Shedding Some Obesity Myths
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Let’s shed some obesity myths!
There are a lot of myths and misconceptions surrounding obesity… And then there are also reactive opposite myths and misconceptions, which can sometimes be just as harmful!
To tackle them all would take a book, but in classic 10almonds style, we’re going to put a spotlight on some of the ones that might make the biggest difference:
True or False: Obesity is genetically pre-determined
False… With caveats.
Some interesting results have been found from twin studies and adoption studies, showing that genes definitely play some role, but lifestyle is—for most people—the biggest factor:
- The body-mass index of twins who have been reared apart
- An adoption study of human obesity
- Using a sibling-adoption design to parse genetic and environmental influences on children’s body mass index
In short: genes predispose; they don’t predetermine. But that predisposition alone can make quite a big difference, if it in turn leads to different lifestyle factors.
But upon seeing those papers centering BMI, let’s consider…
True or False: BMI is a good, accurate measure of health in the context of bodyweight
False… Unless you’re a very large group of thin white men of moderate height, which was the demographic the system was built around.
Bonus information: it was never intended to be used to measure the weight-related health of any individual (not even an individual thin white man of moderate height), but rather, as a tool to look at large-scale demographic trends.
Basically, as a system, it’s being used in a way it was never made for, and the results of that misappropriation of an epidemiological tool for individual health are predictably unhelpful.
To do a deep-dive into all the flaws of the BMI system, which are many, we’d need to devote a whole main feature just to that.
Update: we have now done so!
Here it is: When BMI Doesn’t Measure Up
True or False: Obesity does not meaningfully impact more general health
False… In more ways than one (but there are caveats)
Obesity is highly correlated with increased risk of all-cause mortality, and weight loss, correspondingly, correlates with a reduced risk. See for example:
So what are the caveats?
Let’s put it this way: owning a horse is highly correlated with increased healthy longevity. And while owning a horse may come with some exercise and relaxation (both of which are good for the health), it’s probably mostly not the horse itself that conveys the health benefits… it’s that someone who has the resources to look after a horse, probably has the resources to look after their own health too.
So sometimes there can be a reason for a correlation (it’s not a coincidence!) but the causative factor is partially (or in some cases, entirely) something else.
So how could this play out with obesity?
There’s a lot of discrimination in healthcare settings, unfortunately! In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
True or False: to reduce obesity, just eat less and move more!
False… Mostly.
Moving more is almost always good for most people. When it comes to diet, quality is much more important than quantity. But these factors alone are only part of the picture!
But beyond diet and exercise, there are many other implicated factors in weight gain, weight maintenance, and weight loss, including but not limited to:
- Disrupted sleep
- Chronic stress
- Chronic pain
- Hormonal imbalances
- Physical disabilities that preclude a lot of exercise
- Mental health issues that add (and compound) extra levels of challenge
- Medications that throw all kinds of spanners into the works with their side effects
…and even just those first two things, diet and exercise, are not always so correlated to weight as one might think—studies have found that the difference for exercise especially is often marginal:
Read: Widespread misconceptions about obesity ← academic article in the Journal of the College of Family Physicians of Canada
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Fixing Fascia
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Fascia: Why (And How) You Should Take Care Of Yours
Fascia is the web-like layer of connective tissue that divides your muscles and organs from each other. It simultaneously holds some stuff in place, and allows other parts to glide over each other with minimal friction.
At least, that’s what it’s supposed to do.
Like any body part, it can go wrong. More on this later. But first…
A quick note on terms
It may seem like sometimes people say “myofascial” because it sounds fancier, but it does actually have a specific meaning too:
- “Fascia” is what we just described above
- “Myofascial” means “of or relating to muscles and fascia”
For example, “myofascial release” means “stopping the fascia from sticking to the muscle where it shouldn’t” and “myofascial pain” means “pain that has to do with the muscles and fascia”. See also:
Myofascial vs Fascia: When To Use Each One? What To Consider
Why fascia is so ignored
For millennia, it was mostly disregarded as a “neither this nor that” tissue that just happens to be in the body. We didn’t pay attention to it, just like we mostly don’t pay attention to the air around us.
