Apparently, Bob from The Biggest Loser thinks that it’s easy peasy to grow a garden that will provide vegetables for eating salads all the time.

HAHAHAHAHAHAHAHAHA. Obviously a man who has never actually gardened. You just throw seeds in the soil and they grow into vegetables, with just a bit of watering, right?

Even assuming you have available arable land, or space to put suitable planter boxes, it’s nowhere near that easy. You need money, time, and to learn about growing things. Which also takes time and possibly money.

1. You need soil that will grow stuff. Not all soil will. You need to figure out if it’s already full of nutrients or not, what the local pH is, and a bunch of other things. Food plants generally need very nutritious soil.
2. You need to look at what trees and shrubs are growing nearby (root systems). You need to see what kind of sun the patch of land will get, what kind of wind and weather to provide the right amount of light and stop your garden blowing over. Does the land have a slope? That will affect things too, like water and topsoil runoff. You’ll have to plan for crop rotation, too.
3. You need to decide whether to till and cultivate the patch or use permaculture. You have to clear what’s growing there already and sheet mulch to stop it re-growing. If you don’t know what those things are, you’ll have to read all about them.
4. You’ll need tools. A spade and shovel with a good sharp edge, a fork, a rake, and hand tools like a trowel. You can buy these cheaply, if you want tools that will break or rust and need replacing often, and also make your work harder.
5. To make the soil suitable for food growing, you’ll need to add things like compost matter (which you can buy or make your own, but it takes a while to make your own), blood-and-bone, minerals, etc. Depending on the region and weather you may need to add a type of clay to keep more moisture and nutrients in the soil. And add worms if there aren’t many already in the soil.  If the soil is sandy you probably need to add a liquid wetting agent. You can’t just sprinkle all this on the top either, the soil needs to be dug through to a depth of about a foot.
6. Are you going to irrigate or hand water? What kind of irrigation? Drip or spray? Automated? You have to buy the stuff for that too – either the pipes and valves and timers, or a good long hose and watering nozzle and watering cans.
7. Oh, now you have to keep adding stuff to the soil over the next few weeks-months. Chicken, horse or sheep manure (if you’re rural or near you can usually get this free or near-free from people with said animals, if not you’ll have to buy it), more blood-and-bone, assorted organic matter like lucerne, etc. Lots of digging involved.
8. Now, you can buy plants ready sprouted, or you can set up a nursery if you have a shed or something like that. Either way, you’ll probably have to buy more stuff, or be knowledgable about what you can recycle and reuse.
9. Are you going completely organic, partly organic, or relying on common chemical weedkillers and pesticides? You need some way to keep unwanted bugs and birds from eating your plants.
10. You’ll need to find out what to do with your growing plants to encourage more edible growth. For instance, things that grow on vines, like cucumbers and pumpkins,  you can pluck off new leaf tips to encourage the plant to spend its energy on growing the fruit instead of more leaves.
11. There’s more.

I put all this down not to discourage anyone from gardening a vegie patch, but to point out the absurdity to anyone who thinks it’s a doddle and poor people and/or fat people should just get right on it. There are ways to keep your costs down and manage your gardening time and energy well, but again, you need time to learn these things from somewhere, whether it’s friends, relatives, neighbours, community centres, books, websites, DVDs, TV. And good old-fashioned experience.

This also assumes you have the climate for growing a range of vegetables to keep you (let alone a family) supplied with vegetables over the various seasons. There’s a reason California grows most of the USA’s vegetables and fruit, not North Dakota. What are you going to do with your excess produce? Canning and preserving also takes time and knowledge.

If you have the space, time and money and also the motivation or love of gardening, it’s pretty rewarding and a great way to get fresh vegetables. All this also assumes you are able-bodied enough to do all that digging, bending, planting, and watering. (Raised beds are good if you have back problems or similar, but someone still has to build and install them.) And sure, you can grow things in planter boxes if you have a balcony or rooftop, but probably only enough to supplement your grocery shopping, not replace it. Oh, and unless you own your own home, you’ll need your landlord to grant permission to dig up the yard.

