Santa Claus: a public health pariah?
BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b5261 (Published 17 December 2009) Cite this as: BMJ 2009;339:b5261
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Time has come to start thinking that there is more that one obesity. Obesity is an adipose tissue expansion and aesthetically might be out of fashion. However, in some cases being obese is an advantage in some chronic diseases. Therefore, the first think we should be doing is to define when obesity has to be treated. Let's not get ahead of ourselves...Santa may be a metabolically healthy obese.
Competing interests: No competing interests
On Christmas Eve, spurred on by the images in the article Santa
Claus: a public health pariah?(1) my two children aged 6 and 9 felt
prompted to take immediate action to help Santa Claus with his weight loss
program. Despite my protestations they insisted on leaving him a satsuma
and two hazelnuts, instead of the usual sherry and mince pies.
Santa Claus was still good enough to fill their stockings but I can't help
feeling he was a little hard done by!
References
1. Grills NJ, Halyday B. Santa Claus: a public health pariah? BMJ
2009;339:b5261
Competing interests:
Stephen Harper has helped Santa Claus deliver presents to his children for several years now
Competing interests: No competing interests
Grills and Halyday give a humorous account of Santa’s ability to
influence people, especially children (1). The authors suggest that one
of the things that Santa promotes is the harmful message that obesity is
synonymous with cheerfulness and joviality.
To be very old and obese, yet cheerful and jovial, it must mean that
Santa must be very healthy. So, children and grownups would have to
investigate Santa’s dietary habits at the North Pole for identifying the
reason for this anomaly.
Firstly, however, it would be advisable to consider Santa’s age. No
one will dispute the fact that he is very, very old, as exemplified by his
snow white hair and beard. Secondly, as a North Polian, Santa consumes a
fatty diet abundant in omega-3 fatty acids (2). Also, it is a well known
fact that one puts on weight with age (3,4). Santa needs the excess
adipose tissue to keep him warm at the North Pole and as he travels in the
cold confines of the atmosphere, on his reindeer-drawn sled.
When many have succumbed to heart disease, cancer and other diseases
we find Santa working tirelessly year after year, giving joy to children
around the world. The ideal omega-3/omega-6 ratio in Santa’s diet is
hypothesized as the reason for his lack of heart disease (2) or prostate
cancer (5). It would be of interest to see if this diet has anything to do
with the observation that that he does not gradually lose muscle mass and
become frail as the years pass.
In addition, he does set an example for healthy living, despite his
obesity. He encourages his young helpers to work very hard, to prepare
presents for delivery to the world wide wonderfulkids, in time for
Christmas. Thus, Santa’s Elves are all slender and live a very active
lifestyle, a model for youngsters everywhere.
Santa is very helpful and resourceful as well. In the off season, he
outsources part of “Elf storage” to Washington DC, USA to help stimulate
the economy (Figure 1). With no recession ever, at the North Pole, Santa
can afford to give one of the biggest stimulus packages ever delivered to
the USA. Therefore, we should be thankful even after Christmas for the
numerous jobs that would be made possible by this thoughtful gesture. The
stimulus package would be more than enough to provide for the food,
clothing, housing, transportation (Polar Express) and other needs of the
Elves.
Kids of all ages can take comfort in the knowledge that Santa is not
at all bad at heart and all the negative images portrayed are just a sad
example of the precocious greed of mankind who attempt to use his
influence to peddle their wares.
Therefore, kids and grownups can emulate Santa for his healthy eating
style, for enforcing a strict work routine for his helpers, for his
generous heart and his resourcefulness.
References
1. Grills NJ, Halyday B. Santa Claus: a public health pariah? BMJ
2009;339:b5261
2. Burr ML. Lessons from the story of n-3 fatty acids. Am J Clin
Nutr. 2000;71(1 Suppl):397S-8S.
3. Williams PT. Evidence for the incompatibility of age-neutral
overweight and age-neutral physical activity standards from runners. Am J
Clin Nutr. 1997;65:1391-6.
4. Williams PT, Wood PD. The effects of changing exercise levels on
weight and age-related weight gain. Int J Obes (Lond). 2006; 30:543-51.
5. Dewailly E, Mulvad G, Sloth Pedersen H, Hansen JC, Behrendt N,
Hart Hansen JP. Inuit are protected against prostate cancer.Cancer
Epidemiol Biomarkers Prev. 2003; 12:926-7.
Competing interests:
None declared
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Competing interests: No competing interests
Get a life.