But, much like the air around us, we sure pay attention when something goes wrong with it!
However, even in more recent years, we’ve been held back until quite new developments like musculoskeletal ultrasound that could show us problems with the fascia.
What can go wrong
It’s supposed to be strong, thin, supple, and slippery. It holds on in the necessary places like a spiderweb, but for the most part, it is evolved for minimum friction.
Some things can cause it to thicken and become sticky in the wrong places. Things such as:
- Physical trauma, e.g. an injury or surgery—but we repeat ourselves, because a surgery is an injury! It’s a (usually) necessary injury, but an injury nonetheless.
- Compensation for pain. If a body part hurts for some reason, and your posture changes to accommodate that, doing so can mess up your fascia, and cause you different problems somewhere else entirely.
- This is not witchcraft; think of how, when using a corded vacuum cleaner, sometimes the cord can get snagged on something in the next room and we nearly break something because we expected it to just come with us and it didn’t? It’s like that.
- Repetitive movements (repetitive strain injury is partly a myofascial issue)
- Not enough movement: when it comes to range of motion, it’s “use it or lose it”.
- The human body tries its best to be as efficient as possible for us! So eventually it will go “Hey, I notice you never move more than 30º in this direction, so I’m going to stop making fascia that allows you to go past that point, and I’ll just dump the materials here instead”
“I’ll just dump the materials here instead” is also part of the problem—it creates what we colloquially call “knots”, which are not so much part of the muscle as the fascia that covers it. That’s an actual physical sticky lumpy bit.
What to do about it
Firstly, avoid the above things! But, if for whatever reason something has gone wrong and you now have sticky lumpy fascia that doesn’t let you move the way you’d like (if you have any mobility/flexibility issues that aren’t for another known reason, then this is usually it), there are things can be done:
- Heat—is definitely not a cure-all, but it’s a good first step before doing the other things. A heating pad or a warm bath are great.
- Here’s an example of a neck+back+shoulders heating pad; you can get them for different body parts, or just use an electric blanket!
- Massage—ideally, by someone else who knows what they are doing. Self-massage is possible, as is teaching oneself (there are plenty of video tutorials available), but skilled professional therapeutic myofascial release massage is the gold standard.
- Foam rollers are a great no-skill way to get going with self-massage, whether because that’s what’s available to you, or because you just want something you can do between sessions. Here’s an example of the kind we mean.
- Acupuncture—triggering localized muscular relaxation, an important part of myofascial release, is something acupuncture is good at.
- See also: Pinpointing The Usefulness Of Acupuncture ← noteworthily, the strongest criticism of acupuncture for pain relief is that it performs only slightly better than sham acupuncture, but taken in practical terms, all that really means is “sticking little needles in does work, even if not necessarily by the mechanism acupuncturists believe”
- Calisthenics—Pilates, yoga, and other forms of body movement training can help gradually get one’s fascia to where and how it’s supposed to be.
- This is that “use it or lose it” bodily efficiency we talked about!
Remember, the body is always rebuilding itself. It never stops, until you die. So on any given day, you get to choose whether it rebuilds itself a little bit worse or a little bit better.
Take care!
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Veg in One Bed New Edition – by Huw Richards
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We all know that growing our own veg is ultimately not only healthier on the plate, but also a very healthy activity. Cheaper too. So why don’t more of us do it?
For many of us, it’s a matter of not having the skills or knowledge to do so. This book bridges that knowledge-gap.
Richards gives, as promised, a month-by-month well-illustrated guide to growing a wide variety of vegetables. He does, by the way, assume that we are in a temperate climate in the Northern Hemisphere. So if you’re not, you may need to make some adjustments.
The book doesn’t assume prior knowledge, and does give the reader everything we need from an initial basic shopping list onwards.
A particular strength of this book is that it’s about growing veg in a single raised bed—this ensures keeping everything very manageable.
Bottom line: if you have ever thought it would be good to grow your own veg, but didn’t know where to start and want something practical for a beginner, this is an excellent guide that will get you going!
