If you really have to make new year resolutions..

Mike the Psych's Blog

here are some sensible ones from Dr Mark Porter who writes for the Times (with my own comments added):looking_in_mirror_1600_wht_5647

  1. Get a tape measure and measure your waist. This should be less than half your height to maintain good health. Body Mass Index (bmi) is so out-of-date as I’ve written before.
  2. Buy a blood pressure monitor as one in three of us develops high blood pressure which often requires lifelong treatment. Taking your BP at home may be more accurate than if taken in a stressful environment such as a hospital or GP’s surgery (the well-known white coat effect).
  3. Buy a petrol car next time as diesel has been proved to be dirtier fuel and unhealthy in built-up areas
  4. Learn what sepsis looks like. Blood poisoning or septicaemia as it was once called kills thousands of people a year. It typically starts with bacterial infections of the chest…

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I’m so lonely, I could die

stick_figure_liking_it_500_wht_9170It’s not only the elderly who suffer from loneliness.

Scientists at the University of North Carolina now believe that a teenagers are just as much at risk.

Isolation can cause harmful changes to the body in adolescents just as in the elderly. Those with fewer friends are significantly more likely to have high levels of inflammation and higher blood pressure when they reach adulthood.

The scientists examined four age groups to find out why lonely people die earlier and are more susceptible to many diseases.

A large group of 12 – 18 year olds were asked about their friends and 8 years later had their blood pressure, bmi, and a test to measure inflammation. Social isolation made the teenagers 27% more likely to have high inflammation, a sign of biological stress, in their early adulthood.

A professor of sociology at the university, Kathleen Harris, said scientists had been concerned with the impact of loneliness on the elderly but had overlooked the impact on younger people. “Young people are not as healthy as they appear …. because of the obesity epidemic“.

The weight of the adolescents was also a confounding factor in the study as those who were obese as teenagers were twice as likely to have high inflammation as adults. But were the overweight teenagers less popular because of their weight?

Nevertheless the scientists concluded that an adolescence spent in solitude was likely to lead to health problems later in life. After age 18 the size of the social network don’t matter until people reached old age.

That roll of fat round your waistline could shorten your life

stick_figure_overweight_scale_1600_wht_3853Having a roll of fat round your waist, even if you are thin elsewhere, doubles the risk of an early death compared to people who are obese.

Having fat distributed around your body is actually healthier than just having it round your middle according to a major study of 15,000 people over 15 years carried out by the Mayo clinic in Minnesota.

It doesn’t matter what your bmi is, if you you are “centrally obese” you are more likely to die earlier. If you are a man you are twice as likely to die early.

Central obesity is defined as having a wider waist (measured at the narrowest point) than hips (measured around the widest point of the buttocks) for men and for women having a waist larger than 90% of their hip measurement.

Why should this be? Even Professor Fransisco Lopez-Jiminez, the director of preventive cardiology at the clinic isn’t sure but there are several theories.

  • Having fat outside the abdomen is a good thing as it might have some protective effects entirely opposite to bad fats.
  • People with an abnormal central distribution of fat often have less muscle mass elsewhere which means they are less able to use sugar in useful ways.
  • People who put down fat may be more likely to have a type of fat called “visceral fat” which clumps round the organs. Professor Jimmy Bell from the University of Westminster thought that could be crucial as “over the longterm visceral fat leads to sustained chronic systemic inflammation … believed to have a detrimental effect on many levels – the heart, metabolism, and even cognition

Professor Bell, who wasn’t involved in the study, thought the research was useful in understanding some of the apparent anomalies in obesity research. “We know from our research that there are different body types where people do not fit into the standard bmi. They might have the right bmi but the wrong fat distribution.”

Professor Lopez-Jiminez also said that more research is needed because “we don’t really know what makes fat go to those areas of the body in some people while in others it might go to the right place”.

Earlier research on women‘s body shape found links between bmi, body shape and dementia.

And height:waist ratio has been strongly recommended as an alternative to the bmi which doesn’t take into account muscle weight.

Main source: The Times

Fat teenagers don’t get it

stick_figure_overweight_scale_1600_wht_3853They watch TV programmes about obesity – which usually feature clinically obese people – and think they are OK, even though they are overweight and probably in danger of becoming obese.

Being obese puts people at increased risk of diabetes and increasingly of cancer (an estimated 18,000 cases a year).

When researchers from Cancer Research UK asked teenagers aged 13 to 15 if they were overweight or OK, 40% of those who were overweight or obese thought they were OK.

Obesity, which accounts for about a fifth of cancer deaths, is set to overtake smoking as the main cause of cancer.

The study, published in the International Journal of Obesity, said “Programmes about overweight people tend to show very obese people. Some teenagers who see these images probably think that is what an overweight person looks like so they might not realise if they are slightly overweight”. 

Sarah Jackson, who led the study, said that parents often underestimate the problem putting it down to “Puppy fat“.  Also growing levels of obesity are normalising overweight people as “normal”.

In the study only three-quarters of the teenagers had a bmi within the normal weight range (NB bmi is not the best measure). 20% were overweight and 7% obese.