Remember this if anyone ever claims what Bob claimed. Like I said, not trying to put anyone off gardening, just point out it’s not quite as straightforward as growing a chia pet, possibly Bob’s only experience of growing anything besides his ego.

Well, according to Sumo Salad, an outlet found in food courts everywhere in Australia. See Axis of Fat’s post on this heinousness.

Only they’re a bit like Subway on this “We’re healthy!” front: hypocrites. If you compare their nutritional info sheets to those of McDonald’s, KFC and so on, you can see that they have many menu items which have more fat/calories/etc than a cheeseburger, 6 nuggets, small fries, and other apparently evil food items. The chicken and mushroom salad has 36g of fat, for example. All of their wraps have at least as much fat and energy as a chicken burger. Even their lowest-calorie mini rolls are about on par with a cheeseburger or 2 pieces of fried chicken.

Maybe you’d get a little more nutritional diversity out of a chicken and mushroom salad as opposed to  Big  Mac, but that’s not what the advertising campaign is about. It’s about claiming Sumo Salad is “healthy” and will prevent cankles or whatever the hell else because it’s low-fat/low-cal compared to other fast food franchises. This is simply untrue. It’s just an excuse for some body-shaming and food moralising in an attempt to sell more of their products. Bleah.

Over at yourHealth, you can comment on blog discussion posts, and submit your suggestions for and stories of health care in Australia. One of the current blog topics is ‘How should governments, industry and community groups work together to help us combat obesity?‘. Unfortunately one fat-shaming response made it through the moderation, which is disappointing. Most of the responses seem to be from people who aren’t fat haters as such, but still do believe obesity is a serious health problem and should be ‘combated’. I think the blog could use some Health at Every Size/FA ideas, so if you’re an Australian citizen or resident, please comment on the blog and make your voice heard. You do need to register and confirm your email address, and your comment is limited to 5,000 characters. But this is an opportunity to let the government know that not everyone thinks that fat bodies are a problem that must be solved, and that there are other ways to improve everyone’s health without singling out fat people or focusing on weight or BMI.

You can also tell your health story or give your suggestion either as text or video – see the Contribute page for the links to all these.  How about some stories of how anti-fat bias from doctors negatively impacted your health, or how HAES or FA improved it? Or how anti-fat public health rhetoric is directly implicated in disordered eating? The discussion, especially on obesity, really needs voices from fat-accepting people.

Of course you don’t need to limit your commentary to fat issues, any health issue which is important to you can be discussed!

The survey of 1200 people found one in four people who are considered obese using the body mass index (BMI) rate their health as being very good or excellent, and one in five believe their risk of getting heart disease is low to very low. The chief executive of the Heart Foundation, Lyn Roberts, said that despite years of public health messages, there was still an alarming lack of awareness about the cardiovascular risks of being overweight or obese.

Considering that the BMI is, frankly, a terrible indicator of one’s health, why is the Heart Foundation still using it? The man who invented it in the early 1800s, Belgian Adolphe Quetelet, never intended for it to be used as a measure of health, and a great many medical researchers agree that it is a poor way to measure overweight, obesity, and health risks, especially as epidemiological studies on the relationship between some health risks and BMI show only a correlation, not a causation, and that some health risks decrease with increasing BMI, such as osteoporosis and lung cancer. The same epidemiology continually shows that ‘overweight’ people have the highest life expectancy, ‘obese’ and ‘normal’ people the next best expectancy, ‘morbidly obese’ people rank third, and ‘underweight’ people, independent of illness which causes weight loss, have the worst life expectancy.

Thin people who are sedentary show just as much cardiovascular disease risk as fat people who are sedentary, and fat people who are active share the same reduced cardiac risk as slim people who are active. This was conclusively demonstrated by Drs Stephen Cooper and Glenn Gaesser in a comprehensive study, and has been shown further in yet more studies. How about we have a campaign encouraging healthy activity for all, not singling people out based on the flimsy BMI?

