 Poster: A snowHead
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abc, as I said, it means you're at increased risk.
Current medical thinking is that a high waist to hip ratio is a measure of high levels of intraabdominal adipose tissue (fat!). I know that it's validated for caucasians, not sure about other races.
Current medical thinking is that although genetics may give a predisposition to abdominal obesity, lifestyle is the overriding cause.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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You need to Login to know who's really who.
You need to Login to know who's really who.
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The good news is that all these measurements are taken after fasting for 12 hours. 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Can't access the Australian study.
From the Mexican study: "Logistic regression analyses disclosed that only BMI and age were included in all the models as well as the influence of smoking in DM and dyslipidaemia in men. CONCLUSION: Although these results may not be readily applied to the rest of the Mexican population or to other Hispanic populations, they point to the necessity of similar studies with large randomized samples to find the cut-off levels for chronic conditions in different populations."
In other words, the sample are not "random" enough to include the "usual" range of the population to draw scientifically sound conclusions.
The Hong Kong study concludes: "In men, central adiposity as reflected by WC and to some extent, WHR, explained most of the variance in blood pressure, plasma glucose, lipid, insulin and albuminuria. In women, all three indexes reflecting general and central obesity contribute to the variance in these risk factors."
In this case, waist size was found more significant than waist-to-hip ratio, contrary to the conclusion for Cucasians!
If race can influence the significant of such "size" measurement to such a large degree, I suspect the same applies to individual genetic make up. After all, what's a race but genetic make up?
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You'll need to Register first of course.
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Megamum, take no notice of this lot, have fun on your bike, the fitness thing will become a bonus, I just love being out on my bike, did x miles today in the rain still feel great 6 hours later, pants still damp.
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| Kramer wrote: |
| abc, as I said, it means you're at increased risk. |
"increased", from what?
Crossing the street put you in "increased risk" of getting hit by a bus. But that's an increase from an extremely small risk to another extremely small risk. If there're other factor more important than "sizes", than the "increased" risk for one might be no big deal while it may tip the balance for another.
I'm not arguing size has NO correlation to cardiovascular disease. But I AM argueing those "magic number" of waist size or waist2hip ratio are against scientific principle. In this case, the definition of statistics.
It's far too easy to look at a statistical study and confused it with a deterministic measurement. While a deterministic measurement always yields the same number and applies to each and every one individual, a statistical number only means a portion of the subject (usually about 67~68%) falls on one side of the number. That leaves a good portion of the individual cases it doesn't say much about.
So, just because you're a tiny bit above a certain number, or a minute bit below, doesn't even means your risk increase or decrease accordingly. You have to be a good bit off that "line on the sand" before you can say you're changing your risk in any meaningful way at all!
And the same goes to advices of exercise based on such mis-understanding of these studies. There're large variation amounst individuals that "statistical" conclusions can't "determine".
So measure away if you like. But only for measuring your own progress against your old self. Don't fall into any illusion you're meansuring against any deterministic "scientific goal".
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abc, Go ahead and ignore risk factors for all I care.... Kramer is simply stating the evidence we have.... Population studies are always fraught with problems because unlike rats we cannot lock people up and ensure everything bar one factor in their lives is identical (damn  ).... There are always outliers - you know that... the "freak" who is 7foot 6inches tall.... So we have people that smoke all their lives and go on to live for a long time and not get lung cancer.... However we know that the CHANCES of getting lung cancer (and having limbs amputated and having a stroke and a heap of other stuff) are many times higher in smokers.... You are welcome to argue you are not going to be the one - you may be right .... but me I like to know the odds and I prefer not to gamble too much....
One day we will know more and be able to assess genetic make-up better and the impact of risk factors on this.... but right now Kramer is stating the best we have.... Ignore if you wish - take any measure you want - there are plenty of studies out there with varying degrees of evidence... there are meta-studies also ... and then reviews of multiple studies as well.... Search the cochrane reviews... Take any answer suits you or ignore the lot...
BTW - the study has nothing to do with exercise and I did not see kramer quoting exercise as related to waist-hip ratio.... (I thought he did relate one to possibility of improving other) but I have only scanned this thread as very long....
http://www.bmj.com/cgi/content/full/320/7236/709 Has another way of looking at cardiovascular risk.... and you are right - even that shows that if you are in certain areas you may have to decrease a measure by a lot or decrease 2 measures to get to a different risk level.... Oh and BTW - notice the different tables for diabetics - guess what those anthropomorphic measure you hate are well correlated with diabetes too
You might also wish to contemplate on the fact that actual measurement of central abdominal adiposity is not simple in people(well after they die it is easier) - hence the anthropomorphic measure.... but the correlation between ACTUAL adiposity may well be better - who knows with MRI's maybe we will get better data.
