The world is fat (2)

 Can the Obesity Crisis Be Reversed?

From conclusions: 

Ending the obesity epidemic will take both individual and collective action. Neither alone is sufficient. Individuals try to lose weight and keep it off, but the system is working against them. The route to population-wide weight loss will not be through trendy, unsustainable diets. It will be through widespread, appropriate, personalized, and comprehensive approaches.

The first action we all must take, no matter our size, is to educate ourselves about obesity—and you’ve been doing that by reading this book. People need to understand the structural, environmental, and genetic components of obesity. They need to see the ways in which systemic factors contribute to weight gain. The idea that obesity is a choice or a matter of willpower has been thoroughly disproved. The unfortunate fact that many people still believe this actively harms efforts to reduce obesity rates.

The government should first seek to change the public perception of obesity. Obesity is largely a result of structural forces, not just individual actions. A shared awareness of its origins could foster greater support for interventions that allow people to make healthier choices.

People and institutions need to work together to make healthy foods more accessible, affordable, appetizing, and convenient than unhealthy foods. Reversing the obesity crisis will require environments that promote physical activity and social movements that encourage people to get more exercise. We need to devote more resources to preventive efforts for all ages to improve our health.

To reverse the obesity crisis, we will need an all-hands-on-deck approach. Pharmacological advances, surgery, and other treatments should complement new policies, societal practices, and population-wide interventions that promote healthier diets and decrease food consumption. Improving the nation’s health may require implementing policies perceived as restricting personal freedoms that have long been granted to industries and individuals. But these policies will be essential to keeping the population healthy.

For individuals, the goal should be to reach and maintain your optimum weight, meaning the weight at which your body the optimal physical and mental health. 

Outline of free ebook:

INTRODUCTION: Struggling with Obesity

CHAPTER 1: How Do People Gain Excess Weight?

CHAPTER 2: Why Are People Getting Heavier?

CHAPTER 3: What Are the Consequences of Obesity?

CHAPTER 4: What Are the Best Ways to Lose Weight?

CHAPTER 5: How to Reverse the Obesity Crisis

Let's get fit, not fat

Aportaciones de la economía del comportamiento en política sanitaria: Algunas notas en torno al ejemplo de la obesidad
 The influence of obesity and overweight on medical costs: a panel data perspective

In the EJHE you'll find  a clear message:

The results indicate that obesity is associated with substantial healthcare cost increases and there are large differences in costs by degree of obesity. Specifically, severe obesity raises total direct medical costs by an average of 160 € per patient and year. With total medical costs averaging 600 € for normal-weight individuals, this means that severe obesity is associated with an increase in costs of 26 %. The effect of moderate obesity is more modest: it raises medical costs by 97 € or 16 %. Overweight has an even smaller impact, raising costs by 51 € or 8.5 %.

Therefore, if obesity has an economic and health impact, what next?
The EEA article by A. Garcia-Altés reflects current knowledge on behavioral economics and obesity. However there is a long way to go. As I said in a former post we do need a battery of measures to fight obesity: regulatory, social and individual measures.

The world is fat

 The Heavy Burden of Obesity – The Economics of Prevention

Almost a decade after the publication of the first OECD report on obesity, a new one has been released. This are the facts:

More than half the population is now overweight in 34 out of 36 OECD countries and almost one in four people is obese. Average rates of adult obesity in OECD countries have increased from 21% in 2010 to 24% in 2016, so an additional 50 million people are now obese. Despite a drive in the last decade to deal with increased obesity, more needs to be done amid sedentary lifestyles and an almost 20% increase in calorie supply – i.e. calories available for consumption – in the OECD over the past 50 years.

So what?

The OECD identifies four categories of policies to tackle the problem and gauges the effect of three promising “policy packages” to help countries achieve greater impact and coherence in tackling the obesity epidemic. Food and menu labelling, regulation of advertising of unhealthy foods to children and the promotion of exercise, including by doctors and schools, are among the measures analysed.

