What Really Makes Us Fat
Posted: July 2, 2012 Filed under: Food, health, medicine | Tags: Atkins diet, environmental causes of obesity, fat, Ludwig, obesity 42 CommentsLet’s face it. People feel the fat-antifat kerfuffle is a struggle between good and evil. Gluttony is bad! It’s not gluttony. It’s a disease! It’s not a disease. It’s genetics. It’s okay. It is not okay. You haven’t read the latest positive waist trainer reviews. And so on and on.
Folks, we’re talking about biology. It could be all of the above and then some. “Then some” is actually my preferred answer and I’ll discuss it in a bit. But in the meantime, it’s worth remembering that none of the above are mutually exclusive. The answers vary from person to person and there is no single thing that is true for everyone, or even for one person all the time. As they say on Facebook, it’s complicated. In that spirit, it’s well worth looking at research that tells us about parts of the answer.
Gary Taubes writes about a study in the Journal of the American Medical Association (Ebbeling et al., 2012) on What Really Makes Us Fat:
[T]he study tells us that the nutrient composition of the diet can trigger the predisposition to get fat, independent of the calories consumed. The fewer carbohydrates we eat, the more easily we remain lean. The more carbohydrates, the more difficult. In other words, carbohydrates are fattening, and obesity is a fat-storage defect. What matters, then, is the quantity and quality of carbohydrates we consume and their effect on insulin.
Chalk one up for the Atkins Diet, but don’t therefore assume the American Heart Association is “wrong” when it tells you to eat a low-fat diet of whole grains, fruits and veggies. The AHA is trying to help your heart. Their advice is perfectly good for your heart. The Atkins Diet is trying to help you lose weight. This research says it does. It says nothing about your cholesterol or the kidney-damaging effects of long term excess protein, especially in people with borderline kidney disease they may be unaware of.
The research shows an interesting piece of the obesity puzzle, but unless fat storage regulation is the biggest reason for obesity, it’s not actually going to deal with the epidemic. And the biggest causes can’t be fat storage regulation gone awry. Human physiology hasn’t changed in the last few decades. We have the same fat-storage hormones we’ve always had. Likewise, people have always wanted to eat too much. Nor have our genetics changed a whole hell of a lot in the last few dozen years. And yet obesity (as medically defined and meaning more than mere overweight) has gone from being a rather rare issue to being a problem for a third of all US adults.
The thing that’s missing in too many current discussions of the obesity epidemic is environmental effects. This is not a comment on the research, because that wasn’t its topic. But every single discussion for the general public needs to beat that drum until we all get it. Environmental factors are the only ones that have changed recently. Plus, that explains why we have an epidemic. Epidemics are public health issues, and they’re all embedded in the environment.
The reason it’s so important for everyone to understand the biggest causes is because obesity really is an epidemic, and it really is destroying the health of millions. It’s causing and will continue to cause horrible suffering in people who go blind or need amputations due to diabetic complications, or who become paralyzed after strokes. This stuff is no joke. Nor is it just a conspiracy by the fashion industry (although it’s that too). To the extent that obesity damages health, it’s vital — literally — to understand and fix the real causes and not to waste time on sacrificial food offerings to gods who don’t care.
I think two environmental factors stand out like sore thumbs.
- Advertising for fat-making food and drink
- Endocrine disruptor environmental pollution
You may not think of ads as an environmental factor, but what I mean by that is it’s out there, in your environment, and not something you control. You can’t simply ignore ads, no matter how many people blithely tell you to. Ads have their effect whether or not you pay attention. Your only real choice is to turn them off. An individual can choose to eschew most media, but on a population level, that’s not going to happen.
So we’re in an environment saturated with unavoidable messages to have fun with food. At the population level, some proportion of people some of the time will find themselves wanting that food, wanting that cola, and taking it. At the population level, some proportion of people get more calories than they otherwise would. And some proportion of them get fat.
It’s important to remember that getting fat, being a biological process, is not a simple matter of balancing calories in and calories used. Nothing in biology is simple. Calories in is a factor, certainly. If it wasn’t, you’d see fat people among famine sufferers.
But how the body stores fat stands right between the two halves of the equation. That is a complicated, hormonally controlled process we’re only beginning to understand. Insulin is one of those hormones, but only one. Sex hormones are also among the messengers that carry out the regulation. The starkest example of fat storage gone crazy is rare genetic conditions where the body’s hormones that promote fat storage are so active, they don’t leave enough glucose circulating in the blood for metabolic needs. Everything goes into fat, there’s too little left over for the business of staying alive, and the person is literally starving while putting on weight.
