The Fat Pack Wonders if It's Time to Slim Down

melkor · March 19, 2008

The NY Times has an article about healthy eating for the food obsessed. It's interesting to see the arguments the people quoted in the article make - most of the food writers and critics suggest that there is a less than direct relationship between what you eat and your health. Is that something people who don't write about food for a living believe to be true? I wonder if the skinny food writers also believe this is the case. My experience when I've had back-to-back meals at Michelin starred restaurants that I feel less healthy than I do after a trip to the gym and a salad. The scale the next day confirms this hypothesis. Maybe that's the genetic lottery at work, but it seems pretty direct to me.

weinoo · March 19, 2008

Yep, me too. I've always felt that everything is OK in moderation, and that the only true way to lose weight is to consume less calories than you expend...it's simple math.

I think it's a bit like burying one's head in the sand to dismiss a lot of what medical science has discovered over the past 30 years linking diet and lifestyle to things like obesity and diabetes...and while it's true that genetics and heredity play a huge part in the determination of how long (and in what health) each of us is going to live, there are ways to better one's odds in the long run.

JohnnyH · March 19, 2008

I, too, found the article interesting, and I'd like to take a second to congratulate Jason -- his is quite an achievement.

FG's claim that diabetes is overdiagnosed seemed defensive. As a former journalist, though, I'm perfectly willing to concede that the comment may have been part of a larger thought/comment of his that the author cherrypicked for exactly that reason. That said, and in the interest of giving Steven the full benefit of the doubt, I wonder if he would mind pointing out what evidence he relies on for his statement.

Edited March 19, 2008 by JohnnyH (log)

**Chris Hennes** · March 19, 2008

I think it's a bit like burying one's head in the sand to dismiss a lot of what medical science has discovered over the past 30 years linking diet and lifestyle to things like obesity and diabetes
←

In my opinion, a big part of the problem is the mis-reporting, or perhaps just overzealous interpretation, of the scientific results, which then leads people to mistrust science in general. In science we find a lot of correlations, but can seldom draw a direct causal link. There are a lot of variables at work, and health is a very complicated issue. We also see a strong trend of "fear-mongering" among a large part of the mass media: they seem to love telling us that this that and the other thing will kill us any day now. There is usually a grain of truth hidden in the mountain of hyperbole... I think it is a mistake to simply ignore health advice from scientists just because our understanding of the human body is incomplete.

hummingbirdkiss · March 19, 2008

very good article ..I am an RN/food lover/ and potentially overweight person who has to watch what I eat constantly to be able to eat what I want...I work in a very busy clinic setting where I triage and care for acute/urgent/emergent situations. I would be twiddling my thumbs all day long if there was not an obesity epidemic . I dont care who writes what about what ..I am telling you this is a fact of my day to day life!.....I work my ass off with huge percentage of what I treat directly related to obesity....diabetes, blood sugars so high I wonder how the blood circulates at all... stasis ulcers, renal failure, various cardiac issues, nasty skin infections under fat folds, the inablity to even collect your own urine sample for a bladder infection..the inablity to urinate or empty a bladder at all ....asthma, pneumonia, GERD, hypertensive events, falls, severe post op complications, chf not to mention severe depression at not being able to attend to ones own hygeine...I could go on and on and on...but I think the point is clear...yes there are other health conditions besides this . ..but right now for me as a nurse ..obesity is the greatest issue and the one that keeps me in line ..seeing other people suffer like I do and trying hard to be a decent example of trying to preserve my health is a way of living and it is not easy! Eating is so much pleasure to me!!!

if you eat the foods you love in moderation ..get some exercise ..avoid processed, fast and crapfoods ....you can and will keep yourself well

yes you can get sick and die of anything ..sadly I know that all to well right now .....but folks who choose to ignore obesity will end up in my care (figurativly) with, embarassing to critical conditions that could and should be avoided...

make each bite of food that enters your mouth count for something

and you may never see me! I would not mind being unemployed for those reasons that is for sure!

Edited March 19, 2008 by hummingbirdkiss (log)

annecros · March 19, 2008

Ed Levine's snippet bothered me:

“I love food and I draw so much pleasure from it. How do I not have it kill me?”

I think the whole article almost treats food as the "enemy" - something that simply is not true. Food is not the enemy - age is the enemy. Metabolism changes, exercise is not as easy, on and on.

