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Several newspapers in L.A. have this story on the front page today:<br><br><br><br><a href="http://content.nejm.org/cgi/content/short/348/17/1625" target="_blank">http://content.nejm.org/cgi/content/short/348/17/1625</a> (subscription required)<br><br><br><br>
Here's a take from the L.A. Times:<br><br><br><br><a href="http://www.latimes.com/la-sci-obesity24apr24,1,193984.story" target="_blank">http://www.latimes.com/la-sci-obesit...1,193984.story</a><br><br><br><br>
Obesity Has More Links to Cancer<br><br>
By Thomas H. Maugh II<br><br>
Times Staff Writer<br><br><br><br>
April 24, 2003<br><br>
Obesity plays a much bigger role in causing cancer than researchers had previously believed, accounting for 14% of cancers in men and 20% in women, according to a massive new study by the American Cancer Society.<br><br><br><br>
An estimated 90,000 Americans die each year of cancer caused primarily by obesity and excess weight, according to the study, published today in the New England Journal of Medicine. That makes weighing too much second only to smoking which causes about 170,000 cancer deaths per year as a preventable cause of cancer.<br><br><br><br>
The team studied more than 900,000 people nationwide for 16 years to provide the first definitive understanding of the relationship between obesity and cancer. With only a few exceptions, being overweight increases the risk of virtually every form of cancer and, the more overweight you are, the greater the risk.<br><br><br><br>
Men in the highest weight groups were 52% more likely to die from cancer than those of normal weight, while women in the highest weight groups were 62% more likely to die from it.<br><br><br><br>
"Many of us had believed that these relationships were present before, but they have never been so clearly shown," said Dr. Robert J. Mayer of the Dana Farber Cancer Institute in Boston. "This is an epidemiological landmark."<br><br><br><br>
Researchers have only a limited understanding of what causes the excess cancers. Fat tissue, for example, leads to an overproduction of estrogen and other steroid hormones that play a crucial role in breast and other endocrine-related cancers. Obesity also leads to excess insulin production and an increase in insulin-like growth-factor receptors, which have previously been associated with cancer.<br><br><br><br>
Obesity is also linked to gastroesophageal reflux the eruption of stomach acids into the esophagus. That, in turn, has been shown to increase the rate of various esophageal cancers, whose incidence has grown tremendously over the last two years. But scientists still have much to learn about the biological links, said Dr. Eugenia E. Calle of the American Cancer Society, who led the study.<br><br><br><br>
In addition to causing cancers, obesity also exacerbates their effects. The obese are often reluctant to visit doctors, either because of shame or difficulties in traveling for appointments. Cancers are often harder to detect in the obese because they are obscured by excess tissues, and treatment can be a problem because fat absorbs chemotherapeutic drugs.<br><br><br><br>
An estimated 30% of Americans are considered obese and another 35% are considered overweight. Previous studies have suggested that 11% of deaths from heart disease in men and 14% of cases in women are caused by obesity alone. Excess weight also causes diabetes with its panoply of side effects arthritis, strokes and other medical problems.<br><br><br><br>
"This study makes clear that, now that we are smoking less, morbid obesity represents another major problem that we as a society need to deal with," Mayer said.<br><br><br><br>
"Hopefully, this will spur weight control as a national priority," Calle added.<br><br><br><br>
Participants in the study were drawn from the 1,184,617 volunteers enrolled in the Cancer Prevention Study II, begun in 1982. Calle and her colleagues eliminated those volunteers who had lost more than 10 pounds in the year before the study began, those who already had cancer, and those for whom information on race or smoking history was not available.<br><br><br><br>
That left 404,576 men and 495,477 women. Their average age at the beginning of the study was 57. Over the 16 years of the study, 32,303 of the men and 24,842 of the women died from cancer.<br><br><br><br>
The participants were segregated by weight according to their body-mass index, or BMI. The BMI is an individual's weight divided by the square of their height. A person with a BMI of less than 25 is considered normal, one with a BMI of 25 to 30 is considered overweight, and one with a BMI higher than 30 is considered obese.<br><br><br><br>
As an example, a person who is 6 feet tall and weighs 180 pounds would have a BMI of 24.4 and be considered normal, while a person of the same height who weighed 230 pounds would have a BMI of 31.2 and be considered obese.<br><br><br><br>
