A school-based obesity prevention programme was ineffective
discover.dc.nihr.ac.uk
discover.dc.nihr.ac.uk
Diet, exercise and personal responsibility still do matter. This program was not able to get the target to embrace such things.
That said, there must have been some successes. Who were those? And why? Why was it effective? How can that be replicated and scaled to effect more?
Moi? I suspect too much was targeted at the kids and not enough at the parents. The parents do the shopping. They do the cooking. The kids, by definition, follow the lead of the parents. The kids adapt and conform to the nurture provided to them. Not to sound harsh but how often do to see a (pardon me) chubby kid and then see the parents are similar or worse?
Put another way, I'm willing to bet there was no change for the parents' weight / habits either; in turn no change for the "culture." And so it persists. This is what humans do. We conform to the norms around us.
Ultimately kids might have some control over what they eat at school (depending on school dinners etc), but you're absolutely right that they have little control over what they eat at home. (or rather they'll be given the option to eat what the family eats or cook their own dinners - which no normal teenager is ever going to do week in and week out if there is already an easier option going)
I do also completely agree with you about leading by example with regards to exercise etc.
As an aging former military member it seems like personal responsibility is becoming more and more a foreign concept. I'm saying this not to kvetch but to get peer perception on the thought.
The health behaviour of young children is largely influenced by parents. While promoting healthy eating and activity at school is probably helpful, it’s not enough.
A conclusion of "probably helpful" is not strong enough to spend public education dollars on, at the expense of other academic instruction (there are a fixed number of minutes in a school day, and if you're not teaching healthy eating you can be teaching something else).
Not to mention that what was taught for the past few decades (lots of grains and cereals and no fat) was flat-out wrong and probably contributed a lot to the obesity problems we have today.
Thanks.
Day to day, people I know, people I overhear. people I talk to , show lots of personal responsibility. Sure they might skip the gym, or eat some cake. But they take responsibility for that, and themselves at large.
Frankly its easier to sell newspapers or get views by talking about someone we can look at and say "Wow, I know I skipped the gym today, but I'm not that bad", than to hear an altogether more boring story of the 99% that are basically the same as ourselves.
I understand it's not that simple (e.g., gut bacteria has been tied to weight control). None the less i know people who had what I would consider serious med issues (e.g., cancer) and made no change in lifestyle.
Yes, I'm generalizing. I apologize. But the obesity rate doesn't match well with self responsibility.
95% of the messages are: eat what you want, what matters is you still love yourself." Too few add that the extra weight is unhealthy.
As we've grown more enlightened, as a society, to the reality that pretty much everything comes down to dumb luck in one way or another, we've started using this to excuse ourselves of our negative characteristics in order to relieve societal pressure to change, because either we don't really want to change or just because it is easier.
It's made even worse by the application of labels to the excuses. Once you assign a label to yourself it becomes part of your identity, your memetic self, and now needs to be defended and possibly even reinforced.
Which isn't to say that our old mindset is entirely correct either. "None of the blame" and "all of the blame" are just two extreme perspectives no the same reality.
I guess what I'm saying is that some things are significantly more difficult for some people than others due to factors beyond their control, and we should be more understanding of that than we are, but at the same time that doesn't necessarily mean they shouldn't work towards change, if change is what they desire, or that there shouldn't be consequences to being unwilling to invest that effort.
For context, I was somewhere north of 320lbs when I graduated college and have lost, and kept off, about half of that. It was by far the hardest I've ever done in my entire life. I wage constant war with my own body, every day, to maintain my current weight and I'm willing to do it because I took up a hobby where weighing less is significantly beneficial. As such, I have a very low opinion of people who think that because they have to exert little to no effort to maintain their weight then for others it must be just as easy. However, I also have a pretty low opinion of people making excuses for their weight, and believing that they shouldn't have to deal with at least some of the consequences of it. If you don't mind being fat so much, because you like eating more than what you think you'd get out of being thinner, that's fine, I can respect that, but you don't get to make that decision and not accept the consequences. You are entitled to be treated like a person regardless, but you don't get to complain about having to pay extra to fly because you need two seats.
And some recognition that context, inertia, and available choices matter too.
