What’s Causing the Obesity Epidemic
There is no question that Americans are getting fatter. The CDC animated graphic tells the tale – state by state statistics of the percentage of population that are obese. The big question is, what’s causing it? There are three main hypotheses, which are not mutually exclusive. The first is that activity levels are down. People, especially children, are spending more time indoors in front of computer screens and TVs and less time outside running around. The second is that people are eating more calories. And the third is that the type of calories we are eating is playing a significant role. There are two main camps in this third group: those who blame fat consumption and those who blame carbohydrates.
I do not feel that the evidence supports the third group – blaming calorie type. This hypothesis is great for selling books advocating one fad diet or another, but there is just no convincing evidence that altering the type of calories consumed has a significant effect on weight. Certainly the low-carb craze has not caused a blip in the steady rise of obesity in the country, just like the low-fat craze failed to have an effect. You can argue that this is because not enough people actually adopted an effective diet. However, if book sales are any indication, millions of people tried low-carb diets, and they do not appear to have struck upon the secret of easy weight loss. The clinical data also shows that weight loss is generally a factor of total calories, not calorie type.
It is true that Americans are becoming more sedentary, and it’s hard to imagine that this is not contributing to some degree to the obesity problem. But the data is not clear. The evidence shows an overall association between obesity and greater time spent in sedentary activities. However, recent data suggests that obesity causes lower activity levels (at least in children), not the other way around.
So we are left with the primary factor in actually causing the obesity epidemic being an increased intake in total calories. Multiple independent lines of evidence point in this direction. First of all – if we simply calculate the total amount of food being consumed by Americans it looks as if we are consuming 500 calories per day per person more than we did in 1970. Further – that increased caloric intake completely accounts for the rising trends in obesity.
If we accept that increased caloric intake is the primary culprit, then the deeper question becomes – why are we consuming more calories? It could just be culture, it could be the “supersized” fast food industry, or it could be changing trends in eating habits. One factor often raised is the fact that families with both parents working have less time to prepare traditional meals, and therefore there is more reliance on fast food, eating out, and store-prepared foods – all of which tend to have more calories.
A new study supports the notion that eating out is a significant contributor to caloric intake. The study finds:
The study determined that increased energy intake (+179 kcal/day) by children from 1977-2006 was associated with a major increase in calories eaten away from home (+255 kcal/day). The percentage of calories eaten away from home increased from 23.4% to 33.9% from 1977-2006.
This study shows that kids are eating more calories outside the home, and this contributes to greater overall caloric intake. This does not necessarily mean that such food sources are inherently more caloric – it could just mean that kids have greater access to food outside the home and this is adding incrementally to their overall calorie intake.
However, restaurant portion sizes and overall calories have been creeping up over the years. Prepared foods also compete for tastiness, and that often results in higher calories (even when labeled low fat or low carb). To address this issue there is an increasing push for labeling calories on menus. I find this extremely useful. It’s difficult to be in denial about how many calories a restaurant meal may have when the calories are printed right there on the menu. This does tend to affect food selection and aids those who are trying to estimate their caloric intake.
A more aggressive public health strategy would be to regulate the food industry to reduce the number of calories in prepared food. Such draconian measures are not popular, but as our health care system strains under the weight of the obesity epidemic such measure may become more palatable.
Conclusion
There is still a need for more and better research into the many questions and sub-questions surrounding the obesity epidemic, but at this point, the evidence is pointing to increased overall caloric intake as the primary culprit. There are no easy answers to this problem, but it is becoming increasingly important that we find practical solutions.
Yes! A worthwhile nutrition skeptical discussion. I think all three factors play a role. Recent published studies look at the standard American diet (sad) and have concluded that the fructose moiety of sugar has a lot of metabolic implications that starches and other polysacharides don’t have.
I’ve posted this before but here is a reference and accompanying lecture
http://www.nature.com/nrgastro/journal/v7/n5/abs/nrgastro.2010.41.html
The role of fructose in the pathogenesis of NAFLD and the metabolic syndrome
Jung Sub Lim, Michele Mietus-Snyder, Annie Valente, Jean-Marc Schwarz & Robert H. Lustig About the authors
top of page
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease worldwide, and is commonly associated with the metabolic syndrome. Secular trends in the prevalence of these diseases may be associated with the increased fructose consumption observed in the Western diet. NAFLD is characterized by two steps of liver injury: intrahepatic lipid accumulation (hepatic steatosis), and inflammatory progression to nonalcoholic steatohepatitis (NASH) (the ‘two-hit’ theory). In the first ‘hit’, hepatic metabolism of fructose promotes de novo lipogenesis and intrahepatic lipid, inhibition of mitochondrial β-oxidation of long-chain fatty acids, triglyceride formation and steatosis, hepatic and skeletal muscle insulin resistance, and hyperglycemia. In the second ‘hit’, owing to the molecular instability of its five-membered furanose ring, fructose promotes protein fructosylation and formation of reactive oxygen species (ROS), which require quenching by hepatic antioxidants. Many patients with NASH also have micronutrient deficiencies and do not have enough antioxidant capacity to prevent synthesis of ROS, resulting in necroinflammation. We postulate that excessive dietary fructose consumption may underlie the development of NAFLD and the metabolic syndrome. Furthermore, we postulate that NAFLD and alcoholic fatty liver disease share the same pathogenesis.
http://m.youtube.com/#/watch?desktop_uri=http%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3D0z5X0i92OZQ%26feature%3Dfvst&feature=fvst&v=0z5X0i92OZQ&gl=US
Steve, I would really appreciate it if you could comment on these because I have not found a credible refutation of these points.
PS: could the moderator change my rating from 4 to 5 stars? It was a terrible accident.
Youtube link for non-mobile browsers
http://www.youtube.com/watch?v=0z5X0i92OZQ&feature=fvst
I don’t know anything about this study or the other authors, but Lustig is an Asshole.
The whole concept of “what kind of calories” smacks of pseudoscience. The body doesn’t care; it breaks everything down into simple molecules anyway.
I’m going to be a Mean Person ™ and suggest another cause for the rise in obesity: acceptance. Even in the midst of this “obesity epidemic” we have advocacy groups and tolerance campaigns telling us not to be biased against the obese (and the trial lawyers, as always, looking for a way to sue people for not accomodating and/or encouraging them). If being excessively fat is acceptable, then you get more fat people; pretty obvious, really, yet it’s amazing how many people are startled when it happens.
It is not pseudoscience. Different components are metabolized in different pathways resulting in different metabolites. For example, while glucose can be metabolized into glycogen in liver and muscle and ATP in all cells in the body, fructose can be metabolized into “bad triglycerides” and uric acid. The latter are important in the development of metabolic syndrome. This is all biochemistry, not pseudoscience.