A big contribution of Ebbeling’s and her colleagues’ research is demonstrating the subtle effect of fat storage regulation that’s within the normal range. And since hormones are part of that process, hormone disruption can be expected to have a huge effect on fat deposition.
Which brings me to the second big environmental factor: a whole group of chemicals. They’re called hormone disruptors and they come from some plastics, pesticides, hormonal medicines, and so on. Those break down into hormone analogues and get into the environment. As I said in an earlier post on the Obesity Epidemic, if hormones help regulate energy balance, and if we’ve flooded the environment with bad substitutes for hormones, is it any wonder that people are having trouble regulating energy balance?
So, you may be asking, what does it all mean? What are we supposed to do about it? I’ve said it before so I’ll just say it again:
Like all public health issues, nothing less than a population-level approach will work. Dysentery, cholera, and typhoid are never wiped out by drinking boiled water. They’re wiped out by building municipal sewers. Smallpox wasn’t eradicated by avoiding smallpox patients. It was eradicated by universal vaccination. The individual actions aren’t useless. They just don’t change the widespread causes of the widespread problem.
Modern health problems like cancer and obesity aren’t going to be wiped out by eating fresh vegetables. Eating veggies is good, but it doesn’t address the basic problem. That’s going to take nothing less than a change to clean sustainable industry.
It’s almost enough to make you wish a mere diet really was all that’s needed.
Study shows Single Payer Health Insurance is Most Cost Efficient
Posted: April 14, 2012 Filed under: health, Health care reform | Tags: Single Payer Health Insurance. 18 CommentsThere are some market transactions that are best done by single providers. These services or goods are usually provided as public goods through a government
agency or a private institution granted the monopoly–then regulated–by the federal government. There are fairly standard traits characterizing natural monopolies. One of the primary indicators is that a single provider achieves economies of scale that no other form of market achieves and therefore it has the lowest average total cost. Health insurance is one of those markets where total risk is minimized–with its associated costs–when the risk pool is maximized. The high number of subscribers spreads the risk over many. If costs get high, low risk subscribers tend to drop their policies which leaves only folks that have high usage in the pool. This makes the service highly unprofitable and usually results in an insurance company trying to get rid of the high usage subscribers or any one that has the potential of being high usage. This is called cherry-picking.
Pricing insurance is based on trying to quantify risk of payment and that can be a complex business. Also, insurance–as a third party payer–means the market will eventually break down since the pricing mechanism is based on these ‘gambles’ and the fact that the consumer disconnects health care from insurance payments. Third party payer systems lead to inefficient markets because the normal dynamics of supply and demand do not lead to a market-based price. So, all development nations–except the US–know that having a purely market driven approach to health insurance fails big time. They approach their systems differently and do not rely on the largess of employers and the wealth of individuals to drive health care payment institutions.
This is a very brief introduction, but I wanted to give you some introduction to this important study by professor of economics Gerald Friedman from the University of Massachusetts-Amherst. Friedman shows how a single payer system for the US would save money over the current system and the ACA framework. He also explains how a single payer system could be administered cheaply and easily.
The Expanded & Improved Medicare for all act” (HR 676) would establish a single authority responsible for paying for health care for all Americans. Providing universal coverage with a “single-payer” system would change many aspects of American health care. While it would raise some costs by providing access to care for those currently uninsured or under-insured, it would save much larger sums by eliminating insurance middlemen and radically simplifying payment to doctors and hospitals. While providing superior health care, a single-payer system would save as much as $570 billion now wasted on administrative overhead and monopoly profits. A single-payer system would also make health-care financing dramatically more progressive by replacing fixed, income-invariant health-care expenditures with progressive taxes. This series of charts and graphs shows why we need a single-payer system and how it could be funded.
He succinctly provides the best reasons for choosing Single payer. It’s cheap and efficient.
Health-care costs have risen much faster than income in the United States over the last 50 years, rising from 5% of Gross Domestic Product in 1960 to nearly 18% today. Some of the increase in costs in the United States, as with other countries, is associated with improvements in care and longevity. Costs have risen much faster in the United States, however, because of the growing administrative burden of our private health-insurance system.
The article contains a lot of graphs and illustrations comparing the current system that relies on profit-making bureaucratic private insurance companies who are subject to state regulations that are quite varied. These providers also make paper work difficult because coverage, plans, and payments are nonstandard. This creates high costs for actual providers. The article is easy to read and I’d suggest you take a look at the article which can be found in Dollars and Sense.
