A few years ago, researchers from the Centers for Disease Control and Prevention were examining research on body fat and concluded that being slightly overweight, but not obese, might actually result in a longer life. For the third of Americans who are overweight, that was likely seen as reassuring news. Hell, it even paved the way for the whole “dad bod” phenomenon. But many in the medical community were skeptical, as the findings relied too heavily on Body Mass Index as the sole indicator of health. You see, your BMI is based on only two measurements—weight and height—not more insightful factors, like muscle mass or location of extra fat on the body.
Now, four years later, the latest research, published in the Annals of Internal Medicine, reaffirms that skepticism and finds that being slightly overweight may actually decrease a person’s life span, which is more in line with conventional wisdom about the dangers of gaining weight.
“Our findings confirm that there is no benefit of being overweight on risk of death, and indicate that [being] overweight is actually associated with an increased risk of dying,” head demographer Andrew Stokes told NPR this week. His research actually found a six percent increased risk of death for overweight individuals.
And although Stokes says that six percent “is only a modest increase,” it’s still “extremely worrisome” because so many Americans are overweight. It should also be noted that these findings apply only to those who are overweight—10 to 30 pounds heavier than their ideal weight—not to obese people. There is little debate that people who are obese are at increased risk for diabetes, heart disease, certain cancers and even premature death.
Future research will look at whether overweight people who diet, exercise and lose the excess weight can turn back their risk of disease (and death) to that of an individual who never gained weight in the first place. Here’s hoping, right?
In 2013, NBA big man Dwight Howard developed a rare nerve disorder called dysesthesia while playing for the Los Angeles Lakers. He had tingling in his extremities and was losing motor function, to the point he had difficulty catching passes.
Dysesthesia is common among prediabetics — not men who make a living physically exerting themselves. But Lakers nutritionist Cate Shanahan knew Howard had a “legendary sweet tooth,” and suspected his tingling was due to his sugar intake. Sure enough, Howard revealed to her he had been consuming an unthinkable amount of sugar. According to ESPN:
“Howard had been scarfing down about two dozen chocolate bars’ worth of sugar every single day for years, possibly as long as a decade. “You name it, he ate it,” she says. Skittles, Starbursts, Rolos, Snickers, Mars bars, Twizzlers, Almond Joys, Kit Kats and oh, how he loved Reese’s Pieces.”
Howard will likely be remembered as a good player who never achieved his physical potential. Made of nothing but lean, fast-twitch muscle, he is one of the most impressive physical specimens to ever play in the NBA. But he’s averaged less than 20 points per game over his career, and critics will always wonder how much better he might have been had he maintained a healthy diet during his prime.
Perhaps the most remarkable (or disturbing) part about the Howard story is that it’s not all that uncommon within the realm of men’s professional sports. There are a startling number of high-profile NBA and NFL players who’ve kept objectively terrible diets during their playing days, including:
Kwame Brown: Like Howard, Brown was a highly touted prospect who jumped to the NBA right out of high school. He’s also one of the biggest disappointments in NBA history, recording only one double-digit scoring season in his 13 in the league. That may have been due in part to his dreadful diet. Brown ate Popeye’s fried chicken for every meal, even breakfast, when he entered the league.
Lamar Odom: Long before he was a bit player in the Kardashian universe, Odom was a professional basketball player with a serious candy habit. He ate candy for breakfast before games, saying it helped fuel his performance on the court. Specifically, he ate Twizzler bites, Gummy bears, peach rings and Hershey’s white-chocolate cookies-and-cream bars (his favorite).
Derrick Rose: Back when he was an MVP point guard for the Chicago Bulls, Derrick Rose admitted to regularly eating McDonald’s, potato chips and, of course, lots of candy. He kept a Skittles vending machine in his home. “Everybody’s got their poison, and mine is sugar,” Rose told ESPN in 2010…
Add a new entry to the list of factors that can exacerbate a cancer diagnosis: money. Paying for cancer treatment is expensive, and for many patients, the financial distress can be severe—so much so that, as recent evidence suggests, it could count as another cancer mortality risk factor, alongside smoking, diet, and exercise. So researchers began calling this distress “financial toxicity,” because of how it influences patients’ well-being, their treatment decisions, and health outcomes.
Yet video-recorded clinical interactions show oncologists and patients broaching the subject of expense in fewer than half of their discussions, and that omission can have enormous consequences both for patients and their relatives, says Lauren Hamel, a communication and organizational behavior researcher at the Karmanos Cancer Institute and Wayne State University, in Detroit. In a recent study led by Hamel, analyzing those communications, she wrote, “As the cost of cancer care escalates and the burden of cost shifts to the patient, more patients are incurring debt, filing for bankruptcy, and forgoing treatment.” The study, published in the Journal of Oncology Practice, looked specifically at African-American patients, many of whom lived in poverty and lacked the time and education needed to have such frank conversations with their oncology team.
I was really struck by how much patients were worried about indirect costs.
