> We don’t have solid answers yet, only theories.
The exact quote you gave had a pretty solid answer, certainly not just "theories".
The exact quote you gave had a pretty solid answer, certainly not just "theories".
We have research on what can affect heart health, like what things might be linked to it, such as smoking and alcohol. We also know genetics plays a huge role.
So we don't actually have solid answers, actionable answers as to the rise of heart health issues. Look at this analysis[1] regarding how dietary guidelines specifically for fats (saturated, trans) have very little substantial evidence supporting it. Yet this gets repeated by the average person, that fats are the ultimate evil you must avoid. In another study[2] we find that reducing your fat intake still resulted in the same rates of mortality as those who ate more. This is also why more in the space are shifting away from these sort of claims ("only eat x amount of saturated fat per day") and more to general food composition (eg who cares if a fish has saturated fats, eat the fish with vegetables).
It's quite challenging to figure out, everyone has their theories. All I'm saying is we don't actually have the answers yet.
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9794145/ [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092457/
We're talking years of increased life expectancy.
Sadly statin is not without its downsides.
Huh? Statins are a medication type in which increases in life expectancy are extremely hard to point to all. I think they're almost a "poster child" for medications that correct a problem to an extent but whose overall benefit is quite dubious.
(and given that these medications were highly prescribed before any long term studies were finish - creating considerable incentive for people to find benefit - I'd personally wager they are overall harmful but that's me guessing - the main point is they definitely aren't boost-life-expectancy-by-years drugs but probably aren't reduce-life-expectancy-by-years drugs either, given the studies)
Link from google: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531501/
There is no lobbying like the lobbying for massively selling classes of drugs of dubious effect.
Nestle ? McDonalds ? Burger King ?
edit: you really think insulin prices don't have an effect on the lifespans of diabetics?
The government can work to provide the medication that its citizens require to stay alive. Under such a system, those who are able and willing to work can, via taxes or other contributions, provide medications that some citizens require to stay alive. Many such systems seem to cost less overall than the system currently existing in the United States, so the average man who will work will have to work fewer hours to pay for an average dose of average quality anything required to stay alive.
Alternatively or in tandem, the pharmaceutical companies can sell such medications at cost, with rebates and coupons for no/low-income patients, while still making plenty of profit on reasonably priced pharmaceuticals that patients do not technically require to survive.
https://www.mayoclinicproceedings.org/article/S0025-6196(19)...
That does not seem likely to result in a stable and productive society, particularly when many working people would have below average housing in order that government beneficiaries could have average housing provided to them.
Yes, I believe people should have food and water sufficient for survival regardless of their ability to work.
That doesn’t seem like it will have broadly popular support.
This is certainly possible because it already happens now with the current setup.
> U.S. manufacturer gross prices per 100 international units of insulin were on average 9.71 times those in OECD comparison countries combined.
It is 10 times more expensive in USA.
This is all my THEORY, a speculation that I would like someone to study or to find a study about.
Theory / speculation:
Humans evolved with natural sugars, fats, proteins/meats; primitive cooking, probably some grains (more recently). That's what our bodies know how to process, to react to.
All the fake sugars, modified foods that lack the components our bodies use to regulate internal processes; highly processed foods which also lack those components we need to feel satiated and to produce the messengers to digest correctly: those are likely the causes of obesity (not feeling full, so more eating) and bodies behaving poorly.
'Food Deserts' and corporations that are geared around selling large portions of tasty but unsatisfying food, or only offering huge sizes rather than also offering adults a tasty portion that's not intended for take home leftovers also contribute.
Also: my main vice for this topic. Can I _please_ have lightly caffeinated + carbonated water that isn't outrageously expensive?
I've been hearing this complaint (that the guidelines claim fat are the worst) for way too long, when in (my) reality, all the guidelines I've seen in the last 25 years has put more emphasis on carbs than on fats (i.e. too many carbs is evil).
I know "low fat" diets were the craze a long time ago. And sure, advertisers still like to slap "low/no fat" labels. But I believe the actual recommendation has been to lower carbs since around the 90's.
