Myths, presumptions, and and facts. That's part of the title of a special article in the New England Journal of Medicine Rick and I discuss on this week's PodMed regarding obesity. And embarrassingly, I reveal just how little I really know about the topic, and I'm not alone. Turns out that many healthcare providers and policy makers have beliefs regarding obesity that are very similar to mine, and attempt to either prescribe effective interventions or even develop public policy on the matter, based on erroneous beliefs. Yikes! I'll be first to step up and say mea culpa, and welcome factual education on the topic. So what did this study do?
Researchers examined myths, presumptions and facts related to obesity in relation to the scientific evidence about them. A few definitions are in order, of course. A myth is a persistent belief despite scientific evidence to the contrary, a presumption is one that persists in the absence of evidence, and of course, facts are both believed and supported by the evidence. The results of this survey are fascinating. For example, myths that persist about weight loss include the idea that small, sustained reductions in calorie intake over time will result in large amounts of weight loss, that people should set realistic weight loss goals rather than going for overly ambitious objectives in order to avoid frustration, and that physical education requirements in schools can help reduce or eliminate obesity in childhood. And there's a sacred cow (no pun intended) I freely admit I thought was proven: that breastfed infants were at reduced risk for obesity compared with those who are bottle-fed, as asserted by the World Health Organization. Wrong! Turns out the largest, long term study done so far fails to find any evidence to back up this claim. Guess we can only hope that women continue to choose breastfeeding for their children based on other evidence demonstrating its benefit in passive immunity transfer, which I believe is robust.
How about presumptions? Here's my favorite: skipping breakfast isn't associated with weight gain. Yay, I say, since I'm not much of a breakfast eater and get really tired of being told I should eat this meal. Fact is, I'm simply not hungry until I've been awake for a couple of hours, and I suspect there are many others who feel the same way. Another surprise: consumption of many more fruits and vegetables isn't associated with weight loss, it may actually result in weight gain! Check out the citation for a full list and test your own knowledge. As I've said, Rick quizzed me and I got the incorrect answer on every question!
Other topics this week include an adult immunization update in Annals of Internal Medicine, management strategies for children with diabetes in Pediatrics and antidepressants and an EKG abnormality in the BMJ. Until next week, y'all live well.