<div>It is important to point out that comparing obesity to tobacco use requires clarification. Obesity is a medical condition brought on by genetics, sometimes, and at least two forms of behavior, food consumption and exercise levels. Obesity is not a "behavior." Tobacco use is a behavior, not a medical condition, though of course it can cause medical conditions. </div>
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<div>Also, obesity is not necessarily caused by eating unhealthy foods, but by eating too much food, coupled with lack of exercise. Someone eating an excessive amount of organic pasta and spaghetti sauce, and brown rice, beans and veggies, who lays on the couch all day doing nothing else, could become obese.</div>
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<div>Given that the medical condition of obesity has several behavioral causes, it is misleading to compare it as a cause of premature death to tobacco use, which is a single behavioral cause of premature death.</div>
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<div>To compare tobacco use as a behavioral cause of premature death to the behavioral causes of obesity, as they all contribute in varying amounts to premature death, indicates separately comparing the contribution of diet, as a behavior, to obesity, and lack of exercise, as a behavior, to obesity, with tobacco use.</div>
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<div>Eating too much food is a behavioral risk for premature death. Lack of exercise is a behavioral risk for premature death. Tobacco use is a behavioral risk for premature death. Among the three, which is a greater risk?</div>
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<div>Is this analysis flawed?</div>
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<div>Ted Moffett<br> </div>
<div><span class="gmail_quote">On 8/17/09, <b class="gmail_sendername">Ted Moffett</b> <<a href="mailto:starbliss@gmail.com">starbliss@gmail.com</a>> wrote:</span>
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<div>Apparently the Centers for Disease Control should update and correct their website, if you are correct about obesity (which is not caused only by diet, in many cases, but by lack of exercise. Obesity can occur with over consumption of calories, even from low fat food, compared to calorie burn) being as much or greater a health risk than tobacco. </div>
<div> </div>
<div>They continue to unequivocally declare "tobacco is the single most preventable cause of disease, disability and death in the United States."</div>
<div> </div>
<div>I am not trying to minimize anything regarding the risks of obesity. I only quoted the Centers for Disease Control from their current 2009 website, which at this moment continues to state in bold letters that tobacco is the nation's leading killer: </div>
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<div><a onclick="return top.js.OpenExtLink(window,event,this)" href="http://www.cdc.gov/nccdphp/publications/aag/pdf/tobacco.pdf" target="_blank">http://www.cdc.gov/nccdphp/publications/aag/pdf/tobacco.pdf</a></div>
<div> </div></span>
<div>Perhaps they are wrong. But this discussion is not essential to my argument about banning smoking in bars.</div>
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<div>You do not address what is an essential aspect of my argument regarding supporting a smoking ban in bars (or any workplace): that workers are exposed to the smoke, sometimes over their entire shift, with no way to avoid breathing the smoke. A worker at McDonald's, for example, does not have to eat part of the Big Macs the customers order and eat. In fact, a worker at McDonald's does not have to eat any of the food associated with that business, at all. So the argument regarding worker safety and health, regarding workers exposed to hazardous substance on the job that they cannot avoid, does not apply to the case of fatty food served in restaurants. I made this argument very explicitly. </div>
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<div>I recall clearly you stated workers who do not want to breathe tobacco smoke on the job in bars can work somewhere else if they don't like this... I don't accept this as a valid argument to justify exposing workers to hazardous and addictive substances on the job. Workers often must accept what work they can find, especially in this economy. But even if jobs were in abundance, I think reasonable standards of worker safety should be applied to all workplaces, and tobacco smoke exposure is hazardous, the medical facts are clear.</div>
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<div>Also, if you followed my comments in this discussion carefully, you would note that I mentioned that obesity is caused in great measure by a lack of exercise. So diet is only part of the behavioral syndrome associated with obesity. Low fat foods can contribute to obesity in someone not exercising enough. I can offer again, as I did before, my anecdotal evidence: I grew up in high school eating the fast food diet heavy in meat, fats, etc., in very large quantities, yet never became even close to obese. Why? Because I spent most of the year running, as much as 40-70 miles a week in cross country, track and on my own time, and in general led a very active lifestyle.</div>
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<div>Lack of exercise is one of the most important risk factors causing poor health or disease:</div>
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<div><a onclick="return top.js.OpenExtLink(window,event,this)" href="http://www.medpagetoday.com/PrimaryCare/DietNutrition/15458" target="_blank">http://www.medpagetoday.com/PrimaryCare/DietNutrition/15458</a></div>
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<div>From website above:</div>
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<div>The researchers focused on four factors tied to reduced disease risk: never smoking, having a body mass index (BMI) lower than 30, performing at least 3.5 hours per week of physical activity, and following a healthy diet.</div>
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<div>Vision2020 Post: Ted Moffett<br> </div>
<div><span class="e" id="q_1232aa73fc3da36a_3">
<div class="gmail_quote">On Mon, Aug 17, 2009 at 10:21 AM, Saundra Lund <span dir="ltr"><<a onclick="return top.js.OpenExtLink(window,event,this)" href="mailto:v2020@ssl.fastmail.fm" target="_blank">v2020@ssl.fastmail.fm</a>></span> wrote:<br>
