A large new study of adolescents in the Minneapolis area surprised and excited the study authors and a writer for the New York Times.  They found that many of the girls and over 1/3 of the boys were doing things (changing eating patterns, exercising, taking protein drinks or using steroids) to improve their body composition.  The highest rates were seen among the boys on sports teams and girls who were obese.  Just under 6% admitted using steroids, which is probably an underestimate because people often do not admit “bad” behaviors in surveys.

The researchers and the NYT writer interpreted their findings negatively– “cause for concern” the authors concluded. More careful consideration of the data leads to different conclusions.  The article overemphasized the unhealthy potentials of these behaviors.  Certainly individuals who are overweight or more serious athletically  SHOULD be more serious about taking care of their bodies, including building muscle mass.  The conclusions of this study were overblown, reflecting both a lack of understanding of proper diet and a hypersensitivity to body image issues. 

The CDC estimates that over 1/3 of American teens are overweight or obese (significantly less than their parents).  It is very clear that the most effective ways to reach a healthier weight is through physical activity and dietary improvement, especially by boosting protein intake.  I would add that it is even more evident that weight is far, far less important than is body composition (ie, the ratio of muscle to fat).  Athletes need strength training, both to enhance performance and to prevent injury. Strength training also builds muscle and speeds up metabolic rate, each improving body composition.

Considering the realities of American health in general and the health of adolescents, I am generally pleased by these findings. When I was 12 or 13 I was overweight.  Ken Cooper’s book, AEROBICS, came out.  I read it, changed my eating patterns, began a program of vigorous exercise, lost weight, learned the power of healthy lifestyle, grasped my ability to control my own life and eventually became the doctor I am today.

The use of steroids is very concerning and we need to do more about that.  The researchers and NYT writer apparently had biases which led to their skewed interpretation of the study data.  Although less extreme, I do share some of their concern, particularly the issue of male body image.  

I have always supported the ideal of gender equality.  This is not, however, the path I envisioned taking us towards that goal. Lowering perfectionistic expectations about female bodies was my expectation, not raising expectations about male bodies.  We are moving towards an unhappy and disordered equality.

Columnist  Richard Cohen, commenting on the latest Bond film, pointed out the irony that Daniel Craig’s Bond supposedly suffers weakness and disability of age, while the film simultaneously lingers on his hyper-perfect body.  They are now marketing the “Daniel Craig” workout, so that we can ALL achieve a similarly imperfect body?????  Thanks?


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Michael Carlston, MD is an internationally recognized authority in the integration of conventional and complementary medicine in clinical practice, as well as medical education, research and organizational consulting. Practicing in Santa Rosa, California, Dr. Carlston was voted “Best General Physician In Sonoma County, California” by readers of the Sonoma County Independent newspaper and also named one of the outstanding physicians in the Bay Area by San Francisco Focus Magazine. With 30+ years in private practice, his expertise is in nutrition, homeopathy and sports medicine.

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