From atuinsails, this study on fat genes and exercise.

The report claims:

The researchers found that Amish people with the genetic variant were no more likely to be overweight than those who had the regular version of the gene - as long as they got three to four hours of moderate activity every day. That included things like brisk walking, housecleaning and gardening.

Now this I can believe.

The Amish study involved 704 people; blood samples determined which of those had a variation in the FTO gene linked to obesity. Among those with the variant, those who got about three or four hours of moderate physical activity a day weighed up to about 15 pounds less on average than the least active people.

Fifteen pounds difference *at most.* On *average.* In other words, there was not that significant a size difference between those with the high energy-expenditure levels and those without. If you're talking about big, muscular, German-ancestry men, fifteen pounds is not that much at all. If an adult man weighs 200 lbs, that 15 lbs (again, the maximum) difference only represents 7.5% of his total body weight.

I'm not so sure about this claim:

"It's only if you're not active that the gene hurts," Snitker said. "If you are active, then either way, it doesn't matter whether you have the gene or not."

There is no way to know whether a gene "matters" or not unless you are able to understand the following things: 1) how that gene interacts with *other* genes - IOW, the gene might mediate some other metabolic process not directly related to weight, but also important;

2) Know what the fertility differential associated with that gene is. If people who have it have slightly higher fertility, that's certainly not a question of "doesn't matter." It's an important correlation. Conversely, if it is associated with *reduced* fertility, the question arises, why is it in the population at all, and how does it stay there? If their fertility was higher *with* FTO *and* more activity, for instance, that would go a long way to understand why FTO keeps hanging around in the population.

Finally, why does the researcher assume across the board that weighing 10-15 pounds more as a consequence of having the FTO gene automatically involves "hurt?" Is FTO correlated with higher morbidity or mortality? Or is it just that because less-active FTO carriers simply weigh more, and even 15 extra pounds are automatically considered undesirable?

For that matter, did anyone even look to see if the FTO carriers actually had more body fat, as opposed to denser bones or more muscle as well?

On the flip side, we do have to face evolutionary reality - we most likely did not evolve under sedentary conditions. One of my anthropology professors used to do forensic anthropology, including examinations of bones for cause of death, condition at death, etc. She often used to mention that among the Ecuadorian native Americans of about 5,000 years ago, even the old women showed thick and powerful thigh bones with lots of muscle "scarring" on the bones. (When muscles are used often, they leave characteristic marks on the bones where the muscles attach.) Even the old ladies were working hard.

Simply put, people living as hunter-gatherers (i.e. hundreds of thousands of years of our ancestry) probably walked many miles every day; ran; lifted; tanned leather (which is really physically hard, I hear, from anthropology students who've tried it), and a host of other activities. These ancient experiences shaped the bodies we have today - *not* cars, computers, desk or factory jobs.

Further, they lived in times of extreme swing in food supplies. What surprises me among the Amish is that so few of them (30% or so) have FTO. (Some think that a European diabetes epidemic in the 17th century killed off many "thrifty gene" bearers, thus explaining why diabetes rates are relatively low in those of European ancestry. Those genes may or may not have been FTO or related to FTO, but it would explain low prevalence of FTO in German-ancestry Amish, many of whom came to the Pennsylvania colony in the 18th century.)

In other words, "fat genes" are in the genome for a reason - for millenia they contributed to survival of those who carried them. If they make us fat under modern conditions, perhaps it *is* to some extent the modern conditions which need to be modified, not our bodies. For instance, if Americans are expected to work 50-60 hours a week, and commute for another 10, of course that is going to have a health toll on the body, whether one is fat or not; whether one carries "fat genes" or not. Activity (as the anthropological example above shows) isn't just a matter of being fat or not-fat - for instance, very slender and sedentary women are at high risk for bone-thinning and possibly devastating osteoporosis as they age. (Activity cuts down on osteoporosis risk because muscle use causes the bone to actually thicken.)