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Debate over tongue tie procedures in babies continues. Here’s why it can be beneficial for some infants
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There is increasing media interest about surgical procedures on new babies for tongue tie. Some hail it as a miracle cure, others view it as barbaric treatment, though adverse outcomes are rare.
Tongue tie occurs when the tissue under the tongue is attached to the lower gum or floor of the mouth in a way that can restrict the movement or range of the tongue. This can impact early breastfeeding in babies. It affects an estimated 8% of children under one year of age.
While there has been an increase in tongue tie releases (also called division or frenotomy), it’s important to keep this in perspective relative to the increase in breastfeeding rates.
The World Health Organization recommends exclusive breastfeeding for the first six months of life, with breastfeeding recommended into the second year of life and beyond for the health of mother and baby as well as optimal growth. Global rates of breastfeeding infants for the first six months have increased from 38% to 48% over the past decade. So, it is not surprising there is also an increase in the number of babies being referred globally with breastfeeding challenges and potential tongue tie.
An Australian study published in 2023 showed that despite a 25% increase in referrals for tongue tie division between 2014 and 2018, there was no increase in the number of tongue tie divisions performed. Tongue tie surgery rates increased in Australia in the decade from 2006 to 2016 (from 1.22 per 1,000 population to 6.35) for 0 to 4 year olds. There is no data on surgery rates in Australia over the last eight years.
Tongue tie division isn’t always appropriate but it can make a big difference to the babies who need it. More referrals doesn’t necessarily mean more procedures are performed.
chomplearn/Shutterstock How tongue tie can affect babies
When tongue tie (ankyloglossia) restricts the movement of the tongue, it can make it more difficult for a baby to latch onto the mother’s breast and painlessly breastfeed.
Earlier this month, the International Consortium of oral Ankylofrenula Professionals released a tongue tie position statement and practice guideline. Written by a range of health professionals, the guidelines define tongue tie as a functional diagnosis that can impact breastfeeding, eating, drinking and speech. The guidelines provide health professionals and families with information on the assessment and management of tongue tie.
Tongue tie release has been shown to improve latch during breastfeeding, reduce nipple pain and improve breast and bottle feeding. Early assessment and treatment are important to help mothers breastfeed for longer and address any potential functional problems.
The frenulum is a band of tissue under the tongue that is attached to the gumline base of the mouth. Akkalak Aiempradit/Shutterstock Where to get advice
If feeding isn’t going well, it may cause pain for the mother or there may be signs the baby isn’t attaching properly to the breast or not getting enough milk. Parents can seek skilled help and assessment from a certified lactation consultant or International Board-Certified Lactation Consultant who can be found via online registry.
Alternatively, a health professional with training and skills in tongue tie assessment and division can assist families. This may include a doctor, midwife, speech pathologist or dentist with extended skills, training and experience in treating babies with tongue tie.
When access to advice or treatment is delayed, it can lead to unnecessary supplementation with bottle feeds, early weaning from breastfeeding and increased parental anxiety.
Getting a tongue tie assessment
During assessment, a qualified health professional will collect a thorough case history, including pregnancy and birth details, do a structural and functional assessment, and conduct a comprehensive breastfeeding or feeding assessment.
They will view and thoroughly examine the mouth, including the tongue’s movement and lift. The appearance of where the tissue attaches to the underside of the tongue, the ability of the tongue to move and how the baby can suck also needs to be properly assessed.
Treatment decisions should focus on the concerns of the mother and baby and the impact of current feeding issues. Tongue tie division as a baby is not recommended for the sole purpose of avoiding speech problems in later life if there are no feeding concerns for the baby.
A properly qualified lactation consultant can help with positioning and attachment. HarryKiiM Stock/Shutterstock Treatment options
The Australian Dental Association’s 2020 guidelines provide a management pathway for babies diagnosed with tongue tie.
Once feeding issues are identified and if a tongue tie is diagnosed, non-surgical management to optimise positioning, latch and education for parents should be the first-line approach.
If feeding issues persist during follow-up assessment after non-surgical management, a tongue tie division may be considered. Tongue tie release may be one option to address functional challenges associated with breastfeeding problems in babies.
There are risks associated with any procedure, including tongue tie release, such as bleeding. These risks should be discussed with the treating practitioner before conducting any laser, scissor or scalpel tongue tie procedure.
