To ask what's the gravest longterm health risk - smoking, drinking or obesity?

[Proudnscary]

I drink too much. So does my dh. I'd say probably three times weekly guidelines [bublush].

We don't smoke (well I don't, he has a crafty 2 or 3 a week he thinks I don't know about [buhmm]).

We are not over weight (could possibly do with losing 7lbs each).

Dh therefore says we are fine to indulge in one vice.

He also reckons being morbidly obese and smoking are far worse than drinking.

I say bullshit.

Any doctors, researchers, nurses got a definitive answer? Say if you based it on say the ratio of 20 fags a day v bottle of wine a day v being 2 stone overweight?

Most smokers in our family died in their fifties. Others have been luckier and are still doing well in thir seventies, but they have osteoporosis.

Drinking too much doesn't necessarily make you overweight, I drank too much when I was younger and ate fairly normally and was a healthy weight.

Also there is a debate that even with obese people, it is kind of not known how much is down to being obese and how much down to behaviour that is more likely to be present if you are obese. So very fit but obese people can have good health. But obese people are more likely to eat poorly and not take enough exercise. There is as far as I am aware no real validated studies to answer this either way.

Call - agree. Yes I don't want the dc to grow up in a boozy house.

Yes I'm worried I won't be able to cut down. Though I can and have before - when I'm not with my husband I am able to drink perfectly moderately (most of the time) so it's a bit of a co-dependency thingymajig.

Lesley - so you mean, for example, an obese person who eats too much of the right things can have healhty liver/arteries but just be bigger? Wouldn't being very overweight put a strain on your organs particularly your heart though either way?

It's hard to be specific about it because everyone's genetic predisposition will be different, but I'd say smoking was still the most risky.

However, if you are concerned about the amount you drink, then the answer is in your hands really - stop buying it! Or buy less. Or switch to an alternative. I know it's easy for me to say (and actually, I can say it because I've had to do it as well - once I hit a bottle of wine+ a night, I knew something had to change).

It's harder if your partner won't help you out - but really, it's not down to him, it's down to you. And perhaps if you lead by example, he might follow...

What I found helped was finding something to drink that looked the same but had no alcohol in it - when I was in the UK, it was Waitrose fresh blueberry juice (looks exactly the same as red wine), which I drank mixed with sparkling water. Here in Australia, I have found a pretty decent de-alcoholised Shiraz, which makes a perfectly good substitution for red wine (my favourite). SO, I would recommend you find a sub that you like and drink that instead. Good luck! :)

proud - The argument is that yes it will still put a strain or organs versus being fit will mean that organs will be fine - organs can cope fine with very muscly athletes. I am not arguing either way, just saying that actually we don't know enough about this stuff to be sure.

So for examplethere is a theory that actually it is the amount of fat round our organs that is actually the dangerous thing and that thin but unfit peopel can actually have quite a bit of internal fat.

But of course in the meantime it makes sense to try and be slim.

I think sumo wrestlers who are clearly obese tend to be super fit (disclaimer: this may be crap - I saw it on TV) so I see what Lesley is saying, but I've also known many obese people deluding themselves into thinking that they eat "nothing but fruit and veg" or "hardly eat at all" which I know to be untrue.

Ultimately, it doesn't matter which is worse. I could justify smoking, drinking and scoffing by saying I don't smoke crack if that were relevant! I appreciate how hard it is to cut down when your DH isn't supportive, but you might find that you doing it independently provides him with the impetus he needs once he sees that your life isn't over! Good luck

Yes you are all right re leading by example. It's my only option.

I think I am more worried about the possible arguments/tension about this than the actual cutting down! We rarely argue and have a strong relationship. But this issue is the elephant in the room - he always minimises it and says 'Yes I agree and yes we'll be better but I don't want to talk about it'. DENIAL MUCH?!

Toddlerama - yes my dh has said in the past 'well we don't do drugs' WTF?? The thing is as well, he has got a lot 'better' over the last 17 years. He used to smoke weed every night, gave that up. Used to smoke fags. Pretty much gave that up. We used to go out til 2am every weekend boozing. We haven't for years. So he is coming from a place of 'I am much more moderate and healthy now'!

WibblyBibble Are you sure about that? i read a study a while back that said those who had a slightly underweight bmi of between 17 and 20 lived the longest. Though maybe there are lots of studies that contradict each other on this, I will have to investigate! I remember reading the study as my bmi is around 17.5.
42 units (three times the reccomended limit for women) is a lot to drink a week, that's a litre bottle of a 40% spirit. I imagine that is doing some pretty bad damage to your liver.

40 units is about right, yep.

I had a liver test three years ago and it was clear! I need to have another one. And yes I know liver results can change at any time and that a clear test shouldn't be a green light to keep drinking at these levels.

There are contradictory studies. I have also read that beings lightly overweight before the menopause is better and trhen slightly underweight after the menopause is better.