My primary will not use the Fasting Glucose Tolerance Test because of it's inaccuracy and false positives. I don't know what she is basing that on, but she states it as fact. I have to pay more for the Oral Glucose Tolerance Test, and it is two hours of sitting around (which is why many practitioners use the Fasting Test instead) but I have so many other health issues we have to be absolutely sure that diabetes does not figure in to the mix because my malabsorption issues and GI scarring require that I eat nutritionally dense foods that are high in fat. My blood glucose does weird things from time to time, but as a side effect of other health issues, sort of like gestational diabetes, and at it's worst has only been a borderline problem. Type 2 diabetes, well yeah, lose weight and you don't have to worry about it. Don't ever get old, and you really don't have to worry about it. :biggrin: Or go on Atkins, eat meat three meals a day, lose weight, your cholesterol goes down, and your Type 2 diabetes goes away.

Also, there's a bit of me that wonders if the day that I avoid the pork belly will the day I get hit by a choo-choo train. I pretty much eat the pork belly if I want it.

hummingbirdkiss · March 19, 2008

I eat pork belly and all kinds of fatty foods they fill you up and keep you full unlike processed foods that bind to nothing but the "gimme more factor" .....but eat it in moderation it is a part of an entire plate not the plate itself..

people please know that diabetes is underdiagnosed if anything! one day with me is enough to convince anyone I would think ...genetics are a huge issue so is age ..but you can manage and care for yourself too!

ok nuff said I need to go serve the masses now ...come be a fly on the wall with me and it will make you understand where I am coming from

eat a wide variety in moderation of everything you enjoy and you will do much much better in the long run

that is for sure

bye now and good luck to everyone on this issue!

eta my words are based on what I see and do for a living ..day after day for many many many years and can honestly say the past 10 years there has been a huge increase the number of younger and younger patients with obesity related illness ..it is not easy to avoid this ..but most of these things can and should be avoided ..for quality of life if not quantity...

Edited March 19, 2008 by hummingbirdkiss (log)

bergerka · March 19, 2008

I, too, would like to hear how exactly it is that diabetes is "overdiagnosed," since, um, it's diagnosed by testing blood glucose levels, not by, yanno, flipping a coin or something.

All in all a good and interesting article. I too subscribe to "everything in moderation," and I don't feel it decreases my enjoyment of life at all to do so. If anything, it's increased, since after I eat a meal I don't still feel too full to eat two days later... :laugh:

Tess · March 19, 2008

I've got to run out and get that April issue of Vogue.

Jeffrey Steingarten, the food writer, takes on the troubling issue of genetics, food and pleasure in the April issue of Vogue. As an enthusiastic eater long in search of a perfect figure, he agrees with the Fat Pack’s stance against mainstream diet and exercise advice and their belief in genetic predisposition to heft. “But,” he said, “that doesn’t give an excuse to the fatty to say O.K., I’m not even going to think about it because it is just so hard to do.”

Steingarten's been extremely interesting on the subject of weight and diet in the past.

My feelings about this are split right down the middle. On the one hand, I think Americans are completely deluded on the subject of portion sizes. (Most of the people quoted in the article are from the U.S., no?)

On the other, I think most diet advice that's given out is crummy. People who have experience with weight-loss diets have good reason to be cynical about them. Some of the people quoted in the article are probably of an age to recall when there was a weight-loss candy called "Ayds." What a nightmare. We talk about being more enlightened now, but a lot of that's talk. The statistics about diets "working" long-term seem pretty abysmal.

What are you supposed to do? For me, it's lots of exercise and periodic reversions to Weight Watchers-- which work somewhat while reminding me how hard it is to count calories. I'm never going to look at a fat person on the street and say, "Eat less; more more" or some pat thing like that. For some people it is a really difficult issue.

docsconz · March 19, 2008

Interesting article indeed.

I can attest, both personally and professionally that diabetes is not only diagnosed, it is underdiagnosed and a growing problem in so many ways. When I was first diagnosed almost nine years ago, I thought it was the end of the world. Fortunately, I learned that it was not and that I could still enjoy the foods that I like, only not with the total abandon that I used to. I can also attest that what and how much I eat certainly effects how well I do or don't feel.