Not to mention across my friends and acquaintances weight doesn't seem to correlate very well with any other since of personal responsibility. I have plenty of incredibly hard working heavy friends, and lazy as hell skinny ones.
What are your reasons for blaming an entire generation's(cross nationality, cross species) obesity problem on personal responsibility?
BTW what do you mean by personal responsibility? Is that a shift in culture, or is it a shift in willpower via dysgynic evolution?
Humams look around (subconsciously) and think "what's the norm?" Excess weight has become the norm. What's +40 lbs when 100 is so common? On top of that it's not PC to say anything on the subject.
Put another way, look at smoking. As it decreased, it decreased more. And so on. Individuals shifted the broader norm.
What made smoking different is it was so closely tied to causing cancer. But mention the ills of obesity and you're accused of fat shaming. We have cultural leaders (e.g., Oprah) saying "Love and accept yourself no matter what" but forgetting to add "even it leads to premature death."
Long to short, we've normalized the abnormal, the unhealthy. I personally don't see an end to this trend any time soon. I hope I'm wrong.
For example, type 2 diabetes is nearly always preventable. It is also the gateway if you will to other ills. But the T2D rate is increasing.
I realize this is a very non-HN comment but...I'm tired of people pissing and moaning about the cost of healthcare while they're inhaling another donut and washing it down with a 32oz soda.
There are plenty of med issues that are not preventable. I understand that. But any resources devoted to the preventable drives up demand for med resources, and thus costs overall. This is economics 101.
A kid can’t decide to move and in many cases it’s really hard to use alternatives: either neglect or deliberate attempts to discourage pedestrians mean that there’s very little in walking distance and often not even sidewalks or road crossings which don’t require substantial detours. It may or may not be safe / conducive to cycling but the safety culture is such that a lot of habits are set by the time they’re old enough to do that independently in their late teens.
Child Protective Services agencies need to get involved. In extreme cases it might be necessary to temporarily take away custody and put the child in foster care. But for most parents with obese children I think some mandatory classes on childhood nutrition and fitness could be a good start.
""" What did this study do?
[...]
* an additional 30 minutes of physical activity each day
* a family cooking workshop each term
* in collaboration with local Aston Villa Football Club, three sessions of coaching in physical activities and two on preparing healthy meals, with weekly activity and healthy eating “challenges”
* information sheets about staying active during the holidays, with signposting to local facilities
"""
So 1.5/4 points about diet, and the rest about exercise. Thus mostly focused on exercise. While diabetes is known to be preventable/reversible by primarily diet. Specifically by removing processed foods (that includes oils, refined starches and sugar) and animal(-derived) products (as they are high in saturated fats), while adding lots of whole plant foods. And not only for cooked meals, but for all meals and snacks.
Seems to me they've been trying to optimize the wrong parameters. Just my 2ct.
Just learn to count calories, how much you need and avoid excesses. Bad food in small portions is better than huge amounts of healthy calories.
The combination of nutrients in food can have a large effect on the efficiency of nutrient extraction in your stomach and gut. For example, when you consume alchol and a meal afterwards your body will store more fat than if you'd just taken a (slightly larger) meal. This is because your body will prioritize burning the acetate and alchol over anything else (including carbs, fat and protein). Other foods or chemicals might have effects on the resource burning allocation of your body.
Concerning yourself with highly complex reactions that could happen between foods, when we aren't even sure how/if those reactions happen is effort spent unwisely, whereas calorie counting has a definitive effect and even if those combinations can hamper or help you, even by ignoring them, you still have the overall desired result.
I find that, as a model, calorie in - calorie out works well, even if at some future time we would discover it's not fully accurate.
This isn't necessitated at all. There's no mystery as to what overlaps between what the most successful food regimens prescribe today: cut sugar, cut refined foods, eat more vegetables and eat real food.
Counting calories is important when it comes to weight management, but optimal health does not stop and start just at BMI. You might be thinner on a calorie-restricted junk-food diet, but you won't be healthier. Your insulin would spike all the time, you'd be nutrient-deficient, etc.
All of which to say, you'll be making the task of losing weight easier just by switching to healthy foods, which you should be doing anyway. It's not "complicated", it doesn't need to be politicized.
