Etiology (aetiology) means cause.
While stumbling through websites like the American Heart Association (AHA) and the American Diabetes Association (ADA) and the Center for Disease Control (CDC) I kept coming across the word “etiology.”
I admit that I didn’t know what it meant. So I looked it up. Turns out it’s just a fancy way of saying cause.
The important part here is the context of this word. Like “The etiology of hypertension is unknown.” Or “The etiology of type II diabetes is unknown.”
It was usually one line buried amidst a list of relative risks. But, it’s kinda an important line. And it’s really important who’s saying this line.
We’re talking about big agencies that are pushing forward the “obesity epidemic” and what they redily admit on their websites is that the cause of these diseases is still unknown.
This is not to say they don’t know anything. There’s some animal research that’s provided clues. And some human research that’s given other clues. And when they looked at statistics they’ve noticed some trends.
Like, if you have diabetes, the statistical probably that you are fat is really high. Remember, though, that diagnosed cases of diabetes only makes up 7% of the US population, while fat people make up 60% of the population. Not all fat people have diabetes, even if most diabetics are fat.
But, no one really know the mechanism by which people develop these problems. They can’t answer the question, “How does fat CAUSE type II diabetes or hypertension (or any of the other disease linked to fat?)”
There are a lot of researchers out there trying to figure out how all this works. But, saying that being fat GIVES people these problems is still just a theory.
On of the links I most frequently share is this one from Dr. Sharma’s site on the etiology of obesity (and until I read that post, I had no idea what it meant either). Here’s another great word, “iatrogenic.” It means a physician-caused symptom.
Anyway, my theory about fat and diabetes is that if you make poor lifestyle choices (eat crap, sedentary), then you are more likely to be fat. If you make poor lifestyle choices and have the diabetes gene, then you are going to get diabetes. And, to complicate matters further, insulin resistance often causes weight gain.
Ergo, the diabetes AND the fat are symptoms of poor lifestyle, while at the same time insulin resistance makes you fatter.
Boom! Etiology.
Peace,
Shannon
“if you make poor lifestyle choices (eat crap, sedentary), then you are more likely to be fat.”
You’re assuming that everyone HAS the choice not to eat crap food and be sedentary. There are food deserts out there where the only food to be purchased for miles is McDonalds or Burger King. There are a lot of people out there who don’t have the time to work out regularly, and even more who don’t have the time OR money. This doesn’t change the fact that these conditions will more than likely contribute to fatness, and definitely contribute to overall lack of health.
Jen,
I didn’t mean to imply that people are choosing to eat crap food. If you make poor lifestyle choices, whether voluntarily or out of necessity, is what I should have said. I don’t begrudge anyone who makes poor lifestyle choices, as I am one of them (time being my factor). I was simply trying to point out that poor lifestyle choices can make you fat.
Peace,
Shannon
Perhaps a better would would be “unhealthful” lifestyle choices. “Poor choices” implies a value judgement. Sometimes, a choice that doesn’t promote physical health is still a rational (and hence “good”) choice for a given person. And sometimes, it’s the only choice.
I’m not sure, even with all the reading I’ve done about type 2 diabetes, but genetics seems to be a bigger component of it than lifestyle (for example, both of my husband’s parents were type 2 diabetics, and of their 6 boys, 4 have type 2 diabetes, 3 are thin/average-size, one is fat [DH is the fat one]). All of them had similar lifestyles, as all of them enlisted in the Navy (so they all ate in the Navy mess decks and did basically the same types of exercise). I think DH is the only one using insulin, which has a side effect of weight gain if you don’t go extremely low-carb, which we don’t (bodies do need some carbs, after all).
Genetics is also about 70% responsible for size (just like it is for height, surprise surprise), so it doesn’t surprise me in the least that researchers haven’t been able to figure out how weight and disease are correlated. Not that I think they are, at least not as much as researchers think they are, otherwise, thin people wouldn’t get the same diseases as fat people, and thin people wouldn’t die from them since they are supposedly healthier than fat people (not so, since so fat people have a better survival rate for some things, like cancer, heart attacks, and strokes, than thin people do).
So, I think the etiology of obesity and disease is in its infancy and will be for a very long time.
I’ll freely admit that diabetes is not a subject I’ve researched all that thoroughly. I have a baseline theory that I fall back on, though, in that the diseases typically attributed to obesity are caused by lifestyle. It makes more sense to me than the obesity as cause theory.
