No, no, no. Don’t give up the good fight against fat! Change the focus, however, to respecting our bodies by nourishing them with healthful foods. I submit that the Jan. 16 article “Join the diet resistance” treated this subject in a lightweight way. Pun intended. Where was the “other side of the story,” as in normal editorial style? No physicians’ warnings? Never mind others’ judgments; fight fat for your health. Just because something is hard, do we give up in other situations?

Betty Ann Addison, Fridley

• • •

There is no doubt that women in the U.S. have been victimized by the “diet culture,” but as a physician I’m concerned about the lack of discussion on the health impact of being overweight or obese. In 2009, a study appeared in the British journal the Lancet, where researchers looked at the relationship between the body mass index (BMI) and mortality in 900,000 adults with an average follow-up of eight years. If obese (BMI of 30), the average life expectancy was reduced by two to four years. At a BMI of 40 to 45, life expectancy was reduced by eight to 10 years, a loss similar to that found in smokers. At all ages, and in both men and women, mortality was lowest at a BMI of 22 to 25.

Another analysis of 89 studies found that being overweight resulted in a four times higher risk of diabetes mellitus. For obese women, the risk rose to 12 times higher. Even worse, the risk of most cancers was significantly increased, as was the risk of asthma, arthritis and back pain.

With regard to psychological issues, another study found that depression increased the risk of obesity by 58 percent, while obesity upped the risk of depression by 55 percent. If overweight, the risk of depression increased by 27 percent.

While I agree that the diet culture has become badly overblown and no doubt plays a role with regard to self-esteem and problems with body image, it seems clear that tilting too far to the other end of the weight spectrum carries risks. Moderation!

Dr. Charles E. Dean, Apple Valley

END-OF-LIFE HEALTH CARE

Disarray puts demands on family — that was my experience

In December, my husband died.

That statement doesn’t do justice to the year that he spent accessing our medical system. Nor does it describe the simultaneous journey of a caregiver. A Dec. 17 commentary (“Honoring the aged: Advice from a son and doctor”) chronicled a doctor’s experience with a similar end-of-life journey; mine was quite different. Here are its themes.

1) The lack of holistic medical practices. With the increased specialization, each doctor works in a narrow “silo.” Pain management, cancer treatments, stroke implications are compartmentalized. Yet they all belonged to one person: my husband. To make intelligent decisions in such a world, I needed medical training.

2) The omission of the caregiver. Because of the system of “hospitalists” and shift changes, a continuous stream of people descends on us day and night. My husband often didn’t know who was doing what; I had to be on site continuously to be in when a doctor might visit. Yet nurses consulted me for clarification of the doctor’s orders. Sometimes I even had to make sure those were followed.

3) The lack of treatment coordination. While the primary-care doctor was often mentioned, she never directed or facilitated a treatment plan. The occasional visits were simply post-hospital checks. Instead, each specialist’s visit resulted in the need to approve changes in medication and treatment ideas. The role of “case coordinator” fell to me, the least knowledgeable of all.

Models for improving the system are not far away. Hospice coordinates work around a single case manager; team medicine has been practiced for years at Mayo Clinic. Minnesota’s medical system could be so much better. Just ask the caregivers.

Carol L. Veldman Rudie, Minneapolis

U.S. BANK STADIUM

Shouldn’t I get to smoke outside, then return to my seat?

First off, tremendous game! I had a chance to attend U.S. Bank Stadium (for my very first time) to witness an incredible last-minute triumph over the Saints. The cheers, tears and whirlwind of emotions the crowd endured was quite an experience. Best of luck to the team and Vikings staff going forward — I can’t wait to watch it play out!

The reason I write is to voice a grievance related to stadium policies. During halftime, while attempting to step outside in order to escape the crowds and have a cigarette, I was informed of a total prohibition on re-entry. While smokers are an easy target (due to wide-ranging health concerns as well as the general idiocy of the habit), those who have been unable to kick the dependency remain thinking, taxpaying, functioning adults. And also enjoy the occasional game or event. Despite being “partial owner” of the venue (by being a taxpaying Minnesota resident), attending the game required a truly exorbitant amount of out-of-pocket costs on tickets/parking/concessions/clothing.

Facing a budgetary shortfall during construction, once again a solution (including additional taxation) was found in Minnesota smokers.

Is it too much to ask to have the option to adjourn outside during an event? (Not asking for anything lavish; I’ve gotten used to being deemed a deplorable minority by the nonsmoking public. I doubt there would be grumbling from our camp even if merely provided a single, 10-by-10-foot cage exposed to the elements at a far, far end of the venue.) Regardless of how one feels about public funding/private profits — and the entire stadium matter in general — it felt undignified to be told my ticket would be voided by exiting the arena.

Other venues have been able to offer this “amenity” while still maintaining a secure and safe experience for attending fans. Smokers as a group are regularly targeted, via incredibly regressive taxation, to meet gaps or shortfalls in revenue nationwide. Could we at least have the option to partake in our habit (outside, of course) when attending a venue built and maintained, in part, through our vice?

Ryan Ping, Maple Grove

IMMIGRATION

‘Consult the data’ misconstrues Trump; his issue isn’t with people

Tyler Cowen, who writes that immigrants from Africa are that country’s “best and brightest” (“Was Trump right? Let’s consult the data,” Jan. 16), just does not get it! President Donald Trump was not criticizing the people of the countries; he was criticizing the government. Their people are not taken care of properly, and they flock to other countries. The people are good, intelligent and hardworking people. Mexico is an example of that. Its people come to the U.S. to work and send money home. Some are on a work program and would like to be with their families.

Norway was mentioned because their people to not need to leave their country to have a good quality of life. That was what President Trump meant.

So let’s get the context right. The president was not criticizing the people.

Veda Sirek, New Prague, Minn.

• • •

In light of our president’s recent comments on Africa and the Tyler Cowen commentary, I read with some interest a second article on Tuesday in the Star Tribune: “Miners find 910-carat diamond.” A typical story out of Africa: A lucky miner finds a diamond, but the diamond is owned by a company in London.

My wife and I lived in Ethiopia for three years and Zimbabwe for seven. I’ll be guessing that no Africans are in control of that boardroom. A resource worth millions is found in “a country with high rates of poverty and HIV infection” that “ranks 160th out of 188 countries on the U.N. Human Development Index” (to quote the article). While the U.S. and other countries benefit from the Africa brain drain, the old colonial policies of indentured servitude still continue to keep a continent down. The attitude expressed by our candid leader is a pathetic reminder of how little things have changed. We can do much better.

Alan Briesemeister, Delano, Minn.

• • •

I went to China to adopt a 9-month-old more than 20 years ago. Listening to the argument about sending young people “home” — to other countries they have no conscious memory of ever living in — I cannot help but think of my child. No, DACA will not affect adopted children. But my mother’s heart is broken even imagining how it would be for American children, who have known no other country, to be sent away as young adults, to be separated from every bit of who they are, who they love and what they know. I hope that my elected officials will allow the entire government to shut down before they allow our children to be hurt in this way.

Meg Riley, Minneapolis