The God Of Small, Mean Things
Posted: February 20, 2012 Filed under: abortion rights, Anthony Comstock, birth control, Feminists, fetus fetishists, health, Human Rights, Planned Parenthood, PLUB Pro-Life-Until-Birth, religion, religious extremists, Reproductive Health, Reproductive Rights, Rick Santorum, Women's Healthcare, Women's Rights 41 CommentsIf there’s a positive aspect in the recent skirmishes of the Contraception Wars, it’s the exposed, full Monty view of right-wing political theology.
Rick Santorum, a self-appointed moralist in this ancient battle, espouses views that neatly summarized the public’s [primarily men’s] viewpoint on women’s issues some 100 years ago.
When I listen to Rick Santorum and his carping supporters, who fervently believe that they and only they have a right to determine a woman’s reproductive destiny, I’m certain that the Comstock Laws [back in the day] would have suited them perfectly.
In the waning years of the Grant administration, Anthony Comstock waged a one-man crusade in the US against what he viewed as pornographic, obscene and lewd materials. He was the judge and jury in this matter and after great effort and energy, the Comstock Act was written into law in 1873, amending the Post Office Act. It read as follows:
Be it enacted…That whoever, within the District of Columbia or any of the Territories of the United States . . .
shall sell…or shall offer to sell, or to lend , or to give away, or in any manner to exhibit, or shall otherwise publish or offer to publish in any manner, or shall have in his possession, for any such purpose or purposes, an obscene book, pamphlet, paper, writing, advertisement, circular, print, picture, drawing or other representation, figure, or image on or of paper of other material , or any cast instrument, or other article of an immoral nature, or any drug or medicine, or any article whatever, for the prevention of conception, or for causing unlawful abortion, or shall advertise the same for sale, or shall write or print, or cause to be written or printed, any card, circular, book, pamphlet, advertisement, or notice of any king, stating when, where, how, or of whom, or by what means, any of the articles in this section…can be purchased or obtained, or shall manufacture, draw, or print, or in any wise make any of such articles, shall be deemed guilty of a misdemeanor, and on conviction thereof in any court of the United States…he shall be imprisoned at hard labor in the penitentiary for not less than six months nor more than five years for each offense, or fined not less than one hundred dollars nor more than two thousand dollars, with costs of court….
For the next forty years, Anthony Comstock wielded a censoring club on all things he deemed smutty and obscene. That included any and all materials related to contraception, abortion, sex education, sex itself and managed to extend itself not only in posted materials but literature, suppressing the works of DH Lawrence and Theodore Dreiser as well as banning nudity in artworks, even images and text in medical books, describing and illustrating reproductive functioning.
This is where the push to purity takes one, a mindless rejection of the human body and human nature, an extreme Sin of the Flesh philosophy.
Comstock had a particular problem with women, particularly the likes of Margaret Sanger and her supporters, as well as the Suffragettes, who openly defied Comstock’s puritanical attitudes. These women marched, sent pamphlets to supporters,
opened health clinics, smuggled contraception devices into the country, went to jail, went on hunger strikes, put their bodies on the line. And did not give up.
Women earned/won their right to vote in 1920. Griswold v the State of Connecticut was decided by the Supreme Court in 1965. The decision protected the right of married women to practice contraception and demand access to reliable reproductive services. These rights were eventually extended to unmarried women, the right to privacy established, which later swung the door open to the Roe v Wade decision.
I have no doubt that Santorum and like-minded, right-wing adherents would have no problem, slamming that door shut, hopping into a time machine and revisiting the days of Comstock purity. Let’s review the latest Santorum Hit Parade:
Telling a crowd at the Ohio Christian Alliance on Saturday that President Obama’s agenda was a “phony ideology” not “based on the Bible,” Rick Santorum has offered two explanations: the imposition of secular ideas on the Catholic Church and radical environmentalism that he claims the President specifically and Democrats in general have been pushing to the max.
Where to begin?
On the first charge, Santorum said:
The president has reached a new low in this country’s history of oppressing religious freedom that we have never seen before. If he doesn’t want to call his imposition of his values a theology that’s fine, but it is an imposition of his values over a church who has very clear theological reasons for opposing what the Obama administration is forcing on them.
This is clearly an example of contorted gamesmanship. When there is no defense to your position, you claim your opponent is doing what you yourself desire to do, in this case, impose your beliefs on the greater population. Very Comstock-like.