All sugar and all carbohydrates are converted to glucose. It is either pseudoscience or baseless conjecture to make these wild claims about fructose. There is simply no evidence to support much of the urban legends about this simple sugar. We all consume fructose when we eat fruits, are you suggesting fruit is bad for you?
This is too simplistic. For example In order for the liver to process fructose, it must be phosphorylated by removal of phosphates from adenosine triphosphate (ATP). The ATP gets converted to adenosine monophosphate (AMP), then to inositol monophosphate (IMP), and finally to uric acid,[64] the agent in gout (from Wikipedia, with references).
Uric acid in turn is an important factor in the development of gout which is on the rise in industrialized countries.
The current thinking is that excessive addition of sugar to processed foods is increasing the amounts of fructose consumed. Fructose in fruits is ok because the fiber content in food is proportional to fructose and triggers satiety which prevents overconsumption. This trigger is not present in processed foods.
In other words, the body can tolerate a certain rate of fructose intake and it’s easier to exceed that rate with processed foods than fresh foods?
I know relatively little about biology, but this sounds perfectly plausible to me.
That’s the gist of it because some processed foods have a very high sugar content.
They add sugar to everything: bread, yogurt, cereal, iced tea, pickles. Everything has to be sweet.
Somite has made a very good job summarizing the metabolic pathway and lets remember that evolutionary speaking we grew up eating fruits but processed food is far too recent for our bodies to have evolved a mechanism to cope with the amount of sugar an specially HFCS, without demonizing the latter, but definitely the more calories you consume the bigger the danger.
But lets not forget that culture plays a key role here, US citizens feel proud of their way of life; bigger, faster and more expensive seems to be the main moto behind this.
HFCS was a marketing device. At the time one of the crazy food fads people believed in (things never change) was that fructose sugar was good for you since it came from fruit. But in fact HFCS is simply sugar not very different from plain old table sugar. It is created and used in a liquid form because food processors find that easier to deal with. It saves time and expense if the sugar is already a syrup.
I do have to disagree with the logic that says fructose in fruits is somehow magically goof for you because there is fiber in the fruit. If the HFCS makers left a little corn fiber in it would it be good too?? Somehow I doubt it because the meme is HFCS bad; natural good!!
The high-fructose story seems pretty compelling, and is becoming more so:
Recent data from Princeton University : http://www.foodpolitics.com/wp-content/uploads/HFCS_Rats_10.pdf
Rats with access to HFCS as well as their normal food grew heavier and fatter than rats offered glucose plus food and those offered only the normal food. Abdominal fat levels were higher in the HFCS groups. (Yep, you can cut rats up and check that) The amount of calories contributed by the HFCS was lower than that contributed by glucose (in the respective groups).
Human trial: Journal of Clinical Investigation. … …10 weeks; half took their soft drinks sweetened with fructose, the other half with glucose. … end of the study period, both groups had put on weight, but the subjects getting fructose had more visceral fat (… associated with heightened risk for atherosclerosis, cardiovascular disease, and type 2 diabetes) The fructose group also showed higher levels of LDL cholesterol and lower insulin sensitivity…. (I don’t think they cut these people up) ;-)
Note there ARE differences structurally between cane sugar ( sucrose – a disaccharide – a compound – a joined glucose molecule and fructose molecule) (so is 50/50) and HFCS – which is 55% fructose and 42% glucose, but here, the fructose is free, as a separate molecule. And the balance (3%) is “higher saccharides”.
However, as sucrase in the intestine cleaves the bond and allows glucose and fructose to be absorbed separately, I’m not sure of the significance of this difference.
Worth noting that (once absorbed) glucose stimulates insulin release from the pancreas, fructose doesn’t.
This (below) is enough of an explanation for me. I’m glad this subject came up, I for one will be trying to steer clear of HFCS. Nice work (2004) and the title says it all:
http://jcem.endojournals.org/content/89/6/2963.full.pdf+html
Dietary Fructose Reduces Circulating Insulin and
Leptin, Attenuates Postprandial Suppression of Ghrelin, and Increases Triglycerides in Women.
KAREN L. TEFF etal The Journal of Clinical Endocrinology & Metabolism 89(6):2963–2972
Gimme a study de-confirming preliminary studies about the difference in metabolism of high-fructose vs glucose/sucrose, and I’ll believe you.
Until then, the mice say there’s something we’ve missed.
Either way, eating less sweeteners is a good idea.
The speed of caloric metabolization also matters. That’s why, on Dunning’s post, I mentioned glycemic load and glycemic index.
Steve, I know you’re trying not to give wiggle room to folks like Gary Taubes, but type of food is, within certain levels of relativity, also important.
Otherwise, former FDA head Dr. David Kessler tackled portion sizes and many other things, like the quasi-addictive nature of fast, casual-fast and junk food, in his excellent book.
“Acceptance” Trimegistus has a valid point. Though anecdotal, if you fall into a average and healthy weight class, some view this as being skinny – this status quo weaves through all age groups.
Compare action figures or football players from past to present? For most professional athletes (nor a boy’s doll) BMI’s don’t fit the obese model, but for ex-athletes, weekend warriors or your average Joe six pack, increased weight has a correlation of influence. For the population majority the solution is too “simplistic” – self control.
Oh, please, are you serious?
Even if there were “be nice to fat people” advocacy groups, and I have to say I’ve never heard of one, society still hates obesity, as anybody with a weight problem will tell you.
People who are overweight don’t decide it’s OK to let themselves go to hell and get fat because it’s socially acceptable; that’s absurd. Who chooses to be obese? But that’s the argument you’re making, as though it’s a conscious choice.
Instead, I would venture that most of them give up trying to fight their own metabolisms over the years and sadly resign themselves to a life of thinly veiled ostracism (and sometimes it’s not so thinly veiled). Obesity is about the ONLY physical problem it’s still OK to discriminate against.
The fact is, our bodies evolved long ago when starvation was always a threat and it was in our nature to desire foods that would build up reserves of fat; it promoted survival.
Fast forward: most of us in developed nations are no longer in imminent danger of starvation, but our appetites have not evolved past that. We still crave fattening foods. That, coupled with a lifestyle that’s increasingly sedentary, one where you can do nearly everything in front of a computer, is the major contributor to obesity.
It’s only going to get worse. Unless our metabolisms evolve to desire less fattening foods as our activity levels drop, we are going to get fatter and fatter collectively.
