Pinch me

Fairfax has a piece on myths about obesity that is sensible and properly science-based, and which they are promoting in the banner area of the front page? Maybe there’s something to all this approaching-2012-apocalypso after all.

The layout is better in the dead-tree edition, where the SMH felt no need to illustrate it with a headless torso as they have done in the web version (at least it’s not an OMGDeathFatz headless torso this time).

Gary Egger and Sam Egger originally published a version of this article in Australian Family Physician, and the gist is this:

We assessed the best available evidence on weight loss and maintenance and used this to compile a 20-statement survey – with true or false responses – which we then gave to two groups of people: 173 GPs and 129 truck drivers and tradesmen.

We found doctors were almost as confused as truckies and tradies. The doctors disagreed with most of the supporting evidence on 40 per cent of our questions, the others on 49 per cent.

Another failing of the web edition is that it does not reproduce the table of results for the survey which is shown in the dead-tree edition. Here’s the data in the table seen in the dead-tree version reproduced manually using a spreadsheet:

Tradesmen Big Fat Lies True/False Doctors
%incorrect SMH 2009/11/19 page 21

38 Fruit juice is about as fattening as beer TRUE 20
80 Humans need 8 glasses of water a day FALSE 79
43 Peanuts are a healthy food TRUE 42
74 Dairy products can help weight loss TRUE 73
33 A low protein diet is best for weight loss FALSE 10
55 Fat people don’t get more hungry than lean people TRUE 62
76 Chocolate is healthy provided it is ‘dark’ FALSE 45
27 Spicy foods make you eat more FALSE 32
27 Vegetable juice is healthier than fruit juice TRUE 34
34 Coffee causes cancer FALSE 28
49 Sit ups will not help reduce fat off the waist TRUE 49
77 Exercise is better than dieting for weight loss FALSE 60
52 Swimming is better than walking for weight loss FALSE 27
69 Weight lifting is good for fat loss TRUE 62
77 The best measure of body fat is body mass index FALSE 23
39 You lose more weight doing exercise you are good at FALSE 56
68 An obese person can be fit and healthy TRUE 47
34 You have to ‘bust a gut’ to lose a gut FALSE 33
25 Sauna baths are good for fat loss FALSE 10
8 Exercise can increase depression FALSE 2

It’s depressing to think that nearly 3 out of 4 in both groups believe incorrectly that dairy products do not help weight loss, that more than 1 in 2 in both groups believe incorrectly that fat people get more hungry than lean people, that roughly 2 in 3 in both groups do not know that weight lifting is good for burning fat while nearly 1 in 2 believe incorrectly that sit-ups will burn abdominal fat. On the other hand, at least 3 out of 4 doctors agreed that BMI is not a good measure of body fat, which seems to represent some sort of progress with the medical education on that even if it hasn’t trickled down to Joe Tradesman.

On the gripping hand, doctors don’t seem to have absorbed much in the way of basic biomechanics, believing falsely that one loses more weight doing exercise that you are good at, while the truckies/tradies seem to know the truth – the better you are at something the more efficient you are, therefore the less energy you will burn while doing it. (This effect is possibly/probably confounded somewhat by the aspect that if you are good at something you are more likely to enjoy doing it, and are therefore more likely to do it for longer and thus burn more energy than doing something else for a shorter interval, so this question is not as clear-cut as perhaps the authors intended).

Categories: health, media, medicine, Sociology


9 replies

  1. Yeah, I saw that too! It was most pleasing to see. 🙂

  2. Excuse me while I pick myself up off the floor.
    It will be interesting to see if the AMA comes out with a public response to this… cos doctors are gods and can’t be wrong (not publicly anyway) dincha know?

  3. “On the gripping hand”, can I just say I have a little nerd crush on you for this?
    It is all so true. Most doctors have extremely little nutrition training in their degree and therefore, unless they make a concerted effort to research the topic, most of their “nutrition advice” is gleaned from the same sources as any lay person.

  4. Yes… “gripping hand”… how appropriate for talking about motes and logs in eyes!
    I’m /shocked/ at the percentage of doctors making so many errors… frankly there is no excuse for anyone of them under my own age (pushing 50), as I KNOW what we did in the nutrition components of pre-clinical med (late 70s) and what we did when studying with dieticians (the only thing they did I didn’t was food chem… and early 80s). Then add in all the research since then, 30 years worth, and there is simply no excuse.
    At least non-health-professionals have the excuse of constant bombardment of misinformation by commercial interests, and the faddism of poorly-informed friends.
    Mind you, while these things are fairly basic, there ARE many confounding issues, including brain circuitry that controls appetite, the effect of genetics via things like leptins…. but still.
    I’d /really/ like to see a histogram of the age profile of the doctors interviewed versus the histogram of all of them in the community, ideally with a breakdown on how well/badly each age cohort did. That might give an indication of whether the quality of medical education has changed over the years.

  5. Oh, forgot to mention, if you want to keep up, all you need to do is read the damn headlines in the email newsletters you get after signing up for ealerts on and ticking “International Journal of Obesity” and “European Journal of Clinical Nutrition” on the relevant page. Sure you’ve got to register, but it is free (until you go delving any deeper than the abstract)
    .-= Dave Bath´s last blog ..Missing in action: the key KPI for government =-.

  6. I suggest that paying anything other than extremely skeptical attention to the Weightloss Industrial Complex and its friend Big Dairy is probably pretty unwise.
    What was supposed to be the correct answer to the chocolate question? What does “healthy” mean? What does “good at” mean? What does “better than” mean? What does “water” mean? The questions themselves are a mess. Garbage in, garbage out, no matter who you’re interviewing.

    • Oh yes, extremely skeptical. I was just thrilled that at least some of the questions addressed BMI and that obese people could still be fit and healthy.
      The answer to the chocolate question was in the article and was a vaguely cautionary tale: cocoa flavinoids have “good” antioxidant qualities, but if the manufacturer adds sugar these are reduced, so not all chocolate just labelled ‘dark’ is good. So yeah, the answer is “it depends”.
      FXH FDB made just this point over at LP – for a lot of these questions, the answer is really “it depends”, which is a box he always includes when he’s designing a survey in the beta-test stage to tell him when he hasn’t clarified his questions sufficiently. Egger and Egger could have done a lot better, unless their purpose was to show just how vague a lot of these fat myths are, but so far they don’t appear to have made that claim.

  7. It’s really bloody depressing that 47% of doctors believed “Obese people can be fit and healthy” to be untrue. :o/

  8. I have the paper article here, and it’s a mess. The methodology is utterly shonky from start to finish.
    It may be also worth noting, for those unaware, that AFP is a glossy pharmaceutical-industry-funded rag distributed free to a bunch of docs, and that it has no reputation to speak of in the research world. Its primary function is eyes on ads, dressed up with simple, brief CME type articles on GP management of various presentations.

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