← More or Less
More or Less
Obesity crisis?
00:28:13
Tim Harford discovers that health statistics contradict a report which says obesity is...
Loading summary
Transcript111 lines
- [00:00]
A
Thank you for downloading More or Less from the BBC. This is the version of the programme first broadcast on BBC Radio 4. Here's Tim Harford.
- [00:09]
B
Hello and welcome to More or Less, the programme which mugs the weekly news with a sock full of statistics. This week we'll be fact checking claims about police, firearms, officers, the wet weather apples and the Channel 4 programme benefits Street. But first, obesity. It's a ticking time bomb, or so some experts would have us believe. In 2007, the government commissioned Foresight Report claimed that by 2050, half the UK population could be obese, which is a worrying thought. And earlier this week, the news got even worse.
- [00:44]
C
A new report suggests predictions that half
- [00:46]
A
the British population will be obese by 2050 underestimate the scale of the obesity crisis.
- [00:53]
B
The obesity crisis is even worse than feared.
- [00:55]
D
A new call for urgent action calls
- [00:57]
C
for shock tactics to curb the UK's worsening obesity crisis.
- [01:01]
A
A special breakfast report asks what's being
- [01:04]
C
done to help the seriously overweight.
- [01:06]
B
Oh, dear. This reassessment of the threat obesity could pose to the future of mankind led to worried more or less listeners emailing
- [01:14]
A
us to ask, please can you interview someone from the Obesity forum and ask them how they came up with a prediction that 50% of adults will be
- [01:22]
B
obese in can the statisticians really be serious in their predictions that by 2050 half the UK population will be waddling up and down the streets? So is the obesity situation really getting worse? Ben Carter is more or less his expert on weight problems.
- [01:39]
E
I'm just big boned him now. There are a number of points we need to make. Firstly, the original government commissioned Foresight report published in 2007, you used UK wide data from 1993 to 2004, a time over which obesity definitely was going up, both for children and adults.
- [01:59]
B
And there are two categories, there's overweight and the more severe condition, obesity.
- [02:03]
E
Yes, and the prevalence of overweight adults was rising too, from just over 50% in 1993 to just over 60% about 10 years later.
- [02:13]
B
Got it. So we have this official report published in 2007, but based on data available at the time, and pretty much every statistic was moving in the wrong direction.
- [02:22]
E
But shortly after that report was published, new data came out from the Health Survey of England covering 2005, and it surprised one of the report's authors.
- [02:32]
F
I suppose my main interest was, are these numbers still going up for the obese and the overweight? And it turned out they weren't still going up. They were kind of a Little bit down, a little bit flat.
- [02:43]
E
This is Professor Clim McPherson talking on the BBC Radio 4 programme, the Investigation.
- [02:49]
F
Then you look at it and you say, well, okay, there's a lot of random variation in these data. That could be this year's random fluctuation.
- [02:54]
G
I suppose it could be a blip this year, but if it carried on for another couple of years, then presumably we'd be predicting a very different future.
- [03:02]
F
We would. And we'd also be learning something about what it is that makes those slopes change.
- [03:06]
B
So 2005 could have been a blip, but it wasn't. Loyal listeners will remember that Clim Macpherson came on this very program in 2012.
- [03:16]
F
We now have data up to 2010, and what we notice with the more recent data is that things are changing. They're changing, particularly among the young, but also slightly amongst older people. So what we predicted in 2007, based on data post 2005, should have been amended.
- [03:37]
B
So Clint McPherson says the 2050 projections were overstated in the 2007 report. Not understated.
- [03:44]
E
And other research he subsequently did on child obesity concluded that more recent data suggested a more favourable trend with less obesity and more healthy weight kids.
- [03:54]
B
And what about adults?
- [03:55]
E
We have some new Data from the 2012 Health Survey of England, and again, the numbers have stopped growing. The proportion of overweight adults has remained the same over the past few years, 60%. There are slightly more obese adults than there were 10 years ago. But again, the trend seems to have turned and the figures have been falling in recent years. Intriguingly, the same story is true in the United States. It's a serious problem, but not a problem that's getting ever worse.