Why are financial considerations discussed so infrequently? Whose job is it to bring them up? How can patients and doctors navigate this sensitive terrain in a more productive fashion? Hamel answered these and other questions in a recent conversation with Nautilus.
How can cancer costs be a toxin?
The term “financial toxicity” has been discussed as an additional side effect of cancer treatment. On top of diagnosis, people have this life-changing experience, even life-ending experience, and they and their families also can suffer severe financial consequences. There’s an argument to be made that if people actually talk about the financial cost of cancer, they could prevent or reduce that “financial toxicity.”
But it occurred to me that we don’t have objective evidence of what patients’ questions are regarding the financial impacts of cancer. So my collaborators and I wanted to begin to explore that.
How do you explore the effects of financial toxicity?
I had a dataset of videos from another study of patient and oncologist treatment discussions, and we got a grant to re-analyze those video data for financial discussions. We looked at 103 interactions at outpatient clinics at two urban cancer centers in Detroit, including a National Cancer Institute-designated Comprehensive Cancer Center. All of the patients were African-American, and most of them were low-income. Household incomes were less than $20,000 per year for 42 percent of our subjects.
We developed a coding system to measure the presence and nature of financial discussions and how long they lasted. As we reviewed the videos, we noted who initiated the discussion and what was said. We defined “cost” really broadly, to include mention of taking time off work, co-payments, insurance, losing a job, even parking.
His cap is bleached as white as the bones of a Saharan camel. Is the romance of the French Foreign Legion a cult of death?
Robert Twigger is a British poet, writer and explorer. His latest book is White Mountain: Real and Imagined Journeys in the Himalayas (2016), and he divides his time between the UK and Egypt.
What comes to mind when you think of the French Foreign Legion? Most likely men struggling through the desert in heavy blue coats and white peaked caps. Men who joined up after a lifetime of crime, fighting valiantly, then leaving the Legion to become tough, faceless mercenaries trading on their background, or else dying in the mud of Dien Bien Phu as the last choppers leave for La Belle France.
The reality is different. In its first version, the Legion was seen as a rough mercenary force that guaranteed immunity from criminal prosecution, as well as a new life and French citizenship. In its second incarnation, the Legion became a sort of substitute family. Now in its third, the official image of the Legion is of an elite fighting force, to be compared with the British SAS or the US Navy Seals. Today, legionnaires are much more than a band of mere ‘expendables’.
The modern Legion still has a few things in common with its previous incarnations. There remains an emphasis on marching (to enter, you have to complete several hikes in full kit, ranging from 50 to 120km) and the men who join are still keen to fight. The wages, though, are now quite good, especially if you see duty in a combat zone. Even the most basic pay of a recruit is €1,205 a month, which, considering there are no bills or food costs, is nothing like the five centimes a day it was in the 19th century. Then, a legionnaire could afford wine or tobacco, not both, and certainly no other luxuries.
Young men still queue to join up in great numbers. Several thousand apply per year, and some 80 per cent are rejected – the Legion doesn’t accept anyone wanted by the police or with a serious criminal record, though misdemeanours and petty crimes are still acceptable. The modern Legion is around 8,000-strong and needs only 1,000 new recruits each year to replenish the ranks. The average recruitment age is 23. In recent times, 42 per cent of recruits come from eastern and central Europe, 14 per cent from western Europe and the US, and around 10 per cent from France. Around 10 per cent come from Latin America and 10 per cent from Asia. These young, rootless men swear their allegiance not to France, but to the Legion itself. It is their only loyalty.
The Legion is composed of several branches: engineers, paras, armoured cavalry, infantry, and pioneers. The paras are based in Calvi on the island of Corsica (they are still not trusted to be on mainland France after a coup attempt in 1961). Other arms are garrisoned in French Guiana and the United Arab Emirates. The Legion saw service most recently in Mali, where they helped restore the government against insurgent Al-Qaeda forces.
Recruits must present themselves at one of several centres in France. If this pre-selection goes well, it’s on to Aubagne, a small town about 20km inland from Marseilles on the Mediterranean. There follows one to two weeks of selection where numerous mental and physical tests are taken. The minimum age is 17.5, the maximum 39.5. There are no educational requirements.
Once they make it through selection, recruits sign a five-year contract and are then shipped to ‘the farm’ in the Pyrenees for six weeks of hellish training which further weeds out the unsuitable. Though probably not as tough as SAS selection in the UK, it certainly involves more cleaning, marching, singing and discipline – much more. It is accepted that hard discipline is the only way to weld men from such disparate origins into a single fighting unit. The Legion allows officers to strike the men in a routine manner. The method is age-old and simple: break the man, remove his old allegiances, then give him a new family.
In this new family, recruits are also allowed to choose a new name – the name by which they will be known ever after. And so, by the end, they have become someone new, with a new country and a new identity. Indeed, this is the most obvious pull the Legion has for men: a new life. This life, however, is wrapped up in a world that honours death…