Most of the strategies requires a confrontation with the food industry, and governments usually try to avoid it. We'll see what happens.

A call for a political prescription to tackle obesity

A political prescription is needed to treat obesity
Why Nudge?

Unless there is harm to others, the government cannot exercise power over people. This is the John Stuart Mill's "Harm principle", sometimes called the Liberty Principle. And governments have taken as given that individuals always take decisions in a rational way, fulfilling their preferences. As Cass Sunstein says in his last book "Why Nudge?", such a principle "raises serious doubts about many laws and regulations. Sometimes power is exercised over people in large part to promote their own good, finally people are note entirely sovereign over their body and minds". He argues in favour of paternalism in certain circumstances. We have already explained such details formerly in this blog.
Today I would like to suggest a reading to you, an excellent editorial in the Canadian Medical Association Journal. It is a call for action on obesity and specifically on food policy and taxation on sugar-sweetened beverages.

Our current approach to obesity relies on the assumption that people have choices, often fail to make the right ones, and should be educated and helped to make better choices. This view is simplistic and clearly absurd, given the continued rise in the prevalence of obesity in countries that have been tackling the problem for decades. Are millions of people really choosing to be overweight?

People are not as free to choose as we would like to believe. Neurobiological desires for sweet and high-fat foods gave humans a survival advantage in a world where food was scarce and every calorie counted. Where food is inexpensive and easily available, biological processes related to eating can mirror addiction and will lead to our destruction. We need to change our approach. We need incentives beyond educational messages. Strategies that include individual interventions,  school-based nutrition and activity interventions, incentives for active commuting and changes to the built environment should continue; however, we also need robust ways to restrict portion sizes and reduce the sale of sugar-sweetened beverages and other high-calorie, nutrient-poor food products. Our government needs to consider taxation as a tool to combat the consumption of these addictive foods and beverages, just as it regulates the sale of alcohol and tobacco products for the purposes of population health.

In USA, Berkeley is the first city that will intoduce the soda-tax after a recent ballot. Berkeley’s Measure D proposed imposing a 1-cent-per-ounce general tax on sugar-sweetened beverages and sweeteners used to flavor drinks. The measure will not dedicate funding to a specific cause and did not require only a majority of the vote.
I still remember how a similar measure was discarded some years ago in our country. The times to reconsider the introduction of a soda tax are coming.

Tackling obesity

Integrating Educational, Environmental, and Behavioral Economic Strategies May Improve the  Effectiveness of Obesity Interventions

On top of the priorities for the improvement of public health, obesity deserves a place. However, the tools and decisions to slice its impact on health are still dubious. A recent article may help to put together different approaches:

Obesity is a multifactorial problem impacted by access to foods (supply) and food choices (demand). Neighborhood environments constrain the food choices available to individuals, while complex dietary decisions are driven by taste, cost, nutrition, convenience, and weight concerns. The complex nature of dietary choices therefore requires informed educational approaches that are strategically combined with guided nudges, and environmental interventions that improve access to promote healthier eating. Moreover, multi-institutional  collaborations will likely be necessary to address the obesity epidemic.

Since a multi-institutional approach is needed, somebody has to lead this effort. Is the government able to do it?. If so, don't delay it.

PS. Let me suggest also this Lancet article, my key reference up to now with the OECD one and its update.

Health impact of sugar-sweetened beverages taxation

Averting Obesity and Type 2 Diabetes in India through Sugar-Sweetened Beverage Taxation: An Economic-Epidemiologic Modeling Study

Clever politicians want to know the potential welfare impact of taxation. I said "clever", though this is not always the case. An example of economic modeling for sugar-sweetened beverages to set up the right level of taxation (in India), appears in PLOS Medicine. The summary:

The researchers used survey data relating SSB consumption to price variations to calculate how changes in the price of SSBs affect the demand for SSBs (own-price elasticity) and for other beverages (cross-price elasticity) in India. They combined these elasticities and data on SSB sales trends, BMIs, and diabetes incidence (the frequency of new diabetes cases) into a mathematical microsimulation model to estimate the effect of a 20% tax on SSBs on caloric (energy) consumption, glycemic load (an estimate of how much a food or drink raises blood sugar levels after consumption; low glycemic load diets lower diabetes risk), the prevalence of overweight/obesity, and the incidence of diabetes among Indian subpopulations. According to the model, if SSB sales continue to increase at the current rate, compared to no tax, a 20% SSB tax would reduce overweight/obesity across India by 3.0% and the incidence of type 2 diabetes by 1.6% over the period 2014–2023. In absolute figures, a 20% SSB tax would avert 11.2 million cases of overweight/obesity and 400,000 cases of type 2 diabetes between 2014 and 2023. Notably, if SSB sales increase more steeply as predicted by drinks industry marketing models, the tax would avert 15.8 million cases of overweight/obesity and 600,000 cases of diabetes. Finally, the model predicted that the largest relative effect of an SSB tax would be among young men in rural areas.

The results confirm previous studies, 20% may be the ceiling for a tax . But what happens to health?. Assumptions on a fall in consumption, are just that, assumptions. And former behaviour is extrapolated into the future. This is what happens to any model, and this is the uncertainty and courage that any politician must hold in taking a difficult decision. Such moment is closer than before. If you are not convinced, I would suggest you have a look at this documentary released last week:



The documentary is about weight control, but places special emphasis on sugar (addiction). Please have a look at the quantity of sugar in a beverage!!! (14 sugar cubes). Incredible.

PS. "Superbe" post by Reinhardt: How the Medical Establishment Got the Treasury’s Keys

Obesity: a multifaceted approach

The Current State of Obesity Solutions in the United States

We all agree that we need to face the obesity epidemic. But, when talking about solutions, difficulties and uncertainties  arise. US National Academies held a worksop on 2014 that described interventions designed to prevent and treat obesity in seven settings:
• early care and education,
• schools,
• worksites,
• health care institutions,
• communities and states,
• the federal government, and
• businesses and industry
The book is only a first approach to these experiences, though more evidence is needed in my opinion. They say in the book:

"Much of what needs to be done is clear, he said. The challenge now is to figure out how to do what needs to be done."

 DocField 2017

Now in Barcelona

Tackling obesity: the toolbox

Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking

World Cancer Research Fund International NOURISHING framework 
Food policy framework for healthy diets and the prevention of obesity and diet-related non-communicable diseases. 

 Key message:

The problem of obesity must be reframed to acknowledge on one hand that individuals bear some personal responsibility for their health, but that, on the other hand, environmental factors exploit biological, psychological, social, and economic vulnerabilities that promote overconsumption of unhealthy foods. A vicious cycle is created in which the preference and demand for unhealthy products are not only shaped by the environment, but lead to environmental changes that further encourage consumption of unhealthy foods. This cycle makes it difficult for people to act in their own long-term self-interest, but it can be broken with regulatory actions from governments and joint efforts from industry and civil society to create healthier food systems.

Modificar l'entorn obesogènic o medicalitzar l'obesitat?

 WHO European Regional Obesity Report 2022

A new class of drugs for weight loss could end obesity

Ens ho han dit moltes vegades, i l'informe de la OMS insisteix novament en explicar la situació de l'obesitat a Europa:

Overweight and obesity affect almost 60% of adults and nearly one in three children (‎29% of boys and 27% of girls)‎ in the WHO European Region. Recent estimates suggest that overweight and obesity is the fourth most common risk factor for NCDs in the Region, after high blood pressure, dietary risks and tobacco. It is also the leading risk factor for disability, causing 7% of total years lived with disability.

 Segons dades de l’Enquesta de salut de Catalunya (ESCA) 2020 la meitat de la població de 18 a 74 anys té excés de pes (sobrepès o obesitat), 58,8% els homes i 42,4% les dones. El 33,7% té sobrepès (42,0% els homes i 25,2% les dones) i el 17,0% obesitat (sense diferències entre homes i dones). Respecte a la població de 6 a 12 anys, el 35,9% té excés de pes (el 24,2% té sobrepès i l’11,7% té obesitat). 