> Plants, Fruits and Water
Also fungi. And fruits are plants so do not need a special mention.
Some would say meat can be "unprocessed", but its not part of the WFPB diet that I mentioned earlier and it known for it's health (obesity reversing) benefits. To the contrary.
When moving towards a WFPB myself I had to get used to eating much larger portions. Its bizarre to know how many olives one needs to eat to get the same amount of fats as in one tbsp of olive oil. Also, combined with the fiber in the olives, that same fat is suddenly not that harmful.
Counting calories sucks. I hope we can fix our notion of food in a way that we do not have to teach all children to count calories. Just teach them to differentiate between real food (as it was growing on this planet before we evolved into humans) an what comes from a factory. The go to the beach and show them how your food choices affect you.
> Bad food in small portions is better than huge amounts of healthy calories.
2 strips of bacon vs a 500gr monster salad..? I know my pick.
You're not really contradicting OP, just outlining simple and obvious ways to reduce calories. The end effect is the same. The best part of the salad is not that it's vegetable, not that it's more natural, but that it's low in calories.
> 2 strips of bacon vs a 500gr monster salad..? I know my pick.
I don't know, what else do you have in that salad? Sauce? What kind? Croutons?
Nope. It about nutrients/calorie, which is high in a salad. Try playing with the cronometer.com app and you'll see what I mean. It's not so easy to get all the bars in green.
> I don't know, what else do you have in that salad? Sauce? What kind? Croutons?
WFPB salad, no oil, no processed junk.
https://www.youtube.com/results?search_query=wfpb+salad+dres...
The salad underneath the dressing is usually WFPB as it is, so needs little adjustment.
I also like just salad, with a little salt, pepper and balsamico. But tastes differ. IMHO oil is still not a health food, no not even olive oil. There is science to back it up.
https://www.youtube.com/watch?v=LbtwwZP4Yfs
My personal conclusion: i eat very little (<1tblsp/d) and very high quality coco or olive oil.
"10 people", "18 men" etc. Most are blood tests some hours after a meal.
Nothing about long term effect on health. Just full papers published from what should be one data point and a lot of speculation from the youtuber.
You avoid processed foods, but you add balsamico to your salad?
Balsamico is made by concentrating down grape juice through boiling, and then fermenting the resulting must for years. Isn't that processing, and far away from "whole food"?
And the oil thing is simply scaremongering. Of course oil is calorie dense, but as long as you keep that in mind, it's fine. The papers cited by the guy in the video you linked don't really back up your claims.
(Besides, something doesn't become true, just because there's a paper or two on it)
Worst case you will feel hungry if you eat the wrong calories, but you will definitely lose weight.
Also I doubt that people trying to diet would just eat a few candys for lunch and try to live with that.
And surprisingly the full-feeling does actually correlate with the amount of calories you eat. If you eat 2 strips of bacon (which doesn't seem much) and let it sit for some time (without eating more) hunger passes. Maybe not as much as with better food, but it still does to some degree.
Food has many parameters and so does health. Reducing it to calories is... Hmmm. Over simplifying?
Which makes it dead simple. Not easy, simple.
If you want obese people to lose weight you want instructions making it not complex.
"Should I learn a new way to eat food, new recipes or start cooking for real? No thanks."
"Oh! I can just eat less and switch to 0 sugar soda; no need to make my life harder? Let's try this"
Once they have learned to eat less you can add the trick which is you can stuff your belly with 2lbs of veggies and get less than 1k calories. But for people used to the 5mn in the microwave way of cooking it's an added hurdle.
Do you mean that literally? Because almost every single fruit and veggie you bite into today was improved by humans, for nutritional value, taste and ease of growing.
The exceptions are basically some berries, mostly. And they're sour as hell without processing.
Easy enough to say, but hard when you're trying to get a 6-7 year old (what this article is about) to adopt that lifestyle - that's an age where they eat what they're being served. Given this is in the UK, part would be the school lunch - which is directed by things like cost and preparation time/effort (Jamie Oliver did a series about this) - and part is the parents that feed the kids.