So no, Amish are not generally model-thin, even though they live physically active lives due to their daily work and routines (which is how this report could easily be misinterpreted.) No, 3-4 hours a day of physical activity is *not* going to generally make a fat person not-fat. But the normal, natural human condition through our evolutionary past *is* consistent, most likely, with activity levels.

... because we might have a winner here (and not *that* Darwin award either, but the real kind.)

Fat Women Have Sex. Who'd have thunk it?

But even more interesting besides the obvious was this little gem buried in the article. Perhaps if the study had been done by population geneticists rather than OB/Gyns, the significance might have hit them a a bit harder.

Women in different weight groups were similar in age, cohabitation status, race, ethnicity, education, and total household income. A higher proportion of normal-weight women reported never having borne a child and a higher proportion of overweight and obese women reported having three or more children.

Keep in mind that what the government calls "normal weight" is actually a very low number. (My "normal weight" should, by the charts, be 135 lbs - which I haven't weighed since I was about twelve. I have had three children, though.) So many of these women labeled as "overweight" are probably of a reasonable weight still consistent with fertility.

But if some degree of fatness is governed by genetics, and if heavier women have more children, then there *will* be more fat people (or people with at least the genetic tendency towards carrying more weight) in the population. It's amazing how even scientific researchers can't grasp basic evolution when it appears in their own studies.

Sandy Szwarc (Junkfood Science blog) has an article on children's meals in UK preschools and nursery schools. Apparently the tots aren't getting enough fats, proteins, and cereals; instead, some nursery schools are giving the children disproportionate amounts of fruits and vegetables.

There are several problems with that. For one thing, children need fat both for energy and for brain development. It was interesting to watch our youngest, A. When she was about 12-14 months, she had just started to walk and was beginning to talk as well. She went through a phase of 3 months or so, can't remember exactly how many, when she craved butter. If we were buttering bread, she wanted a pat of butter - forget the bread. So I'd give her pats of butter; one day it seemed she ate almost a third of a stick.

She never got fat, nor is she now as a teenager. But what I did notice is that after a month or so of eating butter, her speech became more complex - she started using more words, starte talking in sentences, all those things people pay attention to under the rubric of "developmental milestones."

What I think happened was that her new energy requirements (from walking) and brain requirements (for speech) simply required fats. Nerves are coated with a sheath of fat (myelin), and the brain is largely fat (mostly cholesterol, interestingly.) I am glad there was no "obesity epidemic" rhetoric back then, to affect my judgment as a mother. This demonization of whole milk for children is especially disturbing to me. We always bought whole milk when ours were little, and have since started again (which has coincided with the fattest people in the house losing some weight.)

Our son did something similar at a bit later age (around two), when he developed cravings for protein, especially fish (mostly fish sticks.) Again, it was tied in with language development, as he was a later talker than the girls (which isn't unusual for boys.) Since fish sticks have a fair amount of fat and carbohydrates as well as protein, obviously there was something there he needed.

As Szwarc points out, children's guts are different than adults. They have smaller stomachs, need smaller meals and at least a mid-morning and mid-afternoon snack. Because they don't eat much at one time, every bite needs to nutritionally "count" - but unfortunately, "nutritious" has become synonymous with high-fiber and minimal calories. That isn't appropriate for young children, who mostly need lower fiber and more calories per bite.

What children *don't* need - and what they too often get - are fizzy drinks, excess sugars, and refined flour (cereal, pastries, etc.) But restricting fats and protein seems like the path to eating disorders and malnutrition.

From Peggy Elam's blog:

Please support this much-needed civil rights law. People of all sizes face discrimination based on body size. It's real. It's not okay. Without a law, we have no protection. The only other places to offer such a law: San Francisco, Santa Cruz, Washington, D.C., Madison, Wisconsin, and Michigan.

You want to help make history?

