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Speaker: Talking past each other: Ideological silos and research

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  • Carol Stewart, in reply to giovanni tiso,

    The sugar tax was introduced in the UK at the same time as sweeping benefit cuts which, given what we know about incomes and nutrition, are guaranteed to lead to poorer diets and more health problems.

    Happy to agree with you on this one. There's an interesting recent book on this topic by two UK public health researchers: The Body Economic: Why Austerity Kills.

    Wellington • Since Jul 2008 • 830 posts Report Reply

  • Russell Brown, in reply to giovanni tiso,

    It’s still not a condition, which is what saying it’s a health problem means.

    I think professional acceptance of obesity as a health problem is very widespread. The more edgy argument is whether it should be called a disease. The American Medical Association officially deemed it a disease in 2013, although not without controversy. The principal objection was the inadequacy of BMI as a measure, but the delegates who voted also addressed another argument:

    "The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes."

    There are some pro-and-anti arguments collected here. Ironically (or sadly), almost all of the it's-not-a-disease arguments are overt fat-shaming of the just-pull-up-your-socks variety

    Auckland • Since Nov 2006 • 22850 posts Report Reply

  • giovanni tiso, in reply to Russell Brown,

    I think professional acceptance of obesity as a health problem is very widespread.

    What's the difference between a health problem and a disease?

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Jackie Clark,

    Do you know what I have just realised?
    In the early days of PAS, I always felt less than. A bit stupid in comparison to all the brainy blokes.
    Nobody ever really replied to any comment I made, and then slowly it happened.
    It appears I have returned to this place of not being an expert or saying anything "sensible" so I either get patronised or ignored completely,
    so I'll just bow out. I don't come here much anymore anyway - too many men (WMS) saying the same things, over and over and enjoying the sounds of their own voices.
    And really, isn't that the way of the world anyway?
    It's my birthday on Sunday, I'll be 52 years old. Life's too short for mansplaining.
    So this isn't a flounce, it's one of my birthday presents to myself.
    See you when the PAS Women's XV is given a bit more space.

    Mt Eden, Auckland • Since Nov 2006 • 3136 posts Report Reply

  • Russell Brown, in reply to giovanni tiso,

    And frankly I would have far less of a problem with the sugar tax if we were also doing all the other things that researchers and public health advocates have been suggesting for years, chief of which is giving poor people more money.

    That would certainly be good.

    But although the most deprived New Zealand households are hugely over-represented in the Ministry of Health's childhood obesity figures, they're still less than half the total. As the ministry says says, it "spans demographics".

    So it think it does make sense to also target the sources of excess calories, although I'm not sure whether a sugar tax is the best way to do that.

    Auckland • Since Nov 2006 • 22850 posts Report Reply

  • Russell Brown, in reply to giovanni tiso,

    What’s the difference between a health problem and a disease?

    I guess that "health problem" is descriptive where "disease" has a definition. The AMA has definitions of condition, disease and disorder, noting that "Condition is perhaps the least specific, often denoting states of health considered normal or healthy but nevertheless posing implications for the provision of health care (eg, pregnancy)."

    Auckland • Since Nov 2006 • 22850 posts Report Reply

  • giovanni tiso, in reply to Russell Brown,

    So it think it does make sense to also target the sources of excess calories, although I'm not sure whether a sugar tax is the best way to do that.

    The issues is that current talk is not about also doing that but only doing that. Meanwhile, if people suggest something as elementary as taking GST off fresh fruit and vegetables, politicians from Labour's Michael Cullen rightwards jump up to defend the sacred simplicity of our tax system.

    You see why people may be getting a bit sick of this?

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • giovanni tiso, in reply to Russell Brown,

    I guess that "health problem" is descriptive where "disease" has a definition.

    I'm not buying this. If "problem" is the same as a disease but without a definition, it's just a sloppy way of saying disease. And I insist we should guard against sloppy use of over-charged language.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Moz,

    Turns out I have a libertarian available to expound on this issue. He's in the US so there's some bias. But a few key points:

    If someone has enough money to buy food and be fat, they can just as well eat less of that food, have more money and probably still be healthier for being lighter.

    it boils down to calories burned versus calories in.

    Trying to attack all the issues at once takes power away from those folks

    Sure it sucks that healthy food isn't available, but that's a different problem.

    What I expect is that clear information be provided and the waters not muddied with targeted propaganda. "Food desert" is an issue of health, to be sure, but it is unrelated to the fact that he is obese because he consumes too many calories.

    Specifically on the sugar tax (and to be clear, he is definitely being sarcastic here):

    Sure, taking away ignorant people's freedoms to protect them is usually the correct answer. Especially if it makes the government money in the process.