If you really dislike hip-waist ratio etc perhaps an MRI of abdomen will make you feel happier
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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abc, and you missed this bit
| Quote: |
| CONCLUSIONS: In Hong Kong Chinese, BMI, WHR and WC provide important information in assessing cardiovascular risks. |
(my bolding)
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| little tiger wrote: |
abc, and you missed this bit
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| CONCLUSIONS: In Hong Kong Chinese, BMI, WHR and WC provide important information in assessing cardiovascular risks. |
(my bolding) |
You're missing the point.
I RE-quoted what I quoted earlier: "In men, central adiposity as reflected by WC and to some extent, WHR, explained most of the variance in blood pressure...".
Yes, the rest are "important" but what "explains MOST" of the variance?
More over, you ARE confusing statistic with measurement, as I pointed out. Those "freaks" you quoted are NOT freaks, they're "normal" statistical variations, which (the variation) is a continium. In other words, there're a lot of the population (about 30%, if they're using the one-sigma cutoff) falling between "norms" and "freaks".
| Quote: |
| If you really dislike hip-waist ratio etc perhaps an MRI of abdomen will make you feel happier |
It's not about ME being happy with the numbers. I'm of a near "perfect" size by that definition.
But my understanding of statistic tells me people are stretching the finding of statistical study beyond its validity.
Also, don't confuse unknown with undetermine. Unknow will one day be known given advances in science. Undetermined factors are statistical. Statistic is just that, by definition, impossible to determin. i.e. we will never know.
Don't think we'll ever know everything about our health. It's statistical. God does roll dice to some degree and we are the result.
To sum it up, the effect of exercise to each individual WILL be different. There're some general indications but there's no golden size that once you pass you're good.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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Would you like me not to treat your "high" potassium or digoxin levels because you MIGHT NOT be at risk?
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Yes, that's positive. It's my choice. Your job is to provide an objective information. You may even recommend but it's ultimately my choice.
I did make some of such choices when the side effects are more intolerable than the "illness" itself. Doctors and pharmacist are too keen to "treat", i.e. throw drugs at, everyone who doesn't fit a certain "standard" (and NOT treat others who doesn't fit the "standard", though that's got more to do with insurance company). Statistically, they're right "most of the time" . But not every time. I'm left to deal with the times when their "statistical" model fails. And lately, I had dealt with more than my fair share of it.
Last edited by And love to help out and answer questions and of course, read each other's snow reports. on Thu 14-08-08 3:50; edited 1 time in total
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OK - no treatment for you for physiologic data outside the "norm" or drug toxicity data above normal....
and we will let your doctors etc know not to wash their hands when treating you because medical hand washing started because someone noticed the "statistic" that women in childbirth where hands were washed had less RISK of developing a fever and dying.... and thought they would give their patients a better CHANCE.....
Let us not use these statistics - the patient we are treating may just not be the one to benefit... so let us just let it all go
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You know it makes sense.
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It's my choice to go to a doctor who's more knowledgable but doesn't wash his hands, or a doctor who are both knowledgable AND wash his hands.
You're throwing out statistics because it doesn't cover your case?
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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No I'm stating the stupidity of ignoring something just because it is only based on a "statistic" at the present time ie we have no better knowledge atm - like with the handwashing they did not KNOW conclusively at that time why this occurred... only that the stats showed better outcome in patients where carers washed hands.... Then (just as now) there were people that argued that it was just a statistic and that the proponents of handwashing had no proof that handwashing did anything constructive... thankfully some people went with the odds... Ditto with vaccination etc etc etc... this is the history of medicine - odds and risk - most is not black and white - we do the best for the patient with the data available - so we treat toxic and therapeutic drug levels as just that for the most - despite them only being statistics.... when we need to go further we also do that....
Yes it is YOUR choice - stop trying to stop Megamum from continuing with HER choice because YOU dislike paying attention to this data...
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Poster: A snowHead
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| abc wrote: |
Yes, that's positive. It's my choice. Your job is to provide an objective information. You may even recommend but it's ultimately my choice.
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It never occurs to you that with a massively high level you may simply be totally unable to make that choice? That if the doctor waits you may never get to make another choice again?
