January 27, 2022

Marriage, obesity, health and ageing

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obesity-740By Henry S. Fraser From Caribbean360

BRIDGETOWN, Barbados, Sunday September 14, 2014 – Last week’s column on healthy ageing evoked quite a lot of comment, appreciation and the pointing out of one important omission – the value of marriage! How could I omit that, after 44 years of marriage?

This was an unfortunate oversight, of course, because a great deal of data have consistently shown that marriage promotes longevity, but especially in men. Men, marry if you want to live long … but make sure you marry for the right reasons, and living long will be the great big bonus, or “added value” that comes with it, although not in the marriage contract! Of course bad marriages can shorten life dramatically, through suicide or homicide. As the feisty Lady Astor, British MP nearly a hundred years ago, said to Sir Winston Churchill: “Winston, if I was your wife, I’d put poison in your tea.” To which Winston replied, quick as a flash: “And if I was your husband, I’d drink it.”

“Who can find a virtuous woman? For her price is far above rubies.” (Proverbs, 31:10)

The fact is, people who never marry are far more likely to die prematurely than those who get hitched or even divorced, according to research reported on the BBC website last month, and therefore readily accessible to everyone. Actually, the report by Kaplan and Kronick was published in 2006, in the Journal of Epidemiology and Community Health, but its implications are of huge importance in today’s dysfunctional society where marriage seems to be seen as old fashioned, and family values and responsibilities increasingly disparaged.

Kaplan and Kronick looked at the relationship between marital status and survival, using the US 1989 National Health Interview Survey and the 1997 National death index, providing follow up over eight years. Their results are summarised in simpler form as follows:

“Among the 1997 respondents, almost 6,000 (9 %) died before 1997 and 61,000 (91%) were known to be alive. Controlling for demographic and socioeconomic factors, the death rate for people who were unmarried was significantly higher than it was for those who were married and living with their spouses. Although the effect was significant for all categories of unmarried, it was strongest for those who had never married. The effect was seen for both sexes, and was significantly stronger for men than for women. For the youngest age group (19–44), the chief causes of early death among adults who had never married were infectious disease (presumably HIV) and external causes. In the middle aged and older men and women, the predominant causes were cardiovascular and other chronic diseases.

It has been postulated that loneliness, including lack of intimate social and family support is an important contributor to the phenomenon. And in our study of Centenarians in Barbados at the CDRC, led by Dr. Susan Archer, while religiosity and a physically active life were the key factors in their longevity, strong family and social support were almost as strong.

As the Bible says: “A virtuous woman is worth more than rubies” and today’s science lends strong support to that other famous biblical injunction: “If they cannot contain, let them marry: for it is better to marry than to burn.” (1 Corinthians, 7:9)

But a good marriage is so much more than good sex: it is the union of like minds, generous spirits and souls of good conscience – leading to love that lasts, and like good wine improves with age. These aspects of human nature and behaviour are harder to study objectively, but not marrying is so much more frequently associated with superficial relationships and “greater isolation from children and other family.”

The other major factor affecting life expectancy is that of obesity and the related chronic diseases – high blood pressure, diabetes and high blood lipids (fats), otherwise known as the metabolic syndrome – that is so common in Barbados and in other populations of the African diaspora. Again the BBC has recently highlighted an important aspect of the obesity phenomenon – that of discrimination and the personal perception of discrimination. Overweight and obesity have now captured three quarters of many western adult populations, including the British, Barbadians and African Americans, with obesity (a body mass index of greater than 30, or what the lay person would simply describe as fat) accounting for one third of these populations. In the Caribbean the men are significantly leaner, as are the young British men, but by middle age they’ve almost caught up with their lady folk. What this means is that overweight and obesity are now the new norm, with all the dangerous health consequences, while leanness is seen only in the minority of adults. Yet discrimination and the perception of discrimination persists, and the world does not cater either on airplanes, trains or in many other places, for the obese.

henry-fraser-150The recent study reported by the BBC, in which 3,000 people in an ageing study were questioned about their perception of discrimination or harassment on the basis of their weight, found that 1 in 20 felt they had experienced such discrimination, but among the morbidly obese (very fat or BMI greater than 40 and associated with multiple problems) the figure was one in three. A valuable outcome of the study, one hopes, is the emphasis by Sarah Jackson, lead author of the study at University College London, that discrimination of any kind is counterproductive, causes stress and comfort eating. Physicians in particular must be strongly supportive, giving facts but working in very positive ways to address the problem and especially to encourage healthy life styles to prevent it in the first place. This is especially important with our children, most of whom are now obsessed with (and often over-indulged with) cell phones, game boys, ipads and all things computerised, substituting thumb exercise for healthy physical activity and are becoming obese teenagers, with increasing incidence of maturity type diabetes occurring in their teens!

Brickbat: To Alex Salmond and his emotional Scottish National Party for following the lead of so many other petty power-playing politicians in trying to break Scotland away from the United Kingdom, to the clear likely detriment of both.

Henry Fraser-Professor Fraser is past Dean of Medical Sciences, UWI and Professor Emeritus of Medicine. Website: www.profhenryfraser.com

For more on this story go to: http://www.caribbean360.com/opinion/henry-s-fraser-marriage-obesity-health-and-ageing#ixzz3DNnP9eJs


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