Among the heaviest women, the team concluded that deaths from uterine cancer were six times more common , those from kidney cancer were nearly five times more common, those from cervical cancer were three times more common, and those from breast, gallbladder, pancreas and esophageal cancers were more than twice as common.<br><br><br><br>
Among the heaviest men, deaths from liver cancer were more than six times as common, those from pancreatic cancer were more than twice as common, and those from gallbladder, stomach and colorectal cancer were 75% more common.<br><br><br><br>
Among the few cancers not found to be related to excess weight were brain, bladder and skin cancers.<br><br><br><br>
Calle said that scientists are only now becoming aware of the great risks associated with excess weight, just as they were becoming aware of the risks associated with smoking some 35 years ago.<br><br><br><br>
"It took a long time to create large changes in the smoking rates," she said, and it will probably take a similar amount of time to affect eating problems.<br><br><br><br>
"We have in the past considered this a problem of individuals," she said. "While individuals do have choices to make, in terms of food and physical activity, there are other levels of concern in terms of policy, cultural norms, and what we do in schools and the workplace. Right now, we have environments that make it difficult for people to be physically active, and that make it very easy to eat large portions of high-calorie foods."<br><br>
------------------------------------------------------------------------<br><br><br><br>
Copyright 2003 Los Angeles Times
 

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I wanted to post the abstract here for anyone interested in more info. This study is a really big deal.<br><br><br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">New England Journal of Medicine<br><br>
Volume 348:1625-1638 April 24, 2003 Number 17<br><br>
Overweight, Obesity, and Mortality from Cancer in a Prospectively Studied Cohort of U.S. Adults<br><br><br><br>
Eugenia E. Calle, Ph.D., Carmen Rodriguez, M.D., M.P.H., Kimberly Walker-Thurmond, B.A., and Michael J. Thun, M.D.<br><br><br><br>
ABSTRACT<br><br><br><br>
Background The influence of excess body weight on the risk of death from cancer has not been fully characterized.<br><br><br><br>
Methods In a prospectively studied population of more than 900,000 U.S. adults (404,576 men and 495,477 women) who were free of cancer at enrollment in 1982, there were 57,145 deaths from cancer during 16 years of follow-up. We examined the relation in men and women between the body-mass index in 1982 and the risk of death from all cancers and from cancers at individual sites, while controlling for other risk factors in multivariate proportional-hazards models. We calculated the proportion of all deaths from cancer that was attributable to overweight and obesity in the U.S. population on the basis of risk estimates from the current study and national estimates of the prevalence of overweight and obesity in the U.S. adult population.<br><br><br><br>
Results The heaviest members of this cohort (those with a body-mass index [the weight in kilograms divided by the square of the height in meters] of at least 40) had death rates from all cancers combined that were 52 percent higher (for men) and 62 percent higher (for women) than the rates in men and women of normal weight. For men, the relative risk of death was 1.52 (95 percent confidence interval, 1.13 to 2.05); for women, the relative risk was 1.62 (95 percent confidence interval, 1.40 to 1.87). In both men and women, body-mass index was also significantly associated with higher rates of death due to cancer of the esophagus, colon and rectum, liver, gallbladder, pancreas, and kidney; the same was true for death due to non-Hodgkin's lymphoma and multiple myeloma. Significant trends of increasing risk with higher body-mass-index values were observed for death from cancers of the stomach and prostate in men and for death from cancers of the breast, uterus, cervix, and ovary in women. On the basis of associations observed in this study, we estimate that current patterns of overweight and obesity in the United States could account for 14 percent of all deaths from cancer in men and 20 percent of those in women.<br><br><br><br>
Conclusions Increased body weight was associated with increased death rates for all cancers combined and for cancers at multiple specific sites.</div>
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I looked at the article and the things they controlled for included-<br><br>
age, race, smoking status, education, physical activity, alcohol use, marital status, current aspirin use, fat comsumption, vegetable consumption, and estrogen replacement therapy in women.