Well it sounds like your dh is on the right path anyway. How about trying a lower alcohol wine, or swapping to weak pimms now it's ( nearly!) warmer? And just gradually cut down. One alcohol free night is a good start- perhaps go to a movie or something where the temptation isn't there.

BMI is misleading and should not be used as any kind of measure of health.

If you really want to know about your health potential, your waist:hip ratio is far more accurate. I really wish the medical profession would stop bleating on about the BMI - the Australians have just started to realise this (thank GOD!) and are more concerned about waist measurements (although WHR is still more accurate than just waist measurement, which takes no account of build)

And yes, low BMI can be as unhealthy as high BMI, but depends on why you have it! if you're a long distance runner like Paula Radcliffe, then it's unlikely to be unhealthy - but if you're borderline anorexic then chances are it IS unhealthy.

Similarly with BMI in the 20s - a lot depends on your fitness, exercise levels etc. I was at least a stone overweight with a BMI of 23 - still technically ok, but it was all around my middle and I was doing next to no exercise - therefore not healthy.

Wobbly - I think that research you show has been THOROUGHLY discredited. Apparently it didn't control properly for smoking.

Even being slightly overweight raises your lifetime risk of diabetes and cancer.

I have a naturally biggish waist though, that's my shape. Not really a fat tummy (well it is a bit at the moment but usually when I'm 7lbs lighter not at all). So is that still 'worse' Thumb?

If you look at any of those online risk assessment things, Smoking is by far the biggest factor.

yes it is proud

use this calculator it has a useful hint as to what is healthy and what isn't so good.
I have "no" waist, never have had, but when I was the right weight, my WHR was fine. Now, not so. I am carrying nearly 2st excess around my middle, primarily and KNOW I have to do something about it.

Oh crumbs . Curse my thick waist.

So cut down on me units AND lose half a stone.

Well I have a challenge and a project now.

I can sympathise with that. I quit smoking years ago because I wanted too. It was only once I'd quit that DH would even consider it. Maybe if you lead he'll follow later?

I was drinking and smoking last night but I was also on the Kinect so I guess I evened it out abit [bugrin]

Trouble is, they're not three interchangeable problems. None is better than another.

You're not overweight so that's good, and you don't smoke, so that's good, but you are drinking way too much.

And I'm not being judgemental, because that's exactly the position I was in a few months ago - although I was/still am overweight too.

Unfortunately you and your DH are enabling each other - again, exactly what was happening with me and my DH.

Ultimately I decided that I couldn't take responsibility for him, but I had to take responsibility for my own health. So since February I have signed up to the gym and a personal trainer - I see him twice a week and try and go at least once on my own.

I'm dieting seriously (low carbing is my diet of choice) and have lost almost a stone since then - another 1.5 stones to go).

I only drink at the weekends, and I have massively cut down on how much I drink on those occasions - half rather than a whole bottle. It's hard, because once you have the alcohol in your blood stream it is so tempting to think that just another glass will be fine - but I have been able to manage this, which I am really pleased about. (I was scared that I was so dependent that this would be impossible).

We had a night out last week, and I drank what I would normally have put away, and expected that it would be fine - but it wasn't and I was horribly hungover the next day, showing just how much my tolerance to alcohol had built up! Also, though - very positively I thought - it showed me that my body was 'recalibrating' itself in terms of alcohol. (I can't think of a better way of expressing that!)

DH still drinks way too much, and he gets very angry and defensive if I try and raise the subject, so I'm just leaving it at the moment, and dealing with myself and my issues. But it really worries me in the longer term and it's becoming the 'elephant in the room', IYKWIM.

I really understand where you are, and based on my own experiences would say that you need to look out for yourself - and be thankful that at least recently your liver had a clean bill of health.

Good luck.

It depends a lot on your genes too. If you don't have genetic susceptibility to liver disease you may live long and prosper even with drinking above the recommended levels. If you are susceptible, though...

As a woman you should have a hip to waist ratio of 0.8 or below. Fat around the belly, and that means waist, is not healthy.
www.bmi-calculator.net/waist-to-hip-ratio-calculator/waist-to-hip-ratio-chart.php

If you are a woman who puts more fat around the waist than the hips, you are at greater risk of heart disease. Although if you are overweight you end up with fat around and in vital organs, which is not healthy at all.

Do you exercise at all? Because even if you were slim, you may not be sufficiently fit.

Yep, this is where the pear-shaped people win out - even though they might be heavier, they're probably better off than the ironing board shaped people, who now have a spare tyre (i.e. me) - turning them into apple-shapes.

Thing is, I can't do much about mine just now because I'm pg, so I'll have to wait. Alcohol is of course out the window completely (but has been for months) and I'm right off chocolate so that should be helping, but I can't do much in the way of exercise (too old, too risky!) like I wanted to and had started to at the beginning of the year.