Posts by dyan campbell
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Not so, Ben. You don't need to eat a lot of food to become obese. Obesity has a number of different factors, not just eating a lot of food; it's quite a complex medical condition.
Whilst that may be true in some cases, I have to say that every obese person I know (and I know a few) stuffs their face a lot. They are very duplicitous about how much they are eating, both to others and to themselves.
Yes, you're quite right Ben, you've identified what obesity clinicians call hyperphagia which simply means "hyper-eating". This is partly due to a poor nutritional profile - as evidenced by that film Supersize Me which saw Morgan Spurlock go from being unable to digest a big Mac (probably due to having been a vegetarian, during which time the body ceases to make large quantities of the enzymes that help to digest meat - this comes back fairly quickly) to being about to down half a dozen in one sitting and still be able to consume more. The body correctly perceives itself to be deficient in nutrients, and the ability to keep eating (i.e. switching off the sensation that tells us we're full) becomes dominant. This is especially true of people that consume artificially sweetened products, because the digestive process that is kick started in our mouths signals an expected consumption of calories - causing an ability to consume a much larger amount of sugar than if no artifical sweetener had been consumed.
The modern diet - very modern diet comprised of processed, nutrient depleted foods - predisposes people to this state, which as Morgan Spurlock proved, can be reached very quickly indeed. Some of the fattest people are the most malnourished.
As Jamie Oliver explained in his last gruesome series, an underweight child in rural Ethiopia is literally better nourished that a fat kid in Britain. This would be true of NZ children too, as evidenced in the Otago study of children. Children here, like in most developed countries, are woefully deficient in nutrients: vitamin D, calcium, iron, fibre... just to name a few. An iodine deficiency due to the popularisation of "sea salt" (non iodised) and fast foods has seen a startling re-emergence of goitre. Add to that the consumption of alcohol, which accounts for between 20 - 35% of the average Australian (don't know what it is for NZers) daily calories, and you have a very fat, very poorly nourished person. Very obese expectant mothers have babies with a poorer nutritional profile than do those who are chronically undernourished due to food scarcity. That's pretty shocking.
But bear in mind we notice an obese person eating and sit in judgement much more than if we see a slim person eating. You can bet Hamish Carter ate at least as many calories as David Lange, and it's likely that wiry little Sarah Ulmer eats as much as the morbidly obese Dawn French. I'd wager the athletes eat much more nourishing food than their morbidly obese counterparts, but I think you'd be shocked at what a very muscular, slim person can pack away. The higher the ratio of muscle to fat, the faster the person burns calories.
Also a slim person can be obese - as the keynote speaker (Dr Ranjan Yajnik, from Pune, India) said of himself at one of the conferences on obesity I helped organise "I am a slim obese man", meaning his slight frame, with a thick middle carried more risk than did the thicker frames of his better proportioned colleagues.
As we learn more and more about the biochemistry of obesity, nutrition and metabolic syndrome (the collection of diseases that are associated with obesity) we find that the assumptions and judgements we make are not always that accurate.
What we do know is that obesity is skewing modern perceptions of what is "normal" has become very distorted. For instance, most parents of obese children do not see their child as overweight, much less obese. What is sad is that despite the the huge number of calories consumed, modern nutrition is often very poor indeed.
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Um, jon, yeah. For starters the blatantly obvious fact that you have to eat a lot of food to get really fat. Without that, it can't be done. Then there's all the countries which actually do have food shortages which sort of corroborate that theory.
Not so, Ben. You don't need to eat a lot of food to become obese. Obesity has a number of different factors, not just eating a lot of food; it's quite a complex medical condition.
For starters it's long been observed that low status individuals will choose high fat, high sugar foods in greater quantity than their high-status counterparts. This has even been observed in chimps: when given unlimited access to very sweet, fatty food the high-status individuals stopped consuming the treats long before their lower-status counterparts.
This is exactly what George Orwell observed in his book The Road to Wigan Pier when comparing the behaviour of working class people to that of a more priviliged class, Orwell had observed how cravings for fried, greasy food, sugar, tobacco and alcohol were greater for the working class than those of a more privileged class. He correctly observed that they "wanted a bit of comfort".
Add to that the remarkable phenomenon of the HPA axis (hypothalamus, pituitary, adrenals) which causes fat to be deposited around the midsection during stress. The midsection is where fat does the greatest harm. The same number of calories from exactly the same foods can be consumed by 2 identical twins, and the one who is experiencing stress with gain more weight around the middle, and suffer worse blood chemistry. This is with exactly the same foods being consumed in exactly the same quantities.
One more factor is the predisposition to obesity that is influenced by one's maternal grandmother, mother and one's own health/weight in infancy. In a nutshell - historical poverty=predisposition to obesity and the worst health effects from obesity.
The linked article describes the deadly paradox of obesity and poverty in the developing world.
Obesity in the Developing World
Having said that, you are quite right in observing that in olden times, the food of the poor (little meat, little oil, no sugar, a lot of pulses, legumes and vegetables) make a healthy diet. But in modern times fat and sugar are not expensive items.