 

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this study has been debunked by the author of the book <span style="text-decoration:underline;">junk science</span>.<br><br><br><br><a href="http://www.foxnews.com/story/0,2933,85744,00.html" target="_blank">http://www.foxnews.com/story/0,2933,85744,00.html</a><br><br><br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block"><b>Waistline Police Pull a Fasting One</b><br><br><br><br><br><br>
Friday, May 02, 2003<br><br>
By Steven Milloy<br><br><br><br><br><br>
Will the waistline police ever leave us alone? Last week, it was the World Health Organization's (search ) nutrition guidelines. This week it's "obesity causes cancer" and "fasting improves health."<br><br><br><br><br><br>
Researchers from the American Cancer Society (search) alleged that overweight and obesity cause up to 14 percent of cancer deaths among men and up to 20 percent among women.<br><br><br><br>
We're expected to swallow these results without scrutiny since the study was conducted by the ACS, published in the New England Journal of Medicine and involved 900,000 adults.<br><br><br><br>
Instead, I'm choking on the absurdity.<br><br><br><br>
First, the study data are utterly unreliable garbage in, garbage out.<br><br><br><br>
The ACS collected the data in 1982 by soliciting 70,000 volunteers to interview 2 million friends and family about their health and lifestyle characteristics. Data on deaths was collected until 1999.<br><br><br><br>
None of the health and lifestyle data were verified for accuracy. The researchers don't really know what or how much the study subjects ate, smoked, drank or exercised, for example. Not even the study subjects height and weight was verified.<br><br><br><br>
The 70,000 volunteers weren't trained data collection technicians. They were amateurs asking potentially embarrassing lifestyle questions of others who had no incentive to answer accurately even if they could.<br><br><br><br>
Does smoking half of a cigarette occasionally make you a smoker? Does a double martini count as one or two drinks? How much do you really weigh?<br><br><br><br>
The data weren't designed to test whether bodyweight is associated with cancer risk. Key cancer risk data weren't collected or considered by the researchers.<br><br><br><br>
For example, information on family history of cancer, an indicator of genetic susceptibility to cancer and a major cancer risk factor, was ignored.<br><br><br><br>
It is beyond belief that conscientious researchers would attempt to establish cancer risk without such critical information.<br><br><br><br>
Using the poor quality data, the researchers could do no better than to produce weak that is, dubious statistical associations between increased bodyweight and cancer incidence.<br><br><br><br>
How dubious?<br><br><br><br>
We accept, for example, that heavy smoking is associated with increased lung cancer risk because studies report about 2000 percent more lung cancer among heavy smokers than non-smokers. The statistical association is so strong that it overwhelms any data quality issues.<br><br><br><br>
In the bodyweight-cancer study, though, the alleged increases in cancer risk are on the order of 9 percent for those who are moderately overweight.<br><br><br><br>
Such weak statistical associations have become such a problem in modern public health studies that the National Cancer Institute once went to the trouble of issuing a special media release discounting alleged increases in risk on the order of 100 percent or lower because of data quality problems.<br><br><br><br>
The ACS researchers also have no biological explanation for how bodyweight might influence cancer risk. They mentioned the vague possibility that extra bodyweight may increase levels of certain hormones perhaps involved in cancer development. But that's just an unsubstantiated guess without persuasive supporting data.<br><br><br><br>
But who needs data when you can spoon-feed junk science to a gullible media?<br><br><br><br>
As for the study proclaiming fasting is healthy, the good news is it doesnt rely on statistical hocus-pocus. The bad news is it relies on another notorious junk science trick laboratory animal research.<br><br><br><br>
Researchers reported in the Proceedings of the National Academy of Sciences (April 28) that mice who were only allowed to eat every other day (intermittent fasting) achieved the same "health benefits" including lower blood sugar and more stress tolerance as mice whose diet was reduced by 40 percent.<br><br><br><br>
The purpose of the study is to strengthen the theory that wed all be healthier if wed just eat less.<br><br><br><br>
The origin of the theory is the longtime observation that laboratory mice on restricted diets tend to live longer than those allowed to eat as much as they want as often as they want.<br><br><br><br>
But the results of mice experiments cannot be extrapolated directly to humans. Mice aren't little people.<br><br><br><br>
Moreover, it will be practically impossible to ever prove fasting has any beneficial effect on human health. Large, tightly controlled clinical trials lasting lifetimes would be required. No one is even contemplating such extraordinary efforts.<br><br><br><br>
The waistline police, instead, intend to carpet bomb us with junk science until we knuckle under to their theory and crusade that food is deadly.<br><br><br><br>
