Helpless to Prevent Cancer? Actually, Quite a Bit Is in Your Control
nytimes.com
nytimes.com
My conclusion was that cancer is best prevented by removing negatives from life, not necessarily adding positives. ie avoid anything from stress to pollution to sunburn to obviously smoking. Interestingly, organic food doesn't seem to matter in the cancer equation, given the data we have.
Yet there's one thing you can ADD to reduce cancer: exercise. Preferably moderately hard to strenuous.
I'm also skeptical that adding foods/vitamins/supplements will prevent cancer.
However, there is one area that adding things seems to be very beneficial, and that is adding things that promote regular bowel movements.
There have been studies of heavy coffee drinkers and their reduced risks of colon cancer. Everyone is looking for some mysterious phenol or antioxidant from the coffee as a magic elixir, but I think it should be obvious that coffee as a laxative is the agent here.
There's also the age-old rule of thumb: an apple a day keeps the doctor away. It's not the apple, it's the fiber.
Regular bowel movements are their own reward!
But diet is a complex system. So while there might not be any magical "direct" benefit from eating a certain fruit or vegetable, they could still produce a significant positive effect.
Perhaps the biggest contribution to preventing cancer that fruits and veggies make is to curb negative behavior. They might replace sugary foods or regulate cravings or satiate (all interrelated). And then, this could feed back into promoting positive behavior: more energy which encourages more rigorous exercise. Which boosts the subject's mood and increases their sense of well-being. Which feeds back into their dietary choices. Etc.
Obviously there's benefits, but I maintain that adding fruits and veggies to an otherwise awful lifestyle is akin to putting lipstick on a pig. Eat all the fruit you want -- if you smoke, you're not fooling your body.
Although only one paragraph, I'm glad the author addressed this.
All of these tips and lifestyle changes are great but this doesn't make those of us with loved ones with cancer feel any better. By all accounts she has done everything to qualify as "low risk," but still got cancer.
It's still an odds game. Better odds don't guarantee anything. It's unfair, frustrating, and infuriating.
Cancer can be caused by things other than mutagens though. There is a certain rate of transcription errors when cells divide, and these errors can build up in the same way mutations from radiation, etc. build up. Things that kill cells and force them to divide speed up cell division, and can cause cancer that way. For instance, acid reflux and drinking can both cause esophageal cancer.
You can also get cancer from just being extraordinarily unlucky.
If we measure success only by how many people eventually die from a particular disease, then increasing life expectancy doesn't count as success at all.
Dying from cancer at the age of 90 should not be counted the same as dying of cancer at the age of 45.
So the statistic I want to see would count cancer free years.
If you have to avoid a certain activity, or take up a certain activity, in order to enhance your longevity, doing or not doing something you'd rather do (or not) may still affect your quality of life.
Science ended up printing a follow-up actually clarify things, perhaps feeling themselves that the interpretation by the public at large got out of hand a little bit[2].
[1] https://www.youtube.com/watch?v=iiH4m7NvV98
[2] http://www.sciencemag.org/news/2015/01/bad-luck-and-cancer-s...
> In other words, this study argued that the more times D.N.A. replicates, the more often something can go wrong. Some took this to mean that cancer is much more because of “bad luck” than because of other factors that people could control.
> Unfortunately, this simple explanation is not really what the study showed. Lung cells, for instance, divide quite rarely, and still account for a significant amount of cancer. Cells in the gastrointestinal tract divide all the time and account for many fewer cancers. Some cancers, like melanoma, were found to be in the group of cancers influenced more by intrinsic factors (or those we can’t control), when we clearly know that extrinsic factors, like sun exposure, are a major cause.
as well, he only opens with that and aims to debunk the bad luck hypothesis by means of the other two studies. which again I personally have no idea about :)
This article is a rather optimistic spin on these numbers. I'd have said "a large majority of cancer cases--75% in women and 67% in men--were not preventable"
On the other hand, when someone tells me that they've optimized a compiler and it can now compile 3% faster I get really excited and pull their repo, I don't turn around and say "you mean 97% as slow" and keep complaining about how long compilation takes and how nothing can be done about it. Show that there are steps you can take to cut it by 33% more than we currently know how and you'll be a god among programmers.