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Ben, I don't mean to suggest the staff at AH ICU were in any way deficient. My point is the infrastructure was so dilapidated as to be alarming. The individual responsible for Frank's death was his GP, who somehow failed to diagnose an incredibly obvious case of pneumonia. He visited her 3x and she diagnosed and kept treating him for asthma - despite the fact he had a raging temperature and his lungs had that characteristic crackling sound pneumonia makes. I am a layperson with only part of a degree, and I could tell it was pneumonia, but why would he have listened to me? I'm not a doctor. Unfortunately Frank kept trusting his incompetent GP and she kept telling him it was asthma. She could not have taken any bloods or even his temperature.
His faith in his GP meant that he was finally taken to AH emerg - 7-9 days too late - where he was diagnosed with pneumonia on the spot.
That it was too late to save him at that time was certainly not the fault of the staff at AH or their doctors in ICU. They didn't know which form of the many dozens of pneumonia they were treating, and quite properly began eliminating the dozens of kinds that were more likely than the extremely rare LD. Had they seen him earlier, they would have arrived at that diagnosis in plenty of time, probably.
The Canadian move to lockdown and the public's response to such heavy handed quarantine measures are quite different than you would find in most countries. While this would horrify civil libertarians in the USA, it certainly prevented a much, much more serious outbreak of SARS in Canada than happened at the time. Canadians have a much greater trust of their government than do most nations, and our docility in response to public directives is quite well known. While people were hugely inconvenienced by the quarantine, and did holler their discontent, there was very little public sympathy or support for them. The public support was almost unanimously for the public health officials.
This is a huge part of why the disease was contained so easily (44 deaths) and the state of the art isolation ward was the other part.
At the time that SARS did hit, which was about 3 weeks after Frank's death, the staff at AH went public about their fears of what would happen if SARS broke out here. They pointed out that Auckland had no facilities to contain an outbreak of anything like SARS or any other deadly disease that is contagious rather than merely communicable.
They were promptly muzzled by the incredibly ignorant Wayne Brown.
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I can understand that people immersed in the culture that bought us SARS, killer bees and Y2K might be cautious and reluctant to engage.
I don't know about y2k or killer bees, but SARS is pretty bloody scary. In Canada there were were 438 cases and 44 deaths. It could have been so much worse.
The only reason it was so quickly and effectively contained with so few deaths is because Canada is a very wealthy country with state of the art pressure lock isolation wards and very, very strict quarantine laws that could not have been enforced in the USA. When the epidemic first hit everyone who found themselves in that hospital that day - cafeteria staff, couriers, visitors - remained in lockdown until the Ministry of Health said otherwise. There were threats - not made tongue in cheek - that people would be chained to beds should they violate their imposed quarantine.
SARS is incredibly contagious, as opposed to merely communicable. It also has an astonishingly high death rate.
My father-in-law here in Auckland died of Legionnaires’ disease at Auckland Hospital, just weeks before the SARS outbreak in Canada. I can well imagine the terror that would have ensued had he become sick after SARS was identified - the diseases resemble one another at the outset, and his doctors were unable to identify the easily treated but very rare LD until it was far too late.
But as my father-in-law Frank lay dying in Auckland's then (2003) dilapidated, oppressively hot ICU, with no state of the art pressure-lock isolation wards, with a window propped open with a piece of busted plywood, flies worrying the IV site on his arm I was horrified and frightened by the state of Auckland's biggest hospital. I can remember around that time some of the senior ICU staff making a fuss to the media about the state of things up there and being promptly muzzled by their bosses.
And a few months later a New Zealand clinician in Hong Kong I think it was - was the first to identify SARS and raise the alarm. For that piece of medical expertise and the world owes a lot, but I would not be complacent about any emerging pathogen.
I hope Auckland's ICU is a bit more modern and less run down now than it was when poor old Frank died.
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Jonathan Myerson has now weighed in with a piece in The Guardian.
Myerson sure comes across as dishonest, self serving and eager to abdicate his own responsibility as a father.
If he thinks pot smoking is the reason his son is alienated, angry and unmotivated he should read up on people like Kary Mullis and Richard Feynman who managed to combine pot smoking with Nobel prize winning.
Alienated slackers have always existed. Ivan Goncharov created an annoying sofa-bound whining slacker in his very funny satirical novel Oblomov. And of course there is Branwell Bronte, the drunk, opium smoking, self-pitying and unsuccessful brother of the more motivated and successful members of the Bronte clan.
Unmotivated, alienated slackers often wind up substance abusers, but the unmotivated alienated part is almost always the result of being over-indulged as children. Like Branwell they are told they are remarkable, brilliant, wonderful and are never held accountable for their failings and never given any responsibility. When they grow up they have no ability to control their tempers, set goals or apply themselves to work.
Sima Urale has made a wonderful movie Apron Strings that beautifully illustrates the dynamic.
If the Myersons don't like how their son Jake has turned out, they should look at their actions as parents, not try to find reasons other than their own failure to raise their children.