It would be enormously refreshing if somebody in the scientific community could address the issue of obesity in context of our culture and genetics, in a straight-up calories-in vs. calories-out sort of way, without slathering their own biases all over the issue.
Wouldn’t it be possible, at least in theory, to finance the health care for obese people from a tax on high-caloric ingredients?
That way you don’t have to impinge on people’s personal liberty. If people want to lead a fat lifestyle, they should be allowed to do so, as long as they don’t cause trouble for the rest of us. If their health-care has already been paid for, as far as I’m concerned they can stuff themselves.
The only difficulty is that children don’t really have a choice (neither under the present system, nor the proposed one) since they’ll just whatever is on their plate. And when they get fat early in life, they’ll stay fat forever. Maybe we could fine parents whose children are too fat?
Most people who eat “high calorie” food do not get obese. Most people who get obese have a genetic predisposition to become obese. Taxing food to pay for health care would please many politicians I’m sure but it would do nothing to fix the problem.
If you believe children just eat what is on their plates then I assume you never raised children. Children eat what they want/like and reject what they don’t like just as the rest of us do.
No one “wants” to be fat/obese. They are genetically programed to be obese and it requires a starvation diet to get them to a “normal” weight. Rarely does an obese person lose all the excess weight and keep it off for their lifetime. Usually even when they are able to lose the excess weight they gain it all back within five years. Obese people have never caused any “trouble” for me, if they cause you trouble I’m really sorry. Just as old people also use a lot of health care I don’t feel they have caused me any trouble either.
It doesn’t make any sense to fine parents of obese children any more then to fine parents of any genetic disease. Should we restart witch trials too?
“Most people who eat “high calorie” food do not get obese.”. This is obviously not true.
I eat high-calorie foods. I’m 6′ and 175 lbs — not obese. I don’t eat a high-calorie diet. Read your quote again; she said “most people who eat high calorie food…”, not “most people who have a high calorie diet.” The latter would be the “obvious” truth.
edit: mis-truth.
So you haven’t paid taxes or insurance premiums to provide health care for obese people? Care that would be far less likely to be required had they been of normal weight. I think I need to report you to the IRS then.
I don’t have a problem with obese people either, even when they take up twice the space I do on the bus and still pay the same price, but my money goes to cure their (avoidable) diabetes. And no matter how “genetically programmed” they may be, you don’t get fat if you use more than you consume. It’s not that hard. I see lots of severely obese people buying giant meals at burger king; you can’t blame that on genes..
Do you believe all obese people are diabetic or will become diabetic??
http://www.gallup.com/poll/123887/u.s.-diabetes-rate-climbs-above-11-could-hit-15-2015.aspx
“Americans who are obese are nearly three times as likely as those who are not obese to report having been diagnosed with diabetes. More than one-fifth (21.2%) of obese adults are diabetics, compared to 7.4% of non-obese adults.”
Obesity is one of the early symptoms of diabetes not the cause. People who have diabetes can usually control their symptoms and even the progression of the disease with diet and excercise. So it is understandable that as the undiagnosed diabetes progresses that one of the symptoms appears to be the cause. There is an interesting parallel to this thinking; prior to the polio vaccine parents would keep their children in the house on warm summer days. Since children usually got polio in the summer the uneducated belief was that it was the summer heat that caused polio. It was not of course and eating sugar or gaining weight does not cause diabetes but that old wives tale persists.
The human body does obey the laws of thermodynamics. Inside every fat person really is a thin person and a lot of chocolate / fries / … . If you can prove otherwise, you’ve got a Nobel prize coming for you.
You also shouldn’t be trivialising the important of a good diet in childhood like that. Contrary to what you say, children do eat what’s on their plate, whether they like it or not. And it is an unfortunate fact that more and more people tend to feed their young too much and too unhealthily, and that kids tend to like that. More and more kids look like space hoppers with feet, and the thought that parents are innocent in this is folly.
The thought that no one chooses for a fat lifestyle is also wrong (I know quite a few people who know they’re living unhealthy lives, but who weighed the pros and cons and don’t want to make to without their usual gastronomical extravaganzas) and saying that you cannot lose weight is just a bad excuse. You don’t need a starvation diet, just a varied and regularly sized one.
Fat people do cause problems for the rest of us. Especially the health care system cannot cope much longer, and the extra costs are coming out of the pockets of thin people too. That is unjust.
But I don’t want to force people to get thin, because people should have a choice (which is why I think a tax of some sort would be a good idea). And then you come along comparing this idea to burning people at the stake. Real classy.
That seems really rude.
You don’t need to rely upon anecdote to know that there is a portion of ‘obese’ people who don’t binge eat or eat total calories less than or equal to the average and yet are still obese.
As an anecdote, I know one guy who still bicycled up and down Yosemite, rode motorcycles across the state, ate less than I do, yet still weighed four hundred pounds. When he busted his knee, of course, his weight ballooned and he still ate less than me… Until he decided to get stomach surgery. Now he eats less than my 4-month old kitten and is losing weight, but it’ll still be years before his BMI is anywhere near mine.
It’s not always about overeating or activity levels, even though those are the largest two variables.
Theres something i dont get. Why does it matter how many calories there are in a portion?
clearly your body knows how much it needs. Non fat people dont stay that way because they watch their calories. If a portion is big you either dont eat all of it or you eat less afterwards or the day after (or even the month after??).
It seems to me like something is throwing off peoples appetite. I find it interesting that appetite is never a factor in studies like this. If portions get bigger why dont all people on average get a little bigger? Some people remain slim even if they eat out or eat junk or whatever factor you re accounting for. I remain skeptical about all this…
You eat the whole portion because you paid for it.
“If portions get bigger why dont all people on average get a little bigger?”
People do get bigger on average, that’s the problem. I think you meant why don’t all people get bigger. Maybe the non fat people compensate for bigger portions, but the fat people don’t.
“It seems to me like something is throwing off peoples appetite.”
This is it. Processed food companies have spent a lot of time and effort to make foods that are high calorie, non-filling and satisfying to chew. This is how you end up eating more calories and never feel full.
Some people are probably less susceptible to this but food companies only need the majority to turn a profit.
It is just a silly conspiracy theory to claim food companies conspire to make us fat or consume more food. Their intent is the same intent we all have when we prepare food that is to make a good and satisfying meal. Fat, particularly butter is very tasty to our palate as is sugar. Who’s fault is that? Genetics? Evolution?
Nope. That is their business. Get you to eat more food so they make more money.
Here’s a wild notion: why not make people take responsibility for their choices and live with the consequences?
Naah. That’s crazy talk. Let’s find someone we can blame and maybe sue.