- [04:25]
B
So, to summarise, the official foresight report was published in 2007 with very gloomy forecasts. Most of the Data published since 2007 have actually shown things aren't as bad as we thought, or at least we aren't deteriorating at the rate we thought we would. But there is one place where things are definitely getting the pages of this new report from an organisation called the National Obesity Forum. They were pretty unequivocal that things are worse than previously forecast and they want plenty of headlines for that claim. So I asked their spokesman to Tam Fry, where they'd got their numbers from.
- [05:02]
D
We think it's got worse because although we have no actual statistics and figures, we have a lot of observations and the word coming through from the clinics all over the country is that greater volume of people coming in for obesity, but more importantly, coming in for the conditions which obesity engenders, that is diabetes, cardiovascular problems, stroke. And 2007 was six years ago. And we have watched not very much improvement from what the government is doing, and therefore we deduce that in fact obesity is growing still.
- [05:40]
B
You say that your research is anecdotal. We do have data. And so the Health Survey of England found that obesity amongst all adults has been declining since 2010. So things don't seem to be getting worse.
- [05:54]
C
All.
- [05:54]
B
Or Another example, Clim McPherson, Professor Clint McPherson, who was one of the authors of the Foresight Report, he acknowledged shortly after that report was published that there was some new data, that maybe it was a blip, but it was rather positive. And when we interviewed him two years ago on this program, he said, actually, all the data that we have since the 2007 report was published has been surprisingly positive. So, I mean, do you think that data is just wrong? And if so, why?
- [06:20]
D
It is very difficult to rubbish data. But there are various problems attached to data. The first thing is that the data mainly relies on body mass index and body mass index traditionally under reports overweight and obesity. There is a lot of literature which actually states that for a fact. The second thing is.
- [06:39]
B
But do we think that. Sorry, do we think that the way the extent of that underreporting is changing systematically in some way, then?
- [06:45]
D
No, we just feel that in fact, or we know that the people reporting that obesity levels are at such a level.
- [06:56]
B
Your report, though, doesn't seem to make it clear that this is basically anecdotal. Soft evidence is important, qualitative evidence is important. But you say in the report that Studies published since 2007 show that obesity is increasing. But actually now here you're saying, well, no, it's actually a little bit more ad hoc than that.
- [07:14]
D
I think that maybe we were a little wrong not to be more forceful in why we were drawing these conclusions. I have to talk about obesity using official figures as well. And the conclusion that I have is that only last week Jeremy Hunt was saying quite specifically that 62% of adults were overweight and that there was a 26% obesity level in adults. And if you project that through another 20, 30 years is what we're doing, you have to have the conclusion that maybe the figures which were arrived at in 2007 or were faulty. And I think it.
- [07:54]
B
The person behind those figures, Climb Macpherson, says indeed they were faulty.
- [07:58]
D
Right.
- [07:58]
B
And the reason they were faulty is actually there's been good news since then and it's not as bad as he thought.
- [08:03]
D
Well, I mean, I respect Klim very much and his work. I think that what we were trying to do is to force home the message. You will criticize me and I'm sure you may well have grounds to do so, that a little exaggeration forces the message home. And that's what we wanted to do.
- [08:21]
B
Tam Fry of the National Obesity Forum. We checked the last available accounts for the National Obesity Forum, which were for the year ending 2010. Those accounts showed that several businesses who manufactured dietary supplements were making donations to the National Obesity Forum. Now, Tam Fry has told us that this is no longer the case. You're listening to more or less.
- [08:44]
A
An inquest jury has concluded by a majority of 8 to 2, that the fatal police shooting of Mark Duggan in North London in the summer of 2011 was lawful. His death sparked riots which spread to a number of cities in England.