80% thought they were the right weight, 7% that they were too heavy, and 10% that they were too light. Girls were more likely than boys to think they were too heavy.

Professor Jane Wardle from the Cancer Research UK Health BehaviourResearch Centre at UCL said “Young people who think they’re overweight when they’re not can sometimes develop devastating eating disorders, so we’re delighted that most of the normal-weight teenagers had a realistic view of their body size. But we need to find effective ways of helping too-heavy teenagers slim down and maintain a healthier weight”

Other posts about obesity

Fat people can imagine the smell of food better

big_nose_1600_wht_11134Which might explain why they’re overweight.

Scientists at Yale University have discovered that a person’s ability to imagine the smell of food correlates with their body mass index (bmi).

Thin people are less able to imagine the smell of food. “Compared to imagining a favourite place or singing a song to ourselves people vary greatly in their ability to imagine smells” said Dr Barkha Patel at the John B Pierce laboratory.

“If people with higher body weights report a heightened ability to imagine odours this may intensify the food craving experience through the creation of more vivid images of flavours and aromas“.

The results of her experiments, where participants were asked to evoke various objects and activities and rate how vivid they were, showed that Normal weight people had a poorer ability to imagine doors compared to overweight and obese people.

Obesity researchers have identified cravings as a crucial part of why people become fat.(Lack of self-control perhaps?)

Cravers create mental images of the desired substance that are immediately pleasurable but which exacerbate their awareness of the deficit. This causes a vicious circle of desire, imagery, and planning to satisfy that desire” said Dr Patel.

Most of us are affected by cooking smells if we’re hungry but for these obese people they don’t even need to have the olfactory cues. They just think about food and they’re ready to start (over)eating.

If they drink as well that could make it worse as having an aperitif makes you eat more.

We’re fat but not as fat as euro neighbours

stick_figure_overweight_scale_1600_wht_3853We know obesity is a problem in the UK but apparently we’re not as bad as our European neighbours. And I’m not talking about fat-cat euro politicians with their unaudited expense accounts!

Projections by the WHO suggest that by 2030 men in Ireland will be the fattest with Spain, Greece, Czech Republic and Poland overtaking Britain.

For women it’s Belgium (perhaps all that lovely chocolate) followed by Bulgaria and Turkey.

Netherlands is the only country to show a decline with only 8% of men likely to be obese. It’s not that they eat more healthily than us but they do take more exercise with only 1 in 5 not taking enough compared to 2/3 of Brits. They also use bicycles for 25% of their journeys compared to only 2% in Britain (to be fair there are no hills in the Netherlands).

In Britain 75% of men and 1/3 of all adults will be overweight as middle-aged people ignore pleas to eat more healthily.

In 2010 70% of men and 59% of women were overweight (as defined by a bmi of over 25). If you are a man 5′ 10″ tall that means you are over15 stones and if you’re a woman 5’4″ tall that means over 12 stone 7 lbs.

The National Obesity forum is urging the government to take action against the food and drink industry as cajoling hasn’t worked.

They say the NHS will collapse under the cost of treating diabetes, heart disease, cancer and other diseases linked to obesity.

Fighting fit? The new Heavy Brigade

Seems it’s not just us civilians who are getting bigger and more obese.

More than 25,000 British military personnel have been diagnosed as obese in the last 4 years. That’s several battalions!

There is now an “obesity working group” looking into the problem and devising ways to keep people fitter and increase  their knowledge of how to eat more healthily.

A spokesman for the National Obesity Forum said; “These people have got plenty of time to keep in shape and I think it’s a responsibility to feed them properly and give them any amount of time to do exercises and keep themselves in shape”.

obstacle_course_boot_camp_1600_wht_11454Soldiers are supposed to have carefully managed fitness routines involving at least four 1-hour sessions of PT a week.

They can also have a diet ranging from 1,500 to 7,000 calories a day depending on their duties. Clearly not everyone is following the exercise routine or eating healthily.

As one senior officer was quoted as saying; “There are obese soldiers in just about every regiment in the British Army and no unit is immune. It’s also a reflection of the quality of food served in some army cookhouses. Unless the armed forces changes the way it feeds its personnel you will have a problem”.

Of course there are statistics and statistics! The number had been calculated using the much disputed body mass index (BMI)  and the obesity cut-off point of 30.

The MoD rightly points out that this can be misleading as “it doesn’t differentiate between body fat and muscle and says individuals are assessed on their ability to carry out military activities rather than on their weight”.

It’s not just the Brits. It wasn’t that long ago that 40% of the German Army was considered overweight and in 2012 the American Army dismissed over 1,600 soldiers for excess body weight, a 15- fold increase on the figures in 2007.

 

Obese? No, not me..

stick_figure_overweight_scale_1600_wht_3853It will probably come as no surprise to learn that the majority of obese people don’t think that they are.

Only 1 in 10 clinically obese people admit that they are; 11% of women and 7% of men.

A further 1 in 4 women and 1 in 6 admitted that they were “very overweight” but the rest thought that they were either simply overweight or just right.

The research carried out by Cancer Research UK and published in BMJ Open found that only 10% of people knew that a body mass index (BMI) of 30 is the cut-off score for obesity.