The most toxic thing in that Jonathan Myerson article is the way he blames Jake for his younger children's behaviour. If he's looking for someone to blame for the fact that his son is unable to take responsibility for his actions, then he should have a damn good look in the mirror.
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The youngest once complained that she kept getting the short questions on a Biology worksheet wrong but she couldn't see why. She showed it to me (Biology PhD) and her answers were 100% correct. On consulting the teacher with this she was told that that was all beside the point. Which was that the markers could only mark the 'approved form of words' which had to be rote learned.
My god, how maddening, how nuts. I was fortunate enough to have a 1st year bio prof who was intent on teaching us the difference between learning and remembering, and would deliberately phrase questions quite differently than the material we learned. So I carefully learned Oparin's theory as proven by Miller, and was completely thrown when faced with an exam question that read: "Describe abiotic synthesis" Huh? I had no idea and lost 20% of my mark. Which I thought was both fair and valuable, even at the time.
My sister was studying physics in her first year of university, and was faced with a question involving a dolly, a gradient and a weight. A dolly she thought? How strange, and poor dolly. Surely a toy car would be better...
Like me she left the question unanswered and also learned a valuable lesson that day... -
It was the "along with their four As at A level" that got me more.
I'm not quite sure what that meant. Graduating high school? Getting a scholarship? Not sure.
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She refused to let us have a lot of food marketed to kids, insanely popular breakfast food in the 1960s.
Er, my paragraphs were in the wrong order there.
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. We are determined that, along with their four As at A level, they also reach maturity with a desire for fresh food, varied food, healthy food.
Ouch.Well, the guy sounds disturbingly zealous, but I agree with him about the importance of getting kids to maturity with a desire for fresh, varied food. He doesn't sound like they made food very enjoyable though.
But some of the worst boomers parents I know raised very unhappy and now morbidly obese adults who were given anything (literally) they wanted to eat as children. Unfortunately for them, they wanted Boston cream pie and Macdonalds food all the time. As young adults with seriously compromised physical and mental health, they still exist on a diet of sugar, fat and preservatives.
She refused to let us have a lot of food marketed to kids, insanely popular breakfast food in the 1960s.
I thought she was pretty mean not to buy me these, but in hindsight keeping Frosted Pop Tarts, Coco Pops, Trix, Lucky Charms and Cap'n Crunch off the breakfast menu was probably one of the best things she ever did for me.
Though my Mum never, ever made us eat food we didn't want she wouldn't give us anything else either. Eat or starve, we were free to choose. She worried, but as my paediatrician told her, no child ever starved itself to death. That said, he also gave her a stack of recipes (some I still make) designed to fatten up underweight children.
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By the Myersons' own account, they decided that it was Jake's fault her novel was ailing, and that therefore he should be co-opted in to fix the narrative -- kicking, screaming and consulting lawyers if necessary. I think she quite clearly lied about the degree of consent obtained.
This is pretty bizarre and cruel, and I think will be quite hard for their son Jake to forgive.
And if this doesn't qualify the Myersons as bad parents, I don't know what does.I don't doubt Jake was acting like a difficult, angry teenager, who by the sounds of it, was also depressed. But if a kid is angry and depressed, there will be reasons why.
I thought it was kind of sad that in Jake's interview he described how good his mother had been to him when he was little, as she'd "given him wonderful presents". Wonderful presents mean rich parents, not good parents.
Parents are there to teach their children how to be adults. When I think of the best things my parents did it's more to do with how gentle or sensible they were as the situations required, not all the great bikes, ski equipment and electronics they bought me.
When boomer parents complain of their lazy, dishonest children I tend to think if they failed to teach their children to work hard and be honest, then it's far better the parents cope with the results, rather than flatmates, employers and society at large.
Many boomers complain bitterly about their kids, but they tend to be people who didn't impose limits or teach consequences. A full blown toddler tantrum was met with soothing and trying to meet the "demands" of a screaming two year old.
Two year olds don't need their demands met, they need their needs met. And if they are throwing a tantrum they need to be ignored until they get the message that tantrum throwing will not get them what they want. I can't believe these people who appeased tantrums for years are now surprised their adult children are still throwing tantrums.
While none of my friends violated their kids' privacy by writing personal and damaging things about them, they often acted as though their kid was a toy or pet or something. I can remember being uncomfortable when one friend would always insist her children kiss guests goodnight, and I'd always feebly suggest this should surely be left up to the child to decide? And others who would invite me to feel their child's soft hair, and I'd think, gee, they are bound to be an actual person who might not want their head stroked by some random lady. These people who are most bitter now were always the same people who were most in love with the idea of being a perfect parent with the perfect child, and they approached their role with a mixture of over-sweet praise and fussing and an attitude that the kid was somehow not inhabited by a sentient being that might have feelings of its own. It made me think of a line in that JD Salinger story, Teddy about a 10 year old genius who narrates the story, saying something like "my parents have no idea who I am, but they have a very clear idea how they want me to be, and beyond that they have no interest in me at all as a person".