Baaaah Humbug
Competing interests:
None declared
Competing interests: No competing interests
Dear authors:
This article is most entertaining, but has been widely reported in the lay
press as a totally serious article. These poor journalists, and their
readers, clearly don't understand the concept of medical humour and
parody, and that this can be subtle! I ask you, please let them know it is
supposed to be humourous (or at least most is) before someone thinks
you're really anti-Santa and want to spoil everyone's fun!
sarah.abrahamson@med.monash.edu.au
Competing interests:
None declared
Competing interests: No competing interests
What and excellent article to bring a smile to the faces of those who
no longer believe in the red faced bearded wonder. However, surely the
authors miss several key points in their assessment of Santa's fitness.
Surely when hopping from chimney to chimney he is contributing to his 30
minutes excercise for the day. Extreme sports also raise the heart rate
effectively and build on leadership and team skills between Santa and his
reindeers. In addition, with the BMA now supporting a greener world, using
sleigh and reindeer is carbon neutral and opting for their choice of
bicycles would run the risk of enducing repetitive strain injuries,
muscles strains or if out on the ice, a nasty fall and possible fracture.
Jogging has also been shown to cause high levels of stress on joints -
middled aged gents may be therefore at higher risk of inducing
osteoathritis?
In addition, Santa is only around for 1 month of the year. Should we
be attacking the Easter bunny in the same way? On the face of it a healthy
animal that is active but underneath that lies a darker side with eggs
full of fat and calories.
Maybe a suitable remedy to the infection risk would be to e-mail
children, webcast and even Twitter to ask what they want for Christmas?
The most important point of the Santa saga is that we do look at him
as the symbol of Christmas and not the nativity. Who knows, maybe in years
to come we will have the baby Jesus being visited by Santa himself?
Until then, I will leave my mince pie (low fat); non alcoholic fizzy
wine and a wish list in the hope that Santa will visit me on Christmas
Eve.
Competing interests:
Believed in Santa Claus until the age of 7
Competing interests: No competing interests
Our Nation’s attention was drawn, via our National Press, to a study published in your Journal warning that Santa is a bad role model for children, ‘Santa promotes a message that obesity is synonymous with cheerfulness and joviality!’
Please be advised that here in the Antipodes a gaunt, anorexic old man with long grey hair and beard is always considered a vagrant, regardless of address or wardrobe.
Best keep the weight on.
Competing interests:
None declared
Competing interests: No competing interests
Grills and Halyday's work is the most entertaining parody of a
research paper I have seen in a very long time. It beautifully magnifies
and skewers the pompousity, pettiness, panicky alarmism, and unabashed
ivory-towerism that can creep into some strains of scientific writing. I
laughed until my head hurt.
Competing interests:
None declared
Competing interests: No competing interests
Re: Santa Claus: a public health pariah?
Santa Claus has received criticism for promoting an unhealthy lifestyle, with his rotund body habitus, penchant for alcohol and mince pies, and predilection for airborne travel.
Yet little consideration is given to the possibility that all is not always as it may seem. Santa is a famously private individual. Without the opportunity to undertake a full history and examination, we are limited in what conclusions we may draw regarding his health.
What we do know is that he spends a great deal of time in soot lined chimneys, seemingly without adequate personal protective equipment (PPE). It seems feasible that cumulative exposure to these conditions might result in some form of chronic interstitial lung disease while alighting in tobacco smoke-filled living rooms might contribute an obstructive component. His centripetal obesity and round face could therefore derive from a cushingoid effect of regular systemic corticosteroids, with his dependence on airborne transportation and multiple helpers indicative of a limited exercise tolerance. Indeed his functional residual capacity may be such that wheezy monosyllabic utterances, such as "ho ho ho", are all that he can routinely muster, with the break neck speeds of his open sleigh necessary to deliver continuous positive airway pressure support.
As good clinicians we ought to be wary of misdiagnosis based on lazy assumptions.
Santa Claus may suffer from disabling medical comorbidities which in conjunction with his advanced age, might easily justify State support. Shamefully, despite the huge progress made in access for the disabled, we still insist on him making home visits via unregulated chimneys. Nevertheless, his dogged determination to continue working, and deliver results in a reliable and timely manner, suggests why in common with many other skilled migrant workers, he remains in such high demand.
Far from being a public health pariah, Santa’s public health relevance extends beyond the mental wellbeing of the paediatric population and their grateful parents. By managing chronic illness without allowing it to dominate his life, he may be a powerfully enabling and destigmatising force.
Competing interests: No competing interests