Slipping through the diagnostic net

Deaths from uterine cancer have increased by a fifth in the last ten years, data from Cancer Research UK has found. It means almost 2,000 women now die annually from the condition. (Telegraph)

Since they report that the number of annual diagnoses has risen by almost half since the mid 90's, this does mean that survival rates are improving. According to Professor Jonathan Ledermann, gynaecological cancer expert at Cancer Research UK,

"the chances of surviving the disease are still better than ever. It’s clear we’re making great progress, but we don’t yet fully understand what’s driving up cases of womb cancer, so there’s still lots more to do.”

Until they solve the mystery (and I hope they are looking very carefully at HRT and synthetic hormones, which the article doesn't mention at all), researchers are falling back on that old staple of weight loss and plenty of fruit & veg, reminding us that being obese 'more than doubles' the risk of uterine cancer.

This gives us some juicy headline statistics, conveniently forgetting that, obesity increases the risk rather than creating it and that lifestyle is far from the only causal factor at work. Yes, folks, it's that old false syllogism again:

Unhealthy lifestyles cause cancer
You have cancer
ergo You have an unhealthy lifestyle

If Professor Ledermann and his team want to reduce the number of deaths, they would do well to consider the inversion of this argument, the application of which nearly cost a relative her life. As applied by her GP in the face of worsening symptoms for nearly two years, it goes roughly thus:

Obese women have uterine cancer
You are not obese
ergo You do not have uterine cancer

With a healthy diet and plenty of exercise, there was, the GP said, no need to bother with an examination. In fact, when the patient complained that she was rapidly losing weight for no obvious reason, the doctor told her she was lucky; "But that's a good thing; I wish I could lose weight like that!"

The diagnosis was finally made by a second doctor at a point urgent enough for the patient to be rushed into hospital within hours for drastic surgery, but the original GP was unrepentant to the point of defensiveness; how could she be expected to diagnose the condition, she demanded, when my 7st relative didn't fit the profile?

Survival rates decline sharply as the cancer develops; the later the diagnosis, the less your chances of recovery. Professor Ledermann doesn't say what proportion of the fatalities are not overweight; it might be well worth his while to find out.

An unholy alliance

Even by the Mail's standards, this is a good one:

The world’s obese people could help stop global warming by going on a diet, scientists claimed today.

Help stop global warming, no less; lose weight and save the planet! I can see it has the makings of a best-selling book. But wait, there's more...

Obese and overweight people were said to be contributing to climate change just by breathing.

We've got used to being lectured about our air miles and car use, but that's going to be a hard one to cut down on. In any case, who's to decide what constitutes overweight? The parameters are, to say the least, somewhat blurred.

The Mail has the scientific 'facts' to back this up; according to a study published in the International Journal of Obesity, scientists at Aberdeen's Robert Gordon University:

if all the world’s heavyweights dropped 10kg, C02 emissions would fall by 49.560 metric tonnes a year. That’s the equivalent of 0.2% of the CO2 emitted globally in 2007.

Now I don't claim to be much good at statistics, but that seems to me an unfeasibly large figure, particularly as there's a whole other issue, so to speak, that the researchers didn't take into consideration:

They did not include methane gas emissions from flatulent large people, despite evidence about cows contributing to greenhouse gases, which is a shame, because it opens up a whole new set of interesting possible campaign slogans*.

So where is all this going? Will a fat tax be combined with a climate change levy on foodstuffs? Will the Nanny State use the findings as an excuse to impose draconian diets and exercise regimes under the terms of the Kyoto protocol? It's a frightening thought, given the energy and single-mindedness with which the PTB pursue the green agenda.

We've already seen measures in place to round up overweight 'clients' for government-sponsored 'healthy eating' programmes and attempts to instil guilt over CO2 generation, now imagine the two combined - it would certainly be the end for drive-thru burger joints (which is, admittedly, something I personally would welcome on linguistic grounds).

It's a perfect storm of righteousness waiting to happen; we just have to hope, for the good of humanity, that no-one in power suddenly decides to take the Daily Mail seriously because it happens to suit their agenda.


*Some years ago, the strong regional accent of a BBC reporter discussing the appointment of a 'Fat Czar' to tackle obesity led to the Spouse mishearing the title as 'Fart Czar', a designation the Tavern gleefully adopted henceforth for any government-appointed interfering busybody.

On weighty matters

I am a Cheddar cheese.

No, honestly! Just bear with me for a moment.

With all this talk of 'fat taxes', I had a highly topical experience this week. I've been advised to join a gym to sort out a dodgy shoulder, so I duly unearthed a dusty pair of trainers from the back of the wardrobe and trotted along in my best lamb-to-the-slaughter fashion.

I have to admit that the gym is not my natural habitat; I find myself pondering awkward questions like "If I'm making all this effort, why is the machine plugged into the mains?" or "Wouldn't it be nicer to go for a walk outside?" or, mostly, just "Why?"

