One day, obesity is boring. Next day, obesity is alarming. What did it?
A 115-paged monograph from the American Council of Science, an organization of scientists who speak to laymen on health and science. It has done much useful work in pesticides and many other issues. Elizabeth M. Whelan, Sc.D., its head, established her reputation years ago with her brilliant book, Toxic Terror.
The monograph contains 17 short readable chapters, each for a different system of diseases, and each followed by footnotes supporting the statements, with full citations to studies, for anyone who wants to see for himself. The monograph is written by Kathleen Meister, M.S., and edited by Ruth Kava, Ph.D. , Gilbert L. Ross, M.D., and Elizabeth Whelan. Each chapter is reviewed by a specialist in the field.
Do you have a friend who has a huge lump on her leg? It is related to diabetes which is related to obesity. Two-thirds of the population of the U.S. is overweight or obese.
Obesity shortens life by 6-7 years. Common now among populations where it had not existed, it increases the risk of heart disease. It is linked to developing cancer, stroke, heart disease and seven (or more) other disease systems, each discussed in a separate chapter.
One of the most prevalent and serious diseases associated with obesity is diabetes. It used to be a disease of the middle-aged but now affects young people as well.
Fourteen million people have diabetes, which is increasing rapidly. Six million do not know that they have it. Deaths of diabetics due to heart disease are increasing.
The process of diabetes is explained in the monograph. The carbohydrates we eat are broken down into glucose, which travel through the blood stream into body cells where it is used as fuel. To accomplish this passage, it must have insulin, which is produced by the pancreas. If the passage doesn’t work, glucose builds up in the blood and is excreted. And the insulin must be constantly replaced.
That’s type 1 diabetes. In Type 2 diabetes, the body has insulin but does not effectively use it “for reasons that are poorly understood,” leaving an excess of insulin in the blood. (Poor understanding, insufficient research, uncertainty as to cause, are apparently common problems in this field.)
Type 2 diabetes is managed by healthy eating, physical exercise, and testing of blood glucose. The purpose is to control blood-levels of glucose. Type 2 is strongly associated with obesity; 85.2% of diabetics are overweight or obese.
Do you know someone who has had a stroke? In the chapter on obesity and neurology, one learns that stroke occurs when the normal blood supply to a portion of the brain is compromised by a blockage of a blood vessel (ischemic stroke) or bleeding from a burst blood vessel. (This fact-filled monograph is full of medical terms which are all defined for laymen.)
Four risk factors for ischemic stroke are high blood pressure, heart disease, diabetes, and smoking. Obesity promotes stroke by increasing the likelihood of developing three of the four—not smoking. Obesity is a “major contributor to preventable deaths.”
Whether the risk of stroke can be reduced by losing weight, has not been established. Research is needed.
A table in the monograph gives Body Mass Index numbers. You can easily read the table to ascertain your Body Mass Index, which tells whether you are normal, overweight, obese, or extremely obese. The table is provided on Internet by the CDC (Centers for Disease Control and Prevention). You enter your height and weight and the computer will tell you what your BMI is. BMI is related to the diseases.
Studies of asthma around the world frequently involve obesity, two recent studies have shown, but it is not known whether obesity causes asthma. (The long hunt for the cause of asthma continues.)
A chapter on obesity and urology discusses incontinence. Increased pressure on the bladder caused by excess weight in the abdominal area is believed to be responsible for increased severity of the problem. Weight loss can decrease “stress incontinence.” In women severely obese, the percentage with “stress incontinence” decreased from 61% before the weigh loss to 12% afterwards.
Body shape can be important, as shown in a study from Finland. Obesity can lie in a thick mass around the waist, the body described as an “apple-shaped.” Or it can lie further down around the hips and buttocks, the mass is known as a “pear-shaped” body. The standard? For waist, 40” in men and 35” in women are too high.
The relation of obesity to Parkinson’s disease has been established, but the association is not to BMI but to the distribution of the person’s fat. Parkinson’s is associated only with waist circumference and waist-to-hip ratio, the apple-shaped body.
The risk of diabetes increases with a more central distribution of body fat.
This is but a sampling of the useful intelligence in this gem-laden monograph, which should be made widely available. (Hospitals, pay attention.) Write to ACSH, 1995 Broadway, 2d floor, N.Y. N.Y. 10023 for free copies (but if you have cash to spare, you might send them a contribution).
By Natalie Sirkin