Amb totes aquestes dades a la mà, què fem? Doncs, la primera opció segur que passa per menjar millor i fer exercici, responsabilitat sobretot individual. L'altra és canviant l'entorn obesogènic, responsabilitat sobretot col·lectiva. Ho he explicat i ens ho han explicat en moltes ocasions. Ara bé la novetat, és que des de fa uns mesos han arribat nous medicaments, es tracta de la tirzetapida i la semaglutida. El Economist hi dedica un especial aquesta setmana, i l'Eric Topol en va parlar amb molt de detall a finals d'any. El meu suggeriment és que hi feu una ullada per tal d'il·lustrar-vos d'un canvi que ve, i que resumeixen amb un titular a l'editorial que diu: Menja, injecta't, torna-hi. És a dir suggereix saltar-se precisament la prescripció inicial a la que feia referència i aprimar-se mitjançant injeccions de tirzetapida o semaglutida. D'això en podríem dir la medicalització de l'obesitat. Els preus al mes als USA són 1.300$ i 900$ respectivament. Per tant, la prescripció de l'editorial de l'Economist no sortirà barata d'entrada, i alhora té alguns efectes indesitjats. El resultat final podria ser que la falta de l'acció individual i col·lectiva, la paguem col·lectivament tots plegats, si el tractament acaba finançat amb diner públic.

Seguirem atents per veure com evoluciona a Europa. Tot plegat hauria de fer reaccionar als governs per tal de modificar l'entorn, la política alimentària i l'accés a determinats greixos. Un metge citat a l'article diu: "l'obesitat és una resposta fisiològica al que ha esdevingut un entorn patològic".  I jo hi afegiria "un entorn patològic on els governs han estat capturats per la indústria alimentària"

PD. A es diari de Menorca: Y si el medicamento más "potente" del mundo es el ejercicio físico?

Coïnt olives, Van Gogh

PD. Gran 60 minutes sobre ChatGPT

A call for a political prescription to tackle obesity (2)

Overcoming obesity: An initial economic analysis


Some days ago, I was asking for a clear determination to our politicians to fight against the obesity epidemics. How? The just released McKinsey report provides 44 measures to implement and its potential impact. Have a look at it, and you'll be convinced that all we need is political will, social consensus and individual commitment to overcome this crucial issue.

Regulating sugar sweetened beverages

Searching for Public Health Law’s Sweet Spot: The Regulation of Sugar-Sweetened Beverages

Nowadays, obesity prevention lies at the heart on any public health policy. If sugar sweetened beverages contribute decisively to obesity, then something should be done. What?. A recent PLOS article explains the options:

The main regulatory approaches are taxes, restrictions on the availability of SSBs in schools, restrictions on advertising and marketing, labeling requirements, and government procurement and benefits standards.

On taxes:

Savvy regulatory design has tremendous potential. For example, there is growing evidence that taxes that are more salient to consumers, such as those included in a good’s posted price (rather than being levied at the register), are more likely to influence purchasing behavior

On public procurement, a practical suggestion for immediate application:

Restrictions on which beverages may be purchased using government funds are a less visible form of regulation, but one with potential to change the consumption patterns of large numbers of people. Outside public schools, these standards are most germane in two areas: procurement standards for public institutions (e.g., government agencies, hospitals, and prisons) and restrictions on what recipients of government benefits for the indigent may buy with those funds.
The UK’s Government Buying Standards prohibit central government bodies from  procuring SSBs larger than 330 ml and encourage the wider public sector to follow the guidelines. Massachusetts  and many US counties and cities have adopted nutrition standards for government contracts, but most apply to a limited set of institutions, such as childcare facilities or youth centers.

