Fat Causes Cancer! Except when It Prevents It! Or Has Dick-all to Do with It! But Didn’t You Hear Us? FAT CAUSES CANCER!

So yesterday, Liss sent me the link to this story, courtesy of reader Tabitha, who astutely noted, “I feel the emphasis was on how fat people are liars.”

The deal is this: turns out eating a low-fat, high-veggie diet does not reduce the risk of breast cancer returning. A government study, which followed over 3,000 women for seven years, “found no benefit from a mega-veggies-and-fruit diet over the U.S.-recommended servings of five fruits and vegetables a day — more than most Americans get.”

Here’s where it gets interesting:

Researchers noted that none of the breast cancer survivors lost weight on either diet. That led some experts to suggest that weight loss and exercise should be the next frontier for cancer prevention research. The study appears in Wednesday’s Journal of the American Medical Association.

Emphasis mine. Here’s what the people in the mega-veggie group were eating:

A group of 1,537 women were randomly assigned to a daily diet that included five vegetable servings, three fruit servings, 16 ounces of vegetable juice and 30 grams of fiber. In most cases, a serving equaled a half-cup. French fries and iceberg lettuce couldn’t be counted as vegetables.

The women were allowed to eat meat, but were told to get no more than 15 percent to 20 percent of their calories from fat, a goal they ultimately were unable to achieve.

None of them lost weight.

Most of them “failed to meet the fat target,” we’re told — not surprising, considering even the FDA recommends we get 30% of our daily calories from fat (and the women in this group still ate about 13% less fat than those in the other) — and blood tests confirmed that these women were telling the truth about eating their mega-veggies.

But they may not have been so honest about the calories they ate. The super-veggie group gained 1.3 pounds and the comparison group gained 0.88 pound, on average.

“There’s no question they were underreporting on calories, especially the heavier women,” Pierce said, or they would have lost weight.

That’s the last line of the story, by the way. The story about how eating produce affects cancer. Which you might have forgotten, since the whole goddamned thing ended up being about weight loss.

Also, um, this study was seven years long. And women in both groups gained about a pound. In seven years. And somehow this means “There’s no question they were underreporting on calories, especially the heavier women”?

How is there no question about that again — considering people tend to gain weight as they age? And how the hell do we know it’s especially true that the heavier women were lying? Your evidence for this is what?

Also, since the women in the low-fat group gained more weight than those in the other, yet ate 13% less fat… uh, WTF? IT’S ALMOST LIKE DIETING WON’T CAUSE LONG-TERM THINNESS!

I love that what they take from this is, we need to study whether “weight loss and exercise” are the key to preventing cancer. First, those are two separate fucking things. It’s well established that exercise has health benefits out the wazoo, so maybe it does help with cancer — that would be awesome. But IT DOESN’T CAUSE LONG-TERM THINNESS. If you try to study exercise and weight loss simultaneously, you’re going to muddy the results regarding exercise alone, which might actually be useful. Second, if your own study just demonstrated that a low-fat, high-produce diet causes weight gain over seven years, how the fuck do you propose to make people lose weight so you can study it? Lipo? Starvation? One of the umpteen other diets with a 95% failure rate? Good luck with that.

Oh, wait, sorry — I forgot they were lying about their calorie intake, especially the fatties. Which you seem have absolutely no evidence for, save a 1-lb. weight gain over seven years. And you do have hard evidence that they were truthful in reporting other aspects of their food intake. But clearly, you can’t gain weight if you consume fewer calories than you burn! It’s thermodynamics, people! DUH!

Excuse me. I need a moment to bang my head against a wall for a bit before we continue.

Okay. I’m good now.

So. Reading this article inspired me to start Googling for info about obesity and cancer. I suspected I would find that some studies show fat can be protective against cancer. And lo, what’s this? Obese pre-menopausal women have a reduced chance of developing breast cancer!

Now, let’s look at the mainstream media version of the same story:

Obesity remains one of the strongest risk factors for postmenopausal breast cancer. Around 80 percent of breast cancers are diagnosed in women who are 50 and over.

