacks the intelligence, wit or wisdom of Enoch or Tony but it suffers the same problem. It starts like this:

McDonald’s cookies have an energy density comparable to hydrazine. Hydrazine is a rocket fuel used to manoeuvre spacecraft in orbit. It was astonishing, then, to watch a small child graze through two boxes of the desiccated biscuits in one sitting. His parents watched on, preoccupied with their own colossal meals: a noxious amalgam of meat, grease and sugar.

Now I'm not about to defend the quality of McDonald's food (although - and we'll return to this - there isn't any proven link between fast food and obesity) but we know where the author is coming from. We have a problem with obesity and, our author argues, it isn't enough to say that it's a matter of personal choice.

It's an argument - one I don't agree with but an argument nevertheless. And we do have a problem with obesity. However, the author loses me with this single line:

Over 63% of Australian adults are overweight or obese.

Note what has been done here. We were talking about obesity - being grossly and unhealthily overweight - and suggesting that perhaps the morbidly fat really do have a problem resisting food. But now all of a sudden we're talking about obese and overweight. We have, to use that piece of sociological jargon, 'problematised' being overweight by implying that it falls in to the same health category as being obese.

And, to put it bluntly, this simply isn't true. Here's the science:

Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality.

This is not some little study either but:

...97 studies were retained for analysis, providing a combined sample size of more than 2.88 million individuals and more than 270,000 deaths.

Essentially the research is saying that having a BMI of between 25 and 35 doesn't represent a health problem  - overwhelmingly the people our author is talking about fall into this category.

So what is the actual scale of the problem? If we take morbid obesity as the essential measure (in the UK this is defined as a BMI over 40) then currently around 1.5% of men and 3.5% of women are morbidly obese. Now this is a lot of people - about 1.5 million - so we shouldn't ignore it as a problem but it isn't anything approach the scary 63% that our author cites. Even if we add those with a BMI between 35 and 40 the numbers only rise to 5% or so - between 3 and 4 million.

And this brings us back to fast food. Quite simply there isn't a strong connection between takeaways and obesity (which isn't to say that fat people don't eat in McDonald's but to say that's not why they're fat):

When the researchers weighed these children they found something rather interesting. Here are the average body mass index (BMI) figures for each group by frequency of visits to fast food outlets. Bear in mind that a 'healthy weight is 18.5 to 25:

Weekly visits        BMI

Every day:            17.8

4-6 times:              18.3

2-3 times:              19.6

Once:                    20.3

Less than once:     21.4
OK this is for children but it makes the point - quite remarkably showing a negative relationship between regular fast food consumption and obesity. It's whats in the fridge at home and the drawer in the office that's the problem not Burger King or the kebab shop.

Our author concludes that we are all victims of:

...the roots of overconsumption: cost of living, manipulative marketing, nutritional misinformation and – often overlooked – simple palatability.

The overconsumption point is an interesting one for, as our author should know but doesn't, overall calorie consumption has been falling. We're still fatter but it's too simple to blame advertising, fast food, offers of chocolate oranges or Big Sugar for the problem. A proper assessment would pick up these facts and ask questions about our sedentary lifestyle, about the support given to very fat people and medical interventions that are possible.

Instead Ben Brooks (an arts/law student or so his biography tells us) chooses to play silly games with the statistics - the evidence, the truth, if you prefer - in order to make his snide little prejudice against McDonalds into a public health point.

Update: some more practical evidence that it's not McDonald's but our broader food choices that matter are on view in this fascinating student project.


1 comment:

Junican said...

Something that is becoming clearer every day is that funding for research is being deliberately targeted in a specific way. Following the tobacco control template, it is necessary to identify and demonise a big, easy target. In the case of tobacco, it was the tobacco companies. In the case of the climate it was oil and coal companies. The target for alcohol attacks are alcohol companies. These big targets can be hit again and again and milked for cash.
In the case of obesity, the big, easy target are companies like McDonalds, but also include major ingredient produces, such as Monsanto(?).
The prohibitionists are following a tried and tested plan, which will be successful unless the government (by which I mean our elected representatives, and not government departments) wake up.