PS. My former posts on the same topic.
PS. Article: The impact of sugar sweetened beverages on depression risk in adults.
PS. Report: Scenarios of Macro-economic Development for Catalonia on Horizon 2030
PS. Report: FBBVA Essential Public Services.
PS. Report: Chronicle of a premeditated offensive.

Paternalisme liberal

Obesity and the Economics of Prevention: FIT NOT FAT

En Thaler diu que no és ben bé un oxymoron. En Becker aplana el camí per a Posner.En Posner diu clarament que si.
No és tant important si ho és o no, més aviat el més important és la rellevància per la política sanitària. I aquí és on ens cal reflexionar de veritat. Al llibre Obesity and the Economics of Prevention: FIT NOT FAT hi ha un capítol suggerent sobre el paper dels governs i el mercat. La referència al paternalisme liberal es resumeix aquí:

Preferences may also be influenced in more subtle ways than through the direct provision of information. An important example is what has been described as setting the default option by advocates of “libertarian paternalism” (e.g. Sunstein and Thaler, 2003). The underlying principle is that individual preferences driving an act of choice tend to be influenced by how the default option is configured. An example of the default option is the routine association of a certain side dish to a main course ordered in a restaurant. Customers may be entitled to demand an alternative side dish, but if they did not exercise this faculty they would receive the standard (default) option. Using a healthy option as a default instead of a less healthy one would have a significant effect on the number of customers eventually choosing to consume the healthy option. Actions involving changes in default options may display varying degrees of interference with individual choice and they may be perceived as more or less acceptable by consumers depending on the nature of the choices they aim to influence. For instance, changing the order in which food is arranged in a company cafeteria (Sunstein and Thaler, 2003) in order to steer consumer choices towards healthy options would seem to be a fairly non-intrusive action. However, other actions based on the same basic principle, i.e. changing the default option, may be perceived as much more intrusive. An example is policies making organ donations a default, with individuals being allowed to opt out upon request, have been viewed as most controversial and have been fiercely opposed in many countries, despite evidence which shows these policies may increase organ donations by as much as 25-30% compared to countries where the default is not consenting to donation (Abadie and Gay, 2006).

I el que fan els països OECD en relació a l'obesitat es resumeix en aquesta figura:














Si l'obesitat és considerada com el factor de risc més important, aleshores convé saber què cal fer. El llibre de l'OCDE mostra l'estat de situació però queda molt camí per endavant. Al McKinsey Quarterly ens diuen que els governs han d'actuar.

The apocalypse and our true fate, who knows?

THE FIVE HORSEMEN OF THE MODERN WORLD: Climate, Food, Water, Disease, and Obesity

In the book of Revelation or Apocalypse of John, you'll find the seven bowls. Seven angels are thus given seven bowls of God's wrath, each consisting of judgements full of the wrath of God poured onto Earth:

First Bowl: A "foul and malignant sore" afflicts the followers of the Beast. (16:1–2)
Second Bowl: The Sea turns to blood and everything within it dies. (16:3)
Third Bowl: All fresh water turns to blood. (16:4–7)
Fourth Bowl: The Sun scorches the Earth with intense heat and even burns some people with fire. (16:8–9)
Fifth Bowl: There is total darkness and great pain in the Beast's kingdom. (16:10–11)
Sixth Bowl: The Great River Euphrates is dried up and preparations are made for the kings of the East and the final battle at Armageddon between the forces of good and evil. (16:12–16)
Seventh Bowl: A great earthquake and heavy hailstorm: "every island fled away and the mountains were not found." (16:17–21)

As you may notice Apocalypse is just that, a book. Daniel Callahan set a title of five horsemen of the modern world as a metaphor of current evils. Global warming, food shortages, water shortages and quality, chronic illness, and obesity could be the key ingredients of our fate?.
At the end, Daniel Callahan calls for a diplomatic model:

to persuade the research, academic, and policy communities to accept what I will call the diplomatic model of relationships, typically now seen between and among nations, and to open a serious dialogue with the business community

Agree.

