Inconvienent Trueths

Last week, October 31st 2007, an article circulated in the lay press about over-weight and obesity and the risk of various cancers. Most of the cancers were in organs believed to be influenced by hormones: breast, pancrease, endometrial, prostate, color-rectal, ovary, gallbadder. Further evidence of hormonal influence was the observation of a protective effect that obesity has on premenapausal women from cancer and the deletarious cancer effects of obesity has on post-menapausal women. Speculation is that estrogens play a role in modulating these cancers. Interesting is the observation that premenapausal women have a lower risk of heart disease and stroke, only to catch up to men's rate of heart disease and stoke 15 years after onset of menapause, irregardless of weight, "normal weight" or obese.

I wondered about the weight issue on heart disease and cancer since I myself have been mindful and repeatedly reminded of my own weight issue.

Over the last several years we have heard much about an obesity epidemic in the USA population, which is spreading to the rest of the world, with the pronouncement by various authorities that this global epidemic is likely secondary to the world populaton assuming our Western diet: high calories and high fat: red meat is bad. The solution: fish, whole grains, fruits, nuts, a prudent Mederteranian diet is good or so the experts/media/politicians would have us believe.

Now the Inconvienent Trueths:

1) Since 1992, for all causes of death (heart, stroke, cancer) have been going down (this is the main reason why our longevity has been going up), as our weight has been going up. Body Mass Index (wt in Kg/M2) is broken into categories: <18 is malnourished, 18 to 25 is ideal body weight, 25 to 30 is over weight, 30 to 35 is class I obesity, 35 to 40 is class II obesity and >40 is class III obesity. The known health effects of weight, whether heart disease, stroke, cancer, are in a "U"shaped distribution; that is, the "excess deaths" occur at both ends of the spectrum. Those with BMI<18.5 and those with BMI >40 account for almost 90 % of the excess deaths. Those with BMI <18.5 compose 6.3% of the population and represent 1/3 of all the excess deaths. Those with BMI in the overweight category (25 to 30), live longer than those in the ideal weight category (BMI 18.5 to 25). Those in the Obesity I category, BMI 30-35 live as long as those in the ideal BMI. One speculation for this "paradoxical" situation has been that as the incidence of cigarette smoking has declined, there has been a decrease in tobacco related deaths, and a weight gain in those previously in the ideal weight category who are now in the overweight category.

2) The diet and heart disease connection was articulated from the observation that Japanese men who immigrated to Hawaii developed heart disease while the incidence of heart disease was low in Japan. The authors speculated that moving to Hawaii meant assuming a Western diet; hence, onset of heart disease. Inconvienent truth; the Japanese who came to Hawaii continued eating the very same diet they had eaten in Japan (not terribly suprising considering our own ancestry, the Czech's continued eating what was familiar to them when they came over at the turn of the previous century to Cleveland Ohio). If all 22 nationalities with data at that time on heart disease in their native lands and immigration to Hawaii had been used in the data set, there was no statistical difference in incidence of heart disease amongst immigrants to Hawaii. There is likely another explaination, but the data has not been analysed for another explaination.

3) In an article by Flegal et al, Journal of the American Medical Association February 8th, 2005, volume 293 pages 1861 to 1866, in the opening sentence for the results of the Women's Health Initiative, involving >50,000 women, "Despite the findings that a low fat diet did not reduce the risk of breast cancer, heart disease, stroke, colon cancer..." Meaning, the intervention of low fat diet over the 6+ years of the study did not change any of the outcome parameters. Yet, the recommendations were to implement a low fat diet!

4) A summary article of the epidemiological evidence linking weight, heart disease, stroke, cancer is: Compos et al, International Journal of Epidemiology 2006, volume 35 page 55. The authors speculate upon why the data that has been known for more than 35 years, including data through 2006, which refutes a link between weight, cancer and heart disease has been ignored. These authors invoke: "moral panic". Moral panic and it assumption by general society at a particular time, is described as "the fabrication of risks during times of rapid society change."

Does any of this sound familiar? Blame Saddam Hussain with WMD. Blame an Obesity Epidemic. Blame Western Culture and diet. Blame Global Warming. Blame mercury in the form of Thermistol in vaccines for the autism in herown child was the most recent Hollywood science starlet on the Oprah Winfred and Larry King shows promoting her book: Inconvienent Trueth: Her child was conceived two years after Thermistol was removed from all childhood vaccinations. What happens during a moral panic, along comes a demagogue: " I have a solution... it'll be painful... you will have to give up some of your rights... but, just do as I say and...."

In my opinion, and what is likely, and from my predictive insight into the future you will see, is that the "clear and present danger" which is blatantly evident to all right now, will fade from view as the light of science is cast upon it. You say there is a lot of science out there linking one thing to another? The problem I see is selective use of science information.To come to the present conclusion; ie, for the majority of us, that there is a health risk with incremental increases in weight, one has to ignore: Inconvienent Trueths. A theory which encompasses all the trueths, eludes us at this time.