Obesity deadlier than smoking.jpg

Obesity deadlier than smoking


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Dear Reader,

Two weeks ago the UK government issued an official health warning.

The effect of obesity in the British population was called worse than global warming and deadlier even than smoking. The figures quoted were that in 2050, 50 per cent of the population would be obese if the present trend continued.

And as the UK is no different from the rest of the EU, this would indeed be a disaster for Europe and of course the US.

If this scenario was to become reality, we should see many young adults with diabetes, high blood pressure and 40-year-olds would die in large numbers from heart attacks and strokes.

You can imagine what this would imply for the economy of the country. Where the 30 to 40-year-olds are at present at the peak of their health and strongest in their career development, they would, in the not too distant future, be disabled and unable to support their young families and worse, put huge financial pressures on the already overstretched health and social services.

The now pillars of the society could soon be a burden and no country can afford that. No surprise that the government rang the alarm bells.

The big question is how to react. The usual calls for public funded programmes, task forces, stricter rules on declaration of food ingredients and prevention at a young age in schools were made.

I would like to recommend you to take a look at the website of the British Medical Journal, www.bmj.com and search for an article called “Obesity: the elephant in the corner” by David Ogilvie and Neil Hamlet, published in December 2005. Reading this fantastic piece of work you will, like me, call out: yes, of course, this is our problem, we live in an obesogenic environment!

Our bodies cannot cope with this environment in the long run and we need to make fundamental changes or suffer the consequences.

Cause of death

Don’t miss this dialog between Socrates and Panacea. Do Statins only change the cause of death in the elderly?

Interesting thoughts were also published in the BMJ in August about how we should approach preventive health care in the elderly. You may have noticed that your GP in the UK is now very keen to measure your cholesterol and blood pressure every year and hardly anybody escapes a prescription for a Statin if the reading is outside the norm.

This fact is due to an initiative of the NHS to give equal access to healthcare to everybody, regardless of age. Meaning that nobody should be denied a costly medication only because she/he is elderly.

This seems principally a good approach only that it does not prove to benefit the patients in question. Currently, we use evidence from younger populations and extrapolate this to the elderly ones. Anxiety about age discrimination means that no upper age limit exists for assessing cardiovascular risk.

In the so-called Prosper study, it was found that this policy is wrong for many elderly.

The 5,000 participants of this trial were aged between 70 and 82. They were given a standard Statin medication, which lowered their cholesterol significantly. The patients who had Statin had less heart attacks but their overall survival rate was not different from a control group. In fact, the treated group seemed to die instead from other illnesses like cancer.

It would be wrong to assume that Statins cause cancer. That theory has long been disproved in several trials. What seems to happen is that the individual lifespan cannot be manipulated by lowering cholesterol in the elderly. The medication just changes the cause of death but not the timing.

Should you wonder why the medications in question are called Statins, it is because the marketing experts of the pharmaceutical industries have given the products names like Simvastatin, Pravastatin, Atorvastatin and Rosuvastatin. They all come from a group called CSIs (Cholesterol Synthesis Inhibitors). The making of cholesterol takes place mainly in our liver and more so at night. This is why your GP was quite adamant that you take the pills before bedtime.

Weight lifting

Another interesting finding was published last month in a well reputed American journal.

It was found that resistance training or moderate weightlifting in the gym has an additional beneficial effect on the control of diabetes. The good effect of aerobic exercise on diabetes has long been known but now it has become clear that you can do even better if you work out every other day in the gym in addition.

The bottom line

You do not need to hesitate if somebody offers you a gym membership for Christmas. It is good for you regardless of your age. If you are 70 plus and your doctor offers to prescribe a Statin, discuss if you will really benefit from it.

Best autumn wishes,

Dr Thomas Kaiser