Improving health in OECD countries

Health at a Glance 2017

Let me highlight toady one figure: 54% of adults in OECD countries today are overweight, including 19% who are obese. Obesity rates are higher than 30% in Hungary, New Zealand, Mexico and the United States.
Many indicators about current state of health in OECD and partner countries can be found in the report. And the public health message is:

While smoking rates continue to decline, there has been little success in tackling obesity and harmful alcohol use, and air pollution is often neglected

These are the new epidemics and prescriptions are not easy to find to curb the current trend.
The report shows many positive messages and this should be a reason for trust in our future, however the uncertainties regarding new risks and how to tackle remain.

Gramophone All Stars Jazz Band. Maraca Soul album. Iko Iko

The obesity industry

 The Hungry Gene. The Inside Story of the Obesity Industry

La mesura del benestar

How's life? Measuring well-being

Hem passat tants anys parlant que el PIB no ho recull tot i ara que surt una alternativa li dediquem poca atenció. Ha estat novament l'OCDE qui ha fet l'esforç per a 34 països per tal de determinar el benestar relatiu de la població. Ho trobareu a: How's life? Measuring well-being. De les moltes dimensions, adjunto la relativa a salut aquí sota. La satisfacció amb la vida estaria al 6,2 mentre que a l'OCDE es troba al 6,7 i quan mires algunes dimensions en particular hi ha sorpreses preocupants. Resulta que quan disposàvem només del PIB resultava fàcil pensar unidimensionalment i en canvi quan n'hi ha moltes cal posar un pes a cadascuna, i això depèn de les preferències individuals. Per tant només hi ha una opció possible, fer servir l'eina interactiva i que cadascú es calculi el seu benestar relatiu (l'agregació de preferències és tasca complicada).

Most OECD countries have enjoyed large gains in life expectancy over the past decades, thanks to improvements in living conditions, public health interventions and progress in medical care. In 2008, life expectancy at birth in Spain stood at 81.2 years, two years above the OECD average of 79 years.
Higher life expectancy is generally associated with higher healthcare spending per person, although many other factors have an impact on life expectancy (such as living standards, lifestyles, education and environmental factors). Total health spending accounted for 9.0% of GDP in Spain in 2008, which is equal to the average of OECD countries. In 2008, health spending as a share of GDP was the highest in the United States (which spent 16.0% of its GDP on health), followed by France (11.2%), Switzerland (10.7%), and Germany and Austria (both 10.5%). Spain ranks below the OECD average in terms of health spending per person, with spending of 2,902 USD in 2008, compared with an OECD average of 3,060 USD. Between 2000 and 2008, health spending per person in Spain increased, in real terms, by 4.7 % per year on average, a growth rate higher than the average in OECD countries (4.2%).
Throughout the OECD, tobacco consumption and excessive weight gain remain two important risk factors for many chronic diseases.
Spain has achieved progress in reducing tobacco consumption, with current rates of daily smokers among adults standing at 26.4% in 2006, down from 41% in 1985. However, smoking rates in Spain still remain higher than the OECD average of 23.3% in 2008. Sweden, the United States and Australia provide examples of countries that have achieved remarkable success in reducing tobacco consumption, with current smoking rates among adults below 17%.
Adult obesity rates in Spain are higher than the OECD average, but child rates are amongst the highest in the OECD. Two out of 3 men are overweight and 1 in 6 people are obese in Spain. One in 3 children aged 13 to 14 are overweight. The proportion of adults who are overweight is projected by the OECD to rise a further 10% during the next 10 years. Obesity’s growing prevalence foreshadows increases in the occurrence of health problems (such as diabetes, cardiovascular diseases and asthma), and higher health care costs in the future.
When asked, "How is your health in general?", 70% of people in Spain reported to be in good health, close to the OECD average of 69%. Despite the subjective nature of this question, the answers have been found to be a good predictor of people’s future health care use.

PS. Per aquells que associen desigualtat social amb menys satisfacció en la vida, els convé veure aquest post i el seu argument trontollarà una mica més.