Would that include big industrial foodmakers taking responsibility for THEIR choices? Of course not, it wouldn’t in your world.
Oh, here’s the latest on the “addictiveness” of certain types of food: http://well.blogs.nytimes.com/2011/07/11/when-fatty-feasts-are-driven-by-automatic-pilot
Of course food is addictive. We all eat and if we stop we will die.
You’re being even stupider than normal. Beyond that, you contradict yourself from comment to comment.
The attempt was to illustrate how your claim that we are addicted to food was kind of silly like we are addicted to water and oxygen. You obviously don’t care for someone pointing out your error.
If you cook you will discover that creating tasty food that people really like requires things like butter and other fats, salt and in the case of confections; sugar. The cooks do not choose these because of some desire to addict you or make you obese, they choose these ingredients because they work. French chefs are highly acclaimed because they have not yet bowed to the politically correct effort to eliminate these things from our diet. Interestingly salt is a required ingredient in foods using yeast (yes some recipies don’t use salt but their results are different and usually unsatisfactory). When you try a low calorie version of a food, like ice cream or salad dressing, that depends on fats/oils or other ingredients not on the approved list you will typically be very disappointed in the taste and quality. Most foods cannot easily be made fat, salt and transfat free and still be appealing.
Socratic makes a very good point here. And most large companies I have worked for are obsessed with year on year growth. All sales and marketing meetings are dominated by the effort to grow next year’s sales by at least 5%.
Of course, companies explore new regions and new products.
But what easier way to grow than by developing strategies to have your existing customers increase their consumption? These are the customers you already have, so the effort and expense may be minimal.
In a word – don’t underestimate them.
Why would I make a Ding Dong (TM) you only want to eat one of when I can make one you want two of? Of course the makers of a product want to sell more of it.
This also gets back to food types, contra Novella. Exactly right, Somite. High fat, high sugar and almost zero fiber … there’s nothing “filling” and so people eat more.
And, Kessler tackles this, too.
I HUGELY recommend “The End of Overeating.” http://www.amazon.com/End-Overeating-Insatiable-American-Appetite/dp/1605294578/ref=sr_1_1?s=books&ie=UTF8&qid=1311662092&sr=1-1
On the “industry,” Kessler’s book notes that fast-casual chains like Chili’s don’t even cook onsite. Instead, the meat, veggies and other stuff is given a sugar glaze and/or breading, then flash fried, then flash frozen at central “factories.”
It’s then briefly reheated at your local “restaurant” by your local “cook.”
Add in how this is, yes for evolutionary reasons, quasi-addictive, and it’s easy for food companies to work with this.
Anyway, the “factory cooking,” alone, might get a few people to not pretend a Chili’s is a whole lot more than a glorified McD’s.
Add in the fact that it takes 8 pounds of vegetable matter to put one pound of weight on a cow, along with massive water, and for other environmental reasons, we could stand to eat less meat anyway.
Somite
This is not a satisfying answer by my standards.Parameters such as “non-filling’ and ‘satisfying to chew” are not scientifically defined terms or at least are not taken into account in any meaningful way in studies. Will people stop getting fat if they eat “filling” and low-calorie food? What food would that be? Why dont weight loss comapanies create food like that? Wheres the wonder diet that incorporates food like that? Is it harder to make than what you re refering to? They d probably make more money than “big processed food” anyway and by doing good btw
The wonder diet is to cook and prepare your own food. The problem is that good food, like fruits and vegetables have a high fiber content and food companies dislike this because fiber doesn’t freeze well and can not be distributed cheaply.
Bingo,bingo, bingo. Some of my friends laugh at me, but when I do make a frozen pizza … (and I do eat junk food at times), I sprinkle oat bran and flaxseed meal on it. I’ll eat a brat at home, but on double-fiber bread rather than a white bun.
“Will people stop getting fat if they eat “filling” and low-calorie food? What food would that be?”
Somite – why yes, yes they will. Take for example breakfast (‘the most important meal of the day’) Have some greek yogurt (high in protein, which can be filling) and a bowl of cereal high in fiber (Kashi Golean, All bran, etc.). Companies DO make this sort of cereal, you just need to do your research to discover it.
The problem with it is that it’s not sexy – it doesn’t taste as good as something covered in frosting, there’s no cartoon character on the front pimping it, there’s no prize shoved to the bottom of it. If I showed my kid something ‘heart healthy’ or with Tony the Tiger on the front, methinks that darn tiger will win out. I still have the final say on what they eat though ;)
Sorry – this should have been addressed to Kostas, not Somite :)
I eat those cereals. They are also crazy expensive compared to the pink and purple “fruity”/sugar ones. I still suck it up and buy them though
“Will people stop getting fat if they eat ‘filling’ and low-calorie food?”
As long as it helps them consume fewer calories.
“What food would that be?”
Vegetables except potatoes, lean meat, egg whites, whole grains instead of refined, skim milk instead of whole, water instead of sugary soft drinks.
“Wheres the wonder diet that incorporates food like that?”
Most diets do.
There is another factor. Certain races are more prone to be overweight/obese and as America changes it’s demographic these races make up a greater percentage of Americans. This is clearly not the only factor but it is a real factor in the statistics.
Now there is something to be skeptical about…
No, there’s a degree of truth to it. Native Americans seem to have higher sugar sensitivity, some tribes in particular. Look at the Tohono O’odham (formerly known to whites as the Papago) and the Pima. HUGE Type II diabetes rates. 60-70 percent among adults.
That said, it’s an open question as to how much of this is genetics and how much of it is socioeconomic. And, of course, there’s another problem, as I’m sure Max, Somite and others also know. The cheap dreck is … cheap. And, lower-income-area grocers, whether in Harlem or on the rez,sell more of it for that reason. But, per “thrify genes” ideas, for people who have spent millennia living on desert foods, genes is part of it.
I seem to remember reading something awhile back that a large part of obesity among American Indians is due to the fact that they use lard to cook pretty-much everything. IIRC, this started a couple generations ago because it was cheap, and has now become quasi-traditional among many tribes.
Yeah, I know “I read it on the internet” isn’t the most credible cite. I mention it here to see if anyone else can elaborate or comment?
CountryGirl: Correlation, possibly; Causation, highly unlikely. And don’t bother trying to blame immigrants, since the countries they emmigrated from do not have the same obesity problems we do.
If the problem is all/mostly genetics, as you seem to want to believe, how do you expllain the dramataic increase in obesity in the last 20 years? Genetics don’t change that quickly.
Mexico has an obesity epidemic too, probably not due to changing demographics.
In 2009, Hispanic Americans were 1.2 times as likely to be obese than Non-Hispanic Whites, so even if all whites magically became Hispanic, obesity would increase at most 20%.