There is not one study that proves a causation between cardiovascular disease and larger amounts of adipose tissue on a body. There are, however, studies which show stress, stigma, discrimination, imposed low self-esteem, poor treatment by health professionals, low socio-economic status, repeated dieting and eating disorders are strongly correlated with and have some direct causation of obesity, all of which are known to contribute to poor cardiovascular health. There are well-known “obesity paradoxes” also, one of which is that obese people survive heart attacks far better than ‘normal weight’ people.

”As our waistlines expand, it appears that our perception of what is a healthy weight has also expanded, so many people who are overweight or obese do not actually see themselves in this way,” Dr Roberts said.

No, it’s that the BMI is rubbish and people know it. Have a look at Kate Harding’s BMI Project sometime and you can see photographs of what the various BMI categories actually look like. The vast majority of the ‘obese’ population are BMI 30-35, which, as photographs show, makes one look chubby at best. The headless fatties, unflatteringly photographed and used to illustrate obesity scare stories in the news, are of extremely fat people who represent about three percent of the Australian population. Surveys such as this one by the Heart Foundation also make no exception for people who are muscular and have solid frames. There’s no section after height and weight for people to write in their body composition and if they’re an athlete or not. A quick look at NRL player stats finds that Joel Clinton has a BMI of 29.1, Nathan Hindmarsh is BMI 28.3, and Wendell Sailor is obviously cause for concern at BMI 31, and most other players are Officially Overweight or Obese. One could claim that such people are not representative of everyone else with a BMI of more than 25, but I can’t seem to find any surveys of this kind which measure body composition and actual fitness levels as opposed to assuming that someone with a BMI of 31 is a couch potato. Assuming isn’t very scientific but it does get you good publicity! …And plenty of grant money, if I might be so cynical.

One in six who had a BMI of 30 or more believed their weight met health guidelines, compared to one in nine last year. The proportion of overweight people (those with a BMI between 25 and 29) who thought they were in the healthy range also increased,, from 51 to 57 per cent in 12 months.

Surely this should be taken as a measure of success, not despair. While “almost half of obese Australians had made no changes to their behaviour to reduce their risk of heart disease” this implies that the other half have, and have thus seen real measures of their health improve, such as decreased cholesterol and glucose levels, better mental health and exercise capacity. They may have lost a little weight (just 1%-5% of bodyweight lost is pushed by health authorities as improving health) but still remain in the ‘obese’ or ‘overweight’ BMI category, or remained the same weight but had body composition change to more muscle, less fat, or even not at all and just improved various actual health measures. There’s also some tricky wording here: believing one is in the official healthy weight ranges when you’re not and believing you’re healthy when you’re not are in fact different things.

The survey, which was jointly funded by the life insurance company Zurich,

Well, of course. Who better to fund a study proving fat people are walking time bombs, ignorant that they are about to die any moment now, than a company which has a vested interest in denying overweight and obese people insurance based on tenuous claims.

…found one in four obese people smoked, with most smoking daily, a proportion 70 per cent higher than people of ideal weight range.

Could it possibly be that they’re that desperate to lose weight that they’ll smoke to keep appetite down? Surveys have shown that young women would rather be blinded or lose two limbs than become fat. Hey, at least chemotherapy’s good for weight loss!

The tendency to judge ourselves against other people, rather than scientifically based weight guidelines, was ”normalising” obesity, said the Heart Foundation, which commissioned the survey.”

Oh yes, obesity is so normalised! Fat people can walk down the street and not have people sneer at them, small children point and stare, groups of teenagers snicker and throw things; fat kids can go to the beach and wear swimmers without their photographs being taken and exploited for anti-obesity articles; plus-size fashions are available at every designer boutique; Kyle Sandilands is telling Magda Szubanski to put those kilos right back on so she’ll be hot again; of course! Apparently Dr Roberts is living in a special magical fantasy world where fat people are not treated like a mysterious brown smear on the bottom of one’s shoe, and the BMI is a scientific measure. (Let’s remember high school maths: human bodies are three dimensional, and volume increases by the cube, not the square. BMI measured by the square: fail number one.)