Mounting evidence about sugar-obesity link

Sugar: Consumption at a crossroads

Should the government and health officials do more to reduce consumption of sugar, and will they in your opinion? The answer is yes, 90% of the European population consider that governments need to act,  but only 52% believe the governments will do it, according to the Credit Suisse Equity Research Nutrition Survey, 2013. You'll find the details in this report.
Why so many people consider that right now something should be done about sugar intake?. Basically because everybody is increasingly convinced about the relationship between excessive sugar consumption and obesity.
The report is a good guide for all the implications and potential governmental regulation and industry self-regulation.
Definitely, something should be done, asap.

A much-needed start: soda tax

Soda Politics: Taking on Big Soda (and Winning)

Obesity is a top concern on public health. Personal and collective responsibilities are linked. The concrete issue is the following one: government may require manufacturers to release information to consumers (about calories, composition, etc.), but is there anything else that he can do?
Current strategies fall short to achieve the goals of obesity reduction. Nutritional labels are not enough, are taxes an option?. Some countries have already implemented taxes on fizzy drinks, fat or salty foods. There are complex technical issues to be considered. However, The Economist says that taxes on fizzy drinks seems to work as intended. If this is really so, then there is a much-needed reason to start in this way.
Marion Nestle in her latest book "Soda Politics" provides the hole list of arguments. Any regulator should read in detail the book, specially part IX on "Advocacy: Soda caps, taxes and more", and take into account her recommendation:

 Let me acknowledge immediately that advocacy to reduce soda intake faces special challenges that distinguish it from advocacy for reduction of alcohol, tobacco, or junk foods. Like these other industries, the soda industry sells relatively inexpensive products that are available in almost every corner of the globe. Like them, this industry is extremely wealthy. Also like the others, health is the industry’s Achilles’ heel. But in sharp contrast to companies selling junk food, alcohol, or tobacco, Coca-Cola and PepsiCo consistently rank among the most admired, respected, and honored companies in the world. Health and environmental advocates must recognize the power of this favorable public perception when encouraging others to resist it.

PS. A must read. Understanding 25 years of health policy in Catalonia, released in this journal: Referent. You'll find an article that I have written for the occasion.

Approaching the golden age of epigenomics and epitranscriptomics

A new twist on epigenetics

If epigenomics is crucial to discard the genetic predestination paradigm, now we can add a new 'omics to the paradigm: epitranscriptomics. Last February, Nature published interesting news related to recent scientific developments:

The epigenome helps to explain how cells with identical DNA can develop into the multitude of specialized types that make up different tissues. The marks help cells in the heart, for example, maintain their identity and not turn into neurons or fat cells. Misplaced epigenetic marks are often found in cancerous cells.

 Chuan He and Tao Pan are two researchers that have been working on new ways of controlling gene expression

He and others have shown that a methyl group attached to adenine, one of the four bases in RNA, has crucial roles in cell differentiation, and may contribute to cancer, obesity and more. In 2015, He’s lab and two other teams uncovered the same chemical mark on adenine bases in DNA (methyl marks had previously been found only on cytosine), suggesting that the epigenome may be even richer than previously imagined.

The team had shown for the first time that RNA methylation was reversible, just like the marks found on DNA and histones.

Methylated adenine bases are the focus of research on gene expression.

A healthier population (after all this years)

Enquesta de salut de Catalunya 2012. Informe dels principals resultats 

It is just a fact. The authors of The Lancet article were unable to have a look at the last Catalan Health Survey. In 2006, 78,6% of population considered their health as good, in 2012 (p54) this figure has moved up to 82,8%. The Lancet only emphasized negative issues without clear evidence. It seems that this is the selling argument of our times.
The most relevant thing from the health survey is that citizens view themselves healthier than before the recession, you'll find additional details inside the report.
However, a closer look may highlight some doubts about individual health behaviours, smoking by young people and specially the obesity epidemics. Therefore, a short applause and a clear public health alert for an improvement of health behaviours.