While an ardent supporter of science and the scientific method, one must also understand the basic reality of science. Rarely does it provide hard and fast answers. We expect science to lead to factual truth, while the reality is that it generally leads to more questions. As such, I rarely take the latest study and media pronouncements with anything other than a grain of salt. fat Guy is right that the landscape is ever-shifting like the sands on a beach. That being said, I agree with those who preach moderation as it simply makes sense and I generally feel better when I apply that dictum. I also believe in variety since one can "have too much of a good thing."

Food and its enjoyment is simply too important for me to give it up or become too stressed by all the little details. I wish to enjoy my life and seek to find some compromise between excess and responsibility. I have always and still do believe in quality over quantity and try my best to adhere to that goal. That helps me achieve the compromise I am seeking as best I can.

Doodad · March 19, 2008

I can relate one thing that has happened in my life that may be what they are talking about at least with diabetes.

My wife has never had a problem with diabetes and it does not run in her family. She did need to lose a few pounds, that is true. She had her physical and the doctor came back and said "you have glucose intolerance" which is a precursor to diabetes. The doctor put her on medication.

Come to find out, my wife was one point over the standard which had been moved downward that year. A few months earlier she would not have been diagnosed this way. The move downward for the threshold was more than one or two points. So now she is on a "maintenance" medication, which I think has ill side effects. Good for the pharm industry though.

annecros · March 19, 2008

I, too, would like to hear how exactly it is that diabetes is "overdiagnosed," since, um, it's diagnosed by testing blood glucose levels, not by, yanno, flipping a coin or something.
All in all a good and interesting article. I too subscribe to "everything in moderation," and I don't feel it decreases my enjoyment of life at all to do so. If anything, it's increased, since after I eat a meal I don't still feel too full to eat two days later...
←

Well, I have no idea where the accuracy of the diagnostic rate for diabetes falls, and would prefer to spend some time researching before I found myself on one side or another. I do know that the condition I have is grossly under diagnosed.

However, I may be able to help you understand that blood tests do not a diagnosis make. There is almost always a clinical component to a diagnosis - that is the patient's symptoms are observed. I may be wrong, and I am sure that the fine professionals here will correct me if I am, but I don't think diabetes is one of those "silent killers" like high blood pressure. In order for a diagnosis to be definitive, I think it takes blood work and symptoms both to come to a probably conclusion. Doctor's are practicing, remember.

So many things can skew those blood tests. Take it from somebody who gets a complete metabolic profile every quarter (along with a bunch of other ancillary tests), Some of the tests depend upon a patient being honest ("Are you fasting today?" "Yes" even though they ate a banana at 4AM), and the lab staff performing them perfectly every time. Just as an example, I had white blood cell counts for a period of about 2 months that would indicate either Leukemia or Septicemia - but had no symptoms. After some time and retesting, the counts found a normal range again, no explanation even from the hematologist. Conversly, my Scleroderma diagnosis was initially a clinical one, based upon symptoms, and I was "sero-negative" for two years before it popped up in my blood work. I had enough symptoms that I could be treated, and thank goodness. However, I would guess that most people would not want the treatment for diabetes based upon blood work alone, especially if the positive result is because the patient sucked on a Jolly Rancher on the way into the lab.

Over medication now, that happens all the time.

My food choices, I make them every day depending upon what I am in the mood to eat. I think many in the medical profession, as an occupational hazard, see only the extremes in patients. If you spend all day long seeing only the portion of the population that are so morbidly obese that their eating habits cause life threatening health issues, then yeah, it would be easy to come to a conclusion that food is an evil killer.

JanMcBaker · March 19, 2008

I can relate one thing that has happened in my life that may be what they are talking about at least with diabetes.
My wife has never had a problem with diabetes and it does not run in her family. She did need to lose a few pounds, that is true. She had her physical and the doctor came back and said "you have glucose intolerance" which is a precursor to diabetes. The doctor put her on medication.
Come to find out, my wife was one point over the standard which had been moved downward that year. A few months earlier she would not have been diagnosed this way. The move downward for the threshold was more than one or two points. So now she is on a "maintenance" medication, which I think has ill side effects. Good for the pharm industry though.
←

And if it hasn't been done already, there was also talk about lowering the 'normal' values for blood pressure. I wondered what hand the drug companies had in that! After all, if your BP is suddenly 'high', what will your doctor likely recommend? Oh, and weight loss does not automatically help. I lost a lot of weight and my blood pressure is still high. No one had ever told me that it might stay high no matter what I did..... :angry:

**Dave the Cook** · March 19, 2008

. . . .
That said, and in the interest of giving Steven the full benefit of the doubt, I wonder if he would mind pointing out what evidence he relies on for his statement.
←

I can't speak for Steven, of course, but I can point to several studies to support his contentions.