What's really needed is a societal change with how food is treated. Someone else mentioned a tax on sugar and processed foods, which could help. But another big step would be trying to teach students about nutritious food and living a healthy lifestyle. Of course, it's difficult if the school is the only place they see this, but I don't think it would hurt to have more outlets for healthy living in a student's life.
[1] https://en.wikipedia.org/wiki/Military_budget_of_the_United_... [2] https://www.cbo.gov/publication/50737 [3] http://markbittman.com/health-vs-profits-in-school-lunches/
(so all the percentages are reasonable)
Why stop at measly taxation of consumption or teaching programs?
Let's progress and go further and simply be the Societal Parent by storing the children units in a controlled environment where they'll only receive information and norms deemed by teeming experts to be beneficial to them or everyone. We could call it the Hatchery and Conditioning Centre.
You could similarly argue that by reducing Social Security & non-school-lunch welfare spending, the school-lunch programme could be increased.
You're also begging the question of whether or not providing lunches to schoolchildren is a federal responsibility. Reading the list of enumerated powers of the United States[0] it really isn't, unless you squint really hard and figure that it's necessary & proper to provide school lunches in order to 'raise & support Armies,' since malnourished children won't grow up to be good soldiers. But if that's the case … then the school lunch programme is part of the defence budget!
[0]: https://en.wikipedia.org/wiki/Enumerated_powers_(United_Stat...
It might be lower than tat some points in the past, but that is great. Just like it's great that a smaller share of our population is engaged in agriculture than in the past: resources are free for other pursuits.
> (this means that other nations are spending far less than they need to).
Or, it means that civilization is advancing , and the needed level as a share of total output is declining.
> You're also begging the question of whether or not providing lunches to schoolchildren is a federal responsibility. Reading the list of enumerated powers of the United States[0], unless you squint really hard and figure that it's necessary & proper to provide school lunches in order to 'raise & support Armies,' since malnourished children won't grow up to be good soldiers.
Actually, there's a much better argument for federal involvement in funding and prescribing anything attached to public education including school lunches in the militia clause, if you insist on seeing it through a military lens rather than a commercial one.
My mum is a special ed teacher in a poor, rural, redneck corner of New England. Many of the students on her caseload only get anything approaching decent food from the school lunch program. Their broken, mixed up, drunk and drugged out parents can't even keep their own shit together, let alone bear the responsibilities of raising a child. Not surprisingly, if tragically, the child suffers.
It's clear from the situation that the free market choices are suboptimal. Who wants to suffer through most of their life and die early? Yet these choices are still made. If you can't educate, then tax fairly and force them to make the right choices.
Apparently the fat people. Otherwise they would change their eating habits.
Why do we want to force people to live some way they don't want to live? It won't work, and it will just flush more tax dollars down the drain.
The main problem is that the current laws, taxes and infrastructure are heavily optimized to produce calorie dense foods. Another is that people like some of those foods on a regular basis in their diet, so they might complain.
I would say this would cost more in political points than in real money.
So the premise of the study seems to indicate that the problem is largely one of education - I guess that's why they dropped this onto the school system. Instead of playing with a few guinea-pigs on a small scale maybe it's time think to think about the big picture:
1. Get all the crap out of the food supply.
2. Put an end, permanently with threat of severe sanctions, to all the fear-mogering in the media that frightens parents into keeping their kids indoors.
3. Deal with small-scale, crime, bullying, availability of drugs, etc. etc. that keep kids inside in front of the games console or TV instead of getting outside.
4. Create spaces were kids can go outside.
5. Get away from schools being places where kids sit on their asses for 6+ hours a day. For example in today' physics lesson on electro-magnetism we are actually going to biuld a 50m maglev track. OK so this is a bit unrealistic but it would be a hell of a lot more fun and everybody would be a lot more active.
... etc. etc., rant, rant.
In other words, the solution to a complex problem which is poorly understood is probably a whole range of solutions to create an environment where obesity simply is not possible. But that would take a huge amount of money, a huge amount of political will, a lot of creative thinking and a general re-wiring of a large number of attitudes and expectations.
Additional taxes may do, it helped for smoking. Slap the same tax on sugar, (processed) animal products, oils. And make a VAT exempt on whole plant foods. That combined with updated nutritional education will save millions.