Sure, not every visitor signs up still, but some group of people found the new copy compelling enough to sign up - with no new, very expensive feature development.
> Lung cancer is by far the leading cause of cancer death among both men and women; about 1 out of 4 cancer deaths are from lung cancer.
http://www.cancer.org/cancer/lungcancer-non-smallcell/detail...
and from the article:
> About 82 percent of women and 78 percent of men who got lung cancer might have prevented it through healthy behaviors.
Back of the envelope: ~20 percent of all cancer deaths are lung cancer deaths that wouldn't have happened without smoking. That leaves just 5-15% of cancer deaths being "potentially preventable" once you've given up smoking. (Here, I'm not distinguishing between cancer cases and cancer deaths; please point to better data if you have it.)
I'd wager less than 5% of cancer deaths are preventable if you neither smoke nor are overweight.
I think this article, and especially its headline, is highly misleading.
If you sell cigarettes and a customer looses part of the lung, you pay or behave to prevent. If you sell alcohol and a customer drives a car in a crowd, you pay or behave to prevent. If you are a narco and sell crack, you pay for the results. The problem is not the unknown problems with those substances, its the fact that the producers are detached from the consequences of their actions.
https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agre...
Should Hershey be required to pay medical costs for morbidly obese individuals because they eat a dozen chocolate bars a day? Sugar is a highly addictive substance, after all.
Should automobile manufacturers be required to pay the medical bills of every individual injured in a high-speed accident because driving very fast generally causes an adrenaline rush, which is addictive?
Stop making it someone else's problem. Start casting blame where it needs to be - on the individual(s).
Nobody is forced to start smoking, or start drinking, or start eating sweets, or drive recklessly, or to do this or that. I'm tired of the popular trend of infantilization that offloads the burden of one's own actions onto society/industry/government.
I think it would be a great start if we started to differentiate- some humans are capeable of this, but others are not. To just leave them to there suffering because they had a "choosing-chance" is just wrong. No pr-opaganda can explain the facts on the ground away, sorry.
As far as "leaving them to suffer" goes, there are plenty of ways for people to get help with just about every health condition and disorder that's lifestyle related. They simply require that the individual actually take responsibility for their own existence and reach out.
Who makes the decision that someone is "not capable" of caring for themselves, and at what level? Do you force them into a special program? Do you take away all of their other individual rights at the same time? Who decides what aspects of personal responsibility apply to which people? That's a very slippery, dangerous slope to tread. Smarter people than you, or I, haven't been able to come up with "the right" answer.
I'll err on the side of personal agency, thanks.
The world you seem to desire would make cellphone manufacturers and service providers fully liable for accidents that happen when an idiot is using their phone and gets in a car wreck.
The individual chose to get into a car, and drive somewhere, and use a cellphone, all at the same time. This despite the fact that it is made abundantly clear that doing so impairs driving ability much like alcohol would, via advertisement and public notice and safety publications, in the news, and even by state law in some cases. You cannot prevent people from doing stupid things. You can, however, make them bear the repercussions of those stupid decisions.
The world you seem to desire is one where every device and tool is covered in thick layers of bubble wrap and warning labels and dozen-pages-thick usage contracts to indemnify the manufacturer.
The world you seem to desire is one where no criminal is punished for their actions because they were just "a victim of their environment and don't know how to do anything else".
And that is something that I cannot and will not agree with, ever, on a fundamental level. Personal freedom comes with personal responsibility.
If there's a tool designed in such a way that using it in an accidentally-slightly-incorrect manner will electrocute the person using it - sure, hold the manufacturer responsible.
But if there's a tool that does exactly what it's designed to do, but someone uses it for a completely different purpose in a completely different way than it was designed to do, and it electrocutes them - that's on the user's head.
Those are your words, my friend. Maybe I misinterpreted them. I didn't say individuals are 0% responsible. It's a mix, right?. Individuals deserve blame but also support. Companies deserve protection from inane lawsuits but also bear some responsibility.