However, on my best behaviour, I walked into what Jeremy Clarkson once described as 'a room crammed with Steves busy lifting things up and putting them down again' to meet my 'Fitness Consultant' (who was, inevitably, a superbly-honed specimen expressly designed to lower the self-esteem of most of us mere mortals).

I wasn't allowed to play with the iron bars and hamster-wheels straight away, though; the first thing they wanted was a 'fitness assessment', for which I was wired up to an assortment of nameless and expensive-looking gadgets. Then it was back to the office for what I believe in lifestyle TV is called 'the reveal'.

Actually I'm not in such bad shape; all the figures in the glossy report were printed in green - all but one, that is. It turns out I have the same percentage fat content as a good Cheddar cheese. As a result, there were angry announcements in red all over the printout saying, basically, "Watch out, the Grim Reaper's on his way!"


Amid all the dire warnings about diabetes and heart disease was the actual percentage figure, so when I got home, naturally I googled it. And here's the thing; I exceed the 'healthy percentage' of body fat for my profile by a mere half a per cent, rounded up.

0.3% less and I would be in the 'acceptable' range; no red lines, no dire warnings, green lights all the way. And what's the margin for error for a calculating machine that gets all its data from sticking electrodes to the wrist and ankle of the recumbent victim and measuring the resistance?

Small wonder, then, that my 'Consultant' hardly batted an eyelid at these woeful prognostications; after all, I'd managed to squeeze in through the door without a struggle and - using the other fashionable statistic - my BMI is unequivocally normal.

Now, I'd like to believe that all these parameters are determined by dedicated, white-coated lab rats hunched over their microscopes for the good of humanity but I suspect that, somewhere, there is a roomful of state-funded statisticians who have arbitrarily decided that a fraction of a percentage more or less will divide the sheep from the goats.

If you have the body fat percentage of cottage cheese, you're among the ranks of the saved; if it's Roquefort, then you're on the road to perdition. Forget St Peter and the pearly gates; we're right back to Ancient Egypt and the Weighing of the Heart.

In view of which, it's probably a good thing that, according to the bizarrely omniscient Frankestein electrode machine, my skeleton and internal organs apparently weigh exactly what they should.

Ride 'em, Cowboy!

                                                            Yee-haw!

From next year, GPs will receive a payment for every obese patient they advise to lose weight - on top of money for keeping lists of those who weigh too much. 

 So that's a bounty per head for corralling the obese into the surgery and signing them up – there’s gold in them thar spare tyres!

Under a national payment scheme for all family doctors, they will be able to boost their income if they record giving “weight management advice” to obese patients, or offer them a free place on a diet club, which the NHS would pay for. 

What an incentive, then, for Britain’s GPs - or practice managers – to leave their desks and go out rounding up ‘clients’ for this service, scouring the town’s fast food establishments and bowling alleys in search of its larger citizens. And imagine the scene when they run up against a rival posse from the surgery up the road, hell-bent on adding to their own list. Rustling would be rife - h/t JuliaM – as they struggle to steer their errant droves into the fold.

The plans form part of a desperate bid to tackle soaring rates of obesity in Britain, with two out of three adults now classed as overweight or obese. 

Desperate sounds about right – GPs surely have enough to do without preaching the gospel of weight loss to all and sundry. And who’s to say what qualifies a patient to generate these payments? A BMI of over 30 - generally accepted as defining obesity? It's the most likely, though it's a crude measure at best, taking no account whether the weight is fat or solid muscle. If so, a doctor could theoretically claim these payments for a patient list composed entirely of top sportsmen. The England rugby team doctor must be rubbing his – or her – hands in glee; everyone else will have to go out and find their own.

Count 'em out , ride 'em in, 
Ride 'em in, count 'em out, 
Count 'em out, ride 'em in,
Rawhide!

  I am indebted to the Moose for inspiration.

For goodness' sake!

You know that white crystalline stuff they keep under the counter? The substance you have to ask for specially, so lethal are its effects?

For years now we've been bombarded with messages proclaiming that salt consumption causes high blood pressure, strokes and heart disease and seen it subject to increasingly draconian restrictions aimed at meeting the future target of no more than 6g per adult per day.

Well, the Belgians may just have blown the whole thing wide open:

An eight-year study by scientists in Belgium found that people who ate lots of salt were no more likely to suffer problems with heart disease or high blood pressure than people who ate less salt.

A turn up for the books, n'est-ce pas? The experiment used data from 3,700 subjects divided into three groups according to their salt consumption and researchers found no diference in the rate of heart and blood vessel diseases. However, there's more:

Participants with the lowest salt intake had the highest rate of death from heart disease during the follow up (4 per cent), and people who ate the most salt had the lowest (less than one per cent).

So, if they are right, not only have thousands of health-conscious people have been eating tasteless food for years for no reason whatsoever (apart from a smug, self-satisfied glow, that is, and a feeling of moral superiority); they may even have been exposing themselves to the very thing they were trying to avoid.

Today I'm having my chips as usual with salt - and an extra helping of Schadenfreude.