- [08:57]
B
After the inquest into the death of Mark Duggan, the BBC managed to grab an interview with the Mayor of London, Boris Johnson. Mr. Johnson expressed his sadness at the loss suffered by Mark Duggan's family, but he had this piece of reassurance for the public. My message, really for Londoners is just about policing in this city and to remind people that our police are deployed. Armed responses. About 10,000 times in the last four years and on only six occasions have they actually fired their weapons, discharged police weapons. That caught our attention. We thought it sounded like an awful lot of armed operations and we wondered, is it just totting up each time an armed officer is standing outside Downing street or guarding the Queen? So we did the more or less thing and decided to investigate. And Charlotte MacDonald's here. Charlotte, what did you find?
- [09:50]
A
OK, well, the big picture is that Boris is broadly right. Armed police are deployed many thousands of times a year and they don't shoot very often. But let's back up a moment because, as so often on more or less, definitions are important. What we actually mean by unarmed police deployment is hard to pin down.
- [10:07]
B
Oh, really? I mean, we know what we mean by police, we know what we mean by guns. How hard can it be?
- [10:13]
A
Well, there are different types of deployment. So firstly, we're not talking about those armed police who stand guard Downing Street, Buckingham palace or, you know, airports and so on. That sort of security work is not included in the figures Boris Johnson was talking about. Instead, he was talking about armed responses which have been authorised for a specific occasion. They're either in response to an emergency or they're planned, like surveillance operations, which can last for days but only count as a Single operation. So, adding up both emergency and planned operations, there were 17,000 occasions where an armed response was authorised in London between 2010 and 2013.
- [10:53]
B
That's according to the Met, and that's a bit more than 10 a day. Clear enough. So, Boris, if anything, underestimated the number of deployments, was he right to say that shots were fired on only six occasions in the last four years?
- [11:06]
A
Well, according to the Metropolitan Police, yes, he was. Six occasions, but 20 shots in total, although half of them were fired last year. And that included, if you remember, the police apprehending the killers of Lee Rigby in Woolwich.
- [11:21]
B
What about fatalities? How many people have died after being shot by police?
- [11:24]
A
Well, still Talking about London, nine people have been killed by police since 2005, including high profile cases such as Mark Saunders, Azar Rodney, Jean Charles, Jimenezes. But only one person, Mark Duggan himself, has been killed by police in the last four years.
- [11:42]
B
Do we have figures for outside London?
- [11:43]
A
Yes. If you take the UK as a whole, five people were shot dead in the last four years.
- [11:49]
B
Every case, of course, is a very serious matter. But I do feel compelled to ask whether you have an international comparison for us.
- [11:55]
A
I'm sure you won't be at all surprised to hear that police in the US kill a lot more people.
- [11:59]
B
Well, not really. It's a big country. We know the police are routinely armed and they have to deal with suspects who are also off and armed. But still, how many people have the US police shot in the past four years? Shot dead?
- [12:10]
A
1,600.
- [12:13]
B
Thank you, Charlotte. My name's Tim Harford and you're listening to More Or Less
- [12:20]
A
Unemployed.
- [12:21]
B
Unemployed. Unemployed.
- [12:24]
D
You see this street here?
- [12:25]
B
James Turner street was one of the best streets.
- [12:28]
A
Unemployed.
- [12:30]
B
Unemployed. No, one of the worst. That's a clip from the Channel 4 documentary series benefit street, which has been proving somewhat controversial. It features a group of people living on James Turner street in Birmingham, and a large number of them are apparently on benefits. But how many?
- [12:49]
A
90% of residents are on handouts.
- [12:53]
G
A straw poll revealed 90% of residents
- [12:55]
C
living in the 130 in which 90% are said to claim benefits.
- [13:00]
B
Headlines from national newspapers. But is that true? Well, after some delving, it turns out they're actually just quoting someone who lives on the street. That is an opinion, a gut feeling, Finger in the air. Reporter Gavin Fisher's here. Hello, Gavin.
- [13:14]
H
Hello, Tim. Channel 4 doesn't back that figure up. It does say most of the people on James Turner street are on benefits, but when pressed, it told us its informal door to door surveys suggest that more than half of occupied households contain at least one occupant of working age claiming benefits.