> But if there's a tool that does exactly what it's designed to do, but someone uses it for a completely different purpose in a completely different way than it was designed to do, and it electrocutes them - that's on the user's head.
Sure. That doesn't apply to tobacco or sugar. We're using it in exactly the way the sellers intended. I don't know why you're stuck on the reckless driving example, when it doesn't really pertain to the general context of the article.
> I'm tired of the popular trend of infantilization that offloads the burden of one's own actions onto society/industry/government.
Sure. But my question stands. Do you think the society/industry/government ever bears >0% of the responsibility?
Moderate tobacco use, in some forms, moderately increases cancer risk. Moderate sugar consumption doesn't overtly increase the risk of heart disease or obesity.
Overuse of most tobacco products dramatically increases your cancer risk, just as overuse of sugar dramatically increases its associated risks.
My point stands that nobody is forcing you to start smoking tobacco or eating large volumes of sugar. Why do you want to push all of the responsibility away from someone who willingly undertakes an optional activity with known risks?
It's not like every widely-available tobacco product hasn't had 50% or more of its packaging plastered with "warning, cancer!" labels for the last 30-odd years.
Should tobacco companies be held responsible for objectively-false advertising and marketing? Yeah, if memory serves they got beat up pretty well for that by the government many years ago. When was the last time you saw an ad for cigarettes on TV? It's been quite a long time since I have. That problem has already been taken care of.
With sugars you might be able to make an argument about a lack of in-your-face warnings - but why should those be required? Moderate consumption is fine. Excessive consumption is where the problem starts kicking in. Various government entities are already kicking up a stink about sugar-heavy products, so I wouldn't be surprised if we got such warning labels in the future anyway.
Where did I say or even imply that? I just said it's less than 100% – but more 0%. You're obviously quite passionate and/or angry about something, some injustice you've seen or something. I feel like we're talking past each other and you want to have an argument just for the sake of arguing on the Internet. I'm not super interested in that.
I hope you have a wonderful rest of the day. Maybe we'll meet in person one day and debate the issue in a higher bandwidth medium. Cheers.
I program Robots for a living, and you know what - im guilty of those peoples lives going to hell when they are let go. They are not guilty that they can not retrain at 40. They are not to blame that there endurance might not be high enough to get a degree. Its also not the CEO who employs me to do my job, which i just do. I could quit my job anytime. Im guilty and thus must work hard, to even that guilt out. I try my best to promote basic income and unshaming unemployment in my home country. Individual responsibility, suddenly sounds less happy, does it? Sounds like hard work and shame.
You arguments sounds suspiciously like shirking responsibility's by idealizing other people. Imagine if a whole society would do that, what a catastrophe, could you even call that a society anymore?
You are introducing irrelevant other ideas to distract from the core of the OP's argument, which while a bit excessive IMO, warrants an honest discussion, not hyperbolic overreaction.
Good luck to you!
It was enough to keep me dedicated knowing I could confidently talk to anyone after I quit without having to wonder if they were immediately put off by my smell.
People who still smoke always complain that ex-smokers are the worst and most judgmental about smoking, and it's 100% true. It's because we feel seriously ashamed of ourselves for being so stupid for so long, it comes out as assholishness sometimes.
I dunno, they might need to get close and smell the breath, the smell of cigarettes to this day (from a distance) still makes me crave one, ever so slightly. Even after having quit 13 years ago (I quit in 2003). The only off-putting smell is in ashtrays or their breath/clothing. The actual burning smell though, that gets me to this day.
I believe in tested e-cigarettes and liquids to cut a chunk of chemicals. I wonder what other people do. Kick their ass into sport ? Reorganizing life ? more hobbies, more social life, more zen ?
After 20 years or so of being a smoker, I just decided I didn't want to be embarrassed about the way I smelled in elevators anymore, and quit. I was a competitive cyclist, despite being a smoker, so it wasn't helping me in those social situations either.
When I did stop, it was hard for about a single day. Irritation and not being sure what to do with your hands are the biggest "withdrawal" symptoms you'll have from quitting. If I'd known just how easy it is to stop, I would have 10 years prior.