It’s not that the genes changed that rapidly, the diet did. American Indians of the desert southwest evolved to their climate for millennia. The diet changed on them rapidly, especially them being on the low end of the socioeconomic totem pole.
There has been a slight increase in obesity. But about 14 years ago the way we determine obesity changed and overnight the number of people labeled obese doubled. The people still weighed the same they were just considered obese when before the change they were not.
Dr. Novella already debunked that argument.
https://skepticblog.org/2011/01/03/the-nihilism-diet/#comment-50423
https://skepticblog.org/2011/01/03/the-nihilism-diet/#comment-50610
It’s a fact. I think what you mean is he presented an arguement refuting it. Just as some people refute evolution.
Did you see the animated map on the CDC page?
http://www.cdc.gov/obesity/data/trends.html
The colors don’t stay constant and then change overnight, they change gradually over time in every state.
Or could it be that those races overwhelmingly make up the poorer and less educated class in the country, and healthy eating is expensive and correlated with higher education? Working two jobs you may not have time to cook that tofu and organic broccoli meal at home every day..
Oprah Winfrey is neither poor or less educated and she has a obesity problem. What she has is genes that make her obese. She probably works very hard to lose her weight and tries to eat a good diet and yet she is obese. So much for the poor and uneducated theory…
I’m not sure a statistical analysis of that data set you quoted(n=1=Oprah)will show any significance.
Would you mind checking that out and getting back to me?
Climate change is causing the obesity epidemic. There is onverwhelming peer reviewed evidence to support this. Where have you been?
Ditto. (Ha. I fooled the system into accepting my short comment).
Noo! I’m the fool. This was supposed to be a reply to Beelzebud’s comment.
Have you seen the “I am Man” Burger King commercial, where the guy sings, “I’m way too hungry to settle for chick food”?
http://www.youtube.com/watch?v=vGLHlvb8skQ
By the way, a little burger joint secret is that they butter the bun.
When I was in Europe, the portion sizes in restaurants were small compared to what Americans would expect for that price.
I lived in Germany for years and obesity is a serious problem for Germans. Would they be even fatter if they ate at McDonalds? I doubt it.
The latest WHO figures on adults whose BMI exceeds 30 has the US percentage at 33.9 % and Germany at 12.9 % . All of the major European countries are well below that US figure.
Two points: WHO data is notoriously bad. Most countries fudge the data for one resaon or another. Sometimes it is because of national pride and other times it is cultural in nature. The U.S. data tends to be quite accurate but most other countries are not
If you compare only Americans of Northern Erupean descent with Northern Europeans the results are very similar. Our large Black and hispanic population skews our obesity rate higher Both of these races are genetically more likely to be obese then Northern Europeans.
Well,at least I gave a source for my data,regardless of what you think of it,which seems pretty much ideological in nature.But let’s set that aside,and you give me your source regarding your second point:
“If you compare only Americans of Northern Erupean(sic) descent with Northern Europeans the results are very similar.”
Still waiting for the data.
All-you-can-eat buffets encourage eating a lot to make it worth the price.
Drive-through windows, pizza delivery, food trucks, and vending machines make cheap food more accessible.
A la carte menus in schools have junk food like pizzas and burgers that get children hooked.
And of course, all drinks, whether soda or iced tea, must be loaded with sugar or a sugar substitute.
My number three son loves buffets. It was embarrassing he ate so much. Then when he joined the army they made him gain five pounds before they would let him enlist. He weight 115. Today he is out of the service and the father of three kids and still weighs 115 lbs. He eats all the time but is far from obese.
For every 1 person like your son,there are 99 others who become obese doing the same thing.Your anecdote is meaningless.
All she has had throughout this thread is anecdote. I have to wonder why such a person would even frequent a skeptic blog.
Actually it would be more accurate to say that for every 67 people like my son there are 33 people who become obese. AND that is exactly the point. About 33% of Americans have a genetic propensity to become obese. It doesn’t matter if they eat at a buffet or eat whole foods. It is in their genes.
Another point, since 67% of Americans can indeed eat what they want and NOT become obese it kind of blows holes in the theory that obesity is caused by the American diet.
You are making the wrong assumption that 100% of that population could gorge themselves at a buffet,and 67% will not suffer weight gain because of it.That is patently ridiculous. Most people do not overindulge on a daily basis to that extreme,but of the people who do,most of them will get fat.A small percent have a high enough metabolism or complimentary activity level to offset that excess,but they are not typical.
Not typical? A comment worth debating – obviously there must be a variation to the populace’s efficiency of metabolism. I’ve been in the pig breeding business (no jokes here) for decades. We measure feed intake, growth rate, and feed efficiency (amongst other things) – there are large variations in individual FE (daily intake of feed vs daily growth rate). This is confounded of course by external factors – but we get it right enough so that selecting the top animals for breeding has improved FE by about 1% per year, fr nearly 3 decades and no sign of stopping – so there ARE significant genetic differences in play.
OK,here’s my premise:
“A small percent have a high enough metabolism or complimentary activity level to offset that excess,but they are not typical.”
The NIH statistics for over weight to obese adults are:
All adults: 68 percent
Women: 64.1 percent
Men: 72.3 percent
That leaves 32% at or below normal weight.Of those,wouldn’t some if not most of them consume a moderate amount of food daily vs gorging themselves? Whatever percentage is left would fit CountryGirl’s profile of the ‘lucky’ one’s who can eat whatever they like regardless,and not gain weight.I am guessing that number is low.
Yes, Tmac – I see your point now, and I agree.
“For every 1 person like your son,there are 99 others who become obese doing the same thing.Your anecdote is meaningless.”
It’s not meaningless at all. My wife eats more than I do and she weighs 120 lbs, the same wieght she has since high school 35 years ago. I have gained 40 lbs. Her parents are skinny, he brothers and sisters are all skinny, her grandparents were all skinny. Its genetics. My family was fat, I’m fat and I eat less than she does. We are roughly equally active. This presons anectodate is not menailgless, it reflects the genetic component of obesity, something that almost no one seems to be interested in.
The reason why I found her anecdote to be meaningless,is that first,it’s unverifiable,but ignoring that,it is quite atypical,therefore not particularly relevant to most people’s experience.
Go to any McDonalds or other fast food store near a large high school. You will see hundreds of skinny kids eating Big Macs and fries with a extra large sugary drink of choice. If it were as simple as fast food or excess food causing obesity then the scenario I describe would be impossible. Fast food, the American diet or all you can eat buffets do not cause obesity. The anecdote was simply illustrative of the larger body of evidence. You need to get out more often.