See this 2007 article in the New York Times. It concerns, among other things, the results of a 1986 study of identical twins separated at birth -- the gold standard for genetic studies (the study was published in the New England Journal of Medicine):

The adoptees were as fat as their biological parents, and how fat they were had no relation to how fat their adoptive parents were.
The scientists summarized it in their paper: “The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect.”
In other words, being fat was an inherited condition.

Another piece in the Times (this and the preceding column are both by Gina Kolata; article here) talks about Rockefeller University obesity researcher Dr. Jeffrey Friedman:

Dr. Friedman points to careful statistical analyses of the changes in Americans' body weights from 1991 to today by Dr. Katherine Flegal of the National Center for Health Statistics. At the lower end of the weight distribution, nothing has changed, not even by a few pounds. As you move up the scale, a few additional pounds start to show up, but even at midrange, people today are just 6 or 7 pounds heavier than they were in 1991. Only with the massively obese, the very top of the distribution, is there a substantial increase in weight, about 25 to 30 pounds . . .
. . . .
Dr. Friedman gave an analogy: ''Imagine the average I.Q. was 100 and that 5 percent of the population had an I.Q. of 140 or greater and were considered to be geniuses. Now let's say that education improves and the average I.Q. increases to 107 and 10 percent of the population has an I.Q. of above 140.
''You could present the data in two ways,'' he said. ''You could say that the average I.Q. is up seven points or you could say that because of improved education the number of geniuses has doubled.''
He added, ''The whole obesity debate is equivalent to drawing conclusions about national education programs by saying that the number of geniuses has doubled.''
. . . .
Obesity, Dr. Friedman says, is a problem; fat people are derided and they have health risks like diabetes and heart disease. But it does no one any good to exaggerate the extent of obesity or to blame the obese for being fat.
''Before calling it an epidemic, people really need to understand what the numbers do and don't say,'' he said.

One more from Kolata:

Scientists now believe that each individual has a genetically determined weight range spanning perhaps 30 pounds. Those who force their weight below nature’s preassigned levels become hungrier and eat more; several studies also show that their metabolisms slow in a variety of ways as the body tries to conserve energy and regain weight. People trying to exceed their weight range face the opposite situation: eating becomes unappealing, and their metabolisms shift into high gear.

Malawry · March 19, 2008

I think this is a very important issue in the food world, and one that is not discussed as often as it should be. I never met a donut or pork belly I didn't want to eat, but fortunately I love grapefruit and broccoli enough that I can work towards a balance.

I hope Fat Guy responds to the questions about his quote in the NYT story, but in the meantime I hope this thread doesn't become a debate about the prevalence of diabetes diagnosis.

Jason Perlow posted a recipe for the grilled mushroom dish he's eating in the photo from the NYT story on his personal blog. Personally, I find the Perlow approach to healthy eating refreshingly nondogmatic and appealingly international in scope.

I once worked with a nutritionist in Washington, DC who has close relationships with several area culinary professionals, including some well-known area chefs who have been clients and collaborators. Learning how to eat well on every level is difficult. I appreciated working with somebody who didn't tell me to completely avoid certain foods, but there aren't a lot of "diet gurus" who do that. It's difficult for most food lovers, no matter what your genetic predispositions.