    And he spontaneously observed that him and me were indeed talking past each other on this issue.

    Sydney, West Island • Since Nov 2006 • 1233 posts Report Reply

  • giovanni tiso, in reply to Moz,

    Perfect.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Deborah, in reply to Russell Brown,

    The American Medical Association officially deemed it a disease in 2013, although not without controversy.

    Here's some of that controversy: an article in Nature about the problems with calling obesity a disease.

    Perspective: Obesity is not a disease

    Obesity warrants medical as well as cultural legitimacy and respect, but needs not be a disease to earn them. Calling obesity a disease contradicts the functioning of our bodies, and implies a blame residing there. But the blame for hyperendemic obesity, and its best remediation, resides not within bodies that work as they ever did, but all around, with the collective actions of the body politic.

    New Lynn • Since Nov 2006 • 1447 posts Report Reply

  • Bart Janssen, in reply to giovanni tiso,

    is not about also doing that but only doing that

    Except nobody here has suggested that.

    Instead what was suggested is that we shouldn't do the sugar tax thing because we weren't talking about the other parts of the problem.

    In short exactly the opposite of what you claim.

    Everyone here has agreed that poverty is a huge part of the problem and needs addressing directly with multiple solutions (some of which will probably fail).

    But saying we can't try to reduce obesity by using a method proven to work with smoking because we're using the wrong language to describe obesity and not tackling the ten other impossible things simultaneously is just a nonsense.

    Every argument I've seen against a sugar tax is a rehash of the same arguments against tobacco taxes. Complete with the same anecdotal evidence of "my dad ..." or "these children ..." and happy to ignore the sheer mountains of epidemiology that contradict the anecdotes. Complete with the same slippery slope arguments. Complete with the same freedom of choice distractions.

    None of this would bother me much except there is a real public health problem and real people, that you claim to care about so very very much, are being harmed day in day out.

    Oh and by the way I'm not all about taking away ignorant (poor) people's freedoms. I actually believe that allowing them to become habituated to high sugar foods is far more of a loss of their freedom than any tax might ever be.

    Auckland • Since Nov 2006 • 4461 posts Report Reply

  • giovanni tiso, in reply to Bart Janssen,

    Instead what was suggested is that we shouldn't do the sugar tax thing because we weren't talking about the other parts of the problem.

    I'm simply referring to the reality of the current political debates. In Britain, the tax was passed along with benefit cuts. No efforts were made to alleviate poverty or make other foods cheaper. In Mexico, proceeds from the tax were supposed to be spent to finally provide large swathes of the population with potable water, but didn't. In New Zealand, the sugar tax enjoys lots of poll support but far more effective measures such as extending the in tax working credit to beneficiaries are politically dead in the water, and the province of marginal advocacy groups.

    Oh and by the way I'm not all about taking away ignorant (poor) people's freedoms. I actually believe that allowing them to become habituated to high sugar foods is far more of a loss of their freedom than any tax might ever be.

    Oh dear god do you think you could be any more patronising?

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Bart Janssen, in reply to giovanni tiso,

    I’m simply referring to the reality of the current political debates.

    Oh dear god do you think you could be any more patronising?

    Good grief. Pot and kettle in the same post.

    It comes as no surprise that a moderately worthwhile thread dies at your hands again.

    Auckland • Since Nov 2006 • 4461 posts Report Reply

  • giovanni tiso, in reply to Bart Janssen,

    Or you could give me examples of places where the sugar tax is being advocated for as part of a balanced package of measures, along with others aimed at reducing the chief cause of the problem - namely, poverty. I'd be all ears. Until then, your wishing doesn't make things so.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Danielle,

    I hesitate to post here again, Bart, since you seem to be railing against things I've said that are urging compassion and empathy for children, and children's bodies. Being careful how we talk about and to them. I can't tell you how discouraging that is to me.

    Charo World. Cuchi-cuchi!… • Since Nov 2006 • 3828 posts Report Reply

  • Russell Brown, in reply to giovanni tiso,

    I’m not buying this. If “problem” is the same as a disease but without a definition, it’s just a sloppy way of saying disease. And I insist we should guard against sloppy use of over-charged language.

    For my sins, I do seem to have started this by using the phrase "public health problem developing", in relation to Type 2 diabetes and child obesity. Somewhere along the way it appears to have switched to an argument about whether "problem" is a synonym for disease.

    I do think that when the World Health Organisation is using words like "crisis" and "epidemic", "problem" doesn't seem to be a particularly over-charged word. But I don't think there's anything to be gained from pursuing the argument through any further iterations.