- [13:32]
B
And let me stop you there, what do we mean by claiming benefits? My family collects child benefit. Are we claiming benefits? My dad's a pensioner. Is he claiming benefits? It's one of those terms that sounds crisp and specific, but actually it's pretty vague when you look at it.
- [13:48]
H
Well, quite. Ch4 mean working age benefits such as housing benefit, job seekers allowance or disability living allowance, but not child benefit and not pensions. We don't have official statistics on James Turner street anyway. The most detailed information from the Department for Work Pensions covers the level of a ward, which is usually about 5,000 people or so. James Turner street is in Soho Ward in Birmingham, where 27% of working age people claim these working age benefits.
- [14:18]
B
But this whole thing's really argument by anecdote. I mean, I know everyone's talking about James Turner street because it's on the telly, but actually it's no more important than any other street in the country. And we know for sure it was picked for television because it was unusual. So what do we know about the country as a whole?
- [14:33]
H
Well, the proportion of working age people in the UK who claim these working age benefits is just a shade under 14%. So Soho Ward is almost double the UK average. The place with the highest proportion of claimants is Rill west in North Wales. It's actually the only ward in the country with a majority of working age people on these benefits, 56.5% to be exact.
- [14:56]
B
And the ward with the lowest rate?
- [14:57]
H
Well, that's Hollywell in central Oxford, where, as far as I can tell, the overwhelming majority of res are students at Oxford Colleges. Only 0.4% of people claim working age
- [15:08]
B
benefits there, although the murder rate there is astonishingly high. I've been watching that gritty documentary, Lewis. Thank you, Gavin. The past few weeks have brought flooding for large parts of the uk. For those whose homes have been damaged, it must feel like a long time since the country was anything other than sodden. But we're sorry to say we may have found the cause when less than two years ago, we faced droughts and parts of southern England even had hosepipe bans. Our reporter Wesley Stevenson was heard to say we need an extra 320 millimetres
- [15:43]
H
of rain this summer, which is about a foot, and that's roughly double what we'd normally expect.
- [15:48]
B
So I think it's probably safe to say that we'd notice if we got it. Well, the evil Rain summoning wizard Wes has a lot to answer for. For no sooner had he uttered those words. And so the floods came. Nice one, Wes. And yes, we did indeed notice rainfall in England wasn't quite double expectations that summer. But for the six months from April to September of 2012, it was about 75% above average, which is just under 550 millimetres. And it feels like it hasn't stopped raining since. And now here we are, almost two years on.
- [16:28]
A
This is ITV News with James Mates.
- [16:32]
E
No end in sight. The worst winter storms for 20 years
- [16:35]
B
continue to grip much of Britain. But have we really seen the worst winter storms in 20 years? As many other news outlets also reported, ITV said it there, so did Channel 4 news, the Guardian, the Daily Mail and many others. The media didn't report numbers to back up the claim and the source, weather forecasting business Meteo Group, told us that rather than being being based on hard data, it was in part a subjective assessment. What a bit like this filthy weather? No, no, no, no, no, no, no, no. I've known worse. Oh, yes. When was that then? The great Storm, when the windmill got blown over. That wasn't the great Storm, that was a moderately windy night. You know, the really great stor with the Great Storm. When was that then? When Dave Bak got decapitated. That wasn't a great storm. Well, it was pretty damn great. The greatest storm was the one when old Harold got blown into the quarry.
- [17:43]
D
Who? That?
- [17:46]
B
Weather forecasting on BBC1's the Vicar of Dibley. To be honest, we just wanted an excuse to hear the voice of Roger Lloyd Pack, who died this week. It turns out that there is a little bit more to the business of judging great storms. I've been discussing the art of weather record picking with Liz Bentley, Chief Executive of the Royal Meteorological Society.
