Child’s play. Rediscovering the joy of play in our families and communities

Vol 53: july • juillet 2007  Canadian Family Physician•Le Médecin de famille canadien 

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FP Watch

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Surveillance médicale

Fat politics. The real story behind America’s obesity epidemic

AUTHOR J. Eric Oliver

PUBLISHER Oxford University Press Canada;

70 Wynford Dr, Don Mills, ON M3C 1J9;

TELEPHONE 800 387-8020;

FAX 800 665-1771; WEBSITE www.oup.com/ca PUBLISHED 2006/240 pp/$19.95

OVERALL RATING Very good

STRENGTHS Identifies the economic and social forces driving the propaga- tion of an obesity epidemic myth in spite of evidence suggesting that body weight, per se, is not a major predictor or indicator of the disease

WEAKNESSES Fails to consider that material living conditions are the primary determinants of both disease and excessive weight among marginalized social groups

AUDIENCE Family physicians, public health professionals, and policy makers

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he author’s initial consideration of the reasons for Americans’ weight gain and their health implications led him to discover that the scanty evidence supporting this association was contradic- tory. He argues, therefore, that the driving force behind the “obesity epidemic” is the quest for profits by the weight-loss and pharmaceutical industries, aided by researchers and public health officials cashing in on money being provided by governments and funding agencies. Negative attitudes toward overweight people held by the public, including health care professionals, facilitate this process.

Initially, the Centers for Disease Control and Prevention reported that excess weight caused 400 000 extra deaths annually among Americans, but later esti- mates were fewer than 26 000. Actually, being slightly overweight—rather than normal weight—predicted bet- ter adult health. Other studies simply compared health status of obese people to others, ignoring confounding factors. Some simply attributed all costs of type 2 diabe- tes and cardiovascular disease to excess weight.

The International Association for the Study of Obesity and the American Obesity Association among others are funded by drug companies, and members are usually supported by these same companies. Weight-setting and obesity task forces are staffed by drug industry–funded “obesity experts.” Public health agencies willingly board the obesity carou- sel and collect the funding ring.

Negative attitudes toward overweight people contribute to the obesity epidemic. More than half of the public are stigmatized as suffering from the disease of overweight, and there are costs associated with dangerous diet pills and faulty surgeries.

The author’s primary fault is neglecting the role that living conditions play in excess disease and weight;

excess weight—and poor health—is especially common among poor people and people of colour in the United States. Considering how the obesity epidemic has gained traction in Canada while continuing high poverty rates are ignored, this book is important reading.

—Dennis Raphael PhD

Dr Raphael is a Professor of Health Policy and Management at York University in Toronto, Ont.

Child’s play.

Rediscovering the joy of play in our families and communities

AUTHOR Silken Laumann

PUBLISHER Random House of Canada Ltd, 2775 Matheson Blvd E, Mississauga, ON L4W 4P7;

TELEPHONE 905 624-0672; FAX 905 624-6217;

WEBSITE www.randomhouse.ca PUBLISHED 2006/320 pp/$17.95

OVERALL RATING Good

STRENGTHS Thought-provoking; inspiring;

easy to read

Book Reviews

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  Canadian Family Physician•Le Médecin de famille canadien  Vol 53: july • juillet 2007

Book Reviews

WEAKNESSES Loosely organized;

sometimes lacks supporting data AUDIENCE General

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hild’s Play offers a thought- provoking message about the importance of natural outdoor play to the well-being of children, fam- ilies, and communities. The author, a well-known Canadian Olympic rower, documents reductions in activity levels in the last generation, associated with problems of increasing childhood obe- sity and stress levels. Laumann provides

inspiring suggestions for recapturing natural playful- ness in all our environments. Written in a friendly first-person narrative style and directed at a general audience, the book is easy to read. Integrating her own observations and interviews with researchers and innovators, Laumann addresses modern chal- lenges, such as environmental issues, pressured lifestyles, parental expectations, and neighbour- hood fearfulness, and presents a practical model for promoting active, healthy, creative, well-adapted children with good peacemaking skills.

The main weakness of this book results partly from the conversa- tional style. The book is loosely organized, and at times it lacks the supportive data that would make the author’s case more effective.

Information is buried in her narrative reports of personal interviews with experts. The addition of a few refer- enced summary tables could better motivate the educated parent most likely to read this book. This could include a systematic listing of poten- tial benefits for motor and perceptual development, future bone and cardio- vascular health, weight management, academic achievement, sleep qual- ity, social problem solving, enhancing

creativity, stress reduction, and other specific areas. She does touch upon recent research documenting the ben- efits of physical education and, specifically, contact with the world of nature on emotional well-being, cognition, and academic performance. Parents and professionals interested in more on this topic might also want to read Last Child in the Woods: Saving our Children from Nature- Deficit Disorder by Richard Louv (Algonquin Books, 2005).

Meanwhile, Laumann’s book makes a good start in a much needed campaign for preserving child’s play.

—E. Jane Garland MD FRCPC

Dr Garland is a Clinical Professor of psychiatry at the University of British Columbia, the Clinical Head of the Mood and Anxiety Disorders Clinic at BC’s Children’s Hospital, and a consulting child and adolescent psychiatrist at the Vancouver Community Mental Health Service.

Healthy at 100

AUTHOR John Robbins

PUBLISHER Random House of Canada Ltd, 2775 Matheson Blvd E, Mississauga, ON L4W 4P7; TELEPHONE 905 624-0672;

FAX 905 624-6217; WEBSITE www.randomhouse.ca PUBLISHED 2006/384 pp/$34.95

OVERALL RATING Poor

STRENGTHS Author has interesting Canadian connections

WEAKNESSES Information from studies is presented in a selective fashion

AUDIENCE General

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his book is intended to inform the public of the “scientifically proven secrets of the world’s healthiest and longest-living peo- ples”—inhabitants of Abkhasia, Vilcabamba, Hunza, and Okinawa. In addition to the fru- gal diet and vigorous exercise of these remote peoples, Robbins hypothesizes that personal relationships, love, and interconnectivity addi- tionally increase lifespan and health.

The author has some interesting Canadian connections. Forswearing any gain from the success of his father’s company, the Baskin- Robbins ice cream empire, he lived for 10 years off the land on a gulf island in British Columbia teaching yoga and meditation. Later he became a successful guru of the links between the environment, diet, and health.

The book is characteristic of its genre. Information from studies is presented in a selective fashion. For example, the author provides reference to the study that indicates that Okinawans have fewer than half as many hip fractures as North Americans. No mention is made that the study also reports an even lower incidence among the Japanese on the mainland (in Niigata). This leads to questions as to the putative contribution of the distinctive lifestyle in Okinawa. In addition, comparisons are consistently presented as the percentage rather that the absolute differences between groups (a favourite