    Auckland • Since Nov 2006 • 22850 posts Report Reply

  • Sacha,

    Ak • Since May 2008 • 19745 posts Report Reply

  • Moz, in reply to Bart Janssen,

    far more of a loss of their freedom than any tax might ever be.

    I think it's interesting that when we talk about restricting the ability of alcohol and tobacco dealers to push their wares there's some discomfort but broad acceptance that we do need both regulations and taxes. Even though the users enjoy the products and find the restrictions annoying. But when it's Coke{tm} rather than coke, some people get all "free to sell a legal product" about it. Yeah, I'm sure Coke{tm} has no interest in making their product more widely available or more addictive, and the health of their users is of paramount concern.

    Speaking of perfectly lawful chemicals that make people fat, I'm expecting is that the new BPA substitutes will prove to be problematic and probably in the same way. So we're going to play the synthetic-cannibis whack-a-mole game with a whole different class of harmful synthetic chemicals. At least there's little chance to argue that people have to eat those one, although manufacturers are still crying "too hard to avoid".

    Sydney, West Island • Since Nov 2006 • 1233 posts Report Reply

  • Russell Brown,

    I've been mulling over posting this for a day or so but I can't get it out of my head:

    Cognitive Impairment: A Hidden Consequence of the Childhood Obesity Epidemic

    The impact of obesity and metabolic disorders on cognition seems to be well established, but the particular impact on children is really upsetting. It compounds any existing disadvantage early in life. The NYU study above and this smaller one did find a direct and proportional relationship to overweight.

    Admirably, the NYU researchers are acting on their findings:

    At-risk kids receive user-friendly reports of their medical results along with information for the whole family about how to turn things around before the child develops type 2 diabetes. “The MRI studies should also help elucidate some of the pathways affected by insulin resistance and obesity, and lead to new treatments to help mitigate these risks,” Convit says.

    This seems a good approach.

    Auckland • Since Nov 2006 • 22850 posts Report Reply

  • Carol Stewart,

    This also seems like a good approach.

    The hapū whānau at the meeting told Ricky that they wanted to find out what the issues were with obesity, why it was a problem, and understand its relationship to wellness.

    Wellington • Since Jul 2008 • 830 posts Report Reply

  • David Hood, in reply to Sacha,

    Contagious?

    I'm going to venture "not on the basis of that article"

    It is a bit difficult to track back- Though credited to Sarah Knapton at The Telegraph (you might know her from articles such as "Long term vegetarian diet changes human DNA raising risk of cancer and heart disease" see critique http://www.statschat.org.nz/2016/03/30/hold-the-lettuce/ and "Brushing teeth regularly could ward off Alzheimer's disease") it is not on the Telegraph site,
    and while Trevor Lawley from the article is published in Nature, it is an article about finding a bacteria in mice that protects against another bacteria (in mice) which seems a bit of stretch to the content in this article (also a couple of letters, but they don't seem to link to the article content either).

    Dunedin • Since May 2007 • 1445 posts Report Reply

  • Danielle,

    It comes as no surprise that a moderately worthwhile thread dies at your hands again.

    Yeah Gio, stop ruining our consensus with your pesky disagreement! What do you think this is, a discussion forum?

    It should be noted that it's not only Jackie who's noping on out of here. There are plenty of others, mostly women, with worthwhile knowledge who aren't posting. But they're reading and talking about it in safer spaces.

    Charo World. Cuchi-cuchi!… • Since Nov 2006 • 3828 posts Report Reply

  • giovanni tiso, in reply to Danielle,

    Yeah Gio, stop ruining our consensus with your pesky disagreement! What do you think this is, a discussion forum?

    Speaking of ideology, the liberal fiction that we're all good people and if only we were all reasonable we'd realise we all want the same things is one you disturb at your own peril.

    Wellington • Since Jun 2007 • 7473 posts Report Reply

  • Rebecca Gray,

    Gotta say, I tend to read rather than participate in internet-based debates (I'm not keen to start tweeting, partly because I'd rather do my snarking privately where it's less likely to be misconstrued or cause drama for others).

    So this may be a bit new to me, but I didn't entirely expect that this post would veer off into people accusing each other of name-calling or of inventing accusations of name calling or of making everything into a talky dude-fest.

    Thing is, people HAVE actually been making some very worthwhile points among the rest of that noise. And some of those points only seem to be at cross-purposes because the commentators are concentrating on different sides to the issue or different terminology for similar issues.

    Wellington • Since May 2016 • 23 posts Report Reply

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