Eat better or eat less? Reporting obesity and activity studies in the news

The BBC’s news site today (23/04/15) has reported on an editorial in the British Journal of Sports Medicine . The BBC report quotes:

In an editorial in the British Journal of Sports Medicine, three international experts said it was time to “bust the myth” about exercise.

They said while activity was a key part of staving off diseases such as diabetes, heart disease and dementia, its impact on obesity was minimal.

Instead excess sugar and carbohydrates were key.

There are a few things I would like to discuss in the news report. Although I have read the editorial itself, I assume the typical BBC News reader will not click through, and hence takes the news report as correctly representing the editorial (or more likely the press release – also available at the link above).

Firstly, claiming exercise doesn’t help is a really big claim, almost radical. Physical activity has been reliably linked to health in significant numbers of studies. But I’ll go with it for now, as the report also mentions later:

[R]esearch has shown that diabetes increases 11-fold for every 150 additional sugar calories consumed compared to fat calories.

And they pointed to evidence from the Lancet global burden of disease programme which shows that unhealthy eating was linked to more ill health than physical activity, alcohol and smoking combined.

So there could be something more important about unhealthy eating than low physical activity.

Secondly, we read at the bottom of the quote above that “excess sugar and carbohydrates were key” – presumably key to having an impact on obesity. Well, ok so far, as it’s pretty well also established that excess sugar is not a part of a balanced diet. This must be the unhealthy eating they were talking about. But it’s not part of a balanced diet for anyone at any size, so my sizism warning light was flashing at this stage. Is the problem poor health or obesity? They’re not always connected.

Which is something even the news report acknowledges:

They said there was evidence that up to 40% of those within a normal weight range will still harbour harmful metabolic abnormalities typically associated with obesity.

40% of those in a normal (“normal”) weight range. That’s a significant number. That’s quite a lot of “normal” weight range people with metabolic abnormalities. I wonder why these abnormalities are “typically associated” with obesity, if there are 40% of “normal” weight range people also displaying them. Sounds quite widespread to me.

The whammy comes next, and this is according to the BBC a quote from the editorial author:

Dr Malhotra said: “An obese person does not need to do one iota of exercise to lose weight, they just need to eat less. My biggest concern is that the messaging that is coming to the public suggests you can eat what you like as long as you exercise. (My emphasis)

Having established that unhealthy eating is bad, and unhealthy eating means excess sugar, which can mess with the metabolism of lots of people, now here’s the fat shaming right here. “An obese person … just [needs] to eat less”.

Not well, not less sugar, just less.

Obese people eat too much. Full stop, says the doctor.

This is a well established trope used within fat shaming and sizism to direct blame for overweight on the individual. I defer to Melissa McEwan at Shakesville to explain.

The logic just established in the report is thrown out in order to make a statement about how obese people just need to control themselves and eat less. I can also imagine some fear mongering going on here to scare normal weight range people into worrying about their diets, because if they are in that 40% with abnormal metabolism then they might be the ones who become obese later, no matter how much exercise they do.

I cannot find a reference to just eating less in the editorial or its press release themselves, so the source of the quote the BBC use is unclear but I’d be grateful upon being informed correctly.

The report sticks in a stock photo of a headless fatty, which is likely purely the BBC’s decision and not from the editorial, followed by two quotes to counter the editorial:

But others said it was risky to play down the role of exercise. Prof Mark Baker, of the National Institute of Health and Care Excellence, which recommends “well-balanced diets combined with physical activity”, said it would be “idiotic” to rule out the importance of physical activity.

A Food and Drink Federation spokeswoman said: “The benefits of physical activity aren’t food industry hype or conspiracy, as suggested. A healthy lifestyle will include both a balanced diet and exercise.”

She said the industry was encouraging a balanced diet by voluntarily providing clear on-pack nutrition information and offering products with extra nutrients and less salt, sugar and fat.

“This article appears to undermine the origins of the evidence-based government public health advice, which must surely be confusing for consumers,” she added.

The page positioning of these counterarguments is telling, below the photo and beyond a point many may read to. News reporters make a clear decision on the structuring of their reports and today this one has chosen a sizism message. Perhaps the message that excess sugar can harm many people and exercise will not counter the health damages that sugar can cause is too complex or not attention grabbing enough.

The editorial itself does make more reference to healthy eating over just less eating, but it also mentions “the obesity epidemic” and that obesity levels have “rocketed” – a whole other issue I won’t take up today! It also says:

many [members of the public] still wrongly believe that obesity is entirely due to lack of exercise

If only this were true, I think the fat shaming I mentioned above would diminish. Fat shaming is tied to ideas about self-control in eating. It is also linked to exercise, but not solely.

Additionally, there’s a number of Tweets today talking about “falling into the Big Food trap” or the “quackery” of the diet over exercise argument. I mention these without comment:


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