Letter received by e-mail:
Editor, This email address is being protected from spambots. You need JavaScript enabled to view it.

Dear Madam,
I am writing because Santa Claus has a really big tummy like my daddy.

Daddy went to a doctor. His doctor does not allow him to eat a lot anymore, because he has diabetes.

Could Santa be sick also, like daddy?

Love,

Virginia, 11
( This email address is being protected from spambots. You need JavaScript enabled to view it. )

From out of the mouth of babes indeed. It took a child to bring to our attention a very logical, very probable association.

Could Santa Claus – like Virginia’s father – be diabetic?
Jolly old Saint Nicholas, Santa Claus, Father Christmas— whatever name he goes by-exudes holiday cheer: his hearty chuckles and “ho, ho, ho’s” are synonymous with Christmas.

A universal figure, Santa is familiar to everyone-even in places where it does not even snow. His image decorates greeting cards, gift-wrappers, shop windows. Songs about him resonate through the airwaves. Children write letters to his home at the North Pole. Fathers dress up to look like him, padding their waists with a pillow or two and get a kiss from Santa’s helper under the mistletoe. Department stores arrange for kids, young and old, to have photo ops with Santa.     

Virginia certainly got me thinking, so I researched that classic, A Visit from Saint Nicholas by Clement Moore, which narrates Santa’s journey from home to home on Christmas Eve. Perhaps it could give me some clues.

T’was the night before Christmas

Father in the story has the first and-it turns out—the only sighting of Saint Nick. Awakened by a clatter on the roof, he says:

“. . .to my wondering eyes should appear, but a miniature sleigh and eight tiny reindeer.

With a little old driver, so lively and quick, I knew in a moment it must be Saint Nick.”

We can tell from Father’s description, that Saint Nicholas is old, but physically fit, he comes down the chimney with “a bound.” He is pretty strong too, for he could carry:

“A bundle of toys he had flung on his back,

He looked like a peddler just opening his pack.”

Father’s superficial (and subjective) description continues as follows:

“His eyes---how they twinkled! His dimples, how merry!

His cheeks were like roses, his nose like a cherry!

His droll little mouth was drawn up like a bow;

And the beard of his chin was as white as the snow.

The stump of a pipe he held tight in his teeth, And the smoke, it encircled his head like a wreath.

He had a broad face and a little round belly,

That shook when he laughed, like a bowl full of jelly.

He was chubby and plump, a right jolly old elf

And I laughed when I saw him in spite of myself.”

Santa Claus had a broad face, and a round belly, chubby and plump, with a stomach that was jiggly.

The tale of the tape
What interests me, a physician, is why Santa’s cheeks and nose should be so red, with a facial plethora. Were his cheeks red and rosy (flushed) purely from the cold weather? (I would expect him to be blue with frostbite.) Other possibilities to consider perhaps: arterial hypertension, or maybe a little (or a lot) of alcohol on the sleigh ride over to warm up on the long journey from the Arctic Circle?

Santa obviously has a large abdomen, with the fat centrally located around his paunch (nowadays referred to as a “beer belly”).     

Of the several ways to measure degree of obesity available to us, the simplest would be a body mass index (BMI), the waist circumference and the waist/hip ratio.

All we need to do is get a tape measure around Santa’s waist and hips. If his waistline is greater than 35 inches, Santa satisfies the criteria for “android obesity.”

To calculate BMI, we need to know both Santa’s height and weight. Unfortunately we have no idea from the story of how tall Santa is–Father refers to him as a jolly old elf.

Can we infer from the word ‘“lf?” that Santa is short? In this case, given Father’s scant information, we would not be able to calculate Santa’s BMI or waist circumference accurately.

Short of conducting a proper physical examination myself, (or getting information from a more reliable eyewitness than Father), by eyeballing Santa from every angle, in every picture ever taken of him, you will conclude that he is pretty hefty. By World Health Organization classification at least obese class 1 (BMI>30). I am sure no self-respecting physician will argue with me.

Maybe Rudolph, or one of the other reindeer pulling his sleigh, might give us an idea of how much extra weight they are pulling.

Santa better watch out
Because Santa has been around town a long time (his longevity is amazing), he is at the age where chronic lifestyle diseases develop.

It is no surprise that Santa is obese. Even if he appears fit and strong, remember Father’s sighting of the old man was 189 years ago this year. Santa has aged since the story was first told, and by all accounts, now lives a more sedentary lifestyle. He rides a sleigh instead of walking (one reindeer, Vixen, mighty vexed, wanted extra pay for excess baggage, and she doesn’t mean toys).

Apparently Santa now merely supervises all his elves at the toy factory, and does no hard lifting himself. (Spends all his time answering fan e-mail, playing Angry Birds and checking his mentions on Twitter.) Just think of all those gallons of milk (full-cream no less) and cookies (Oreo’s or chocolate chip are favorites) he consumes at every single household he visits, every season.

Worse of all, Santa cannot seem to kick the habit, he is still puffing away (even if he insists he doesn’t inhale) at his pipe.

When Santa Claus next comes to town
At the very least, Santa needs to get a proper medical examination. He certainly needs to get some blood tests and whatever else his doctor thinks necessary, including medication.

The most important: Santa needs to overhaul his lifestyle.

What can you, boys and girls (young and old), do to help old Santa out?
For starters, don’t stress him out with too long a wish list. He needs to spend less time answering fan mail and seeing to each of your wish-list toys. That will free him up for some exercise time.

Don’t leave Santa cookies; serve fruit and yogurt, or if you insist, lower calorie snacks like soda or ginger cookies. Leave skim milk, or a diet soft drink. Or a short, decaf, non-fat cafe latte, but hold the almond biscotti. Water is best: all natural, no calories.

Put a NO SMOKING sign at the door (or chimney entrance), and don’t leave an ashtray lying around.

Have a sign at the bottom of your driveway: PARK REINDEER HERE, so Santa will have to walk up to the house. Install rungs in your chimneystack, so that Santa will have to climb down, then up again.

If we all cooperate, next Christmas season, when Santa comes to town, we may not recognize him. He will be a shadow of his former self, leaner, but definitely healthier.

Editor’s last word to Virginia
Yes, Virginia, Santa Claus is probably diabetic— for all the reasons I have given. If not now, he may be by 2025 — when there will be 500 million other people all over the world with diabetes.

But don’t worry: both your daddy and Santa can reduce their risk of diabetes (and of being stuck in the chimney) by doing all the things their doctors suggest.

Most of all, Virginia: Pray that Santa (and daddy), be good, for goodness sake!
Love, Patricia

P.S. I almost forgot: to quote Santa Claus himself: “Merry Christmas to all, and to all a goodnight!”