“Go to any McDonalds or other fast food store near a large high school. You will see hundreds of skinny kids eating Big Macs and fries with a extra large sugary drink of choice. ”
Another example of a meaningless anecdote.First,if you were to observe such a scene,how do you know how many calories those skinny kids are taking in on average? Next,how do you know whether they are sedentary,active,or involved in vigorous physical activity when they are not eating fast food.The answer is,you don’t.
I don’t deny that genetics is part of the problem,but even in the genetically predisposed population,greater availability of high calorie food choices coupled with more sedentary lifestyles is playing a major role.And for those who are not at risk genetically,those same factors are causing an increase in obesity,apparently on a worldwide scale,as food availability increases.
Is there truly a need for so many studies saying that eating more and sitting around more leads a person to become a disgusting fat body? Maybe it’s just me but I think it’s an obvious connection. laziness plus tubs of butter leads to the fire department having to cut a hole in your wall in order to haul your 600 pound self to the hospital.
They show that eating more completely accounts for the trend in obesity, so other factors like sitting around more have been less significant. The question is why do people eat more than before.
so your telling me that these lazy gobs of goo wouldn’t lose weight if they A.)got up and did something besides play video games and surf the net all day and B.) didn’t shove cruddy food down their greedy gullets? A few relatively minor changes in diet and activity levels and after a while these lazy fatties wouldn’t be lazy fatties anymore.
My friend, read my comments up above about American Indian tribes. I almost hope you get some “stereotyping” disease as a form of schadenfreude.
Anyone aware of a study of the nutrient density of the food people consume over time?
Perhaps we consume more because our bodies aren’t getting the nutrients they require:
http://www.ncbi.nlm.nih.gov/pubmed/21054899
“A high micronutrient density diet mitigates the unpleasant aspects of the experience of hunger even though it is lower in calories.”
Why do start with the premise that the government must do something? Even if the government could do something effective, which I doubt, and even if we wanted it too, we still son’t have the money. The federal government is 14 trillion dollars in debt, now is certainly no time to take on an additional mission.
For individuals who want to lose some weight or at least not gain any, I have had good results with the “don’t shovel crap into cakehole all the time” diet. Check it out.
The complications of obesity are already a big financial burden.
Exactly, why make them more so?
Because government regulation does not necessarily translate to increase government costs. Government regulation can be done to reduce costs and the common good. The FDA and EPA already regulates other substances that would cause harm or would increase government costs.
That is true, government regulation can reduce the common good. I am skeptical of the rest though.
If the government will stem the epidemic, there will be fewer complications.
Also, this has been done previously with tobacco companies. Regulation of tobacco products has taken many forms including prohibiting the addition of compounds that increase the bioavailabity of nicotine, warning labels and taxes.
Coincidentally they are precisely the same companies.
Klondike Bar labels say, “Not a Light Food.” I haven’t seen that anywhere else.
You’re onto something here with correlation to tobacco companies and a step the government took with that industry that should also be applied here; prohibiting advertising directed at children.
Beginning in the 50s with the rise of TV and the increased availability of processed sugar American children have increasingly become the ultra impressionable targets of advertisers. Children today are bombarded from every possible angle with promises of happiness, fulfillment and even popularity that will come from consuming one particular brand of sugared food-type product or another.
It will save Medicare and Medicaid millions of dollars.
Otherwise, what Somite said.
Even if it would save millions of dollars, which it won’t because there will need to be new bureaucracy set up to manage the regulations, so what? The government is 14 trillion dollars in debt, there is simply no money left for low priority stuff like this.
http://www.diabetes.org/advocate/resources/cost-of-diabetes.html
“The national cost of diabetes in the U.S. in 2007 exceeds $174 billion. This estimate includes $116 billion in excess medical expenditures attributed to diabetes, as well as $58 billion in reduced national productivity. People with diagnosed diabetes, on average, have medical expenditures that are approximately 2.3 times higher than the expenditures would be in the absence of diabetes. Approximately $1 in $10 health care dollars is attributed to diabetes.”
http://articles.nydailynews.com/2011-01-25/entertainment/27096549_1_heart-disease-preventive-care-american-heart-association
“The costs of heart disease in the United States will triple between now and 2030, to more than $800 billion a year, a report commissioned by the American Heart Association predicted on Monday…
‘By 2030, we estimate that 40% of U.S. adults will have one or more forms of cardiovascular disease,’ it reads…
Most heart disease is preventable with better diet and more exercise, according to the Heart Association…
One easy fix would be for Americans to eat less salt, the report recommended.”
diabetes is genetic. You get it from your parents. Unless you want diabetic people to stop procreating you won’t prevent diabetes.
A small minority of people cannot tolerate salt. Everyone else simple ecretes excess salt in their urine and it causes them no problems.
What you fail to realize is that people die of something!! When you hear about an 89 year old man/woman dying of natural causes it is most likely a heart attack, cancer or a stroke. Even if your theory were true (which it probably is not) that eating a “good” diet will make you healthier we would still spend billions on medicare and medicaid. The only thing that would have changed is people would get sick and die older. You would still have as many heart attacks, cancers and strokes.
Do you know of anything of higher priority than one of the leading causes of preventable deaths and health care cost?
Also your dogmatic stance about bureaucracy is showing. Bureaucracies come in all forms, necessary, money-saving, wasteful and everything in between. It entirely depends on the humans that drive them. Everything you have and have accomplished in life was possible because of bureaucracies that allow infrastructure and social programs to exist.
I didn’t say that all bureaucracies are wasteful, just that adding new ones to manage obesity regulations will have a cost and won’t actually save any money at all.
It reminds me of a shopper who buys a $200 pair of shoes because they are %10 off. They end up paying $180 and think they have saved $20, but in reality they have just spent $180.
In our case we don’t have the $180 to spend, so it doesn’t matter if it would be well spent or not. (but just for the record, it won’t be”
Also, this is just an appropriate function for the government. If someone wants to be huge fatass and die an early death, that is none of the government’s concern really.
That is true, this is just an appropriate function for the government. I am skeptical of the rest though.
See what I did there?
But seriously, did you see the article above about the tripling cost of heart disease? Everyone ends up paying for that.
Yeah I saw the article about heart disease and I am not saying that treating it is cheap. I am saying that we don’t have the money to take on new obesity regulations right now, and even if we did we shouldn’t.
People have the freedom to be obese in this country. In fact they have the freedom to do many things that are dangerous and bad for their health. The reasonable approach would be to let live them as they as they please but also let them be responsible for their own healthcare costs.
