访谈录 2010-07-21&07-25 姐就是长的胖，怎么了吧-

Information is good, and information in context is very good. The calories, I'm a big fan of calories post on menu board, but most people think they are supposed to eat 2000 calories because nutritional 1 labels are always based on 2000 calories a diet. Or if you are six foot five, that works for you, but if you are a sedentary American, you really need…be eating somewhere roughly within, if you take your ideal healthy weight, whatever you perceive that to be, multiply that number by ten. That’s roughly your base level of calories since not very many, if you want to eat more than that, you have to exercise to earn those extra calories, so for someone like me, I can’t eat more than 1300 calories if I’m not goanna exercise, that’s not a lot of food. So I run four miles a day, and I’m eating somewhere close to 1800 calories a day, but people don’t understand that, everyone seems to think they are supposed to eat 2000 calories and we are warped 2 in what we believe is a normal portion, a normal manner calories, and normal eating. Sorry, I just don’t understand what you just said. You were saying that you run four miles a day and eat only eighteen hundred calories, right? No, no, if... Or thirteen hundred if you don’t work out.

If I expect to stay in the low 120s, I’m five foot six, and that’s a healthy weight for me and I feel really great, every item of my blood panel and everything is in excellent shape. So if I were a sedentary person, did nothing, I would need to eat somewhere around 1300 calories, probably every bite of that, very nutritious 3, to maintain the way where I am. Well, I’d like to eat more than that, so I make sure to exercise every single day. I run four miles, I happen to live in the city so I’m doing a lot of walking, so I’m able to get myself hundreds of more calories through exercise, so I can have indulgences, so I can eat more than I could, if I were sedentary with the expectation that I wanna stay the way where I am. That’s really interesting and that’s just about 300 calories off where I was about four years ago when I was really sick and had hair falling out of my head. But you are five foot nine.

No, you are right, and um, but I’m not saying you that have any anorexia 4, I’m not saying that. I definitely believe, you know, that there’s something going on, cause you are quite passionate 5 and I think a little fat-phobic. But I think that, you know, it’s, thirteen hundred calories is a little extreme. I really...

Which is why I don’t eat 1300 calories, but if you look at the longevity 6 studies coming out of Harvard and University Wisconsin, you’ll see that the races among kids have been falling for decades now, those on about 30 percent decrease from what they would eat, if they could have access to all food, are living longer and better, and so there’s a lot of studies looking at, staying at lower-end BMI, perhaps giving us longevity and healthier longevity.

Right, so when I was eating 1000 calories, and lost my menstrual cycle for 3 years, and might not be able to have children. I mean I think that says something that’s way too little. Is anyone suggesting anyone do that, because that sounds terribly unhealthy? I think that if you get to a point of what appears to be a healthy way, but you do it in a very unhealthy manner, you are never going to be healthy.

I think it’s amazing that you say people aren’t recommending that, because most diets are. And if you…I wouldn’t know a thousand-calorie-diet sounds horrible, I don’t know… I guess it’s a weird 7 fat diet recommended…No, it’s not even weird fat diet, it’s … if you look at sort of the things that we do, that we take on as our sort of healthy living habits that we get from the media, from people who are not , you know, nutritionists, people who are suggesting that we do these things, we wind up not eating.

But Maryann, would you agree the message right now was pretty much mostly vegetarian 8 diet, drinking water instead of sweet drinks, and getting regular exercises, to me that seems to be the overt 9 message and that seems to be like the pretty decent one, none startling, none frightening, mostly vegetarian diet.

Let me just break in for one second. I think we all know, eat right, exercise. I guess the point to Meme is we don’t have… There are a lot of people who believe we don’t have obesity 10 epidemic 11, and we have inactivity epidemic. I mean four miles a day sounds very ambitious running, but should we then talk bring discussion of exercise into this as well.

Well, I think that more movement is possible for some people than others. I mean I’m at work for nine to ten hours a day, I come home and you know there is the making of dinner, it’s dark outside, and I live in Florida, you know I’m lucky that I have fresh produce available year-round, but I don’t even have kids in my schedule list packed, you know between writing books, you know interacting with people. It’s certainly betweenone of thehealthy lifestyles. It’s certainly something that you have to make the time for, nobody in this stage is ever going to find the time because we are all so busy, but if it’s important to you and you want to fit it in, you can fit it in. And you know, I have a hard time with exercise, you know, something I didn’t do when I was living my way.