They have a tough case to prove, though, with life expectancy the best overall indicator of public health ever increasing despite our supposedly bad eating habits. U.S. life expectancy, in fact, just hit an all-time high of 77.2 years.<br><br><br><br>
Of course, who would even want to live that long if they were only allowed to eat every other day?<br><br><br><br><i>Steven Milloy is the publisher of JunkScience.com, an adjunct scholar at the Cato Institute and the author of Junk Science Judo: Self-defense Against Health Scares and Scams (Cato Institute, 2001).</i></div>
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Steve Milloy is highly critical of pretty much all studies concerning health and the environment. He points out a lot of important failings of commissions, policy makers, and quacks, but it also seems he dissmisses anything that is not the equivalent of an ironclad proclomation from God. He poo-poos concerns about arsenic in playground equipment, second hand smoke, Mad Cow Disease, etc, etc. And he is correct that many of the flaws he points out are flaws, but that doesn't mean the whole study is "junk". It just wasn't perfect. Most research is far from perfect. It's hard to do perfect research.<br><br><br><br>
Likewise I would not say that this study was perfect by any means, nor that it "proves" anything. But it is highly suggestive. The variability produced through interviewing techniques and other things mentioned are to a degree minimized when you are looking at 900,000. That is an incredible N, and I doubt there have been many if any studies with that large of an N without anything in the design that could be criticized.<br><br><br><br>
Studies aren't "debunked" they are critiqued, and people who read the studies and understand epidemiological research can interpret the data according to their judgment. Even with its flaws, this study is still highly suggestive.<br><br><br><br>
Lack of perfect evidence that there are health risks of obesity does not mean there are none. It just means we have been unable to demonstrate them if they are there. There are very few areas of epidemiology that are as solid as say tobacco and lung cancer. That is the gold standard for showing a connection, and a very hard one to demonstrate, especially when the effect isn't as strong as with tobacco.<br><br><br><br>
I think scepticism about health claims is often lacking on this board, and if you scrutinize research in other areas half as much as you do for obesity, then I congratulate you.<br><br><br><br>
Through your comments about the lack of hard evidence about obesity, Kreeli, I have become more skeptical when I hear various claims. But I am not going to ignore this strong evidence pointing in the direction of health risks. For me, personally, now that this study has come out I am going to err on the side of caution; this study has already inspired me to make some changes.<br><br><br><br>
I would urge anyone to look at these kinds of studies with caution, but not to dimiss them out of hand.
 

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i appreciate your viewpoint, thalia. thank you.<br><br><br><br>
the big thing for me is that this study is just one more in a long line of questionable studies that seem to only contribute to the discrimination of fat folks. it is reminiscent to me of how there were once many studies that drew conclusions stating that blacks were intellectually inferior to whites. why is there so much research, so much money, poured into the study of overweight and obesity when there have been no non-correllational links proven between obesity and health during all the studies conducted in the past? i am not sure, but i suspect that the $30 billion a year dieting industry, and the medical industry that piggybacks on it, have something to do with it. weight loss and fatphobia are big business. fat is considered an almost taboo topic. go on out and walk up to a fat person and use the word "fat" to their face. you'll either get punched out or they'll burst into tears, 90% of the time. why? because in our society fat people = evil. why? because someone out there is making money off of it. the media has picked up on this and capitilized on it and with it, so has virtually every other industry and community--the vegetarian community is no exception, and, in fact, seem to be some of the worst of the bunch.<br><br><br><br>
no one is doing studies on the health, longevity, and propensity of getting cancer among thin people, although in my experience the <i>only</i> people i've known to get cancer have been a "normal" weight.<br><br><br><br>
this study also failed to look at how the years of being bombarded with discrimination based on weight, and years of dieting and starving oneself, might affect a person's chances of getting cancer.<br><br><br><br>
although i think it's very important for everyone to look after their health, eat well, and get plenty of activity, frankly, these "obesity" studies just piss me off. they serve no one. even if being fat made you 9% more likely to get cancer, well...what the heck are you going to do about it? 99% of diets fail the dieter and in fact just make it more likely they will get even fatter. all of the methods of 'weight loss' have abyssmal long term success rates. what point does this study serve, except to reinforce the fat-hating public's fear and hatred of fat people?