Post-release support by a certified lactation consultant or feeding specialist is necessary after a tongue tie division. A post-release treatment plan should be developed by a team of health professionals including advice and support for breastfeeding to address both the mother and baby’s individual needs.
We would like to acknowledge the contribution of Raymond J. Tseng, DDS, PhD, (Paediatric Dentist) to the writing of this article.
Sharon Smart, Lecturer and Researcher (Speech Pathology) – School of Allied Health, Curtin University; David Todd, Associate Professor, Neonatology, ANU Medical School, Australian National University, and Monica J. Hogan, PhD student, ANU School of Medicine and Psychology, Australian National University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Do we really need to burp babies? Here’s what the research says
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Parents are often advised to burp their babies after feeding them. Some people think burping after feeding is important to reduce or prevent discomfort crying, or to reduce how much a baby regurgitates milk after a feed.
It is true babies, like adults, swallow air when they eat. Burping releases this air from the top part of our digestive tracts. So when a baby cries after a feed, many assume it’s because the child needs to “be burped”. However, this is not necessarily true.
Why do babies cry or ‘spit up’ after a feed?
Babies cry for a whole host of reasons that have nothing to do with “trapped air”.
They cry when they are hungry, cold, hot, scared, tired, lonely, overwhelmed, needing adult help to calm, in discomfort or pain, or for no identifiable reason. In fact, we have a name for crying with no known cause; it’s called “colic”.
“Spitting up” – where a baby gently regurgitates a bit of milk after a feed – is common because the muscle at the top of a newborn baby’s stomach is not fully mature. This means what goes down can all too easily go back up.
Spitting up frequently happens when a baby’s stomach is very full, there is pressure on their tummy or they are picked up after lying down.
Spitting up after feeding decreases as babies get older. Three-quarters of babies one month old spit up after feeding at least once a day. Only half of babies still spit up at five months and almost all (96%) stop by their first birthdays.
There’s not much research out there on ‘burping’ babies. antoniodiaz/Shutterstock Does burping help reduce crying or spitting up?
Despite parents being advised to burp their babies, there’s not much research evidence on the topic.
One study conducted in India encouraged caregivers of 35 newborns to burp their babies, while caregivers of 36 newborns were not given any information about burping.
For the next three months, mothers and caregivers recorded whether their baby would spit up after feeding and whether they showed signs of intense crying.
This study found burping did not reduce crying and actually increased spitting up.
When should I be concerned about spitting up or crying?
Most crying and spitting up is normal. However, these behaviours are not:
- refusing to feed
- vomiting so much milk weight gain is slow
- coughing or wheezing distress while feeding
- bloody vomit.
If your baby has any of these symptoms, see a doctor or child health nurse.
If your baby seems unbothered by vomiting and does not have any other symptoms it is a laundry problem rather than something that needs medical attention.
It is also normal for babies to cry and fuss quite a lot; two hours a day, for about the first six weeks is the average.
This has usually reduced to about one hour a day by the time they are three months of age.
Crying more than this doesn’t necessarily mean there is something wrong. The intense, inconsolable crying of colic is experienced by up to one-quarter of young babies but goes away with time on its own .
If your baby is crying more than average or if you are worried there might be something wrong, you should see your doctor or child health nurse.
If your baby likes being ‘burped’, then it’s OK to do it. But don’t stress if you skip it. Miljan Zivkovic/Shutterstock Not everyone burps their baby
Burping babies seems to be traditional practice in some parts of the world and not in others.
For example, research in Indonesia found most breastfeeding mothers rarely or never burped their babies after feeding.
One factor that may influence whether a culture encourages burping babies may be related to another aspect of infant care: how much babies are carried.
Carrying a baby in a sling or baby carrier can reduce the amount of time babies cry.
Babies who are carried upright on their mother or another caregiver’s front undoubtedly find comfort in that closeness and movement.
Babies in slings are also being held firmly and upright, which would help any swallowed air to rise up and escape via a burp if needed.
Using slings can make caring for a baby easier. Studies (including randomised controlled trials) have also shown women have lower rates of post-natal depression and breastfeed for longer when they use a baby sling.
