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Tuesday, 12 June 2012

Dietary modification to improve the public's health. New news to chew on.

Mayor Bloomberg’s pronouncement that he hopes to ban large sized soft drinks has caused a flurry of diet related activity. No reference here to the mayor’s comments as the blogosphere is filled with opinions on the relative value, morals and expected impacts of such a ban.  Our only comment is it was NYC’s 2006 ban on unsaturated fats that led the wave across the country and resulted in considerable benefit in reduced unhealthy fat consumption.

Let us begin by reiterating that there is no clearly demonstrated effective long term cure for overweight and obesity.   The consistently most effective intervention is bariatric surgical intervention which is unlikely to be widely endorsed for other than the morbidly obese. 

So the issue of obesity gives great fodder to fill lay magazines, morning talk shows and fuel for weight loss schemes – all of which are thriving.   This blog is no less guilty than others of trying to weigh into the fray.  healthy environments and obesitylosing weight  low sodium diets,  Motivational interviewing for obesity,   obesity and political ramifications

Three more items to expand the discussion.  To reinforce what we all know is a study demonstrating that Americans know it as well.  Losing weight is tough, and tougher than completing their taxes.  The original article at Science daily on losing weight.  The executive original work can be found at food information council survey and with the encouragement that primary review of such reports is good practice.  Lost in the press release headlines about how difficult it is to lose weight, are some good tidbits of information on the current state of American health on food intake, obesity and physical activity. It is challenging on the site to actually determine the methodology other than an on-line survey which may contribute to certain biases.

A review that confirms that there is up to a 14% benefit in cardiovascular events in men only in modifying dietary fat that resulted in lower triglycerides and LDL.   There was no benefit noted in all cause or cardiovascular mortality.   The full review (a 2011 update of the 2001 review) is available within the Cochrane database – the abstract at Dietary modification for cardiovascular events.

Lastly is a piece on the reduced risk of childhood obesity amongst infants born vaginally compared to Caesarean  section.   Biologically this is being promoted by changes in GI tract flora.  An interesting avenue for additional research.   Is anyone aware of a good retrospective study looking at adult weights at birth type?   C-section and childhood obesity.

Diabetes and endocrine disorders continue to be some of the few causes of death and disability that are increasing, and obesity is a significant risk factor to the development of these conditions.  The solution is prevention, but in working towards prevention, we need also grapple with early intervention and in intervention when manifest problems are developing.  


  1. Mayor Bloomberg has been the brunt of many jokes and jibes due to his planned "ban" of oversized beverages in service establishments. However, obesity must be tackled. In the public health context of food and activity, it seems we are damned if we try to intervene, and damned if we don't try.

    Don't take away our freedom to eat what we want, don't raise the price on gas, don't raise taxes for public transport and bike lanes.

    But why are you letting industry put trans fats and so much sugar in our foods? Why aren't school foods more nutritious? Why can't my obese child be in a comprehensive treatment program? Why is the parkade more than 1 block away from shopping?

    One definition of insanity is to expect a different result despite doing the same thing.

    Kudos to New York for consistently being the first goose in the V - taking on the bulk of public resistance and drafting the rest of policy makers behing them.

  2. Marion Nestle's blog www.foodpolitics.com has some good posts on this issue (and many other food issues). Nestle -- pronounced ness-sill -- is a nutrition prof at NYU, with a background in food guide development with the USDA. She is the author of a number of nutrition and food safety books, and a regular media contributor. Highly recommended for passionate foodies and farmies.