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<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">Ted asked:</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">“</span>Can you provide a reference to the study that claims obesity is the number one cause of premature death in the US? I have not found any credible evidence that obesity has overtaken tobacco as the number one cause of premature death, though obesity has increased, especially among children. It would be interesting to look at this study, given it contradicts the Center for Disease Control.”<span style="FONT-SIZE: 11pt; COLOR: #1f497d"></span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">Sorry for the delay in responding, Ted – this got lost in my Inbox, and then my motherboard started dying, etc.</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">In any case, I was slightly mistaken about the study I was recalling – it wasn’t specific to the US and it only looked at men:</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"><a onclick="return top.js.OpenExtLink(window,event,this)" href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=19244221" target="_blank">http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=19244221</a></span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p>Combined effects of overweight and smoking in late adolescence on subsequent mortality: nationwide cohort study</p>
<p><span><span style="COLOR: black"><a><span style="COLOR: black; TEXT-DECORATION: none">BMJ.</span></a></span> 2009 Feb 24;338:b496. doi: 10.1136/bmj.b496.</span></p>
<p><span> </span></p>
<p><span>“</span><b>Conclusions</b> Regardless of smoking status, overweight and obesity<sup> </sup>in late adolescence increases the risk of adult mortality. Obesity<sup> </sup>and overweight were as hazardous as heavy and light smoking,<sup> </sup>respectively, but there was no interaction between BMI and smoking<sup> </sup>status. The global obesity epidemic and smoking among adolescents<sup> </sup>remain important targets for intensified public health initiatives.”<span style="FONT-SIZE: 11pt; COLOR: #1f497d"></span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">And, of course, I’m sure you know there have been a boatload of studies published since the 2005 CDC study you cited showing obesity to be as great a predictor of premature death as smoking – just go to PubMed and you can pull up recent studies with more than you ever wanted to know about obesity, morbidity, and mortality. Indeed, the more research that’s been done in recent years identifying the multitude of ways obesity negatively impacts health, the more researchers are predicting obesity will <b>greatly</b> eclipse smoking as the leading cause of premature death in all adult age groups.</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">Look, the point is that neither obesity nor smoking are “healthy” and both individually are huge predictors for premature death, and not just in the US. I guess I just didn’t understand your interest in minimizing the risks associated with obesity and premature death. In fact, lots of people who have experienced both “addictions” think the food addiction and developing healthy eating habits is much, much more difficult to beat than tobacco, particularly in these times when more Americans are eating out – or grabbing food to go – than in this country’s history . . . well, at least until the GOP’s policies created the economic crisis. With smoking, you can just completely give it up, which isn’t something one can do with food.</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">And, if our City Council is going to get in the business of prohibiting <b>legal</b> behavior, why <b>shouldn’t</b> they get in the businesses of telling local restaurants to serve healthier foods??? Regardless of activity levels, Ted, high fat diets aren’t healthy for anyone, nor are the low fiber foods that are epidemic on the Palouse. I’ve heard more people than I can count comment that the most veggies they eat are from when they eat in restaurants, which is a sad commentary. And, with a few notable exceptions, I’ve heard lots & lots of comments about the lack of affordable and healthy vegetarian options when eating out, both in the community and in our schools.</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">Of course, I don’t think our City Council should be in the business of doing either, but since they’ve done one, why not the other?</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">Saundra Lund</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">Moscow, ID</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">The only thing necessary for the triumph of evil is for good people to do nothing.</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d">~ Edmund Burke</span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><b><span style="FONT-SIZE: 11pt; COLOR: #1f497d">***** Original material contained herein is Copyright 2009 through life plus 70 years, Saundra Lund. Do not copy, forward, excerpt, or reproduce outside the Vision 2020 forum without the express written permission of the author.*****</span></b></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
<p><span style="FONT-SIZE: 11pt; COLOR: #1f497d"> </span></p>
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<p><b><span style="FONT-SIZE: 10pt">From:</span></b><span style="FONT-SIZE: 10pt"> Ted Moffett [mailto:<a onclick="return top.js.OpenExtLink(window,event,this)" href="mailto:starbliss@gmail.com" target="_blank">starbliss@gmail.com</a>] <br>
<b>Sent:</b> Saturday, June 27, 2009 3:33 PM<br><b>To:</b> Saundra Lund<br><b>Cc:</b> <a onclick="return top.js.OpenExtLink(window,event,this)" href="mailto:bear@moscow.com" target="_blank">bear@moscow.com</a>; Tom Hansen; Moscow Vision 2020<br>
<b>Subject:</b> Obesity Compared To Tobacco: Premature Deaths: Physical Activity & Obesity</span></p></div>
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<div>
<p><strong>Saundra Lund</strong> <a title="[Vision2020] Draft Ordinance Banning Smoking in Bars" onclick="return top.js.OpenExtLink(window,event,this)" href="mailto:vision2020%40moscow.com?Subject=%5BVision2020%5D%20Draft%20Ordinance%20Banning%20Smoking%20in%20Bars&In-Reply-To=1f0ec0aaa8f65b5a1a10e2ee96d4b9ef.squirrel%40secure.fsr.com" target="_blank">v2020 at ssl.fastmail.fm </a><br>
<i>Wed Jun 24 11:15:40 PDT 2009</i> wrote:</p></div>
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<p>Let's see . . . obesity is either the #1 or #2 cause of premature death in<br>the US depending on what study you read. </p></div>
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<p>Can you provide a reference to the study that claims obesity is the number one cause of premature death in the US? I have not found any credible evidence that obesity has overtaken tobacco as the number one cause of premature death, though obesity has increased, especially among children. It would be interesting to look at this study, given it contradicts the Center for Disease Control.<span style="COLOR: #1f497d"></span></p>
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