So yes, listen to the above poster. It won't kill you to quit, it will kill you not to. If you honestly think you can't, it's a very simple problem to solve. There are really only three components to quitting. Nicotine addiction (easy to taper off with substitutes like gums, switching to vaping with decrementing nicotine levels, etc), Habit (the act of smoking, vaping/e-cigarettes/gum chewing/going on walks instead can help replace this) and the social pressure, which is usually smoking with your smoker friends or partner. Fun fact, they all want to stop too, even if they don't say so. Get them to quit with you, and if one or more refuse or abandon, ignore them and be selfish with your health.
All that said - the "pain" of cold turkey lasts a day and all the anecdata that I've collected seems to make it the most effective way to stop.
I once stopped smoking for ~3 weeks and I too found it easier than advertised, but not nearly as easy as you; also, the most problematic symptom for me was irritability (I was a complete irrascible bastard while stopping). And I know people for which it is very, very hard (cold sweats, migraines, etc. for two weeks).
After that, it's all habit. That takes closer to 3 weeks to break. Here I find it helps to create another habit, maybe buy a bunch of candy and eat one when you feel like a cigarette.
It's all very doable.
Best way I found to get over those 3 days is to be sick, drunk, hungover or all of those, coinciding with a strong urge to quit and running out of tobacco (or throwing it out) at the start of it.
And it's not easy. But it might be for some. But I wonder if the ones that can quit really easily are really the ones that need all this anti-smoking advertising, anyway? I mean they can just have a moment of clarity, realize the health risks and quit. Well good on you (I mean it). I'm glad there is all this negative pressure nowadays, means I will have to say "no" less often, and feel supported by it.
And even though I feel quitting is hard for me (compared to people who can smoke once every two months or so, or maybe never, just like that), when I hear these stories about people having physical withdrawal symptoms for weeks, that sucks, I feel for them and wish them strength too.
Also, nicotine has the highest capture rates of any drug (over 30%) and the third highest dependence rate (after heroin and cocaine). Startup founders with unbelievable amounts of determination may be able to just give it up and say it was "easy" (I said the same thing the first time I quit) but many people are not so gifted.
The other partner tried everything. Cold turkey, gradual reduction, patches, gum, change of location plus each of those, the works. As you can imagine given the domestic situation, she had exactly the right kind of support. None of it helped for over a decade. She was finally able to quit for good around 2010, and just a month later discovered that it was too late. Smoking had already given her the cancer that would end her life.
That said, this story kind of agrees with you. The partner who quit is still alive, and quite healthy. It might be easy, or it might be the hardest thing you've ever done. No matter how hard it is, though, lung cancer is even harder.
We have tobacco companies still cranking out the same garbage, almost with the attitude that they are forced to keep making this horrific product because people are hooked on it. They keep taking our money, apologetically, as they kill us.
I smoked less than 3 packs of cigarettes in my life, stopped 15 years ago, and I still get cravings. Alcohol on the other hand has zero pull for me.
I stopped 6 years ago and have zero cravings. But I am curious how you define "cravings". Is it a physical sensation? Is it a mental "pull" when you see someone light one up?
Smoking is easy to quit for most people, and ridiculously hard for most smokers. When I was 17-20 50% of my friends smoked cigarettes and 80% of my friends quit by the time they were out of college a year or two without any problems. The remaining 20% of my friends couldn't quit for the world. They've tried quitting 20 different ways and never succeeded. I think the difference is some people are just wired for quitting smoking to be hard, but most people aren't. And the former population is way over represented among the smoking population.
So with that I can say: the pain of quitting doesn't last only a day, it's good you didn't experience depression, I never had depression before or after that but I was clinically depressed for 3 weeks, I was apathetic about life in general, would wake up and not feel motivation to do anything, I'd do them anyway because it was a routine (eat, shower, work) but I really felt I'd never be happy as I was before.
It began to fade after the first week, during the second week I'd still feel urges to have a cigarette after a coffee or lunch, or just when I was bored. Third week was easier and by the end of the first month I was over the initial withdrawal symptoms.
