CDC Spins Breastfeeding-Obesity Link

October 27th, 2015 No comments »

CDC is continuing to perpetuate the old canard that breastfeeding is protective against childhood obesity. In the recently released publication, Vital Signs: Improvements in Maternity Care Policies and Practices that Support Breastfeeding-United States, 2007-2013,  the CDC states “In addition, evidence suggests that breastfeeding is associated with a reduction in the risk for obesity and diabetes in children (3).”

The reference is a 2007 evidence report on CDC’s sister agency, the Agency for Healthcare Research and  Quality website. However, unlike several other citations, there is no link to the paper. Why? Perhaps because AHRQ identifies the paper as “Archived” and states, “It (the paper) was current when produced and now may be out of date.” Here’s the link:  http://archive.ahrq.gov/clinic/tp/brfouttp.htm#Report.

Maybe out of date? No fooling! See here, here and here for updated research which CDC decided to overlook.

 

Overselling Breastfeeding

October 21st, 2015 No comments »

Courtney Jung has an interesting opinion piece in the New York Times, “Overselling Breastfeeding.” The writer points out that the goals for the duration of breastfeeding are more accessible to upper and middle-class white women than other mothers. Furthermore, she decries the drift from making breastfeeding a choice for mothers to make to policy decisions which penalize non-breastfeeding mothers. She writes, “Demographic differences in breastfeeding rates also justify government interventions that punish poor women who do not breastfeed. This isn’t just the little unobtrusive little “nudge” in the right direction, designed to compel people to make better decisions. It’s more like a shove, with a kick for good measure.”

Jung notes that arguments that breastfeeding prevents childhood obesity have been largely disproved. See our analysis on this point.

 

Causes of Obesity: It isn’t Physical Activity

January 5th, 2015 No comments »

So, our popular culture, as well as many physicians, believe that increased physical activity can either prevent obesity or bring about weight loss. The Today Show is an example of this popular, if wrong, view.

Lost in all this panting-cries for more steps are the actual research results. So it was interesting to find this interview at the University of Delaware annual Foltyn Family Health Sciences Seminar with Dr. Amy Luke of Loyola University Chicago. Dr.Luke has a distinguished career and a host of peer-reviewed publications.

Dr. Luke has been at the epicenter of the debate over whether it is energy intake or energy expenditure (i.e. physical activity) that is the cause of the obesity epidemic. Her research has taken her to rural Ghana, the Seychelles, urban South Africa, Jamaica, and the U.S.  Using objectively measured criteria (stable isotope techniques and accelerometers in five cohorts) Luke found that in developing countries, residents were not expending significantly more energy than those in developed nations like the U.S.

She told the U.Delaware audience, “Physical activity is important for a whole host of health benefits, but it may not be as important as we thought in the prevention of obesity. This points to the need for strong objective measures of the factors on which we are basing public policy.” (Michelle Obama: are you listening?) Dr. Luke has concluded that it is diet, not physical activity, which is responsible for the obesity epidemic

 

NYC Ban on Beverage Cups Crushed

June 27th, 2014 No comments »

The New York State Court of Appeals has affirmed lower court decisions banning the sale of sugar sweetened beverages in cups over 16 ounces capacity. The Court of Appeals decision, as was the case in the lower courts, focused on the power of the New York City Board of Health to make several policy decisions in this area when the New York City Council and the New York State Legislature had not acted in this area.

Predictably, some activists pointed to the money employed to fight the City’s regulation. They miss the point. This regulation was bad policy at the outset. Those who think obesity is the result of “One Thing” are always disappointed when it turns out that changing the “One Thing” does not affect the accumulation of excess body fat. In addition, the regulation had numerous inconsistencies. It suffered from “over-inclusion” because it affected everyone buying a beverage in New York City and from “under-inclusive” in that other beverages of same or greater caloric content were not covered.