If you want someone else to pay your healthcare bills then you have to allow them some control over your behavior and decisions. To me that is not a good trade off.
What is your precedence for arguing that enacting regulation is costly? The budget of the entire FDA and EPA are pennies compared to the military and medicare.
Just because something is cheaper than the U.S. military certainly doesn’t mean that it is not costly. By that standard almost nothing would be considered costly.
Besides, the U.S. has the highest prescription drug prices in the world. Do you think the FDA has anything to do with that?
Nyar,
When healthcare costs grow, you end up paying more, whether it’s out of pocket or through higher insurance premiums.
And the reduced productivity hurts the economy as a whole.
The Meal Snap iPhone app analyzes photos of food to determine the ingredients and estimate the calories. Turns out the company that developed it was hiring people through the Mechanical Turk to analyze photos of meals for a couple cents per photo.
I have lost 50lbs over the last year. Now a reasonably trim 180lbs. It was simple, but not easy. Exercise more, eat less. Give up donuts etc. Take a walk every day. Instead of driving to the coffee joint, walk.
“Simple but not easy” is exactly the point. Something like 80% of people who try to lose weight fail. Lifestyle changes are hard, especially if you don’t have a lot of resources, free time, etc. The question is how (or even if) we can help large segments of society make the changes you did.
Actually losing weight could imply using less resources,such as spending less on eating out and buying fewer ‘bad’ food items.As for free time,the average TV watching for US adults is 2.7 hours per day.Using about 1/2 an hour of that each day for a brisk walk 5 times a week,should not be too onerous.
I heard these obesity studies need to control for exposure to food advertising when they’re sedentary (watching tv).
Apparently tv adverts have a measurable effect regardless of diet and exercise.
Here’s part of a review I wrote of Kessler’s “The End of Overeating”:
Without lambasting “Big Ag” or “Big Food” too much, Kessler talks in an easy-to-follow level about how the food industry (no other word for it) in modern America creates and fuels cravings.
And, while fast food or quick-eating restaurants continue to expand elsewhere in the developed, or even developing world, nobody is yet that close to America on this problem. (And, in the EU, they appear to be ahead of America on willing to tackle at least some of this via regulation.)
Back to the main point, though. Kessler describes how the struggle with food is, indeed, a compulsion or addiction. (I don’t come down on one side or the other of particular word usage on behaviors that primarily involve social actions, not chemical influences, and don’t want to distract from the main point.) Most of his suggestions for dealing with eating issues (he just tackles weight, diet, food addictions/craving, not anorexia or bulimia) comes from general psychology. He suggests using cognitive, behavioral AND emotional tacks as a multi-angled approach while not getting so “attached” to or obsessional about the problem that it boils down to a matter of “willpower.”
Anyway, the picture he paints about the “why” of eating disorders and problems is kind of grim. At least here in America. It’s refined sugar (and its cousin, refined white flour), along with fats and salt. They’re all cheap and therefore more likely to be in more and more people’s diets. (Oh, and the “refining” isn’t just in the substances, it’s in their preparation; after this book, you’ll look at places like Chili’s and TGIFriday’s in a new light.)
But, Kessler adds hope to his message at the same time. That’s primarily because, even though he was FDA commissioner and is an M.D., he’s also battled weight issues for years. This book is a personal journey as well as professional advice.
I think that there is too much of a caricature of the obese being used in some of these comments.The fact is that most people who are overweight/obese, have become that way over many years of weigh creep of about 1 1/2 to 2 lbs a year.That represents only about 15 to 20 calories consumed per day over the amount used. That is a very different picture than that of a person stuffing themselves in a fast food frenzy (although that probably does happen with a very few).
So given that relatively small surplus,it would seem that caloric awareness,and constant monitoring of one’s body weight,and a realistic and moderate exercise program could do much to prevent that small incremental increase.The problem is that people ignore the problem until they are 20,50,or even 100 lbs overweight,and then it seems like a problem too big to overcome.And we are also in a culture that wants immediate and dramatic solutions to problems that really require a long term and incremental solution,to be successful.
Yup. Although I’ve always been a bit overweight even as a kid, it wasn’t until I hit my mid 30s that I started to constantly gain weight bit-by-bit over several years. After gaining 50 lbs, I decided to make a change when I turned 40 and it took me about a year and half to lose the 50lbs. As another poster said, it was simple but not easy. I gained a bit of it back and lost it again, but my weight is more stable. As studies suggest, I have found that exercise — while it may improve my health and energy level — seems to have minimal effect on my weight. I know because I’ve gone for some extended periods without much activity and no change in weight, while other times I was exercising regularly and started gaining weight because I started getting lazy with my diet(which I then corrected). So the major factor for me seems by far to be diet. I do prescribe to low carbs but only because it is a diet that works for me compared to other types, not because I’m convinced there is anything special about it.
It is quite true that it’s much easier to ‘lose’ say 300 calories by NOT eating a donut,than by exercising for an hour,but then you don’t get the added health benefits of exercise,so there is a trade-off.
Congratulations on losing the 50 lbs,that is a major investment in your health!
Sure, but the point is that studies have shown that moderate exercise is enough to get the bulk of the health benefits. So, instead of trying to find all the time and will power necessary to exercise a lot in order to burn a significant number of calories, it’s easier to focus on diet. Just don’t forget to throw in a bit of regular exercise for the other health benefits.
Thanks for the kudos.
Nyar it seems you are fighting a losing battle, or at least one in which you are outmanned. The idea that the government should be legislating activity is a bad one. Why should everyone be punished when not everyone is being affected? Everyone who decides to eat one of these foods will be forced to pay an extra fee regardless of their condition. This fee will then be handed to the government, and then what? Do you expect to see that money come back? I guess I just don’t understand the idea of needing the government protecting me from myself.
You got that right! It is most definitely a losing battle. Governments seem to be particularly susceptible to mission creep. It is surreal to me that we would even need to have a discussion about what government should do about obese people. The answer is obviously “nothing! they are not a concern of yours, don’t do anything.”
@CountryGirl: This comment has to be addressed:
“If you believe children just eat what is on their plates then I assume you never raised children. Children eat what they want/like and reject what they don’t like just as the rest of us do.”
I happen to have two kids, and curiously enough one is at the border of underweight and the other was overweight. Children do eat what you put on their plates if you work with them. There is such a thing as conscious, health loving and disciplined children. You cannot get them to eat a pound of lettuce, but you can get them to accept a halfway point between the healthiest, unpalatable food and the delicious (for some) junk food.
In my experience, children are still able to flourish on a less than perfect diet, so you can let them use negotiation to agree on an acceptable diet that they will eat.