Leaving aside the fact that the BMI has been discredited when used as a single measure of health and better methods have been discovered it perhaps reflects the fact that being overweight has become normalised in our society.

The director of the Cancer Research UK Health Behaviour Centre at UCL said; “It’s a real worry that people don’t recognise that their weight places them in the obese category because it means that they aren’t aware of the increased risk of a number of health problems including cancer”.

She also thinks that the term obese is considered derogatory and rejected by overweight people, and this might have been worsened by campaigners using extreme images to get their message across, something most people won’t identify with.

It also seems that many GPs struggle to categorise patients as either overweight and obese and now that health care workers aren’t allowed to use the word “fat” just what can be done about it? Enforced boot camps?

The government would rather throw money at it by providing gastric bands for people with no will-power or motivation to stay healthy.

Waistline should be half your height

apple_measure_tape_1600_wht_13129There is now further evidence on this from research carried out by Cass Business School at the University of London. It claims to be the first study to analyse official health records to measure the impact on life expectancy on obesity as measured by the ratio between your waist and height.

This is clearly not true as I posted about this in May 2013 describing research at Oxford Brookes University which also looked at the Health & Lifestyle survey, which goes back to 1984, and the Health Survey for England which studies 8,000 people every year.

Leaving these academic institutions to fight it out the results from both studies have the same message: your waistline – as measured at the narrowest point without breathing in – should be half your height or less. So a person who is 5′ 10″ should have a waist of no more than 35″, and a person who is 5′ 4′  have  a waist of no more than 32″.

If a man expands his waistline to 60% of his height he loses 1.7 years of life and a woman doing the same 1.4 years.

Dr Margaret Ashwell, a co-author of the study, said the rule applied regardless of a person’s age or ethnicity. Dr Ashwell first popularised the discovery that apple-shaped obesity is more dangerous than pear-shaped obesity in 1996 (see post: “What fruit is your bum“) because of the amount of central fat in the body which affects vital organs causing heart problems and diabetes unlike fat on thighs and hips.

She said people who rely on their body-mass index (BMI) live on false hope. Using the waist;height ratio puts 69% of the population at risk compared to 56% if you use BMI.

But whether adopting this as the preferred measure will make any difference is anybody’s guess. GPs, who recently attacked childhood obesity welcomed the findings but thought it was unclear whether “worrying people about their weight actually motivates them to make a long-term commitment to lifestyle changes”.

Simple tests to predict your life expectancy

elderly_man_holding_a_custom_text_sign_12871With the government planning to tell future pensioners how long they are likely to live so they can better plan their finances this new research might be useful.

Research at University College London, and published in the BMJ, found that people in their early 50s who scored poorly on three simple tests of strength and co-ordination were nearly four times as likely to die in the next decade as those who did well.

The three tests were:

  • grip strength
  • chair rise speed
  • standing balance time

You can do two of these tests at home.

The chair rise test is: see how quickly you can get up and down from a chair 10 times. 16.5 seconds puts you in top fifth and 26.5 seconds in the bottom fifth.

The balance test is to see how long you can stand on one leg with your eyes closed. More than 10 seconds puts you in top fifth and less than 2 seconds in bottom fifth.

The research was carried out using a cohort of people born in 1946 who had had their health monitored all their lives. They were tested at age 53. In the following 13 years there were 177 deaths in the group (of around 2,800), half from cancer and a quarter to coronary heart disease (CHD).

Those who had performed poorly on the tests were more likely to have died regardless of other factors such as wealth or exercise.

The few who couldn’t do any of the tests were 12 times more likely to have died than all those who performed the tasks. Those in the bottom 20% of scores on these tests were almost 4 times more likely to have died than the others.

Fitness levels drop off from age 45 on average but there are wide variations. Separate research, also published in the BMJ, found that walking or taking similar light exercise for an hour a day could stave off the onset of osteoarthritis.

In the UK the NHS has been accused of ageism in its reluctance to offer surgery to older patients. Now scientists at Seoul University in South Korea have developed a test to predict whether or not a patient will survive an operation to stop doctors using age alone to decide whether they can cope with treatment.

They found that patients with a high frailty score were more likely to die within a year of having an operation.

They assessed patients over 65 on their ability to walk, dress, wash and carry out other tasks as well as their performance on memory tests, their nutrition and the number of drugs they were taking. In the following year 9% of these patients died, 10% experienced complications, and 9% had to go into a nursing home. These were all patients who had scored highest on the frailty assessment.

The researchers found that post-operative one-year all-cause mortality rate, length of hospital stay, and discharge to a nursing facility, could all be predicted from their assessments.

Finally back to the grip test referred to above. Researchers at the International Institute for Applied Systems in Austria have found that the strength of a handshake is a good way to assess how fast people are ageing. Using grip strength as a marker of biological age people who did poorly at school age about 4 years faster than those who did well.

Reviewing 5o studies on grip strength they found that weakness in the hands is linked to high levels of disease and early death.

If you’re younger and relying on the body mass index (BMI) remember it’s no longer considered reliable.