- [18:08]
C
We classify things particularly around storms in different ways. You might look at the amount of rainfall that we received, which was obviously very important over the last three or four weeks because we've seen, you know, significant flooding. You might look at the wind strength, for example, and again, there were some very extreme storms that came through, particularly during December, with wind strengths well above average. Or you might look at the central pressure of storms and particularly on the 24th of December we broke a 200 year record. So the classification, I should say.
- [18:39]
B
The 200 year record. Yes, you had me at that. That's impressive. So 200 year record for what?
- [18:44]
C
Yeah, so this is looking at the lowest mean sea level pressure that's recorded at a stat. So anywhere in the uk For a storm that develops that comes either close or crosses the UK and low pressure
- [18:57]
B
tends to mean wind rain.
- [19:00]
C
Absolutely. Okay, so the pressure got down to 935 millibars and it was I think 1886, so not quite 200. It's probably 150 years since we saw a pressure falling that low recorded and it was recorded at a place called Stornoway, which is in the outer Hebrides. The 1 in 20 year event that you mentioned in your question is more to do with looking at a whole range of storms that hit the UK during December and looking at December as a whole month and then looking back in the records to try and find when was the last month that we saw wind and storms such as this severity. And you have to go back to January 1993, so about 20 years ago. And that's why it's classified as a one in 20 year event.
- [19:42]
B
And is that an official classification or is that unofficial and is it an objective classification or is it expert judgment, common sense?
- [19:50]
C
It's a little bit subjective, but it gives you a headline message which can be very useful to, I guess the general public to understand how likely, how frequent we get these kind of events. And are they that unusual or are they fairly common?
- [20:05]
B
So the statement that this was the worst set of winter storms for 20 years, that's not something that you can sort of cast iron quantify and prove, but it's actually perfectly reasonable and helpful.
- [20:16]
C
Yes. And I think if you look back to the particular event that we were talking about, December 2013, the beginning of the month was actually quite settled. It was about the middle of the month when the storms really started to develop. So we're actually looking at only half of the month, averaging it over a whole month, and then trying to find a month somewhere back in history that actually had a similar set of storms coming through. If we want it to look for just a two week window, we probably have to go much further back in time.
- [20:47]
B
Liz Bentley from the Royal Meteorological Society, you're listening to More or Less. And our email address, as always, is more or lessbc.co.uk. just before Christmas, all those stories about turkey and mince pies were replaced with headlines about a different sort of food.
- [21:05]
A
An apple a day keeps thousands of deaths at bay. Why an apple a day could be as good as a statin for over 50s.
- [21:13]
B
The BBC news headline said apple a day call for all over 50s. And their first paragraph said, if everyone over the age of 50 ate an apple a day, 8,500 deaths from heart attacks and strokes could be avoided every year in the uk, say researchers. Well, a source of these headlines was a study that featured in the British Medical Journal. But contrary to what you might think, this wasn't an exhaustive clinical trial of munching on Cox's orange pippins and Granny Smiths. Instead, a group of researchers at the University of Oxford used mathematical models based on earlier research about the general health benefits of fruit and veg to test the proverb an apple a day keeps the doctor away. They did essentially two thought experiments. One, currently, there are 5 million people considered at risk of heart disease who were already prescribed statins by the nhs. So what would happen if we prescribed statins to everyone in the UK population over 50? And how many lives might be saved each year by preventing heart disease if we did that? And then the second thought experiment, why not go one step further and see if we could work out how many lives could be saved each year from heart attacks and strokes if everyone in the population over 50 ate an apple? Lo and behold, the researchers found that eating an extra apple a day would indeed save 8,500 lives, almost as many as offering statins to all over 50 year olds. All very nice. But Paul Morantz, a doctor in the US at the Albert Einstein College of Medicine, had some problems with the paper. He wrote a blog post about it. Why?
- [22:54]
I
What they did was, if you'll pardon the pun, compared apples and oranges. They took data from the statin trials, which were based on randomized controlled trials, and compared it to what they actually called apple consumption. But that was already an extrapolation from studies of fruit and vegetable consumption, and they just modeled it as if that meant apples. And even more to the point, no studies of dietary patterns can follow the randomized control trial paradigm. So this is not to say that those sorts of studies aren't important and can't yield meaningful inferences, but it's not at the same level of methodologic rigor.