JohnnyH · March 19, 2008

. . . .
That said, and in the interest of giving Steven the full benefit of the doubt, I wonder if he would mind pointing out what evidence he relies on for his statement.
←
I can't speak for Steven, of course, but I can point to several studies to support his contentions.
See this 2007 article in the New York Times. It concerns, among other things, the results of a 1986 study of identical twins separated at birth -- the gold standard for genetic studies (the study was published in the New England Journal of Medicine):
The adoptees were as fat as their biological parents, and how fat they were had no relation to how fat their adoptive parents were.
The scientists summarized it in their paper: “The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect.”
In other words, being fat was an inherited condition.
Another piece in the Times (this and the preceding column are both by Gina Kolata; article here) talks about Rockefeller University obesity researcher Dr. Jeffrey Friedman:
Dr. Friedman points to careful statistical analyses of the changes in Americans' body weights from 1991 to today by Dr. Katherine Flegal of the National Center for Health Statistics. At the lower end of the weight distribution, nothing has changed, not even by a few pounds. As you move up the scale, a few additional pounds start to show up, but even at midrange, people today are just 6 or 7 pounds heavier than they were in 1991. Only with the massively obese, the very top of the distribution, is there a substantial increase in weight, about 25 to 30 pounds . . .
. . . .
Dr. Friedman gave an analogy: ''Imagine the average I.Q. was 100 and that 5 percent of the population had an I.Q. of 140 or greater and were considered to be geniuses. Now let's say that education improves and the average I.Q. increases to 107 and 10 percent of the population has an I.Q. of above 140.
''You could present the data in two ways,'' he said. ''You could say that the average I.Q. is up seven points or you could say that because of improved education the number of geniuses has doubled.''
He added, ''The whole obesity debate is equivalent to drawing conclusions about national education programs by saying that the number of geniuses has doubled.''
. . . .
Obesity, Dr. Friedman says, is a problem; fat people are derided and they have health risks like diabetes and heart disease. But it does no one any good to exaggerate the extent of obesity or to blame the obese for being fat.
''Before calling it an epidemic, people really need to understand what the numbers do and don't say,'' he said.
One more from Kolata:
Scientists now believe that each individual has a genetically determined weight range spanning perhaps 30 pounds. Those who force their weight below nature’s preassigned levels become hungrier and eat more; several studies also show that their metabolisms slow in a variety of ways as the body tries to conserve energy and regain weight. People trying to exceed their weight range face the opposite situation: eating becomes unappealing, and their metabolisms shift into high gear.
←

Point taken, but Steven's quote had to do with diabetes -- "I think the whole diabetes thing is a major hoax," he said. "They are overdiagnosing it." -- not obesity.

**Dave the Cook** · March 19, 2008

Fair enough.

An increase in diagnoses isn't the same thing as increased incidence. This article discusses the issue:

It may just be that more people are learning they have the disease, not that the number of those with it is increasing.
. . . .
In a paper published last year in Diabetes Care, federal scientists used those data to ask what was the total proportion of the population with diabetes — diagnosed and undiagnosed.
Their surprising conclusion, said Katherine M. Flegal, an author of the paper and an epidemiologist at the National Center for Health Statistics, was that the overall age-adjusted proportion of the population that has diabetes had not really changed from 1988 to 2002, the most recent year for which federal data are available.

melkor · March 19, 2008

What are you supposed to do? For me, it's lots of exercise and periodic reversions to Weight Watchers-- which work somewhat while reminding me how hard it is to count calories. I'm never going to look at a fat person on the street and say, "Eat less; more more" or some pat thing like that. For some people it is a really difficult issue.
←

Obviously people are born with a tendency towards one body shape or another - all of us know someone who eats everything in sight and stays skinny. That doesn't give the rest of us an excuse to ignore a huge health problem. I fail to see how being born predisposed to being heavy is an excuse not to take care of yourself.

The problem is that there aren't any easy answers. Pork belly and fried chicken isn't the key to longevity, though my grandmother, being one of those people who eats everything and stays skinny is under the impression that ice cream has kept her healthy all these years. It's a problem with a different solution for each of us. The only sustainable solution for me has been to get a lot of exercise and eat more intelligently. More veg and fish, sane portion sizes, etc. I eat whatever I want, but I pay attention to portion size and I spend 6-10 hours a week at the gym. For me, that yields a pound of weight loss every two weeks or so, but more importantly I don't need to give up eating the food I love. At this rate it'll take me about a year before I'm at my target weight.

weinoo · March 19, 2008

The only sustainable solution for me has been to get a lot of exercise and eat more intelligently. More veg and fish, sane portion sizes, etc. I eat whatever I want, but I pay attention to portion size and I spend 6-10 hours a week at the gym. For me, that yields a pound of weight loss every two weeks or so, but more importantly I don't need to give up eating the food I love. At this rate it'll take me about a year before I'm at my target weight.
←