This is ultimately a strawman.
The modern lifestyle is incredibly sedentary and every civilisation is built on staple foods that can feed hours of manual labour (with modern snacks thrown on top).
Calling a major food group evil is just a good scapegoat because it’s much more palatable than telling people that they don’t move enough and eat too much food.
Also, I agree with your general sentiment: Framing carbs are evil is lazy. First, calories matter. Second, if your calories are general under control, most people need fewer calories as they age. Many choose to restrict carbs to maintain weight.
Whether that leads to actual heart disease is iffier, but not terribly controversial among cardiologists as far as I can tell. It's only doubted on the Internet where everyone wants to be a galaxy brain with some answer the doctors don't want you to know.
But nobody ever demonized fat in general, and demonizing carbs is just as stupid. Eating enormous amounts of carbs is fine as long as you actually use them. My daily calories right now are around 3,900 with carbs at 650 grams a day, a fair amount being syrups I eat early in the morning while running. If you listened to the Internet, you'd believe I was diabetic already, yet basically every remotely serious endurance athlete eats like this and is fine. Glucose that is continuously and immediately shuttled into muscle cells to power mitochondria and provide energy for movement does no harm whatsoever. It's roughly the entire point of animal metabolism. Glucose that sits around in your blood forever because you're sitting around staring at a screen for 16 hours a day while stuffing your face is what causes problems because of all the oxidizing effects of glucose when it isn't taken apart quickly and turned into ATP.
My BMI is 21.6 for what it's worth. As far as I can tell, the whole "mystery" behind why no diets work is because no diet can magically make people eat less when they spend the overwhelming majority of their time not moving and hunger decouples from energy expenditure. If you're sufficiently active as a lifelong athlete, every diet works. I ate super sized McFlurries, entire boxes of Entenmann's donuts, and Little Debbie's treats as a teenager as staples of my diet. As an adult, I've tried paleo, zone, mediterranean. Right now, I pretty much just eat the standard American food pyramid. None of these has managed to magically poison my brain or destroy my metabolism because metabolic function can be trained just like any other bodily function and it is trained by doing regular athletic activity with a high energy demand. Just like your muscles atrophy if you never do any resistance training, your metabolism atrophies if you never do any aerobic exercise.
I can't claim to know the secret to weight loss but I know how to never get fat in the first place. On every team I was ever on from middle school to college to my time in the Army, whether that be cross country, track, volleyball, basketball, tennis, or general outdoor adventurism and long-haul hiking with a weighted pack, the overweight rate was never 0 but it sure as shit wasn't 70%. And we were all eating the same "poisons" and manufactured foods from evil Nestle that the rest of you were eating.
Regarding other factors, American culture is fairly similar to Canadian culture. However Canadians have free healthcare, meaning more Canadians see doctors than Americans. So I wonder if they have lower levels of obesity, heart disease and diabetes, and if their lifespans have also been decreasing.
> However Canadians have free healthcare
Also, Canadians are pretty fat. It looks like 65% are overweight, which includes obese. Ref: https://www.statista.com/statistics/1317268/overweight-obesi...
> It is extremely hard in a highly advanced economy to provide quality healthcare at less than 10% of GDP.
In the US we pay 17% of GDP towards healthcare and tons of people still can’t afford it.
A quote from another comment here is:
Australia’s health system far outperforms the .. US healthcare system, which spends nearly twice as much per capita as Australia to deliver far worse outcomes — including Americans dying five years younger than us. > No copay/deductible/coinsurance bs.
I don't know why is this even a question. Do people really think being overweight is a net positive?
Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis
> Conclusions and Relevance: [...]overweight was associated with significantly lower all-cause mortality.
When you move toward obese or into underweight category, health problems kick in.
I find that when I point this out, people often get mad. They feel they aren't obese. But the research doesn't support them, if you are anywhere outside of the "healthy" categorization you are at the same risk (that we know of so far) as "clinically obese" people.
I tried adding 10kgs and it said "Overweight".
Seems ok to me.