Because of this, the slight protective effect of obesity against disease early in life should not be taken as license to pack on the pounds at any point in life, Michels warns.

What the article fails to note is that, even if obesity is a risk factor for post-menopausal women where breast cancer is concerned, it is also significantly correlated with longer life in general, with an increased ability to recover from cardiac events, and with higher bone density — all pretty big pluses for older women. (Though in any case, whether it supports my argument or not, correlation is still not freakin’ causation.)

As someone with no family history of breast cancer, I would absolutely take my chances on obesity prolonging my life, even in light of what they’re saying here. Don’t get me wrong — if you do have a family history of breast cancer, of course it’s worth following these studies more closely than I would. (Though I’m not sure what you can do about it if you’re post-menopausal and fat, since diets still don’t work in the long term, even if being fat is a genuine health problem.) But this article is telling us that no woman should think it’s okay to be fat, because being fat might mean a higher risk of breast cancer later in life — even though fat protects against numerous other diseases later in life (and breast cancer earlier in life!), and the list of risk factors for breast cancer is about a mile long; among all the others, obesity barely rates.

What else does Google have to tell us about obesity and cancer? Well, there are all the articles about how a low-fat diet will conquer cancer — which, uh, the study we started out with here has disproven. And then there are all the articles about how being fat gives you cancer, which mostly issue from this study, published in 2003.

A couple things about that study:

1. It only measured subjects’ BMIs at the outset of the 16-year-study. So if, over those 16 years, subjects lost weight — either from the cancer itself, the treatment, or dieting — it went unacknowledged. Meaning at least some of the correlation with “obesity” could actually be a correlation with weight loss or weight cycling. We’ll never know.

2. What he said. Paul Campos to the rescue of reason once again. (And thanks to NAAFA for archiving it.) The highlights of that response:

  • The study actually showed the lowest cancer rates among “overweight” people — those with a BMI of 25-29.9.
  • The only real increased risk was among those with a BMI above 40. That’s less than 5% of the population. (Yet all the MSM articles are quick to point out that 60-odd percent of the population is “overweight” or “obese,” so we should all be worried!)
  • Even among that group, the association was weak.
  • Studies by the American Cancer Society from 1995 and a 1999 showed a correlation between intentional weight loss and increased cancer mortality risk.

That last bit especially makes a small, selfish part of me want to say, “Go ahead, assholes. Study whether weight loss prevents cancer recurrence. ‘Cause you’ll probably find that it fucking increases it, and we’ll have yet more evidence that fat doesn’t kill, and dieting does.”

But the problem is, we’re talking about real people with real cancer here, not just statistics. I don’t want to see anyone die to prove a point. But that’s exactly what will happen if researchers willfully, insistently keep barking up the wrong goddamned tree, ignoring the mountain of evidence that the “overweight” BMI category has the lowest mortality rates when it comes to just about everything, the “healthy” weight category consistently has about the same risks as the “obese” one, and both extreme obesity and underweight are equally unhealthy — and equally rare. Not to mention if they keep insisting that calories in/calories out is the key to weight loss for everyone, despite that having been disproven about a gazillion times over, and if they keep insisting that anyone who fails to lose weight on a controlled diet must be lying about what they eat.

And lay people will continue to be woefully misinformed, as long as reporters keep framing the studies like this: Obesity Is Found to Make Ovarian Cancer Deadlier. From the middle of the article:

The researchers acknowledge that their study, published yesterday in the journal Cancer, has certain weaknesses.

They found that a slightly lower dose of chemotherapy relative to body surface was given to obese patients, and it is possible that this underdosing may have had a role.

In addition, fluid in the body cavity, a symptom of the disease, may have artificially increased the B.M.I. of some patients. And it is possible that other diseases like hypertension and diabetes, more prevalent among the obese, could have decreased survival among those patients.

The study was also limited by its retrospective method and small sample population.

Emphasis mine. The article goes on to say that the researchers suspect fat somehow promotes tumor regrowth or “makes tumors less sensitive to chemotherapy.” You know what else might make chemotherapy less effective? NOT GETTING ENOUGH OF IT. Did you just miss that part in your own research, guys?

