Keeping weight in check - does the weight of the adviser matter?

A wide range of advisers - from family doctors to pharmacists - can be effective in providing lifestyle advice aimed at reducing risk of serious diseases of the heart, brain and circulation - including advice on diet and exercise aiming to help with weight loss.
However a new study, organised by the Royal Society for Public Health, suggests that people seeking advice on weight loss are less likely to take it seriously from someone who is overweight, whether from a health professional or another source, including hairdressers and celebrities.
In response to this report, the Royal Society for Public Health is recommending that NHS staff not only advise 'do what I say'  but also 'do what I do' when it comes to advise on weight loss – ie NHS staff and others involved in advice on reversing overweight should be aware of the importance of acting as role models to help the public at risk to engage in losing weight.
A major challenge for the NHS as "more than half its 1.3 million-strong workforce, are estimated to be overweight or obese".

See more on the study

What's new on health matters from Australia?

@HealthMed Recent news concerns infection alerts, raising awareness of the risks of overweight, and ethics of using social networking to undermine efforts to combat drinking and driving.

'Grabbable gut' as clue to being overweight.

How do you engage the public in long-term interest in benefits of keeping weight in check? The recent ‘LiveLighter’ Australian anti-obesity campaign campaign, supported by the The Heart Foundation, aims to improve recognition of overweight as a personal problem. The campaign includes dramatic pictures of internal excess fat, accompanied by images of a man who does not appear realise he has a weight problem - with the reminder that if you can 'grab your gut' ie have enough spare loose abdominal flesh to grasp by the handful, there is a problem.  In other cultures, 'spare tyre', or the advice 'if you jump up and down and it bounces you're overweight' ... have similar resonance. 

Some critics have complained that the campaign further lowers self-esteem in those who already feel under psychological threat - or simply claim that these messages won't work. This overlooks the obvious - increasing failure to perceive that a given build is excessive, with overweight becoming the norm, both in developed and less developed countries.

  Key challenges are more about how to raise awareness that weight is even a problem, why that matters, and what initial and long term sustainable measures will help to keep weight in check and avoid preventable long-term cardiovascular and non-cardiovascular serious health risks.

Raising public awareness is all the more pressing with recognition, for example from recent data from the US NHANESIII study presented at the European Society of Cardiology Congress in Munich, that relative overweight [based on increased waist-hip ratio] is more important than raised weight based on body mass index, for predicting increased risk of serious heart disease and other causes of premature death.

Random roadside alcohol checks

In parallel with public health messages about the risk of drinking with any alcohol in the blood, random alcohol tests are being used in Western Australia to discourage drivers from drinking.

Several different initiatives have been used in other countries. In France, by a new 2012 law breathalyzer kits are compulsory for all cars. In Sweden and the USA, alcohol ignition interlocks have been used for drink drinking offenders, and several other countries have piloted these schemes involving a breathalyzer coupled to the ignition – if any alcohol is detected, the car’s ignition is inactivated. Elsewhere, a timed arithmetic test is used as barrier to starting the car, based on the adverse effects of alcohol on brain function of even modest alcohol intake. Rather than accepting help not to drive when potentially a danger to pedestrians and other road user, some drunk drivers have been reported to use a friend or even pay a sober contact to beat the tests.

In Australia, booze bus spotters have been posting messages on social networking sites to warn drivers of its location. Worrying not least from the question how and when drivers are accessing these messages.

Rise in ’Ross River cases’

RossRiver virus, an RNA alpha virus and member of the togaviridae family of viruses, is spread by mosquito  bites and is endemic in Australia and several South Pacific islands. The illness was first reported in 1928. The main reservoir animals appear to be kangaroos and wallabies.

The features include rash and flu-like syndrome, the acute features usually settling within 12 months, with however some of those infected by the virus reporting subsequent long-term ME like debility.

Why now provide an update on the virus? Public health reports indicate a rapid ~5-fold increase in numbers of cases of Ross River disease in Western Australia over the past 3 years from, 332 in 2009-2010 up to 1570 in 2011-2012. This rapid increase has been attributed to increased numbers of the vector - mosquitos - due to a series of La Niña events [coupling of Pacific Ocean currents with weather patterns].  This has lead to an increase in rainfall in parts of Australia, the resulting humid conditions and increase in ground-water favouring greater breeding by mosquitos. 

Romeo's 'Sick health'

@HealthMed One of Romeo's string of oxymorons [Romeo and Juliet Act 1, Scene 1: reflecting on his heart sickness for fair Rosalind], 'sick health' illustrates the challenge of preventing more conventional heart disease - with its long prodrome of apparent health masking the development of sub-clinical disease from unrecognized risk factors, which may however be reversible if identified and addressed.

Why don't more people engage? Many reasons, including fear of finding a problem if tested, difficulty accessing advice/health checks, lack of interest or knowledge of outcomes of 'treatment', lack of confidence in self-efficacy to achieve supporting or first-line life-style changes, in diet, exercise, weight, smoking cessation, alcohol intake ...

To find out more on challenges and solutions for success in behaviour change, look for sources on Theory of Planned Behaviour e.g. this referenced link from the University of Twente.

See my previous blogs on smoking and alcohol.

Stopping smoking: why and how?

Hip fracture risk and smoking

Smoking: literary warnings

Alcohol: literary warnings

Alcohol and the French paradox

Ideas for maintaining variety in providing for multiple special diets

What to do about special diets? It is possible with a little research to prepare an individual meal to cater for a cluster of guests each with different special dietary needs and preferences, for example allergy to gluten, diabetes mellitus and preference for vegetarian food. There are also now many recipe sources for individual special diets, for example in the UK the BBC website (separate listings for gluten-free, nut allergy, egg-free, dairy-free, 'healthy', pregnancy-friendly, shellfish-free, vegan and vegetarian), the Coeliac Society for gluten allergy and Diabetes UK and other international equivalent organisations for diabetic recipes. But when more than one allergy is present in the same family, maintaining daily variety is much more difficult.
Xavier Ternisien in today's Le Monde [Sunday 14th August] has highlighted a blogger for francophones who has risen to this challenge. Bordeaux 'blogueur' Anne Lataillade worked in financial services after graduating from business school. Struggling for inspiration for meals for separate gluten and egg allergy in her 2 children, she has been blogging on practical recipes since 2005. Her aim is to provide simple to make recipes that work, with ideas for savoury foods and desserts compatible with both these allergies. She accompanies her blogged recipes with photographs of the dishes and information on the sources and properties of the suggested ingredients. Her website also provides information on archived recipes and on publications arising.
A further website worth checking is 'Cooking Allergy Free'. This site, after free registration, allows access to a large menu of potential allergies and then to a limited range of suitable recipes compatible with a a very complex range of needs and preferences.
Attractive varied suggestions are a good approach to complement other measures to encourage adherence to special diets for medical allergies.
US actress Zooey Deschanel highlighted the challenges of catering for multiple food intolerances and preferences by appearing on a 2009 US television programme in which chefs were asked to provide food suitable for vegans intolerant to dairy, eggs, soya and gluten.