But again: it's not "just a day", it's not really "omg, this is so easy, I'm over it". I had to constantly remind myself to NEVER had a drag, I got drunk during the third week and it was a pretty good feeling to deny a cigarette a friend wanted to share.
I was a 2 pack a day smoker during the last year of smoking, that might have impacted how much the withdrawal symptoms lasted or how strong they were.
It's on of the best things I've done in life, it also gave me a huge boost of confidence to do other stuff, my mindset nowadays is "I quit smoking cold turkey, I can do almost anything when I commit to".
Part of it may be that because of the whole bike racing thing, I had had several occasions where I'd been through weekend long periods I couldn't really get to smoke, or had to make due with patches or gums. I would also immediately light up when I got away from those friends. Those times, I'd also tried white-knuckling through weekends, been just as irritable, but it kept going for days like you said. When I mentally made the switch to not smoking anymore though, it was different, much easier than those 3 day weekends ever were.
I've heard lots of people say the same thing to me, once you do it, you know it's done. You're not just holding off for a few days or seeing how long you can go, you're just mentally done with it. Or maybe I just tricked myself and it worked. :)
A critical mass was reached in the 2000s, though, and now the bulk of social pressure is on helping people quit and stay quit. Frequently it's the smoker who will be alone in the cold on their smoke break. & besides, we have effective smoking cessation drugs like Chantix (how my wife quit).
On the plus side:
1. I quit and stayed quit.
2. I'm mostly back to my old self. No more depression or panic attacks. Not now, and never again!
3. The whole experience cost me so much that I doubt I'll feel much temptation to use nicotine ever again.
Get bikes please people.
When I changed my mindset to more of a "I just don't really smoke anymore." it was ok to have one every once in a while when I was out with friends and not feel like I failed. Now I'm basically down to only one cigarette a year or two when I'm with old friends, and I usually feel bad enough in the morning after it that I don't really have any desire to smoke again for a long time.
I'm glad it works like this for you, though :)
Many forms of heart disease are easy to understand. My heart is blocked up with a fatty deposit because I ate too much junk food? Makes sense, I could stop doing that.
Some of my skin cells are dividing uncontrollably because I sat in the sun too long 20 years ago? And somehow it's spreading to totally unrelated organs? I don't get it.
With hearts, you open up and you see clogged arteries, for example. It doesn't get much simpler than "too much fat is bad for your heart".
With cancer? It could be anything. And there are tons of different types, seemingly hitting all kinds of people, fat smokers and lean non-smoking vegans alike.
...which just goes to show how complicated causation vs. correlation is in real science. It was a pretty obvious conclusion that clogged arteries would cause heart disease...except that it's both obvious and wrong.
This "Assumption" would be a good case study of the infection of common knowledge with charlatanism.
Better scientists than Ancel Keys already knew that polyunsaturated oils were not appropriate for human consumption. Soybean oil and Linseed oil were used to make paint & stain, because they're good 'drying oils'.
But Dr. Key's theory was picked up by the mass media and used to demonize butter, and to promote garbage like "I Can't Believe It's Not Butter"...
People are easy to swindle.
The fat clogging our arteries doesn't necessarily come from dietary fat.
A lot has changed when it comes to heart disease. For example, not even the USDA supports the claim that excessive dietary cholesterol is linked to heart disease anymore. Their new official stance is that you shouldn't worry about it at all, no upper limit, eat as much as you want.[1]
Contrast that with the last 50 years we've all spent having conversations and making comments about how dangerous egg yolks and meat are because of the cholesterol, and all the foods promoted for being cholesterol-free or low-cholesterol. Cocoa Puffs getting the American Heart Association checkmark on the box because they're low-cholesterol.[2]
It's very difficult to get good information on this because the food industry spends billions selectively funding research to muddy the waters and spread misinformation the same way tobacco companies did in the '50s and '60s. Their 2 biggest goals on this front are:
1. Defend refined sugar and carbohydrates against claims that they're unhealthy/toxic. These are the most profitable commodities because they're the most shelf-stable, they're easy to shape dye and flavor into just about anything, and they're extremely cheap because of food subsidies.