Oh, also? According to this doctor, being obese doesn’t increase your chances of getting ovarian cancer; just of dying from it (slightly) earlier if you already have it. So once again, if you don’t have other risk factors for ovarian cancer — like, off the top of my head, if you don’t have ovaries — being fat will probably not increase your risk of dying from it. But as always, the upshot is, JUST DON’T BE FAT, WHOEVER YOU ARE.

The article’s conclusion:

”Reducing obesity and maintaining an ideal body weight,” he said, ”is important for many reasons. This is just one more health problem in which obesity plays a role.”

Yeah. The problem is, when you look at the data, the “role” obesity plays usually seems to be “back row of the chorus,” but both the reporting and the research keep trying to force it into the lead.

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18 Comments

Filed under 09_kate_harding

18 responses to “Fat Causes Cancer! Except when It Prevents It! Or Has Dick-all to Do with It! But Didn’t You Hear Us? FAT CAUSES CANCER!

  1. Great post as always, Kate. Right on.

  2. You know, at this rate, by 2439 someone might accidentally write an article indicating fat =! sick. But I won’t hold my breath.

  3. DBK

    The mainstream media reporting on a scientific study? Not hard to find stupid in something like that.

  4. Kate Harding

    The mainstream media reporting on a scientific study? Not hard to find stupid in something like that.

    Well, yeah. I’d be out of a couple blog-jobs if it were.

  5. I’ve been waiting to see Sandy Szwarc’s take on this one, but you have already given us a masterful takedown. Thanks, as always, for a great read.

  6. Thanks Kate — Brilliant as usual.

  7. keshmeshi

    While cancer can cause weight loss, chemo can also cause weight gain. Did they bother taking these factors into consideration?

    The anti-fat (in terms of diet) thing is so out of date. Too little fat is as unhealthy as too much, especially if you don’t get any healthy fats. I think we better just leave the real preventive medicine to the naturopaths.

  8. Susan

    Pardon my language, but fucking hell.

    Teo former co-workers of mine:

    “Anne” has always been an athletic young woman (32 years old) who was particular about her eating habits. No family history of cancer. She developed breast cancer and eventually had a double mastectomy.

    “Mary” (55) was a health-conscious woman who maintained a low weight through exercise and diet. She was an nurse and advocate for music therapy for cancer patients. Mary died four years ago from lung cancer. She had never smoked.

  9. Mom of Es

    “Studies by the American Cancer Society from 1995 and a 1999 showed a correlation between intentional weight loss and increased cancer mortality risk.”

    Funny thing about that is that when I was in med school, they taught us that losing weight is so difficult that if a patient was losing weight–even if they told us it was intentional–that we should have a high level of suspicion that there was something else going on like an occult cancer or diabetes.

    I know in my practice, if a patient loses more than about 20 pounds, I get nervous that they have something bad that I just haven’t found yet.

  10. t87

    But clearly, you can’t gain weight if you consume fewer calories than you burn! It’s thermodynamics, people! DUH!

    Yes, what do these study authors know, especially when it may disagree with a second-hand, unsourced, unverified, non-peer reviewed account from a “kindly and patient person who has a PhD in human biochemistry.”

  11. Meowser

    Studies by the American Cancer Society from 1995 and a 1999 showed a correlation between intentional weight loss and increased cancer mortality risk.

    That last bit especially makes a small, selfish part of me want to say, “Go ahead, assholes. Study whether weight loss prevents cancer recurrence. ‘Cause you’ll probably find that it fucking increases it, and we’ll have yet more evidence that fat doesn’t kill, and dieting does.”

    “No, we don’t want THAT answer! We want THIS answer! And damn it, we’ll keep dredging that data until we get it!”

    Anyone wanna explain the difference to our friend t87 the difference between a real study conducted by people with no vested interest in the outcome, and a data dredge commissioned by people who have diets, pills and surgical equipment to sell? And how the MSM, including vaunted sources like PBS and NPR (albeit them less often), uncritically push the latter on us like it’s the freakin’ gospel, because it dovetails perfectly with advertiser/sponsor needs and audience prejudices? I just don’t have the stomach for troll patrol right now.

