Nutrition

Parents and paradoxes

Published 6.7.2017
Periodically, I collect interesting links about a given subject. Today's topic is nutrition.

This result should not surprise. Kids follow the parents’ lead— if the parents adopt a healthier lifestyle, then so do the kids. Parents bring the food into the house. Don’t buy junky crap and your kids won’t eat it. Sure, they may have some when they are out with friends or if they have their own money, but most children get the bulk of their food from their parents who provide and pay for it. Parents can’t control everything, but what’s available to be snacked on certainly can be controlled.

There is no obesity paradox. Yet another study has refuted Flegal et al’s 2013 meta-analysis that asserted that there was.

Using data from three large cohort studies, comprising over 225,000 individuals, the researchers demonstrated that, no, there was no protective effect of being overweight. In fact, there was a small, but significant, added risk for all-cause mortality.

What did this study do that the 97 in that meta-analysis didn't? They looked at maximum weight achieved over the past 16 years in addition to current weight. This helps to account for those people that lost weight due to underlying, perhaps undiagnosed, diseases.

I think this must be the second or third study to debunk Flegal. The bottom line is that a singly snapshot of BMI is not conclusive of anything.


In Thailand, excess weight is associated with gum disease.

Compared with normal-weight individuals, those who were obese (BMI ≥25) had more than quadruple the risk for severe periodontitis (odds ratio 4.52, 95% CI 1.37-14.95, P=0.012) after adjusting for factors including age, sex, fasting glucose, smoking, and physical activity, reported Supanee Thanakun, PhD, DDS, of Mahidol University in Bangkok, and colleagues.

For overweight study participants, the risk was more than tripled, although the results were not quite statistically significant (OR 3.61, 95% CI 0.99-13.81, P=0.51). Overweight and obese individuals also had more overall dental inflammation as seen on panoramic radiographs than normal-weight people, Thanakun and colleagues wrote online in Oral Diseases.

The Asian BMI (body mass index) scale used BMI>25 has the obese market. BMI of 23-25 is considered overweight and a BMI of < 23 is considered normal.

There’s no cause given for this finding because cause can’t be determined from this type of study. However, it doesn’t seem like such a stretch to postulate that obese Thai might eat a bit more sweets— certainly they eat more food. That’s a certainty because despite protestations to the contrary, mass isn’t created from nothing. To maintain a larger body size you have to ingest a larger quantity of calories, or move a whole lot less.

Finally, a sensible take on gluten free diets, though she doesn’t make the point that legumes have no gluten and can be a part of a healthy gluten free diet. Gluten is required for nothing nutritionally. Gluten makes bread chewy and puff pastry flaky. It adds nothing to the body’s health.

I cede her point that people avoiding gluten and feeling better might have other dietary sensitivities that are being masked. On the other hand, doctors don’t really know how to measure what they gut in sensitive to, and if avoiding gluten works, why fuss about it? The statement presumes that the patient has had the test for celiac’s though, which is what I did before deciding to give gluten free a try.

However, that is transparently naive on my part. One doesn’t need to spend much time reading diet blogs to realize that the people don’t wait for official tests or diagnoses. In any event, I’m pleased that the idea of avoiding gluten is not automatically defined as being unhealthy.

A high fiber diet helps avoid osteoarthritis in the knees? What a surprise. Where do you find fiber? In plants. The fact that eating a diet rich in plants increases health should surprise no one.

Among individuals enrolled in the Osteoarthritis Initiative (OAI), those in the highest quartile of fiber intake had a 30% lower risk for developing symptomatic OA (OR 0.70, 95% CI 0.52-0.94, P<0.002) compared with those in the lowest quartile, according to Zhaoli Dai, PhD, and colleagues from Tufts University in Boston.

And among participants in the Framingham Offspring cohort, those with the highest intake had a 61% decrease in risk (OR 0.39, 95% CI 0.17-0.88, P=0.026), the researchers reported in Annals of the Rheumatic Diseases.

Eating fruit lowers the risk for type two diabetes, which should not be a surprise, but with the concerted effort to downplay the importance of eating plants in some quarters, perhaps it is.

Among individuals without diabetes at baseline, daily fruit consumption was associated with a 12% lower risk for getting diabetes compared to never or rarely eating fresh fruit (hazard ratio 0.88; 95% CI 0.83-0.93; P<0.001); this corresponded to a difference of 0.2 percentage points in 5-year absolute risk, said a research team led by Huaidong Du, MD, PhD, of Oxford University in England.

The study found a dose-response relationship between fresh fruit and diabetes risk, with each daily portion of fruit consumed linked to a 12% reduction in risk (HR 0.88; 95% CI 0.81-0.95; P=0.01 for trend). This association was not significantly modified by sex, age, region, survey season, or a range of other factors including smoking, alcohol consumption, physical activity, body-mass index, and family history of diabetes, Du and colleagues reported online in PLOS Medicine.

Only 100g of fresh fruit a day is what’s necessary. That's really not very much fresh fruit. A single apple or mango can weigh more than that.