In Nutrition, Rest Day/Theory

October 10, 2012

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Dr. Lon Kilgore finds a numbers game at the heart of the obesity epidemic.

An increased frequency of obesity is a cross-societal issue that is receiving a tremendous amount of scientific and media attention. Current estimates of obesity range from 33.8 percent in the U.S., 23.0 percent in the U.K. (with Scotland leading the way with 27.0 percent) to an international low of 3.4 percent in Japan.

There are myriad proposed explanations for the upward trend in obesity occurring since 1960, with most explanations based on correlation and conjecture rather than causality. Despite the lack of causal data, the correlative data is used as a basis for many nations’ public health policy. In the U.K., the National Health Service proposes that 55 percent of the adult population will be obese by 2050 and will represent an annual fiscal health care burden of 4.2 billion pounds ($6.63 billion). This is an alarming statistic and merits attention, and there is significant movement within policy makers to respond.

But we need to examine the historical aspects of obesity and its measurement in order to avoid alarmism and potential misdirection of national assets. To more fully understand obesity and our current straits, we need to consider whether the epidemic of obesity is authentic or an artifact of changing social values and constantly changing definitions.

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4 Comments on “Fat of the Land: Mismeasures and Missing the Point”

1

wrote …

Kilgore (and the CFJ Editors) MISSED the point. There are serious fatal flaws, as the CF Chief Scientist, calls them.

Obesity is defined as a BMI over 30. Three-zero. Overweight is defined as a BMI over 25. Talk about mismeasures!

The 33.8% of obese Americans number doesn't include those with a BMI of 25 to 29.9. An additional 34% are overweight. Yes, 2 out of 3 Americans are overweight or obese.

The article keeps discussing the dramatic change of numbers now that obesity went from BMI of 27.8 to 25....why should I believe any of his numbers?

Next, and this is another serious ('fatal') flaw, the management of cardiovascular disease in the 1960's is not comparable to the management in current times. I'm not really sure this even merits explaining, but it's probably like comparing car safety in the 1960s to now, as well. It's just an entirely different.

Is BMI a perfect tool? No, no good scientist claims that it is, but it's ease of use compensates well for it's issues with accuracy. Does a muscular crossfitter with a BMI of 29 have the same cardiac risk as a short, chubby, obviously fat (not muscular) BMI of 29? No. Does the other person need a change in lifestyle? Yes. Do people who Crossfit regularly transform their body from more fat to more muscle (and less muscle)? Yes. Obviously that is a more healthy transition despite lacking BMI changes.

2

wrote …

Dr. Kilgore,

I wanted to add this information...

Per the CDC:
Total prevalence of diabetes among people aged 20 years or older, United States
2003=18million
2005=20.6million
2007=23.5million
2011=25.8million

Perhaps these data are more relevant than diabetes deaths?

3

wrote …

I agree with Matt and would like to add that BMI is only used as an initial screening tool for a fitness professional. If you have a BMI over 25 it is a flag that more testing or explanation is needed to find out your actual body composition. If a trainer is using BMI and no other tests in conjunction with it to determine actual composition then you are not a fitness professional or don't understand what BMI is used for.

4

wrote …

Another unaddressed issue is the health care cost associated with the lower rates of death from heart disease and diabetes.

At this point America has an estimated $45 trillion unfunded health care liability in Medicare. We won't be able to pay the bill for all that life extending medicine sooner or later without change.

If the death rate went down but cost are soaring treating these people then measuring what it cost to lower that rate is important.

Keeping sick people from dieing is not equal to success.

Keeping people health in the first place with a higher quality of life equals success.

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