    You’re so right, Kate, it’s all the same shit over and over again. “Keep dieting, ladies! Keep sweating! Keep starving! Make yourself as tiny as you possibly can! Trick yourself into thinking you have no appetite for anything except servicing your man! Never ever listen to your own body about what it really wants and needs, because you’re a woman and your wants and needs are just NOT important.”

  12. Fillyjonk

    Meowser, t87 is apparently deeply protective of his right to hate himself. Since he’s a pain in the ass, I say we grant him that right. He’s been given more than enough resources to educate himself if he ever decides that’s worthwhile.

  13. Kate Harding

    Fillyjonk, exactly. I very much support t87’s right to hate him or herself.

  14. Kate Harding

    Funny thing about that is that when I was in med school, they taught us that losing weight is so difficult that if a patient was losing weight–even if they told us it was intentional–that we should have a high level of suspicion that there was something else going on like an occult cancer or diabetes.

    Mom of Es, that’s fascinating. And I hope you’ll submit yourself to Stef’s Fat Friendly Health Professionals List.

  15. Just a minor point: if I understand the first study you mention, it’s talking about recurrence of cancer in women who’ve already had one bout, and the question is whether obesity makes a *recurrence* more likely. Having had cancer is a much huger indication of one’s tendency to develop the disease (statistically, that is. Not necessarily in any specific individual.) than obesity or even, I believe, smoking. So, given that they were looking for a rather small effect, the design flaws in the study that you picked up on only make their whole endeavor that much more hopeless. However, their study doesn’t actually say anything about the statistics of obesity and its correlation with developing cancer in the first place. (Puzzled face here.) Right?

    A few things you mentioned in your post really need to be said over and over and over again. Weight cycling is the problem, not weight. Lack of exercise is the problem, not excess calories. Lack of good nutrition is the problem, not gluttony.

    Obesity really is used as a stand-in for the real issues, as you’ve pointed out time and again. No wonder the results keep coming up crap. It reminds me of the old joke about the guy who wanted to figure out why scotch on the rocks made him drunk. So he tried rum on the rocks. He got drunk. Then he tried a wine cooler with ice cubes. His conclusion: it was the ice.

  16. Meowser

    Funny thing about that is that when I was in med school, they taught us that losing weight is so difficult that if a patient was losing weight–even if they told us it was intentional–that we should have a high level of suspicion that there was something else going on like an occult cancer or diabetes.

    Which brings up an interesting point: If women are expected always to be dieting dieting dieting, how can doctors tell the difference between intentional and unintentional weight loss? (Other than a serious, dramatic drop, like 20 pounds or more in a month.)

    You’re so right about that, though. My XH, after years of being assumed by doctors to be type 2 diabetic because he was fat, was eventually discovered to have a rare genetic disorder called hereditary hemochromatosis (HHC). This condition creates toxic iron levels in the blood and in its advanced stages (which his was, because no one had ever thought to test him for it until an emergency room doctor ran some tests on a whim) damages internal organs like the liver, pancreas and kidneys. So for him, losing bunches of weight would not necessarily be signs of a bodily happy, even if he wanted to do that; it could also be a sign of organ failure.

  17. Two things which seem to help prevent and treat cancer are cannabis and turmeric. There are probably a few more herbs like them.

  18. However, their study doesn’t actually say anything about the statistics of obesity and its correlation with developing cancer in the first place. (Puzzled face here.) Right?

    Quixote, yep, you’re right about that study. And I tried to be conscious of that distinction both there and with the ovarian cancer study — though I also discussed articles that talked about obesity and developing cancer. Please feel free to point out any specific place where I mischaracterized the study, and I’ll correct it. (That’s not me being snarky, btw. I just honestly don’t see it, but that doesn’t mean it’s not there.)

    (Oh, wait, I just reread your comment and now realize your puzzled face might have been direceted at the researchers, not me. Oh well. Either way, the above paragraph was probably a point worth making.)

    LOVE the joke. No kidding.

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