So, given what you’ve said about the genetic component of diabetes, how would you explain the increase in Type 2 diabetes cases, both among adults and children? (I’m trying to find the stats, but am having trouble).
As far as the genetic component of weight gain, I think it has more to do with the sort of cards you’re dealt, rather than the size you will end up. The studies that determined that 70% figure basically looked at adopted children and compared them to their biological vs. adoptive parents, and they consistently had the same body size as the biological parents. Now, I don’t think that means that you are born with a preprogrammed weight, but I do think it means that those kids had their parents’ genes for things like appetite, hunger, satiety, metabolism, and the “thrifty” gene. So, maybe their environment wasn’t the same as what it would have been with their biological parents, but they still have the same basic drives that put their parents at whatever their settled weight was.
I think that lifestyle can put you over or under your parents’ weight, but you will be fighting your genetic endowment all the way. Some people can handle it, others can’t. Still others think they’re doing everything they should be doing to stay thin, but still gain the weight because that is what their bodies dictate.
You’re right, obesity research is in its infancy and the fact that the so-called experts claim to have absolute knowledge isn’t help any.
Peace,
Shannon
I think the increase in cases of type 2 diabetes is due to increased testing and lowered standards for what “normal” blood glucose should be. Twenty years ago, normal blood glucose was in the range of 120 to 160 (HbA1c of 5.8 to 7.2). Now, doctors are saying a “normal” HbA1c should be 5 (which means a fasting blood sugar of 97). That’s a drop of 16 to 43%, and if you have two fasting blood sugar tests in a row over 100, your doctor will tell you that you are pre-diabetic (if you’re fat, that is, I’ve yet to hear of them telling that to a thin person with those blood sugar numbers).
I also think a lot of type 2 diabetes cases diagnoses in children are misdiagnoses, since children are growing and their blood sugar tends to fluctuate then (I wish I could remember where I read that, I think it was Junkfood Science).
Let me see if I can make a metaphor that might clear what I mean up a bit.
A risk factor for getting a cold is not washing your hand and being in the same space with someone that is sick. But the etiology of a cold is a virus infecting your body.
Lifestyle is a risk factor for type II diabetes. But we don’t know the etiology (aka cause.)
The word is important becasue it means, despite knowing the lifestyle link, the scientists are still trying to figure out how the inner workings of those who end up with metabolic diseases are different than those who don’t.
On wiki it says : “Etiology is sometimes a part of a chain of causation.” The place where I get skeptical about the links of fat to health is that they still seem to be sorting out the “chain of causation.” Like they have a bunch of possible clues but they haven’t sorted out exactly what those clues mean.
If your interested in fighting against the fat bias created by supposedly scientific claims, then knowing that the scientist are still not entirely certain what’s going on, is an important piece of information.
So correlation is not causation.
But I don’t see how saying that being overweight is correlated to having diabetes is in any way showing fat bias.
B -
If the representation is that all, or even most, fat people will get type II diabetes, which is a belief many people hold, then we’re talking about a fat bias.
Here’s why:
7-10% of people in the US have diabetes. (ADA)
60% of people in the US are overweight. (CDC)
Based on those widely accepted statistics, the truth is that most fat people don’t have and won’t get type II diabetes. What is actually true of the statistical correlation between fat and diabetes, is that if you HAVE diabetes you are almost guaranteed to be fat, not the other way around.
If you don’t want to believe that misrepresentation of the facts shows a bias, then there’s nothing else I can say.
Because, when it is that fat is correlated with diabetes people tend to think that a) all fat people get diabetes, and b) only fat people get diabetes. Neither of those statements are true but that is the overwhelming belief in our society. That is fat bias. The vast majority of fat people will never get diabetes, and a significant number of people with diabetes are thin or average weight.
I would say that the statement itself would be innocent enough, in a society free from fat bias. If fat people are more likely to get diabetes, then a correlation does exist.
However, given that most people do have certain biases, and do interpret every data point through a massive amount of fat hate, I think it’s important to contextualize statements about the link between fat and disease.
For example, if one is attempting to make a fat-positive argument, it’s helpful to say “There is a correlation between fat and diabetes, but…[most fatties never get it, genetics and lifestyle are bigger factors, etc.]“, because most people will read the statement as implying that all fatties get diabetes.