That’s right. I don’t like everyday making myself busy. I do it for…Because I want the consequences of exercise, I want the consequences of making healthy choices, it’s important to me.

And I make those choices as well, and I look completely different from you. You know there are times when I’m more active and there are time when I’m not as active based on whatever is going on in my life, when I’m not…But you don’t even know how many calories you are taking in because you don’t count them. Weight lost and weight gain is calories in, calories out. You are gonna gain...

But to your point I just answer what you brought up. Over the decades we have not seen a dramatic change or dramatic decrease in activity, we’ve seen a dramatic increase in calorie intake 12. I will never fight against exercise; you cannot be healthy without daily exercise, no matter what size you are, but we have not seen in the studies a dramatic decrease, even though we all need more exercises, there has not been a dramatic decrease in exercise over the decades, but a dramatic increase in calories intake.

If you knew, if we knew what it took to decrease excess fat accumulation and the fat itself, and let those fats be released for energy, so that the body would no longer become obese 13, and we do know that answer, why aren’t we telling the American public this when the answer is not only known, but it’s been known for well over a hundred years?

Are you talking about a diet with so many hidden sugars and refined carbohydrates 15 that spikes 17 insulin so we are packing on fat and the general population's unaware 18 of that? Because I’m glad that you brought that up because it is leading us into a diabetic state, pre-diabetic state, and when we do spike 16 our sugar, the insulin rushes in, and then you think you are hungry now or later, so it’s an artificial cue to eat, and when you do have this burst of insulin, you are packing on fat, especially in the mid-section, so it is so important that we get the hidden sugars out of the foods, because the food marketers want us to eat more so it make sense for them to hide it in everything that we eat.  So this is why the health wouldn’t be considered a healthy diet like you were mentioning before, that you ate a healthy diet, you eat a healthy diet and yet you are still over fat, perhaps what we consider a healthy diet isn’t one. So I will take a little bit issue with something you said, maybe Dr. Bether can correct me, but there are studies that correlate inactivity with children, i.e. numbers of hours watching TV, etc, and increases in childhood obesity, so maybe it doesn’t have direct correlation 19 to fat storage, but clearly it correlates to inactivity, it correlates to weight gain among kids.

You are right, there is a lot of epidemiologic data that shows an increa ... the correlated increased sedentary activity in children and obesity and overweight. Somewhere it has to do with the behaviors, when children are watching television, it’s a…There’s very often a linked behavior, if he sits down to watch TV, he get a bag of chips, and a soda 20 to drink, and those are linked. So there is that connection, there is not, though, a lot of evidence that choose that interventions 21 that focus solely 22 on exercise will lose a lot of weight, you really need that accommodation. You will, you're gonna do one thing to reduce weight, focusing on healthy choices on food, it's gonna have more impact, but there are so many other reasons to get kids out to play, and it is part of the equation, it’s just not that strong on its own.

This is mostly a question for Ms. Roth,  given that better indicators 23 of health are things such as your cholesterol 24 level, your blood pressure, you know and all those sorts of other things, why are we not focusing on those numbers rather than the number on a scale?

I think that we are absolutely looking at those numbers, and if you go to get any blood report, those are the numbers they look at, if they are looking at the rise of diabetes 25, they are certainly looking at glucose 26, when we are looking at refined carbohydrate 14 and sugar, we are looking at the triglycerides that result in blood stream, so we are looking at all of those numbers, and I think the number on the scale is when you looking at the BMI, you going to a school, it’s not invasive, they can get a lot of kids on the same time, as an initial screening. I’ve never known anyone to take BMI and make a final, medical diagnosis 27 based on it, but it’s an excellent cheap, not invasive …We are not talking about medical diagnosis; we are talking about broad legislation, not broad legislation, broad, um, rules and things that are being put into place based on their BMI, not their blood pressure, not their cholesterol.

When you go back to insurance and you know what, as long as the actuarials are using the BMI equals this much risk, equals this much cost, that’s what they are goanna use. If they were, if they had all this information, if you, everyone of us gave all of our medical data over and said: look at everything and decide, maybe it will come out differently, but they are saying that they are drawing a connection between high weight to disease, to high cost. And as long as that’s the case, that’s how they are gonna set up that business model.