What, exactly, is wrong with allowing fat people a little self-esteem? Psychiatrists and dieticians who work in the eating disorder wards know that good self-esteem and mental health is the foundation of good health. When Dr Roberts comes along and gets in a flap that even though you have taken to eating better and exercising you’re still a fatty and therefore all your positive health gains amount to nowt, and of course you must be completely ignorant of any of the anti-obesity messages which saturate our society, then it’s enough to make one feel like giving up. Perhaps that’s what they want. There are a lot of people whose entire careers depend on the moral panic that is obesity, and frankly it seems like some of these people get a sick little thrill about how they’re paid to bully fat people in public.

Frustrated with the range in a big Target I was in recently, I was leaving the store via the not-plus section, when I realised that some of the size 18s hanging on the racks actually looked kind of large. So I tried on some cardigans, which is what I was shopping for. They all fit just fine. And because they were “Misses” sizing rather than “Womens”, they weren’t too long for me and didn’t have armholes that went down to my waist, and so on. A 16 in some styles even fit. I’m not sure how they’d go on a woman with a larger bust than mine, though. So if you’re in Target, do have a look at the size 16/18s in the other sections. About half of the stuff there goes up to an 18 and nearly all to a 16. I’ll have to try this out at other department stores.

City Chic seems to be having a sizing problem too. Last year I bought an awesome coat from them in XL, after trying on quite a few other coats in the same size. I am a bit smaller than I was this time last year (see my numerous posts on thyroid), so the coat wasn’t a good fit anymore. I went back to City Chic to try on some L coats. Which were too small. Tried on their XLs. Still too small. WTF? I know they’re juniors sizing, but this makes little sense. Maybe they changed production factories or pattern designers. I hate when this happens.

As for Autograph, I think their clothing is getting uglier by the minute. I actually have some items from there from two years ago which still looks great, but every time I’ve been in there recently, nothing has stood out to me. Forget My Size. They are embracing the Big Boxy look. It doesn’t help that they put size 12-14 models in their catalogues and are obviously pinning the clothes back on them and they’re STILL big ‘n’ boxy. With dowdy-looking mid-calf skirts. When they have skirts.

Thankfully the Australian dollar is climbing back up against the US dollar and I can start buying a few bits from B&Lu and so on again.

I think I’m just going to have to clear a space here in my house and start sewing again. Fat fashion retailers are failing us.

The main domestic carriers are Qantas and Virgin Blue, supplemented by budget Singapore-owned Tiger Airways, Rex (Regional Express), and JetStar, Qantas’s budget subsidiary.

I’ve flown both Qantas and Virgin Blue often enough, and have never had any problems with respect to my size. I’m 155cm/5′ tall and about a size 26 at the hips and 22 on top. Recently very few flights I’ve been on have been full, especially at off-peak times, like daytime on a weekday.

Qantas: I fit into the economy-class seats on Qantas’s 737s, and it’s not painful to have the armrests down but it is more comfortable to raise them. The seats are the same width as on their 767s. The armrests do go up on most seats, and the seating charts available on the Qantas website indicate which. The only exception is that the armrests on the window side are not raisable. I usually need a seatbelt extender, though you get the odd plane where the seatbelts are longer for some reason. The Qantas flight attendants have always been perfectly polite about getting me one when I ask. I have not flown on a Qantas Dash-8 but according to their website the seats are the same 17.5″ width as other planes.

Business class seats on Qantas are about 30% wider and have more legroom, but cost three times as much usually. There is no economy plus on Qantas domestic, although sometimes they fly a 747 between east and west coast to move the planes around and you can luck out and get a whole row to yourself on those!

JetStar flies Airbus 320 and 330-200s. I’ve never flown with them but I have heard from people who have that it’s much the same fitout and service as Qantas.

Virgin Blue: Seating is much the same as on Qantas on their 737s and 767s, and also on the new Embraer 170/190 jets. The armrests go up again except for the window side. Embraers are 2 x 2 seating, so there are no middle seat worries. Virgin Blue flight attendants have also been super nice about getting me a seatbelt extender.

Virgin Blue’s Premium economy seats are not wider than regular economy. They just have a kind of console/armrest thing where the middle seat it, and slightly more legroom.

