Cart before Horse?

(Jul 26, 2016)

Predicting the exact impact of weight upon mortality has proven to be a tricky business. That obesity is on the rise is universally acknowledged, but in recent years we have seen research studies reach differing conclusions, depending on the populations examined and the measures used. For example, there has been debate over whether the breakpoints used to analyse BMI, the most prominent weight measure are appropriate in all populations. A key issue posited, however, has been that of "reverse causality" - which in this context is usually interpreted as the failure to adjust for weight scores that are considered "healthy" under the BMI scale but in fact derive from illness-related weight-loss. The question…

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Tags: mortality, research, reverse causality, obesity, BMI

Sweet and Sour

(Feb 17, 2016)

Public health initiatives, such as those being considered in the UK around sugar, carry risks as well as potential benefits for any government. The first consequence of action is the near-certain accusation of presiding over a nanny state. Although the archetypal nanny, Mary Poppins, was famously enamoured with sugar's ability to help the medicine go down, nowadays, most debate is around whether it actually sends our societal need for medicine in the opposite direction. Is sugar a particular driver of mortality and morbidity that merits state intervention? The World Health Organisation seems to think so, with it's recent report on Ending Childhood Obesity making an unequivocal call for effective taxes…

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Tags: longevity, sugar tax, obesity, diabetes, health intervention

Weighing The Evidence

(Mar 10, 2015)

We've previously discussed the significant challenges involved in forecasting mortality by cause of death. Needless to say it isn't any easier to predict the impact of trends in lifestyle factors that drive those causes. One example is the research actvity around rising obesity, and specifically around the possibility rising obesity may negate the improvements in smoking-related mortality. Sturm and Wells (2000) asserted that obesity had a significantly higher impact on health outcomes than lifetime smoking or poverty. They reasserted these conclusions in 2002. It is clear that in both the US and UK we do see a diminishing prevalence of smoking allied with surging increases in obesity, but working out…

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Tags: obesity, mortality improvements, smoking, back-test

Discrimination

(Jul 8, 2009)

In an earlier blog I discussed the role of Body-Mass Index (BMI) in measuring obesity.  An alternative measure to the BMI is to measure your waistline, since this is more directly indicative of health-threatening abdominal fat than the BMI is.  The British Heart Foundation (BHF) has a free information pack on such matters as they relate to heart disease.  The pack includes a tape which is colour-coded so you can immediately read off both your waistline and risk category.

One unexpected feature of the tape measure is that one side is labelled "European" and the other is labelled "Asian", with the colour-coded risk categories being different on each side.  This seems odd, since surely an…

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Tags: obesity, discrimination

Measuring obesity

(Jun 23, 2009)

Obesity is a public-health concern throughout the developed world, since it is linked to a variety of chronic conditions such as diabetes.  Obesity is also of interest to insurers, since it is linked to excess mortality from a wide range of causes, including heart disease.  The most commonly used measure of obesity is the body-mass index (BMI), which is calculated from a person's height and weight. The British Heart Foundation has an online BMI calculator which is free to use.

Now, the United Kingdom doesn't often take a leading role in the EU, but sadly obesity is one area where it rather stands out, as shown in Table 1.

Table 1. Prevalence of obesity among adults in selected large EU countries (Source: Health Interview…

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Tags: obesity, body-mass index, BMI, concentration risk, basis risk

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