If you were a woman in labour in 1830 who do you expect would tell you the "objective" information?.... How would you have decided? Remember Pasteur and his "germ" theory are >50years in the future...
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| Quote: |
stop trying to stop Megamum from continuing with HER choice because YOU dislike paying attention to this data...
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You totally don't get the point and went off argueing something no one cares about!
The whole point is exactly this: I'm NOT "stopping" Magamum from making her choice but rather prevent her from making a choice based on incorrect information.
In fact, the only person ever telling Megamum what to do is Kramer. He insist if she only cycle 3 times a week, it's not going to do her much good!  And he reached such a conclusion based on his understanding of... guess what, statistics!!!
The point is not whether statistics should be used. It's about statistics should be taken as "golden" that applies to EVERY SINGLE INDIVIDUAL with no exception. That's not about risk. That's stretching probability into certainty, which is beyond its validity.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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You need to Login to know who's really who.
You need to Login to know who's really who.
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little tiger, not sure, but I think it's your links that have messed up the page width. Perhaps you could turn them into 'shortcuts'?
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Hurtle, Don't know how - this site is different to others .... has its own strange ways
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You'll need to Register first of course.
You'll need to Register first of course.
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little tiger, it's easy, achilles taught me how - one silver surfer to another! 
First you copy your long url on to your clipboard, then type [url=, then paste it in, then close the square bracket. Carrying on without spaces, type b within square brackets, and then a shortcut word or phrase, such as here is the link or something, then (still no spaces) type [/b][/url]. Bingo.
I think the purpose of emboldening - which has nothing to do with creating the shortcut in itself - is to highlight that it is a link, which might not otherwise be sufficiently clear.
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Yoda, Thank you! Easier than my explanation, which was very difficult to type without actually emboldening stuff by mistake. If you see what I mean. 
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Hurtle, if you tag the text with [code] it overrides the automatic linking.
Anyway, I played an hours tennis last night then decided it wasn't enough so went for a 5km run as well 
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Swirly,
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if you tag the text with [code] it overrides the automatic linking.
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Oh thanks, didn't know that.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| abc wrote: |
In fact, the only person ever telling Megamum what to do is Kramer. He insist if she only cycle 3 times a week, it's not going to do her much good! And he reached such a conclusion based on his understanding of... guess what, statistics!!!
The point is not whether statistics should be used. It's about statistics should be taken as "golden" that applies to EVERY SINGLE INDIVIDUAL with no exception. That's not about risk. That's stretching probability into certainty, which is beyond its validity. |
Actually my initial point was to someone else whose personal trainer had given her out dated information suggesting that exercising three times a week was adequate, which is out of synch with current guidelines.
Also I reached such a conclusion based on my understanding of medicine and health issues, including my professional knowledge and qualifications, critical appraisal of research, wide reading around the subject, and my own personal experience.
I agree that you are right, statistics only give us a broad picture, and are meaningless for an individual, but they do tell us what advice and interventions we can give to populations as a whole. I think that if you read my posts about waist to hip ratio carefully you'll see that at no point do I talk about certainties, merely about risk.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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I'd argue that for the purpose of losing weight (which if often the reason people exercise) 5 times a week at the same intensity isn't the optimum. As I stated earlier the body gets used to the exercise and eats more.
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What were the results of the study?
It would be a positive result if this encourages people who are struggling to perform the recommended minimum amount of exercise. But it’s still advisable to try to meet the target of five days a week, and exceeding it is even better. Improvements in blood pressure, waist circumference, hip circumference and performance on the ‘functional capacity’ test were noted in both the three-times-a-week activity group and the five-times-a-week group, but not in the control (sedentary) group.
The study did not show any improvements in weight or body mass index in the group that exercised five days a week. Surprisingly, however, there was a decrease of these in the people who exercised three times a week. There were no clinically significant differences between the groups in their lipid levels (blood fats).
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http://www.nhs.uk/news/2007/August/Pages/Isexercisingthreedaysaweekasgoodasfive.aspx
As performance in many sports is helped by a higher power to weight ratio (esp biking), one could argue that the lighter "3 day a week exercise" person is fitter.
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| little tiger wrote: |
| you went on arguing that his "science" is not robust but just based on statistics.... |
Kramer's scicence IS statistics:
| Kramer wrote: |
| I agree that you are right, statistics only give us a broad picture, and are meaningless for an individual, but they do tell us what advice and interventions we can give to populations as a whole. I think that if you read my posts about waist to hip ratio carefully you'll see that at no point do I talk about certainties, merely about risk. |
More over, ("Kramer's") statistics is as "robust" as Einstein's relativity or quantum mechanics!