2. Promote the idea that our health and well-being as it relates to nutrition, is entirely determined by one's ability to balance calories in vs calories out. If that's all it is, then all of their products are exonerated from all negative health effects, and they can shift the burden of blame onto their own customers.
I'm all for personal responsibility and companies having the right to produce delicious junk food and consumers having the right to purchase and consume as much of it as they want, but I think we'd all be better off if the food industry stopped funding nutritional research.
[1] https://www.washingtonpost.com/news/wonk/wp/2016/01/07/gover...
[2] http://www.nytimes.com/2004/09/21/health/nutrition/beware-fo...
ps: I tried to get off processed food for raw veggies and fruit, but most cities are flooded with utterly shitty ones. It's still a huge increase in terms of health (sugar really is like a drug), but way suboptimal.
"Nutritionally speaking, frozen veggies are similar to -- and sometimes better than -- fresh ones. This makes sense, considering that these veggies are usually flash-frozen (which suspends their 'aging' and nutrient losses) immediately after being harvested. Frozen veggies were often picked in the peak of their season, too."
I have a fruit (blueberries, cherries, mango, banana) and greens smoothie almost every morning. The banana is the only thing that's not frozen. It seems healthy, although I admit, it's not low-carb.
For the tl;dr crowd:
- written by a physician
- people often think that heart disease is controllable by our actions whereas they feel that cancer is not
- > people can’t change many risk factors of heart disease like age, race and family genetics
- > A more recent study published in Nature argues that there is a lot we can do. [about cancer]
- > Using sophisticated modeling techniques, the researchers argued that less than 30 percent of the lifetime risk of getting cancer was because of intrinsic risk factors, or the “bad luck.”
- > [another study] identified four domains that are often noted to be related to disease prevention: smoking, drinking, obesity and exercise
- if you limit that stuff, and not meaning 0 smoking, but "having quit within the last 5 years", no more than 1 drink a day (women) or 2 drinks a day (men), your BMI is >= 18.5 and <= 27.5 (BMI is such a shit and antiquated metric, IMO, incidentally), and perform 150mins/wk moderate intensity excercise or 75mins/wk vigorous intensity exercise, then you're in the low risk group. so the barrier to entry is not super high.
HOWever:
> No study is perfect, and this is no exception. These cohorts are overwhelmingly white and consist of health professionals, who are not necessarily like the population at large. But the checks against the national data showed that if anything, these results might be underestimating how much cancer is preventable by healthy behaviors.
[...]
Optimistic conclusion, for a skeptical cheapskate like myself,
> As we talk about cancer “moonshots” that will most likely cost billions of dollars and might not achieve results, it’s worth considering that — as in many cases — prevention is not only the cheapest course, but also the most effective.
Hard to fault this article. I'm glad you posted it, thank you.
I'm not sure of the health factors but if you're training for 2 - 2.5 hours a day and dieting it can be normalish.
Why the down votes?
Check the scales: http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmic...
My body-fat percentage is definitely not 5%, though. My guess is that it's around 14-15%. Everyone drastically underestimates how low their body-fat percentage is, and I am not a bodybuilder. I lift heavy and like pasta.
[1] terrible picture of me from a few weeks ago for reference: https://i.imgur.com/42WFEyA.jpg
I clearly remember asking my gym teacher in middle school why my BMI suggests I was fat even though I clearly wasn't. He then proceeded to tell the entire class "he's a good example of someone who's labeled as fat, but isn't." Somewhat embarrassing.
Metabolically muscle is worse as it needs more oxygen and fuel. Which is one of the reasons body builders can often die young from a heart attack.
Those cancers are going to be mostly a function of height, not caring about weight for most people.
Neither of those is a reason to care about the ratio that BMI represents.
Gaining weight increases skin, which is why skin reduction surgery happens for people that lose lot's of weight. GIS for skin folds.
Weight / height ^2 is a proxy for both it's far from perfect, but it's also really easy to collect.