It is important baby carriers and slings are used safely, so make sure you’re up to date on the latest advice on how to do it.
So, should I burp my baby?
The bottom line is: it’s up to you.
Gently burping a baby is not harmful. If you feel burping is helpful to your baby, then keep doing what you’re doing.
If trying to burp your baby after every feed is stressing you or your baby out, then you don’t have to keep doing it.
Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University and Nina Jane Chad, Research Fellow, University of Sydney School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Move – by Caroline Williams
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- Get 150 minutes of moderate exercise per week, says the American Heart Association
- There are over 10,000 minutes per week, says the pocket calculator
Is 150/10,000 really the goal here? Really?
For Caroline Williams, the answer is no.
In this book that’s practically a manifesto, she outlines the case that:
- Humans evolved to move
- Industrialization and capitalism scuppered that
- We now spend far too long each day without movement
Furthermore, for Williams this isn’t just an anthropological observation, it’s a problem to be solved, because:
- Our lack of movement is crippling us—literally
- Our stagnation affects not just our bodies, but also our minds
- (again literally—there’s a direct correlation with mental health)
- We urgently need to fix this
So, what now, do we need to move in to the gym and become full-time athletes to clock up enough hours of movement? No.
Williams convincingly argues the case (using data from supercentenarian “blue zones” around the world) that even non-exertive movement is sufficient. In other words, you don’t have to be running; walking is great. You don’t have to be lifting weights; doing the housework or gardening will suffice.
From that foundational axiom, she calls on us to find ways to build our life around movement… rather than production-efficiency and/or convenience. She gives plenty of tips for such too!
Bottom line: some books are “I couldn’t put it down!” books. This one’s more of a “I got the urge to get up and get moving!” book.
Get your get-up-and-go up and going with “Move”—order yours from Amazon today!
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16/8 Intermittent Fasting For Beginners
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Health Insider explains in super-simple fashion why and how to do Intermittent Fasting (IF), which is something that can sound complicated at first, but becomes very simple and easy once understood.
What do we need to know?
Intermittent fasting (IF) is a good, well-evidenced way to ease your body’s metabolic load, and
give your organs a chance to recover from the strain of digestion and its effects. That’s not just your gastrointestinal organs! It’s your pancreas and liver too, amongst others—this is about glucose metabolism as much as it is about digestion.This, in turn, allows your body some downtime to do its favorite thing, which is: maintenance!
This maintenance takes the form of enhanced cellular apoptosis and autophagy, helping to keep cells young and cancer-free.
In other words, with well-practised intermittent fasting, we can reduce our risk of metabolic disease (including heart disease and diabetes) as well as cancer and neurodegeneration.
You may be wondering: this sounds miraculous; what’s the catch? There are a couple:
- While fasting from food, the body’s enhanced metabolism requires more water, so you’ll need to take extra care keep on top of your hydration (this is one reason why Ramadan fasting, while healthy for most people, is not as healthy as IF—because Ramadan fasting means abstaining from water, too).
- If you are diabetic, and especially if you have Type 1 Diabetes, fasting may not be a safe option for you, since if you get a hypo in the middle of your fasting period, it’s obviously not a good idea to wait another many hours before fixing it.
Extra note on that last one: it’s easy to think “can’t I just lower my bolus insulin instead of eating?” and while superficially yes that will raise your blood sugar levels, it’s because the sugar will be sticking around in your blood, and not actually getting released into the organs that need it. So while your blood glucose monitor may say you’re fine, you will be starving your organs and if you keep it up they may suffer serious damage.
Disclaimer: our standard legal/medical disclaimer applies, and this is intended for educational purposes only; please do speak with your endocrinologist before changing anything you usually do with regard to your blood sugar maintenance.
Ok, back onto the cheerier topic at hand:
Aside from the above: for most people, IF is a remarkably healthful practice in very many ways.
For more on the science, practicalities, and things to do/avoid, enjoy this short (4:53) video:
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Want to know more?
Check out our previous main feature on this topic:
Intermittent Fasting: Mythbusting Edition
Enjoy!
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