If you live in Massachusetts:

1. Call your state Representative: 617-722-2000 (ask to be directed based on your zip code). Ask how the Rep. will vote for H. 1844, how they will support this historic legislation.

2. Come to the crucial hearing! Tell your story!
Tuesday, March 25, 2 p.m.
State House, room A-2, in Boston

If you don't live in Massachusetts, please forward this info to anyone you know who does.

For questions, contact Marilyn Wann: marilyn @ fatso.com.

Nationally, everyone has a stake in this issue. While it's important for states to have anti-size-discrimination legislation in place, IMO what's ultimately needed is an amendment to the 1964 US Civil Rights Act to include height and weight as protected categories.

Yes, there are some jobs that fat people physically might not be able to do. Those physical requirements would constitute "BFOQs" - "bona fide occupational qualifications." For instance, if a job required routine lifting of 50 lb objects, then it would not be discrimination to say so. What *would* be discriminatory would be to say, "Applicants must be fit," and for the prospective employer to automatically assume that a fat applicant was "unfit." The question should be, can the applicant endure the frequent lifting? Some fat applicants could; some thin ones might not be able to.

Just as disability rights are critical for everyone, because every one of us is just one illness or car accident away from becoming disabled, so are size-rights in the workplace. Any one of us, through illness, can find our body size/shape changes - and can face employment discrimination as a consequence. It's not just a "fat person's" issue.

my_daroga sent this article from NPR called Put Your Money Where Your Girth Is, about a company which takes your money and donates it to charity if you don't lose weight on a set timetable, or if you regain the weight after having lost it.

The problem, as I see it, is that for many people, weight loss and regain are not rational. Most dieting "fails" NOT because of will power, but because a body already out of healthy balance is put into a worse state by the dieting. The objective measure of dieting "success" is weight loss, but I don't believe that number in and of itself is that meaningful. I mean, cancer patients lose a lot of weight, too.

Here's a concrete for-instance. Some people simply cannot tolerate a lot of sweet, refined carbs. Oh, they like them - heck, they love them. One might even say that some people are in a way "addicted" to them. Mental hospitals used to give depressed patients shots of insulin because it made them feel better (they gained a lot of weight, too.) Sylvia Plath was subjected to this treatment, as was mathematician John Nash, during their late 1950s/early 1960s hospitalizations. So it may be that the surges of insulin which come from eating a lot of high-glycemic carbs is so pleasurable that it even becomes seen as "necessary" to the person.

Traditional dieting says that you can eat these things "in moderation." That may be true for some people. However, for some, it's entirely untrue. So they may "cut back" (as the terminology goes), only to feel terrible, physically and emotionally. Then they break down, binge on cookies or loaves of French bread, and consider themselves diet "failures."

This isn't a matter of willpower, any more so than a medical side effect of a drug is a product of the will. Consequently, because our genetic makeup is unknown to us (or anyone else), it's a crap shoot. Some may be able to use a behavioral incentive. But others are going to screw themselves up, not just emotionally but maybe physically as well, because their "diet failures" aren't failures of will, but a failure to eat in accordance with their underlying physiology and genetic makeup.

So putting up money to maintain weight loss is in a sense like putting money on whether you will or won't have a particular side effect for a drug.

A favorite movie around here is David Cronenberg's Existenz. In it, hapless videogame players get drawn into a simulation that's virtually indistinguishable from real life. In one scene, they're eating at The Chinese Restaurant From Hell. One character has to ask for "The Special." A creepy waiter tells him, "It's only for ... special ... occasions." He brings a platter full of some of the most disgusting food you've ever seen - boiled, oddly colored, unrecognizable even as to species.

Candyboots has collected some 1970s Weight Watchers recipe cards for your viewing pleasure. A few I've seen on James Lilek's Gallery of Regrettable Food. Others are new to me, like Rosy Perfection Salad, which looks like it should be crawling around the dark damp corners of a horror film. Liver Pate en Masque has apparently been doused in wallpaper paste. Mexican Orange Salad might have been spawned by Audrey II from Little Shop of Horrors.