Seating tips:
For both Qantas and Virgin Blue, online check-in is available, and I highly recommend doing it as soon as it’s open, usually 24 hours in advance. Go for a row at the back of the plane, and an aisle seat is usually best as you can raise the outside armrest. They usually do seat assignment from front-to-back, so if the flight’s not full, chances are you will get an empty seat next to you. From what I’ve read from airline reps, they don’t have a compulsory two-seats-for-fatties policy as they know that nearly everyone who’s quite large buys two seats or goes business class anyway.

Rex is a regional airline and so flies turboprop Saab 340s. I couldn’t find any information on seat width, but other airlines with the same planes have 16″-17.5″ seat width listed on SeatGuru. The layout is also 1 x 2, so if you called to check whether the armrests went up, a seat in the single-seat row could work out for you.

Tiger - I’ve never flown with them. They’re a very budget airline – no business class, user-pays for everything. That’s about all I know.

Internationally, I’ve flown with British Airways on their 747s. Seat width is a standard 17.5″. The flight attendants were also very very nice and polite, and one on-the-ball fellow even brought me an extension without asking as I rolled my eyes upon seeing that the seatbelt was about 2cm too short. “Here you go, sweetie! Aren’t these seats just ridiculous?!” He also showed me the trick of putting the complimentary pillow on the tray table so my meal tray would sit flat, as my belly gets in the way of the tray table folding all the way down; and he also asked the person in front of me to put their seat back up so it was as un-uncomfortable as possible.

Again, online check-in is a good idea. Go to SeatGuru and check out the seat plans first. I was travlling with my boyfriend, and on most 747s there are a few outer rows at the back with only two seats in them. We picked one of those and while it’s a little bumpier down the back of the plane and you get people queuing for the toilet standing next to you – if you don’t mind that then those seats are a good choice.

British Airways Economy Plus seats are no wider than standard economy and may in fact feel smaller as they have the solid armrests that wedge you in.

I’ll be flying with Cathay soon, and I’ll be interested to try the new style of seating they have – it’s a “shell” seat and some people have said they’re terribly uncomfortable, complaining of too-thin padding on the seat and lack of leg-room as the seat slides forward instead of reclining, while others have loved them. I’m short enough that legroom is rarely an issue, and I’m well-padded myself, so we shall see how they are. They’re the same width as usual, apparently.

Happy trails!

I

Roche is of course claiming that it’s not their product, it’s that just that being fat causes liver failure.

All the information is here:

Online Consultation on Body Image – calling for submissions

The link to the survey is about 2/3 of the way down the page.

For example, here’s Dave deBronkart’s short bio from the site:

Diagnosed with advanced kidney cancer (median survival 24 weeks), e-Patient Dave deBronkart rapidly learned to use every aspect of empowerment, technology, and participatory medicine to beat the odds.

I’m sure we all know doctors who still refuse to treat a patient as an intelligent person capable of being active in their own health care, and yet more who express concern about the idea that patients will believe anything they read on the internet and do themselves harm. There’s an excellent white paper linked from the site that addresses these issues: e-Patients: How they can help us heal healthcare. The paper found that this idea that online patient support and information sharing will harm people is simply not true.

Here are some other recent highlights from the blog:

Participatory Medicine as Revolution! Think Critically! Communicate!
This post examines health care using perspectives from Pedagogy of the Oppressed, a  famous book on education: “Participatory medicine cannot tolerate an absurd dichotomy in which patients are merely following their doctors’ decisions—a dichotomy reflecting the prescriptions of the dominant elite. Revolution is a unity, and doctors cannot treat patients as their possessions.”

Applying paticipatory principles to EHR/PHRs
e-Patient Dave original story of the health data transfer from his hospital EHR to Google Health PHR is remarkable in many ways and shows why participatory medicine could well be one of the fastest way to lower the overall cost of health care by helping fix some specific dysfunctions in the system. It took just one active and engaged patient to produce a remarkable change in the way interoperability between EHR and untethered PHRs is going to be defined at BIDMC and probably at HITSP, at a minimum.

In other words, one single real event, driven by a patient has given more effective feedback to improve the national standards than years of deliberations of the cream of the cream in HIT in their rarefied tower of knowledge.

