I hope your Thanksgiving holiday was a happy one, and that you are looking forward to a pleasant December. But vigilance about your health is not taking a holiday, as two new releases yesterday--one in a medical journal and the other from the Centers for Disease Control and Prevention--are bound to make you think twice about that extra helping of stuffing you ate while enjoying your Thanksgiving meal.
The first report is in today's edition of the New England Journal of Medicine, and written by a number of authors--including a colleague of mine from the American Cancer Society, Dr. Michael Thun--who examined the interminable question of whether or not being overweight as well as being obese can impact how long you will live.
This article will give the boot to the old adage that you can never be too rich or too thin. The scientists don't say anything about being too rich--we will have to leave that one to the psychologists to answer--but they do suggest that in fact you can be too thin.
The other report, from the United States Department of Health and Human Services offers statistics on the rate of obesity in the United States today, and sets goals for what we can accomplish in reducing those rates over the next decade.
In the New England Journal report, the researchers combined information from a number of scientific articles and concluded that an "ideal" BMI to have the lowest "all cause mortality"--that is, the lowest chance of dying prematurely from any cause--is just about where we thought it should be, around 20-24.9 (we traditionally have used a BMI of 25-29.9 as defining "overweight" and a BMI of 30 or more as obese). If your BMI is less than that range or higher, then your risk of death increases, especially if it is higher.
For those of you not familiar with BMI, it stands for "body mass index." It is a measure of your weight relative to your height, and can be calculated simply with the use of various calculators easily found on the web, such as at cancer.org. Plug in the numbers for your height and your weight, and you will have an answer very quickly. In fact, I am of the opinion that BMI is so important in defining most people's health that calculating it should be part of your routine medical care. So if you have difficulty figuring out your BMI, ask your health professional to do it for you.
We have known for some time that the risk of serious chronic disease, such as certain cancers, heart disease, diabetes, high blood pressure and stroke, are all increased the higher your BMI. What amuses me from time to time is hearing from people who have high BMI's is their intonation that athletes (usually Arnold Schwarzenegger or Sylvester Stallone) also have high BMIs as a result of their substantial muscle mass. Sometimes you just have to laugh when you look at an obviously overweight couch potato who tries to deflect the fact that their bodies just ain't the same as Messrs. Schwarzenegger or Stallone. BMI may not be perfect, but it's the best we have.
For many years there have been questions about whether or not a little bit of extra fat around the middle may in fact be good for you. I still recall interviewing the author a number of years ago about of his study that came from one of the National Institutes of Health groups which came to that conclusion. As a result of that study and some others there were experts who concluded that being a bit overweight may not be such a bad thing.
This current study--from some of the most respected experts in the field, who examined prior research studies that included over 1.4 million white adults from the United States between the ages of 19-84--puts that assumption to rest. The bottom line is that being overweight or obese increases your chances of death at an earlier age compared to someone who has a normal BMI as defined above.
What was also interesting in this study was the observation by the authors that people who had a BMI below 20--those are the really thin folks--also had an increased chance of death, although not as high as the obese crowd. When examined further, the researchers were able to determine that if you were thin and fit, then the increased risk was less. Smoking had a greater chance of being associated with earlier death in the "too thin" group as compared to the "too fat" folks.
So why is all of this important?
The answer to that question is reflected in the second report released today, called "Healthy People 2020."
You may not know this, but every 10 years the government puts a great deal of effort in analyzing the current health status of our population in the United States, then sets goals for the next decade to improve our health. And, as they should, they also analyze how well or how bad we did on meeting the goals set 10 years previously.
Today's report shows that we aren't doing particularly well when it comes to overweight and obesity (not that that is a particular surprise, since that information is tracked regularly).
So here is what the government had to say today about our current rate of obesity, and where we should be:
- The target for 2020 is for 33.9 percent of the population to be at a healthy weight in 2020. Currently, 30.8 percent of the people age 20 and over are at a healthy weight.
- Next, we need to reduce the proportion of adults in the population who are obese to 30.6 percent. The current number is 34 percent.
- For children between 2 and 5 years old (yes, 2 and 5 years old), we need to reduce the number of kids who are obese from 10.7% to 9.6%. For children between 6 and 11, 17.4% are considered obese and that goal for 2020 is to get to 15.7%
These goals, my friends, are modest. But it is the baseline numbers that catch my attention, and reflect on the fact that we are about to inflict on our children a shorter life expectancy than ourselves, since these obesity figures predict a significant increase in serious chronic diseases for our kids. Not to mention the serious increase in chronic diseases in adults that we are experiencing in this country.
Let's face it, my friends: we know a lot of adults are obese, but over 1 in 10 kids between the ages of 2 and 5 are obese and almost 1 in 5 between ages 6 and 11? How does that happen? Are we kidding ourselves into thinking that is not a serious epidemic in this country?
So here we are, finding ourselves in the midst of a holiday season, and wondering what we can do to improve the health of our nation. Maybe it's just me being a bit curmudgeonly, but couldn't they have timed the release of this information this a bit better, like in early January when all of us are making our commitments to improve our health? I just don't see many people taking this type of news to heart at this particular time of year. Even in my own family, we are probably at a point when we are putting off a number of lifestyle adjustments until 2011.
But the facts are what the facts are, and I am going to be here to remind you again early in 2011 of what we have learned this year about weight and health--and don't forget the research reports about impact of waist size and how many hours you sit in front of the TV and how that also increases your chances of an untimely demise. The good news just keeps coming and coming...
Sooner or later, somehow, we as a country are going to get the message that we can't eat all we want, or sit around all day and expect the doctors to make us well. It just doesn't work that way forever. Doctors and medicines can patch over some of our transgressions (think cholesterol lowering medicines, improved treatments for diabetes, heart bypasses and knee replacements to name but just a few) but they can't fix everything. Only we can do that for ourselves.
So call me a grinch or whatever favorite word comes to mind, but I am here to prod you into action about taking care of yourself. The statistics don't lie, and neither should you (to yourself). Embrace this information, make a decision, and take action. Now is as good a time as any.
And maybe if enough of us get the message, we will in fact meet some of those goals that have been set for the next "Healthy People" report in 2020. There is always hope.
Now, on to the next holiday party.
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