A recent research study published in the New England Journal of Medicine has received quite a lot of recent media coverage.
Here are the basics of that study.
Myths, Presumptions, and Facts about Obesity
Research Study Published 1/31/2013
in the New England Journal of Medicine.
Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may
divert attention away from useful, evidence-based information.
Using Internet searches of popular media and scientific literature, we identified, reviewed, and classified obesity-related myths and presumptions. We also examined facts that are well supported by evidence, with an emphasis on those that have practical implications for public health, policy, or clinical recommendations.
We identified seven obesity-related myths concerning the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals for weight loss, rapid weight loss, weight-loss readiness, physical-education classes, breast-feeding, and energy expended during sexual activity. We also identified six presumptions about the purported effects of regularly eating breakfast, early childhood experiences, eating fruits and vegetables, weight cycling, snacking, and the built (i.e., human-made) environment. Finally, we identified nine evidence-supported facts that are relevant for the formulation of sound public health, policy, or clinical recommendations.
False and scientifically unsupported beliefs about obesity are pervasive in both scientific literature and the popular press.
(Funded by the National Institutes of Health.)
Below are the myths, presumptions and facts:
Here are the beliefs that were found to be untrue.
1. "Small sustained changes in energy intake or expenditure will produce large, long-term weight changes".
2. "Setting realistic goals for weight loss is important, because otherwise patients will become frustrated and quit".
3. "Large, rapid weight loss is associated with poorer long-term weight-loss outcomes as compared with slow, gradual loss".
4. "It is important to assess the stage of change or diet readiness in order to help patients who request weight-loss treatment"
5. "Physical-education classes in their current form, play an important role in reducing or preventing childhood obesity"
6. "Breast-feeding is protective against obesity"
7. "A bout of sexual activity burns 100 to 300 kcal for each participant" (Their calculation comes to about 14 calories).
These are subjects that as yet remain unproven one way or the other.
1. "Regularly eating breakfast is protective against obesity"
2. "Early childhood is the period in which we learn exercise and eating habits that influence our weight throughout life"
3. "Eating more fruits and vegetables will result in weight loss, or less weight gain, regardless of whether any other changes to one's behavior or environment are made"
4. "Weight cycling is associated with increased mortality.."
5. "Snacking contributes to weight gain and obesity."
6. "The built environment, in terms of sidewalk and park availability, influences obesity."
These are the nine points the authors feel there's sufficient evidence to be true.
1. "Although genetic factors play a large role, heritability is not destiny"
2. "Diets (reduced energy intake) very effectively reduce weight, but trying to go on a diet or recommending that someone go on a diet generally does not work well in the long term."
3. "Regardless of body weight or weight loss, an increased level of exercise increases health."
4. "Physical activity or exercise in a sufficient dose aids in long term weight maintenance."
5. "Continuation of conditions that promote weight loss promotes maintenance of lower weight."
6. "For overweight children, programs that involve the parents and the home setting promote greater weight loss or maintenance."
7. "Provision of meals and use of meal-replacement products promote greater weight loss."
8. "Some pharmaceutical agents can help patients achieve clinically meaningful weight loss and maintain the reduction as long as the agents continue to be used."
9. "In appropriate patients bariatric surgery results in long-term weight loss and reductions in the rate of incident diabetes and mortality."
Regarding the issue of potential food and drug bias within the study, I think that it's worth noting that the author of the NEJM paper, Dr Allison, has the following disclosure regarding his relationship to the food and drug industry:
"Dr. Allison reports serving as an unpaid board member for the International Life Sciences Institute of North America; receiving payment for board membership from Kraft Foods; receiving consulting fees from Vivus, Ulmer and Berne, Paul, Weiss, Rifkind, Wharton, Garrison, Chandler Chicco, Arena Pharmaceuticals, Pfizer, National Cattlemen's Association, Mead Johnson Nutrition, Frontiers Foundation, Orexigen Therapeutics, and Jason Pharmaceuticals; receiving lecture fees from Porter Novelli and the Almond Board of California; receiving payment for manuscript preparation from Vivus; receiving travel reimbursement from International Life Sciences Institute of North America; receiving other support from the United Soybean Board and the Northarvest Bean Growers Association; receiving grant support through his institution from Wrigley, Kraft Foods, Coca-Cola, Vivus, Jason Pharmaceuticals, Aetna Foundation, and McNeil Nutritionals; and receiving other funding through his institution from the Coca-Cola Foundation, Coca-Cola, PepsiCo, Red Bull, World Sugar Research Organisation, Archer Daniels Midland, Mars, Eli Lilly and Company, and Merck."
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