For the "Bean and Mushroom Salad" at right, Candyboots says, "See how the Ceramic Mushroom Family has gathered to show their children what happens to bad little mushrooms." They get immobilized in jello and subjected to really bad color schemes, for one...

ETA: And if that's not enough, these folks are making their own, like Phallic Worship Weenie Roast (my name for it.)

I've lost around 20 lbs in the past six months, not so much deliberately, but as a consequence of changing a lot of old eating habits. The weight loss seems to be stabilizing out as my body adjusts to the (relatively) new regimen. (By social standards, I'm still fat.) Nor am I saying that everyone "has" to do this; it's just what's worked for me as far as feeling better. My suspicion is that I'm of that old pre-agricultural Northern European genotype, which subsisted mainly on meat, vegetables, eggs, and dairy. But since I'm not interested in spending hundreds of dollars on mitochondrial DNA testing, I guess I won't know ... ; )

What I've eliminated so far:

- All sugared/diet soda.
- All juice (except for an occasional splash of grapefruit juice in club soda.)
- All artificial sweeteners.
- All white bread, pastry, pizza crust, pasta - basically anything white-flour-based and baked.
- I severely limit my baked whole grains (whole wheat bread, muffins, pasta etc.) to a small amount once a day, and always mixed with proteins and fat.
- I'm avoiding added sugars.

What I'm mostly eating:

- Vegetables. I can tell that we're eating a lot more, because every time I buy some in a plastic bag, I save the tie-wrap. We always used to run out of tie-wraps; now I have a whole container full of them, and even throw some away now.

The aim is to get as much variety as possible, so I'm always trying new ones, even if some of my experiments are met with turned-up noses.

It's a big adjustment, learning to cook with a wide variety of vegetables on a daily basis. I can understand why many of the overworked poor don't often do it. Back in the fall I actually got a bit of a wrist sprain from all the chopping and peeling, and so B. bought me a set of knives and new cutting boards. It takes a lot of planning, or the veggies rot in the vegetable drawer. And they're not cheap, either, as they used to be (relatively speaking, that is.)

- Whole grains (i.e. the whole seed itself, boiled.) I haven't gone much out of my oats, barley, rice comfort zone, but want to experiment with cracked wheat, tabouleh, etc.

- Beans are a touchy subject around here. A. loves them, but she and I end up eating the bean soups all on our lonesome, because no one else can digest them. I have tried adding vinegar, cooking them with tomatoes, etc. but it doesn't seem to help those who can't tolerate beans. Usually we compromise on lentils, which seem to have less ... explosive ... effects.

- Dairy, mostly fermented (cheese, yogurt.)

- Eggs.

- Tubers like potatoes, turnips, sweet potatoes, etc. The tubers have taken hard raps as "white" or "high glycemic" foods, but I see no problem with them in moderation.

- Nuts, especially those high in omega-3s.

- A note on fats: If I want butter on vegetables, or coconut milk in curry, I use it, as well as olive and sesame oils in stir-frying. I don't trim fat off meat, and it bothers me that meat is sold that way. I use fat for flavor in soups and stews. About 20 years ago there was a strong "fat makes you fat" movement, but the "low fat" substitutes turned out to have tons of added sugar, and were in some ways worse.

I find myself often going back to my "hippie roots," dipping into old cookbooks like Anna Thomas's The Vegetarian Epicure, Madhur Jaffry's World of the East Vegetarian Cookbook, and the timeless Laurel's Kitchen. Even though we're not vegetarian, these give us a wide variety of recipes other than just plain steamed vegetables, which get pretty boring after awhile.