 

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here is a second article criticizing this study:<br><br><br><br>
from: <a href="http://www.rockymountainnews.com/drmn/news_columnists/article/0,1299,DRMN_86_1922466,00.html" target="_blank">http://www.rockymountainnews.com/drm...922466,00.html</a><br><br><br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block"><b>Campos: Fat-cancer link hysteria</b><br><br>
April 29, 2003<br><br><br><br>
A front-page story in the April 24 edition of the Los Angeles Times reports that "obesity plays a much bigger role in causing cancer than researchers had previously believed." The story goes on to relate "men in the highest weight groups were 52 percent more likely to die from cancer than those of normal weight, while women in the highest weight groups were 62 percent more likely to die from it." The story pointed out that "an estimated 30 percent of Americans are considered obese and another 35 percent are considered overweight," and then followed these statistics with a quote from a cancer researcher: " 'This study makes clear that, now that we are smoking less, morbid obesity represents another major problem that we as a society need to deal with.' " The story is typical of the sort of coverage that the study, published in the April 24 issue of The New England Journal of Medicine, received in the national media.<br><br><br><br>
All this is of a piece with the general hysteria about the supposed health risks of "excess" weight, as reflected in such texts as the Surgeon General's 2001 Call to Action to Prevent and Decrease Overweight and Obesity, and new Surgeon General Richard Carmona's claim that "obesity" represents a greater threat to national security than terrorists wielding weapons of mass destruction.<br><br><br><br>
Now consider the study's actual data. Among supposedly "ideal weight" individuals, (Body Mass Index 18.5 to 24.9) the study observed a mortality rate from cancer of 4.5 deaths per 1,000 subjects over its 16-year course. Among "overweight" individuals (BMI 25 to 29.9 - a category that currently includes about twice as many adult Americans as the "ideal weight" cohort) the mortality rate was 4.4 deaths per 1,000 subjects. In other words, "overweight" people actually had a lower overall cancer mortality rate than "ideal weight" individuals!<br><br><br><br>
Among the "moderately obese" - people weighing anywhere from about 35 to 70 pounds more than the government's recommended maximum - the death rate was 5.1 per 1,000 subjects. That is, even among people who would in general be considered quite fat, the correlation between increasing weight and cancer mortality yielded a total of approximately one extra cancer death among every 2,000 people over the entire span of the 16-year study.<br><br><br><br>
Among people weighing 75-100 pounds more than the recommended maximum, the death rate was 5.8 per every 1,000 people. Among the extraordinarily fat - people weighing, on average, much more than 100 pounds over the recommended maximum - the death rate was 6.8 cancer deaths per 1,000 people.<br><br><br><br>
In short, what this study actually found was a negative correlation between increasing weight and cancer mortality for the majority of the 135 million Americans who are currently categorized as overweight or obese, and only a small increase in risk for all but the very fattest people. (A good illustration of the depth of America's weight hysteria is that the risk for cancer death among "morbidly obese" women in this study was still lower than the risk faced by "ideal weight" men. Yet it's unlikely that this statistic will lead to a surgeon general's Call to Action to Prevent and Decrease Masculinity.)<br><br><br><br>
Just as in the war on drugs, the war on fat has reached the point where systematic distortion of the evidence has become the norm, rather than the exception. The strategies employed in these two wars are strikingly similar: Treat the most extreme cases as typical, ignore all contrary data (there are dozens of studies indicating cancer mortality decreases with increasing weight), and recommend "solutions" that actually cause the problems they supposedly address. And, as in all wars, truth ends up being the first casualty.<br><br><br><br><br><br><br><br><br><br><br><br><i>Paul Campos is a professor of law at the University of Colorado. He can be reached at <a href="mailto:p[email protected]">[email protected]</a>.</i></div>
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