- [23:40]
G
So initially, I would certainly concede that the level of evidence underlying the effectiveness of statins is a higher level or a better degree of evidence.
- [23:50]
B
This is Adam Briggs, one of the authors of the study.
- [23:52]
G
The related evidence for fruit and vegetables, and for apples, and so fruit more generally, is a meta analysis again, but instead of trial data, it's of observational data. So it's following people forward, looking at what they eat. Now, it's not as good evidence as statins, but it is the best evidence that is currently available. It is very difficult, if not impossible, to Do a proper randomised controlled trial of increasing apple intake in a population. Yes, people may argue that these two things should never have been compared in the first case. However, I would argue also that in the degree of health care at the moment, we have to make decisions about what we do for our population. So things, what people will call apples and oranges are being compared all the time and they have to be to make decisions. In the main paper about this, we make very transparent our assumptions and our limitations for this research and I think that's really crucial when you do any kind of modelling.
- [24:42]
B
Now, the article featured in the Christmas edition of the bmj, reputed for being more light hearted than usual and jokes abounded in the piece
- [24:51]
H
A Statin a Day Keeps the Doctor Away, Comparative Proverb Assessment Modelling Study, no side effects were modelled for increased apple consumption, aside from the distress caused by a bruised apple and the theoretical risk of identifying half a worm inside.
- [25:08]
B
Do you think the authors were joking or not?
- [25:10]
I
I feel very confident that the authors had their tongues firmly planted in their cheeks in this paper.
- [25:17]
G
So I don't think we're joking in terms of what the potential benefits can be of preventing disease and ways of doing that, I. E. Lifestyle changes or taking medications. How the article's presented. Yes, a lot of it was tongue in cheek and that, as I say, fits with the Christmas BMJ edition. And the tongue in cheek bit is saying, an apple a day keeps a doctor away. That's the tongue in cheek bit, picking an apple. To do this, you could write a more serious nuance paper which stresses the fact that actually it could be any extra piece of fruit. To do this, you could then compare it to other drugs, you compare it to other vegetables, etc. So I would say that an apple a day has the potential to significantly improve population health and that preventing illness in the first place is better than treating it. And what we've identified is that simple interventions can lead to really important health benefits and that what we're not saying to take it the other way, Tim, is that you should be swapping your statins for apples. Instead you should be adding in your apple.
- [26:16]
B
To sum up, the Christmas British Medical Journal does contain articles which are pure jokes, but it also contains articles which, while they have a humorous tone, are serious. And Adam Briggs says he was indeed serious. So I put that to Paul Moretz.
- [26:31]
I
No harm done for discourse among the scientific community. I think this paper made very important points. The whole issue of what's the relative impact of a lifestyle modification approach versus a pharmacological approach. This is a major issue in preventive medicine and it's an important issue. And I think what I objected to was the way it was promulgated by a press release from the bmj, as if this were a truly serious study and then got picked up by a lay press that was completely blindsided by the fact that this was really kind of a joke, but a joke with an underlying point.
- [27:11]
B
But Adam Briggs thinks that even when his paper reached the likes of you and me through the filter of an excitable press release and excitable headlines, it was still a contribution to public health and public discourse.
- [27:22]
G
This is clearly something that the public are interested in and all we're doing is hopefully being able to bring forward that debate that both medicine and lifestyle interventions can have really meaningful effects on people's health.
- [27:36]
B
Adam Briggs, that's all we've got time for this week. Please keep your questions and your comments coming to more or lessbc.co.uk. you can download the program and many other editions at our website BBC.co.uk more or less until next week, Goodbye.
- [27:55]
A
More or Less was presented by Tim Harford, the Financial Times undercover economist. It was produced by Ruth Alexander and made in association with the Open University. You can Download many more Radio 4 programmes for free. Find these@BBC.co.uk Radio 4.