How could anyone ever tell you
You were anything less than beautiful?
How could anyone ever tell you
You were less than whole?
- Libby Rodrick, "How Could Anyone"

"Anti-obesity activist" Meme Roth was on this recent morning news program, and said:

When we first heard about the fat acceptance movement, I think we all thought it meant that we wanted no one to be cruel to any one at any size and I think every one of us would agree to that, but it’s kind of become is somehow “big is beautiful,” a glorification of obesity ... it’s really kind of gone off the bend.

Roth repeated herself again in the green room interview taken after the show, that she was particularly affronted by the "big is beautiful" idea.

I suspect that a great deal of Roth's opposition to fatness is really more about aesthetics, rather than health. But who controls the cultural definition of what is beautiful and what is not?

Roth's opposition to "big is beautiful" is also about shame - about claiming the power to make people feel ashamed if their bodies don't conform to the dominant "ideal." Shamed people spend money on any number of products, surgical procedures, therapy, you name it. Shamed people's bodies are either invisible in the media, or objects of horror or buffoonery.

So it's not clear what exactly Meme Roth and her supporters want fat people to do. Not leave the house until they're acceptably thin? Wear a green triangle showing that they eat their vegetables and exercise? (Not that these are bad things. But it's not the job of the individual fat person to make him or herself acceptable to Meme Roth.) Walk around going "I'm so UGLY?"

In the green-room interview, Roth kept trying to turn the conversation around to "common ground." Yes, there is some. Some people do need to lose weight for solid medical reasons. Schools are not well-served when they depend on junk-dealing vending machines for revenue. But there's no common ground on aesthetics, on what people find beautiful or desirable. And achieving the common-ground goals by mocking someone for the shape of her ass is ultimately counter-productive, because it just makes you look mean, self-serving, and short-sighted; another version, in fact, of the fat-hating playground bully.

When your husband watches cable TV, you get so used to certain ads (the impotence-remedy and weight loss program ones come to mind) that you just tune them out. So when a new one appears, it's almost impossible not to notice.

The newly-advertised drug was the subject of this recent New York Times article. Anti-seizure medication Lyrica was approved last year to treat fibromyalgia, a painful chronic condition which mostly affects middle-aged women. Since approval, the drug has skyrocketed in popularity.

Worldwide sales of Lyrica, which is also used to treat diabetic nerve pain and seizures and which received F.D.A. approval in June for fibromyalgia, reached $1.8 billion in 2007, up 50 percent from 2006. Analysts predict sales will rise an additional 30 percent this year, helped by consumer advertising.

One thing which interests me about "obesity epidemic" rhetoric is that it almost never takes into account weight gain caused by drugs or drug interactions. Yet one side effect of Lyrica, according to the article, is "severe weight gain."

In many patients, Lyrica causes weight gain and edema, or swelling, as well as dizziness and sleepiness. In 12-week trials, 9 percent of patients saw their weight rise more than 7 percent, and the weight gain appeared to continue over time. The potential for weight gain is a special concern because many fibromyalgia patients are already overweight: the average fibromyalgia patient in the 2007 survey reported weighing 180 pounds and standing 5 feet 4 inches.

How severe? That translates to about a 13-lb gain over a 12-week trial, with more down the road. Googling around, I found this patient forum, where people report gains of 60-100 lbs in a year; sometimes in excess of 20-30 lbs in the first *month* of use.

Of course anecdotal comments like these don't represent a controlled study. But even the patient information handout for the drug mentions weight gain. It also points out that one indication for the drug is diabetic neuropathy, and the drug-induced weight gain is made *worse* if the patient is already on oral diabetic medications.

Now - what's wrong with this picture? Prescribing medications that cause extreme weight gain for conditions which are made worse by weight gain (such as diabetes, joint pain, back pain, overall body pains) just does not make sense to me. And when literally millions of people take these kinds of medications - and are sometimes told by physicians that they have to take them *for life* - what is this doing to people's overall health?