No doubt those who believe in the value of restricting marketing of food items will be back at work trying to find a way to work around  this decision. These advocates need to keep in mind that the Supreme Court (and other courts) have set a very high bar on legislative restrictions on marketing. These cases are based on First Amendment  (which was not even touched in the New York City case) to arbitrary restrictions on commercial practices. Restricting or banning advertising of food to children is a frequent mantra in prevention-of-obesity circles. The Supreme Court is pretty clear that such restrictions are not likely to be upheld.

 

Swedish Children Most Mediterranean

June 20th, 2014 No comments »

You heard that right! Dr. Gianluca Tognon of the University of Gothenburg and colleagues have found that, across 8 countries, children who were highly adherent to the Mediterranean were less likely to be overweight or obese than those who were lease adherent. Data were based on surveys of parents.  Sweden and Italy ranked the highest while Cyprus was the lowest ranked country.

The irony is that the Eastern Mediterranean Region has one of the highest rates of overweight and obesity in the world, according to the World Health Organization.

 

Study finds Sugar-Sweetened Beverage consumption does not correlate with BMI

February 7th, 2014 No comments »

An interesting study out of Canada may upset a lot of assumptions about sugar-sweetened beverages (SSBs) and obesity. After following over 10,000 adolescents in three regions, researchers found no correlation between SSB consumption and Body Mass Index (BMI).

(If you would like to read a parody of studies about SSBs, see Teddy Wayne’s “The Sacharine Method” in the January 3, 2004 The New Yorker magazine.)

 

US Task Force Recommends Screening for Gestational Diabetes

January 14th, 2014 No comments »

The US Preventive Services Task Force (USPSTF) has issued a recommendation for preventive screenings for gestational diabetes in asymptomatic women after 24 weeks gestation. The USPSTF recommends moderate gestational weight gain, based on pre-pregnancy BMI and cites the IOM recommendations for weight gain during pregnancy. This is of particular concern because more women are entering their child-bearing years with obesity thus increasing their chances for gestational diabetes. Gestational diabetes in the mother has been associated, in one recent study, with greater adiposity in the offspring.

 

NYC ban on large soda cups unconstitutional

July 31st, 2013 No comments »

New York State Supreme Court Appellate Division has held that the New York City’s ban on the sale of sugar sweetened beverages in cups over 16 ounces unconstitutional, upholding a lower court decision. The ruling held that sugar-sweetened beverages were not inherently a health risk, only when not taken in moderation. It found the New York City ban, which applied to some food outlets and not to others and to some sweetened beverages, but not others, exceeded the Board of Health’s authority. The rule covered non-diet soft drinks, sweetened teas, sweetened black coffee, hot chocolate, energy drinks, sport drinks and sweetened juices. It did not cover alcoholic drinks, milkshakes, fruit smoothies, mixed coffee drinks, mochas, lattes and 100% fruit juices. It applied to delis, fast-food franchises, movie theaters, stadiums and street carts but not to grocery stores, convenience stores, bodegas, gas stations and other similar businesses.

The appeals court found that the NYC ban violated all four factors indicative of usurpation of legislative functions. They noted that the NYC ban was not an all-encompassing regulation but included numerous economic and social policy decisions, reserved to the legislature.

The appeals court did not address the issue of whether such a ban was an unconstitutional restriction on personal liberty.

While the appeals court relied on New York State law, it is worth noting that federal constitutional law, especially the First Amendment, as interpreted by the Supreme Court, contains a very high bar to regulations which provide such loopholes and exceptions. See, The Supreme Court and the Future of Obesity Policies. Obesity advocates need to be much more aware of the limits of policy-making in this area. The risk that some policies will be over-inclusive, on the one hand, but under-inclusive in other ways, will make for difficult law and adverse decisions, such as this one.

Mayor Bloomberg is serving his last term and his tenure will be noted for its commitment to improving the health of New Yorkers. Hopefully, he will spare us another petulant moment after the first court rejected the cup size ban, when on the David Letterman Show, he pleaded (with whom?) “As long as you don’t to ban ‘Cheezits’. ‘Cheezits’ are ok.”

I hope the next Mayor of New York, or any public official understands obesity is tougher than you think. See, Note to Mayor Bloomberg: It’s Harder Than You Think, September, 2102.