Just not deterministic hence NOT applicable to EACH AND EVERY individual!
Kramer and I may disagree on how far reaching the conclusion of these studies should or should not be, and where their validity extends and ends. At least we were debating about the same thing and having a meaningful (albeit spirited) discussion...
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You know it makes sense.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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| abc wrote: |
| More over, ("Kramer's") statistics is as "robust" as Einstein's relativity or quantum mechanics! |
 isn't a lot of physics based on probability? I.E we don't know how each individual particle will react to the condition but we know what the overall effect will be, e.g. two gasses will mix together but we know way of knowing which whether an atom will move. If I understand quantum mechanics correctly, the Heisenberg uncertainty principle tells me that I can't know everything about a sub-atomic particle and yet it is still possible to make large scale predictions of their behaviour.
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Poster: A snowHead
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I am particularly sceptical of prescriptions of exactly what exercise we should be doing, and whether it should be in 5 chunks of 20 minutes, 2 chunks of 50 minutes, to 80% maximal heart rate, to gentle breathlessness etc. It seems to me that views on this change so frequently, and it is so hard to conduct a proper randomised double-blind study of sufficient length. In addition I suspect that many people are at risk of spending 10% of their discretionary free-time (ie excluding work/sleep/eating) doing exercise which adds less than 5% to their life expectancy. Is this an effective use of time?
abc, I can see where you are coming from, but just because something isn't statistically completely certain doesn't make it wrong or worth ignoring.
Abdominal waist measurement is useful. I am not sure however that there have been decent interventional trials which show that (unless you have developed impaired glucose tolerance - where there is excellent evidence of delaying/preventing onset of diabetes) that there are long-term health outcome benefits to altering it by the amounts achievable by the majority of people. In other words it may be a marker for a risk of morbidity - but has altering it been proved to be practical and beneficial in real-world studies?. Probably I have missed something here.
Smoking, perceived autonomy and Socio-economic class also still remain very powerful predictors of disease too, and the last 2 are often ignored. I was also surprised to see on the MSB just how many snowHeads smoke.
Bottom line - those of us with families cannot always do exercise sessions more than 2 or 3 times a week, anything is probably better than nothing, and exercise you do not enjoy, or which becomes a chore, is a waste of your limited time on this planet.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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is this the longest thread ever ?
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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critch, nope - 
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You need to Login to know who's really who.
You need to Login to know who's really who.
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| Quote: |
is this the longest thread ever ?
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no, but one thing I can assert with reasonable confidence is that had we all been out on our bikes instead of reading it we'd be better off! There's nothing we like better than being slumped in front of a keyboard arguing about how many one-handed pressups can dance on the head of a pin.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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stoatsbrother,
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exercise you do not enjoy, or which becomes a chore, is a waste of your limited time on this planet.
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I think this is a very good point and one I agree with but with one major caveat that a lot of sports /exercise etc only become really fun when you have put in a bit of effort to overcome the early difficulties. When I get round to ecercising regularly I usually really enjoy it and find it relaxing. The initial struggle to gain/regain fitness after missing out for a while is rarely enjoyable.
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You'll need to Register first of course.
You'll need to Register first of course.
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stoatsbrother, your summary sounds like the old joke "living healthy doesn't make you live longer it just seems like it".
Talking of being surprised at numbers smoking in various groups, it's always the medical profession who I am most surprised at. I'd not expect many Snowheads to be superfit serious athletes (though I'm sure some are) but simply people who enjoy recreational snow sliding.
However, your overall thrust was something that I either posted earlier or meant to. Which is that I think a lot of families would find it easier to go for a half day hike/cycle/whatever at the weekend than go to the gym 5 days a week for half an hour. I don't know if the health benefits are similar or not though but should one take the view than anything is better than nothing? OTOH, so far, I think I've been successful in finding ways to exercise that mean I don't have to go the gym or turn my home into a gym.
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peura, relatively few of us quacks smoke these days. The only few GPs I have seen smoking in the last few years have been snowHeads....
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 I didn't just mean "quacks". I was thinking more of nurses, various therapists (e.g. OTs, PTs), health workers etc.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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peura, they all need to smoke to put up with us Doctors...
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FAQ
I'd be happy to arrange a test 
, with its zero allowance to individual variations.