I understand its hard to see folks making choices that diverge from my personal sense of what's optimal. But it is a cost of living in a free society.
We're discussing ideas on how to get a hold on the obesity crisis. I suggested some extra taxes. Yes some gov't regulation.
You suggested me to use the free market, but food is already on the free market. So I fail to understand what you are actually suggesting.
At the same time you say "get rid of the crap", while not defining how to do so (without gov't regulation accordin to your own preferences) and without defining what in your eyes crap then means...
Please make a real argument.
And why should any solution be "consistent with American values"; obesity in the US is VERY CONSISTENT with American values. Maybe to turn the tide on it we have to look in a diff direction.
I'm sensitive to this topic. Live in a University town. Periodically some idealistic students petition the City Council for some totalitarian ban as part of a social engineering agenda. The latest was, Permit only Organic Coffee to be sold in the city limits.
This clueless banning/taxing/penalizing folks for living as they please is inconsistent with American values. More typical of nanny states and other less savory government styles.
Bollocks. Read your law books. Weed is only recently legal in some states. Ciggies are taxed heavily, so is petrol. Try walking butt naked in the streets.
My point: your values are arbitrary. And calling them American(TM) does not give them any credibility in my eyes. In fact what you are doing is similar to what you despise in others: setting some standard and calling it "universal" (ok US-niversal)
> To make it clear: what people eat and how they exercise is a very personal matter.
Except:
When there is a public healthcare system that takes care of you fuck up.
When advertising is everywhere shoving "eat unhealthy crap" messages into our collective sub-conscience.
When some sentient being needs to suffer/die/have-children-taken-away-at-birth/is-forcefully-impregnated-(also-called-rape)...
What I'm saying is that I see cases around me of diet not being a strictly personal choice. I think if you try hard you can see it too. It's not so black-white as you make yourself believe.
That said, I agree with you about choice. Creating a Nanny State only further disables the masses, and perpetuates the Nanny State. If you're always doing my homework, how am I going to learn to add?
Moi? Unless, there's a personal responsibility / accountability most people won't change. Not to get off topic, I do believe we (i.e., the USA) should have an accessible healthcare system. That's simply modern common decency. However, making misguided decisions (i.e., preventable diseases) affordable and acceptable is dangerous and expensive.
So you agree it is there? Are you against them taxes now then?
Don't act like the US is some an-cap utopia or something, it full of tariffs, permits, taxes, privileges, etc., pretty much like any western country. Slapping a heavy tax on unhealthy foods is not making a huge diff in that picture.
Made mice less active! Not people. It was a link to an article about a mouse study
Then the wealthy spend their money convincing the public that the government shouldn't have to guarantee reasonably priced medical care because it would tax the wealthy out of the money they gained from this system. This is a pattern that repeats across a lot of issues that affect the poor. Look at overdrafts on bank accounts, mandatory prison sentences, for profit prisons, drug laws...
If history has taught us anything, it's that the wealthy/powerful will continue this cycle until they're getting decapitated on the streets in a few decades, rather than make minimal changes now to head off the problem, no pun intended.
I would observe as much at the supermarket on the regular in an area I once lived in, heartbreaking to see.
If they really wanted the internet is full of freely available information.
Low-income workers are as such because they're "ignorant"? Uh..
Why this would work is that free delicious food isn't likely to be turned down. I think people are often creatures of habit and feel intimidated by cooking, along with (as you suggest) disinterest. You don't just teach the mechanics and call it a day, they can walk away with a cheap delicious food and see how easy it is to put together. Ultimately also easier on their wallets than a cart full of 2L soda bottles, frozen pizzas and chips.
This program was phenomenally clueless and ill-conceived. Instead of patronizing inappropriate low-calorie choices (which drove students to hoarding dingdongs in their lockers), how about providing plentiful good food? That might have had a positive effect.
{edit: I thought they were talking about the federal school-lunch initiative, sorry}
I think a requirement to eat the school provided meal would probably be local stupidity.
The school lunch program feeds anybody who shows up. Nothing to do with income.
It comes with things like minimum standards for the meals, but I don't think it comes with a limit on how much food each student can be served.
There is absolutely a limit on food.