who decides ?

Bill, agreed - it is surprising how some people seem to be able to "do all of the wrong things" and still engage life with much vitality, pleasure, joy, and creativity in various mixtures. That's an interesting point you raise - many of them may seem to identify less with their body images and maybe bodies. Then there are those who live in this exuberant way and die young. And those who "do everything right" and have a major coronary-feeding artery that for some anomalous quirk passes through a muscle instead of over it, or other compressive reasons, and croak while they are on their piece-of-cake early morning run. So many things can go wrong, and amazing how many things continue to go right despite what we do. It seems to me, as you probably agree, that some of this has to do with choice and some has to do with the ability apparently to accept 'what is' in their condition without heavy judgment or power-diminishing self-critique, as well as other idiosyncrasies of life history, inherited gifts, weaknesses and such. I admire some of this power in a lot of people who are or were ADHD-like and maybe can put on a lot of miles of dissipation with strong voices and energetic presentations, or those who might be diagnosed as Bipolar II with an abundance of upbeat attitude and applied verve. Some of the street people are like this - heavy alcohol and drug abusers for many years, now physically limping along or of diminished cognitive acuity, yet somehow still strong of voice and with continued aspects of sharpness and survival savvy. So much inherent variation in this complex life. And so much choice-bringing variation. Heereshz to life. :~}

I think food affects us in complex ways and over long periods of time, so identifying what caused this or that is very hard for medical researchers to do. 

Smoking is not as bad as the simplistic "smoking kills" message -- most smokers don't get cancer. Red wine is actually a choice drink for people who low-carb. There are various syndromes that a few researchers think are caused by wheats and glutens which our digestive tract allow to pass into the blood stream where it causes an auto-immune reaction, and auto-immune problems might lead to lots of stuff including multiple sclerosis, alopecia, colitis, etc. Anecdotally a few people claim to have relieved schizophrenia by avoiding wheat. But a big problem is that these auto-immune conditions set in over decades of time so it is really hard to pin it down. 

Plus everybody is different and food affect them differently based on not just their DNA but what sort of environment they grew up in which could cause their DNA to become expressed in different ways. 

Then on top of that there's all the cultural agendas that people load onto food. The other day on the news they said that "wealth is a big factor in obesity", and then showed a chart of the most wealthy countries and how the obesity got higher as they got richer. But they also showed a chart of very poor countries, and you could see that the poor countries got fatter more quickly even though they were far less wealthy. So that's a real head scratcher -- why would poor countries get fatter quicker that wealthy countries if wealth was a big factor in obesity?? And the simple answer is, I guess, that wealth is NOT a big factor. But I'd never have really spotted the second chart or thought about it because I'd heard them say, "wealth is a big factor" so often. We're always being told that, right?

As it happens I'd read about this question in a book, "why if wealth is a big factor, is obesity such a problem in countries that are malnourished?" And the author of that book said, basically, it doesn't make sense. So obesity must be about the kinds of foods people eat, and in particular, the kinds of foods that poor Africans eat. What do they eat? Grains. 

But that one book is questioning 50 years of medical opinion. So it isn't easy. But it did get me wondering. Stuff like, if exercise is always recommended for weight loss, why is it that exercise burns so few calories? I mean, you can calculate it using those calorie counting websites, how many calories a run or hike would burn, and when you look you see it is a really small quantity. You could just leave a bit of food on the plate and have avoided more calories than a mile run. So why is everyone so hot about exercise for weight loss? It makes no sense. But everyone keeps saying you have to exercise.

Notice how many long distance runners are skinny? Now the message we hear is, they're skinny because they run. But in terms of calories and a lot of other issues, it doesn't actually make sense. An alternative theory is that they run because they are skinny. What's happening is that their genes are such that their bodies just don't store energy as fat, they just don't produce the kinds of hormones or whatever that tell the body to store fat -- just like your genes decide how tall you'll likely be, or how big your feet are, your genes also decide where you'll store fat and how much -- so with long distance runners, they have genes that say "we don't store fat" so when these people eat, they can't store it as fat -- their bodies just don't -- so all that energy is just free in their body, and what happens is, their bodies are full of energy and they have to move. So they run and run and run. They run because they are skinny.

I don't know if that theory is true, but just looking around, like you're doing, just looking at people and comparing what you see with your own eyes, to what you've been told, it gets into a real head-scratching sort of thing. These people seem to be doing bad stuff but they seem full of energy. Now it isn't that they're defying their own bodies, I think we've just been told a lot of stuff about health that isn't generally true.

And there's also a lot of health issues that take decades to develop. This is how we can continue to eat the wrong foods whilst being told they are the right foods and when people eventually, 40 years later, get ill, the true cause is so hard to uncover, and people can always say, well, you must have eaten too much red meat or you must have not had enough exercise or drunk too much wine, when actually it is possible that none of those things have anything to do with why someone got multiple sclerosis or heart disease or diabetes.