They even warn that BMI should be used along with other indicators.
https://doi.org/10.4158/endp.19.1.50042678317gx698
The evidence that being overweight is healthier is a bit dubious, but the evidence that having a "normal" BMI is healthier than "overweight" is nonexistent.
IIRC mostly they had to do with seasonal sicknesses like the flu, the theory being that your body can burn the extra fat during periods you aren't able to eat well.
We’ve normalised being fat.
I saw more grossly obese people at that airport in the first ten minutes than I had back home in probably the previous year. It really stood out to me.
It must be your general dietary makeup and lifestyle. All that corn syrup. Also, I don't see any reason why it would have gotten better since then.
Just calling a spade a spade from an outsider's perspective..
It’s not just America [1].
Norway’s obesity rate runs at roughly half America’s [2]. But the trend across the world is increasing rates of overweightness, obesity and--most worryingly--child obesity.
[1] https://news.ycombinator.com/item?id=41634611
[2] https://en.m.wikipedia.org/wiki/List_of_countries_by_obesity...
Having read (well, listened to) Attia's excellent OUTLIVE, I've reversed my own (slowly turned bad) trajectory by switching my diet to the basics - all home made meals, making my own breads, lots of milk and eggs, meats (not in excess), exclusively extra virgin oil and pure butter in my cooking (zero blends/veg oil etc), and not buying any (sugar) snacks - combined with exercise. Oh and no alcohol for the past few years either - sacrifices had to be made. :-)
Luckily my own kids are showing zero signs of obesity, they are very healthy.
Disordered eating is a norm and being ashamed is a norm.
As in, inability to keep them long term is biological defense of organism that does not have genetic predisposition toward anorexia.
We dance around it and call it 'obesity' but the real medical cause of obesity is an addiction to unhealthy food.
This is compounded by the fact that it is completely legal for people to make their food more addictive and therefore unhealthy and advertise it to addicted people with underhanded marketing techniques that take advantage of their addiction.
Until we recognize this as an addiction issue that is compounded by dealers being able to operate with impunity we won't make any headway -- short of technological advancements like Ozempic that allow people to side step their addiction.
Says who? Are you implying that true societal shame is still being enforced right now, without hundreds of refuges in the form of safe spaces and social justice advocacy groups? I'm pretty sure that such shame worked pretty well in the past, and still does in countries like Japan.
In the end, you'll just have to realize that the root issue you're facing is decadence, and that's there's no fighting it.
I'm a good example of how it fails. I have long arms and legs which causes my BMI to be fairly low. However, my body fat is fairly high. I need to lose fat but were I to rely solely on BMI I'd think I'm fine.
What I'd want instead of BMI is body fat percentage. I think that gives a much better measure of health problems.
"Overweight" is longer-lived than "Normal," and "Grade I Obesity" isn't significantly less longer lived than "Normal." So what you're pointing out is misinformation, which is why people are annoyed by it. There is a case that "Normal" includes more sick and dying people because sick people often lose weight, but the difference still can't be as stark as reddit knowledge makes it out to be.
https://pubmed.ncbi.nlm.nih.gov/23280227/
Conclusions and relevance: Relative to normal weight, both obesity (all grades) and grades 2 and 3 obesity were associated with significantly higher all-cause mortality. Grade 1 obesity overall was not associated with higher mortality, and overweight was associated with significantly lower all-cause mortality. The use of predefined standard BMI groupings can facilitate between-study comparisons.
No. If you fall above healthy, you are "overweight". You need a higher BMI to be classified as obese.
Depends. All cause mortality is notoriously lower for "overweight" people than "normal weight" people.
That doesn't mean obese people are "to blame" for any medical complications they might suffer from obesity. It also doesn't mean that obesity is a death sentence; people's bodies function differently and we've all heard stories of pack a day smokers that lived into their 90s. But there is absolutely a connection between the two.
It is so pervasive though it is hard to tell until you go on a really boring and restrictive diet. It is just hard to not gain weight on average when the food tastes this good with such incredible variety.
That is even if you buy something at the store. With our "foodie" culture, restaurants are an entire other level of choice and taste on top of that.
Corporations have intentionally created incredibly addicting food.