And that's certainly one of the most sensible ways to do it - fad diets, pills, etc. are not panaceas - the way you're approaching it should help you to stay at your target weight, as long as you continue to eat sensibly and exercise - calories in minus calories out - if the number is negative, you'll lose weight; if not, you'll gain. Simple math.

weinoo · March 19, 2008

Come to find out, my wife was one point over the standard which had been moved downward that year. A few months earlier she would not have been diagnosed this way. The move downward for the threshold was more than one or two points. So now she is on a "maintenance" medication, which I think has ill side effects. Good for the pharm industry though.
←

Well, as with any medical conditions, you can hopefully participate in the decisions being made. Do research, get a second and third opinion.

Numbers for safe cholesterol and blood pressure have been lowered over the last ten years - most docs prefer to err on the side of caution (might have something to do with liability) and we certainly can't rule of the pharm industry from pushing these newer standards down our throats.

So far, it seems that the medical professionals posting in this topic agree that diabetes is a big problem, and it is being under-diagnosed - see docsconz and hummingbirdkiss' posts above. So maybe that's the reason for the lowering of the range of what's considered "healthy" in today's society.

**Dave the Cook** · March 19, 2008

With all due respect, asserting that a condition is underdiagnosed is a logical impossibility. The only way to obtain facts to back up such a statement is to have, well, diagnosed the condition. In which case . . .

weinoo · March 19, 2008

With all due respect, asserting that a condition is underdiagnosed is a logical impossibility. The only way to obtain facts to back up such a statement is to have, well, diagnosed the condition. In which case . . .
←

But what if people avoid even going to the doctor? Then, they hit the emergency room and voila, the condition(s) is/are diagnosed.

annecros · March 19, 2008

With all due respect, asserting that a condition is underdiagnosed is a logical impossibility. The only way to obtain facts to back up such a statement is to have, well, diagnosed the condition. In which case . . .
←

Makes sense. The term should be misdiagnosed, if any term is necessary. Now over treatment or over medication can very well apply in this situation. Type 2 Diabetes, that I think about 80% or so of the diagnosed Diabetics suffer from, can be controlled with diet and exercise. Although who is to say that the pancreas behaves differently in a person that is predisposed to being overweight?

No symptoms, no problems, no doctor visit, no ER visit = no diagnosis.

melkor · March 19, 2008

With all due respect, asserting that a condition is underdiagnosed is a logical impossibility. The only way to obtain facts to back up such a statement is to have, well, diagnosed the condition. In which case . . .
←

Wouldn't Perlow be an example of an undiagnosed case of diabetes? Dude thinks he's healthy, starts feeling crummy, talks to a doctor who says "Surprise, your 400 pound self has diabetes!". How many people like that are walking around under the impression that everything is fine?

melkor · March 19, 2008

Well, as with any medical conditions, you can hopefully participate in the decisions being made. Do research, get a second and third opinion.
Numbers for safe cholesterol and blood pressure have been lowered over the last ten years - most docs prefer to err on the side of caution (might have something to do with liability) and we certainly can't rule of the pharm industry from pushing these newer standards down our throats.
So far, it seems that the medical professionals posting in this topic agree that diabetes is a big problem, and it is being under-diagnosed - see docsconz and hummingbirdkiss' posts above. So maybe that's the reason for the lowering of the range of what's considered "healthy" in today's society.
←

The folks over at Gawker seem to agree with the medical professionals on this thread. I really can't fathom how anyone would make the case that diabetes is a myth or that ignoring the health risks associated with obesity is wise. There are several studies that disprove the idea that overweight people require more health care - the general consensus seems to be that if you're morbidly obese you'll require more health care each year of your life but your life will be so much shorter that in the end the total costs are similar to that of someone who is a healthy weight. My family has a history of heart disease; my father had two heart attacks at age 57; his father died young of a heart attack - there's no doubt in my mind that if I don't take care of myself the same thing will happen to me. It seems to me to be completely irresponsible to advocate eating yourself to death. If you want to pretend to be a duck raised for foie gras, feel free to grab a funnel and shovel everything you can find into it - that's a personal choice. It isn't a good one, but everyone can make their own decisions.

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