So the possibility of such false positives is not that high, making still a good heuristic. Not to mention: if one is a thin, mostly-muscle powerlifter type, they already know they are not obese...
It is good for predicting in general populations, but can easily fall apart with individuals. It doesn't take into account what the makeup of your mass is. Muscle is denser than fat, so a muscular man and a fat man of the same height and weight would have the same BMI, but vastly different health profiles.
While it can "easily fall apart with individuals", the difficulty lies in finding an individual to measure that will make BMI fall apart.
And that's because the huge majority of us is of the kind of complexion and body type where BMI works well.
So, sure it can give false positives, but for a quite small fraction -- besides any other rough medical heuristic does the same (e.g. signs of having the flu can also be caused by 200 other reasons).
A vastly more accurate proxy is waist circumference.
BMI was developed largely because the proxy data (height and weight) are so readily available, especially in databases. Few doctors take waist measurements, and doing so is slightly more complicated.
> the difficulty lies in finding an individual to
> measure that will make BMI fall apart
I was 212lbs this morning, giving me a BMI of 29.6, which has me at the border of "Overweight" and "Obese Class I (Moderately obese)", and is high risk.
I don't think you'd think I was a weird shape if you looked at me.
Both measures put you in an at risk categories. Why doesn't that concern you?
How many runners do you know who would complain about BMI? Or weight lifters? It's the fat people who don't like it.
Calipers are also $10 and measure body fat accurately enough for health purposes (body building may be an exception in this as well, but only in extreme cases).
BMI is something that fails in theory and works in practice.
The parent was saying BMI is not a good diagnostic tool for individuals, and it was good for populations.
You're not addressing that point. You're saying that populations don't consider people individually. Which is true.
But you haven't made an argument against the use of population wide BMI, which is the only case it's generally accepted as being valid for.
(I agree it's over recommended as a individual measure, or overrecommended without caveats. E.g. BMI + waistline, or BMI + strength test.)
"No person" is a rather extreme position.
Turns out some doctors are idiots, or frauds, or incompetent.
Turns out some just follow the protocol they're told to follow, even if they laugh at it (as in the link above, from this thread).
>In fact, for most people BMI correlates quite well with adiposity. In one study researchers compared BMI to a more direct measure of body fat percentage using skin-fold thickness. They found that when subjects met the criterion for obesity based upon BMI, they were truly obese by skin-fold thickness 50-80% of the time (depending on gender and ethnicity). When they were not obese by BMI they were not obese by skin-fold 85-99% of the time. So BMI is a rough but useful estimate, good for large epidemiological studies where more elaborate fat percentage measurements are not practical.”
https://www.sciencebasedmedicine.org/does-weight-matter/#mor...
http://www.cdc.gov/physicalactivity/basics/measuring/heartra...
E.g. if you do an hour on the elliptical machine at 150 bpm then that's already 80% of your exercise RDI for the week.
BMI combined with body fat percentage is still useful, and likely every single doctor knows when to ignore BMI.
This idea that there are doctors looking at bodybuilders and saying, "well this number here says you're obese, so you're obese!" is absurd.
When I last went through a health screening with a qualified professional, I was congratulated on my great health and great cholesterol levels. However, on some online screening I had to do for health insurance around the same time, I was warned that my BMI is a smidge high and my cholesterol is 1 point higher than desired. The online screening did not take into account activity level, functional health, or the differences between HDL and LDL. When health or financing decisions are made algorithmically there are some real traps.
Yet another super long article that the bottom state the obvious.
I'm 6'0 and the last time I was under BMI 25 I was a triathlete. The only way I could be <25 would be to exercise 3 hours a day and eat 1200 calories. F-off and die
I did quit smoking though:
- Really wanted to - Picked a good mental argument against it ($100k CAD over 20 years) - Picked a quit date - Patch + zyban + nicotene lozenges
If you live in British Columbia, the government will pay for your patches or lozenges (hint: ask a friend)
If you're an athlete, or a bodybuilder, or particularly tall or small, it won't necessarily fit you. but if you're of normal-ish stature (ie 5'4 to 6'3), and don't keep track of your weight, it's probably bang on.
