Free advice often contains cultural myths and personal opinions. Though often supported by anecdotal accounts and—in the case of the Adventist health message—by a religious fervor, the General Conference Health Ministries Department has sought to advocate biblical, Spirit of Prophecy, or evidence-based strategies for health. The persistent belief in myths, despite evidence to the contrary, affects us all.
A recent article by Krista Casazza and others in the New England Journal of Medicine (NEJM)* synthesized current knowledge about obesity. This article involved contributors from the University of Alabama; University of Copenhagen; Pennsylvania State University, University Park; Pennington Biomedical Research Center; University of South Carolina; Boston University; and Montclair State University.
It is a fundamental concept that the caloric value of one’s food intake should match one’s metabolic utilization in order to maintain a given weight (simply put—calories in should equal calories out). There are, however, numerous recommendations and beliefs that influence our behaviors that are assumptions—not proven interventions. The assumption that small reductions in intake will result in large, long-term loss has not been proven, and does not take into account the body’s adaptive metabolic changes that may take place with weight changes. Many recommend slow weight loss versus more rapid weight loss; but, in fact, long-term follow-up supports the more aggressive weight-loss approach, with maintenance efforts.
Many promote physical education in school as a preventative strategy. As currently provided, this does not seem to be the case. Breastfeeding is touted as protective against obesity. As the NEJM article pointed out, a World Health Organization report stated that persons who were breastfed as infants were less likely to be obese in later life. Additionally, they felt the association is “not likely to be due to publication bias or confounding.” Later analysis, however, found “clear evidence of publication bias in the published literature it synthesized.” Another myth is that sexual activity burns 100 to 300 kilocalories for each participant. Clearly these are unfounded exaggerations. The point is not that physical education, breastfeeding, or sexual activity are not healthy, but that they are not factors causally related to obesity.
As Adventists, we often promote what are better called presumptions, such as regularly eating versus skipping breakfast as protective against obesity. Eating breakfast has many benefits, but we stretch the credibility when we relate it to preventing obesity. We promote eating fruits and vegetables, but without other changes, this alone is not a proven factor in preventing obesity.
So, what are some facts about weight loss?
Genetics play a role in obesity, but are not definitive. Diets can help people lose weight, but recommending one or adopting one is usually a short-term strategy.
Exercise improves health and in sufficient amounts helps maintain weight loss.
Continuation of the factors that promote weight loss retains the lower weight.
Overweight children do better when the whole family becomes involved in the weight-loss programs.
The Spirit of Prophecy advises more often about “gluttony,” or overeating, than about specific food items. Regular exercise and moderation are strongly recommended. Clearly, in her balanced and consistent lifestyle advice, Ellen White captures the essence of weight control.
Selective biases and personal opinions affect us all, but great care is needed in making recommendations for others. Failure to consider the changes in metabolic mechanisms that follow specific dietary modification have led to many of the myths currently in vogue.
As Adventists have taught for decades, it is the whole lifestyle, not isolated factors, that is important in weight control, as in many other aspects of our health.
Send your questions to Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland 20904. Or e-mail them to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend you consult with your personal physician on all matters of your health.
* NEJM 368, no. 5 (Jan. 31, 2013): 446-454.