There are some who express concern that electronic health records will be used against patients by government or health authorities. This is addressed in the post Please! No more magical thinking in HIT! – wherein it’s pointed out that patient participation is essential to avoid those fears. It’s no good implementing EHRs and thinking that will solve everything unless you actually ask the people who own the data–the patients–and get their collaboration and participation in creating The New Health. And patients want security, and full access to their own data to check that it is correct. I personally would like to see the option for people to not have their data included in statistics, and to be absolutely sure that if it is, all personally identifying information is removed, with full disclosure of what the data will be used for. And, of course, the option for someone to not have an electronic health record at all.

Why is this important for fat people? Well, there’s already a revolution going on in health care for fat people, and it’s being driven by fat people themselves through online communication and information sharing. It’s all these fat acceptance blogs and mailing lists and forums. We share with each other information on health and fat to counter the poor reporting and biased studies. We share where to find fat-friendly doctors and warn about anti-fat doctors. We discuss Health at Every Size. All kinds of help, advice, and support for physical and mental health. Again slowly, oh so slowly, doctors and other health professionals are getting wise to the ways of HAES (much to the alarm of any other doctors who make money off “treating” fat people). There’s some top-down pushing from such people as Linda Bacon, and then there’s all push from the patient end of the stick – fat people refusing to see doctors who treat them badly, discussing HAES and weight-neutral health with the doctors who might be dubious but are willing to communicate, and support for doctors who are pro-HAES. (And yes, I do realise that there are fat-acceptance people who don’t consider HAES that great and have concerns about healthism, but this isn’t the post for it.)

Elelctronic health records are only a part of the new healthcare, and you could in theory have collaborative medicine without them. It’s this collaboration and conversation that’s driving change.

I would actually love to get an electronic copy of my entire health record which I could keep in the manner I deem secure. I’d keep it on one of those nifty IronKeys probably, with backups. If it was kept online, I think something like the YubiKey would be useful for secure passwords. I’m actually far more worried about the security of physical records – I know at my GP’s office, the records are on full display behind the reception desk. And an enterprising information thief would only need to crack one window to get in and at the records. But I digress. I prefer to be in charge of my own information. Having an EHR to which I could add corrections and clarifications, instead of relying on a busy doctor to write down “pernicious anemia” instead of just “anemia”. I’d probably delete “obesity” and just put “fat” as one thing I could do to resist the medicalisation of a body size[1]. The Dave deBronkhart I mentioned previously discovered that because of wacky insurance billing codes, he “had” all these medical conditions he previously never knew he had, which could have caused problems when new doctors were looking at his record, and so on. Getting a hold of his own data allowed him to publicise the problem and correct the record.

In conclusion, I think that pushing for this new model of health will ultimately benefit fat people. It’s a long road, given how many fat people themselves are convinced they hate themselves and deserve poor treatment. The fat-isn’t-actually-a-moral-failing-and-won’t-kill-you cat is out of the bag, on the internet, and you can’t undo it. Take charge of your own health care, whether it’s full involvement you want or you just don’t care that much and are happy to say so.

For an interesting documentary on what’s popularly called “Web 2.0″, specifically as it relates to government, watch Us Now. Us Now in high-def or Us Now in regular. Imagine what they’re saying, applied to health care. In fact, the bits on mumsnet.com are easily applicable. It’s about new models of trust and reputation – one woman mentions how they are tired of ‘ridiculous’ information on child rearing from doctors and social workers and they trust information from other mums far more, because they’re also mums. These days, if you are a person in authority and you say something ridiculous or dubious, anyone can go look up more information on the net, and connect with other people, other experts, and see what they have to say.

—–

[1] I can see where there’s some artificial inflation of ill-health-correlated-with-obesity statistics: I went to the hospital a few months ago because I was badly dehydrated from gastric flu. When I finally saw the doctor, he had put on my exam card “gastroenteritis” and “obesity”. My fat has nothing to do with my hospital visit, yet is recorded as such. Frak that. Now If I had proper electronic access to my own record I could go in and put a note on it to the effect of “how is this relevant?”. To do that on the paper record is a pain in the arse.