No one is forcing anything on Santorum, the Church or those who agree with their rigid position. The ‘compromise’ the Administration offered has already been accepted by Catholic charities, hospitals and universities as reasonable and workable. The fact that Santorum and the Catholic Bishops want to run their position into the ground does not make it right or timely. It’s simply a narrow, constipated outlook that belongs to an age when women were securely under the thumb of men like Santorum and the whims of Catholic Church. History has passed; attitudes and positions change.
In defense of the second explanation—radical environmentalism—Santorum had this to say to Bob Schieffer’s Face the Nation:
This idea that man is here to serve the Earth, as opposed to husband its resources and be good stewards of the Earth. And I think that is a phony ideal… I think a lot of radical environmentalists have it upside-down.
What pops out to me is the phrase ‘husband its resources.’
Change that phrase to the single word ‘extraction’ and we get the gist of what’s being said. So, anyone opposing the Keystone Pipeline would be deemed a ‘radical environmentalist,’ even though the 1700 mile pipeline endangers America’s bread basket and a major aquifer, would not reduce our dependence on unfriendly oil suppliers [80% of the refined tar sands is contracted for export] and would offer, at best, 5000-6000 temporary American jobs. Even an amendment to this new bill, a proposal that would have ensured that at least the steel for the pipeline would have been from the US, was rejected out of hand.
Color me a Environmental Radical. The Keystone project benefits no one but the rich financiers behind it. They get the mega-profits; we [the public] get stuck with a wasted landscape and the cost of any cleanup.
Or perhaps, Santorum is speaking about the WH’s kibosh on the uranium mining deal for the Grand Canyon. Splendid idea there. Turn one of the Wonders of the World, a national treasure into a money pit for mining interests. I’ve stood on the rim of the Canyon, marveled at the grandeur, the colors, the staggering expanse. And this, we would turn into a uranium mine? What a small, stingy idea!
I suspect Teddy Roosevelt [one of those evil progressives] is turning in his grave.
But Santorum outdid himself with this comment:
He lambasted the president’s health care law requiring insurance policies to include free prenatal testing, “because free prenatal testing ends up in more abortions and therefore less care that has to be done because we cull the ranks of the disabled in our society.”
Culling the ranks of the disabled?
Don’t mistake this comment as a defense of religious liberty because this is a coded charge that what contraception and abortion [presumably determined through prenatal testing and care] really involves is a form of eugenics. We will cull the herd of imperfections. Or we will attempt genocide of minorities. This is Glenn Beck hysteria. Billboards in Georgia revived the old smear against reproductive rights, charging that African American women were being targeted for abortion services. Black children, the claim stated, were an ‘endangered species.’
Funny that. I thought we were all of the same species.
If we truly want to talk about minorities being endangered, why don’t we talk about our prison population, comprised primarily of people of color. But, of course, that would be uncomfortable, deemed unfair by Republican politicians, who in their infinite wisdom want our prison system privatized, which will ensure maximum capacity for the sake of profits.
These arguments are old and pathetic. They’ve been leveled against anyone and everyone who have supported basic health services to women. Prenatal screening is a mainstay in the health of an expectant mother and the viability of any pregnancy. Problems can be picked up early and corrected before a delivery. The health of an expectant mother translates into the health of the developing fetus. The idea that screenings should be done away with or not offered to low income women is cruel.
The religion that Rick Santorum and his ilk would like us to swallow whole is one dictated by religious fanatics, purists like Anthony Comstock, where it’s their way or the highway. It is small. It is mean. It is unworthy of anything approaching the Divine.
We want a healthy society? Then we offer health services to all our citizens. Yes, even women, who deserve to be the arbiters of their own reproductive lives.
Garry Willis, historian, journalist and Catholic intellectual had this to say in a piece entitled “Contraception’s Con Men”:
The Phony “Undying Principle” Argument
Rick Santorum is a nice smiley fanatic. He does not believe in evolution or global warming or women in the workplace. He equates gay sex with bestiality (Rick “Man on Dog” Santorum). He equates contraception with the guillotine. Only a brain-dead party could think him a worthy presidential candidate. Yet he is praised by television pundits, night and day, for being “sincere” and “standing by what he believes.” He is the principled alternative to the evil Moderation of Mitt Romney and the evil Evil of Newt Gingrich. He is presented as a model Catholic. Torquemada was, in that sense, a model Catholic. Messrs. Boehner and McConnell call him a martyr to religious freedom. A young priest I saw on television, modeling himself on his hero Santorum, said, “I would rather die than give up my church’s principles.” What we are seeing is not a defense of undying principle but a stampede toward a temporarily exploitable lunacy.
I rest my case!







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