Every time I've taken BMI, the result is that I'm "slightly overweight". That's bullshit. If I actually tried to eat less, I'd probably end up having health complications related to malnutrition.
So BMI is very much bullshit when applied to individuals. It might have some relevance for the average case, and therefore be useful for demographic comparisons of large groups.
You could weigh 184 pounds and have a BMI <25. Even with a sedentary lifestyle you'd still burn 2,199 calories a day. This is patently false.
Why economic transformation in cancer research? The cancer research community suffers from a high level strategy problem: the majority of treatments are only applicable to a small number of cancer types, out of the hundreds of known types, and the majority of new technology platforms under development will be just as expensive to adapt to a different type of cancer as to build in the first place. A much more efficient approach is needed, as there are only so many researchers and only so much funding in the world.
This is much on my mind because I'm helping to raise funds for one such project right now. It involves taking on the less well-supported but still necessary part of building a universal cancer treatment platform, one that can target all cancers. This could be built for about the same cost as one of today's highly specific single-cancer treatments. Obviously that is an immensely better path forward.
The approach is to block telomere lengthening: all cancers must lengthen their telomeres in order to grow, and abuse a small number of target mechanisms in order to do so. These mechanisms, telomerase and alternative lengthening of telomeres (ALT), are very fundamental to cellular biochemistry. If they are turned off, it is expected that there is no way for a cancer to evolve around that dead end. Many of today's cancer therapies, in addition to being very specific, also leave room for a cancer cells to evolve a different way of conducting business that renders them immune.
A number of research groups are working on sabotage of telomerase, but next to no-one is working on ALT. It is known that telomerase cancers can turn into ALT cancers, so it is probably the case that both doors have to be slammed shut to have a truly effective universal cancer therapy. So I'm helping a fundraiser to use an ALT assay to scan the standard drug candidate library for compounds that act to suppress ALT, something that should greatly advance that part of the field, both by identifying more lines of investigation, and by finding potential therapies for ALT cancers. Since ALT doesn't happen in normal cells, completely suppressing ALT should be a pretty safe treatment if an approach with limited side-effects can be identified. The telomerase blocking will need more work on compensating or targeting for other effects, since stem cells require it. But that is still a lot less work than producing one therapy per cancer type.
After two paragraphs about how the only way to save yourself is to give generously? Ya don't say...
In NYC, cigarettes cost $12-$14 per pack it is against the law to buy cigarettes until age 21. Countries that have universal healthcare such as Canada, UK, France all have tobacco taxes that exceed $5 per pack. Our US Federal tax is about $1.
The high cost of tobacco and the increase age for buying tobacco (now the same as drinking alcohol which is also 21) helps to prevent teens from becoming using and becoming addicted to tobacco.
The majority of my family on my father's side who are smokers have died of heart disease, strokes, lung damage.
Even at my workplace 9 of 10 people who died were smokers. I think the buddy system where they need to smoke in groups just enforces their denial.
I've seen the "scared straight" situation many times where a middle aged smoker suddenly decides to quit only to be diagnosed a month later with cancer. Only now it's e-cigarettes instead of quitting so they can still be addicted to nicotine but quit cigarettes.
I like to tell them there are worse things than cancer which has a possibility of a cure or surgery. My dad has IPF a scarring of lung tissue and there is no chemo or surgery to cut it out or slow it down. It occurs from many years of small amounts of lung damage in my dad's situation it was blue collar work welding, paint fumes, wood dust, grinding dust etc.
It's the ratio of plant protein to animal protein in the diet. So no you don't need to go hard vegan. But yes, it is the diet and there is hard evidence.
My personal question is, does a high fiber ketogenic diet (high fiber, high fat, low carb) raise or lower cancer risk? I don't know of strong evidence either way.
Nutrition seems difficult to study because there are so many biological mechanisms at play, but we can get a rough picture at the macro level.
Of course someone always blows findings out of proportion and decides to take things to an extreme.
Added: Schistosomiasis infection is such a huge cofounder for colorectal cancer rates that it is ridiculous to have claimed dietary cholesterol from animal sources as the cause.