The F.D.A. reviewers who initially examined Pfizer’s application for Lyrica in 2004 for diabetic nerve pain found those results unimpressive, especially in comparison to Lyrica’s side effects. The reviewers recommended against approving the drug, citing its side effects. ...

But senior F.D.A. officials overruled the initial reviewers, noting that severe pain can be incapacitating. “While pregabalin does present a number of concerns related to its potential for toxicity, the overall risk-to-benefit ratio supports the approval of this product,” Dr. Bob Rappaport, the director of the F.D.A. division reviewing the drug, wrote in June 2004.

I'm still waiting for that mass media headline - "Are Your Prescription Drugs Making You Fat?"

It's been an interesting year around here, especially in the cooking department. In some senses this year has been a bit of a surprise, because I wouldn't have seen myself doing all this scratch ingredient shopping and scratch cooking a year ago.

Daughter A. came back from a Colorado wilderness camping trip in July, and for awhile wanted to be vegetarian. That didn't last, but what did was what started with her cooking her own soups. I had already been making some stabs at trying to achieve a more healthful way of eating, but the soup cooking (while it lasted) was fun, and better yet, got me into some habits that have been paying off.

One thing that I've slowly started to get into has been cooking from scratch. (I'm not "there yet" with bread. Baby steps.) But I'm making our own soups, stews, and chilis. I make a big pot, and put half of it in the freezer. The rest goes in the fridge, and gets eaten over the next day or two.

We've pretty much transitioned to whole wheat bread, pasta, and whole grains (i.e. "old-fashioned" oatmeal instead of instant), including lots of different kinds of whole grains like barley and brown rice in soups and stews.

I get the odd complaint. Son D. doesn't like brown rice; prefers the white, for instance. A couple of people around here still occasionally crave white bread (which glycemically is about the equivalent of eating a sugar cube.) I try not to act like a "food nazi," but I figure if I'm doing the work of cooking, I'm going to cook as I see best.

We've really cut down on packaged food. I still buy a few things like box cereal, but try to focus on the lowest sugar varieties.

I can tell by looking at our credit card receipts that we've substantially cut down on shopping at the chains. I don't think it will be possible this year to eliminate chain shopping, but I'd like to keep slowly transitioning over to independent (and local!) vendors.

This isn't just indulgence on my part. Both my husband and I have strong reasons to pay attention to whole, fresh, low-glycemic foods. We're seeing slow changes in ourselves as we make changes in what we eat.

So while I said to myself in early January that I wasn't going to make "official" New Year's resolutions, I do have a few goals I'd like to set for myself for the upcoming year.

1. Learn how to bake a decent, *sliceable* loaf of bread that people around here will use for sandwiches - one that's whole-grain, high fiber, but tasty.

2. In February, start getting ready to do some container gardening on the patio and deck (peas, cabbage, lettuce, maybe broccoli.) If that works, I will try onions, peppers, and cukes later in the spring/summer season, when it's very hot. (No one around here likes tomatoes, which is unfortunate, since they grow like weeds where I live.) In fall, we can probably get more lettuce, peas, green onions, and winter cabbage IF I can find the cabbage plants.

3. Pay more attention to buying *local* (or at least regional) products. That's not so hard around here. There are many small farms within 50 miles, and the grocery store where I shop is starting to offer more and more local food. There's something to think about when choosing for instance between something from California at a high price, versus something from a farmer 20 miles away whom I might even get to know through the farmer's market.

4. I am going to try initiating one *hard* thing this year. That would be something like transitioning *some* of our meat-buying over to free-range, grass-fed, organic meat. Or it could involve trying to buy milk locally from a dairy farmer who uses no growth hormones etc., rather than store milk. Or going to farmers' markets to find free-range chickens. These are big, significant changes which could potentially cost us a lot of money, so I'm hesitant without looking into it carefully.

5. I am terrible when it comes to gerbil-in-a-treadmill gym-type exercising. So I figure if I do more gardening and clean my house more, that counts for physical activity, too. ; )