If you put some food on their plates and they reject it and you throw the towel, you are doomed and also your kids.
Don’t kid yourself. Hopefully you aren’t abusing your children over what they eat. Children will NOT eat somnething they do not like. You CAN make them but why? There are other options. Children who are obese are genetically predisposed to be obese and the only way you can prevent it is with a starvation diet. I suggest you read what a starvation diet is and try it for a few months before asking others to go on it.
From what I gather from friends and acquaintances, most children have natural dislike for everything healthy. But they will eat it without grumbling if you make it abundantly clear that they don’t have a choice in the matter.* And over time they will come to like it, because most tastes are acquired anyway.
* I now remember a funny episode from my own youth. For some reason I didn’t want to eat brown beans, I don’t know why (they’ve got the rare kind of taste that children tend to like) but I thought them horrid. ‘You won’t get dessert or anything else before you stomach your meal, which your mother has put so much effort in &c. &c.’ Well, a few hours later I was sitting meekly in the kitchen, eating away. Nowadays I love brown beans and I cannot imagine why I was being so fussy.
It is indeed possible to make kids eat what they do not like. The question is: is it wise. Everyone’s taste change as they get older so it is just as likely that children will eat foods as an adult they would not eat as a child. I consider it a mistake to browbeat children into eating foods they don’t like. There are many options that will satisfy nutritional requirements to choose from without inflicting emotional trauma on young children.
Yes,and what’s with these so called “parents” who go around making their kids wash their hands before eating,clean their rooms,brush their teeth,go to bed at a decent time,and pick up their toys? I mean,can you imagine the horror stories these kids will have to tell their therapists,when they grow up? Shameful,I say!
“I do not feel that the evidence supports the third group – blaming calorie type”
I do not feel that you’ve looked in the right places. It’s not about fad diets, it’s about much of the original research from the first half of the 20th century, namely surrounding to lipid hypothesis, being completely wrong. The lipid hypothesis was accepted by congress (despite heavy opposition citing huge lack of evidence) and now everyone accepts it as fact.
I’ve yet to read it but Good Calorie, Bad Calorie is supposed to be a review of this history (i.e. doesn’t promote or sell a fad diet). I’d be interested to know what people here think of that book.
I dunno, I’ve done a low carb diet myself and lost 50 lbs in a few months without any exercise. I was still eating a lot of calories, the numbers don’t quite ad up. It’s way more complicated than “it’s all glucose anyway.” I think the theory in support of this is that insulin is what regulates fat storage, which is driven high by carbohydrate intake. It’s unfortunate that there are so many fad diets surround the idea that it makes it hard to distinguish science from psuedoscience and hard for anyone to do research without being ridiculed.
Most of the “so-called” research is/was biased. Most of the information in fad diets (including Good Calorie, Bad Calorie) stems from this biased research and just plain personal opinions. There is no “bad food”. If you are getting the nutrients you need then your diet is good. If you are not genetically predisposed to become obese you won’t and if you are not genetically predisposed to be diabetic then you will not become diabetic no matter what you eat.
Explain why nurses who said they had one or more servings a day of a sugar-sweetened soft drink or fruit punch were twice as likely to have developed type 2 diabetes during the study than those who rarely had these beverages.
Did their diabetes genes make them drink sugary beverages?
And getting back to the original question, what’s causing the obesity epidemic? Not just in the U.S. but also in Mexico and other developing countries.
What do you think about Nyar’s “don’t shovel crap into cakehole all the time” diet?
I think both Nyar and Steelsheen have been offensive, even grossly so, whether out of ignorance or willfulness, I don’t know. I’m writing a top-of-tree separate comment on that.
It could be statistical anomaly or the inevitable poor results from self reported data or the research was flawed or a long list of other reasons. The fact still remains that diabetes is genetic and consuming sugar does not cause diabetes.
Even though your quote “Did their diabetes genes make them drink sugary beverages?” was intended to be witty you have unknowingly stumbled upon part of the complexity of genetics. It is usually not one gene that controls symptoms or physical outcomes it is often multiple genes. It is also genetic to want to consume large quantities of food. That “could” cause obesity or it might not depending on many factors. So yes it is quite possible that having diabetes (dignosed or undiagnosed) could cause you to crave sweets.
I think some of the comments here, notably by Nyar and Steelsheen about “don’t shovel crap into cakehole all the time,” “lazy gobs of goo” and “lazy fatties” have been offensive, even grossly so, whether out of ignorance or willfulness, I don’t know.
Let me provide some real-world information for you.
I have multiple friends who have had major weight gain from being on bipolar medications. Nothing they can do.
I have a friend and former boss who has noticeable weight gain from multiple sclerosis drugs. Nothing she can do.
I have friends on disability who have post-disability weight gain. Not much they can do.
I have a friend who had a kid at 20 or 21, was afraid of being a dad, and got a vasectomy from an unscrupulous doctor who didn’t tell him he was too young for a vasectomy. He has serious weight issues and there’s nothing he can do.
In cases 1 and 2, modern medications have a lot of hormonal-type side effects. In case 4, a surgery obviously does. In case 3 pre-existing conditions have side effects.
Those of you with whom I’ve tangled before have provided further reasons to not be liked.
Not quite offensive, but sad, is that Dr. Novella hasn’t weighed into this conversation for about three days, and provided exactly this type of medical information.
But if you’re in the mood for ‘real world information/anecdotes’ then consider this: Being at the same company for 11 years now i’ve seen the weight of friends go up and down.
– My boss was the typical all american ‘high school quaterback’. Fit as can be and in great shape. Once he started working here with a desk job I’ve seen him put on probably 150lbs. He doesn’t exercise anymore and eats junk food all the time. In the morning he’ll crack open a pepsi and grab a bag of chips. He does this all day. He has now developed type II diabetes. According to him, he has no excuse for this other than he makes bad eating choices.
-I have many friends who were of average build when we started working here, but have since been gaining weight. they do nothing but sit in front of a computer all day, eat crappy food, slam back the mountain dews and then go home and play games online. And their waistlines are suffering.
In fact, most of my co-workers are gaining weight from being sedimentary all day long. I see them all eating bad breakfasts and lunches.
So I just don’t buy the excuse that all of this is unavoidable. I agree that certain medications will cause a weight gain, but to me it just seems like it’s just another excuse to blame something on someone else rather than themselves.
note – ‘sedentary’ not sedimentary :)
None of what you cite countervails any of my examples. Sorry. Sorry that, albeit in a politer way than the names mentioned above, you think it’s always 100 percent the person of weight gain’s fault.
That said (and I don’t know if you’re a political conservative) but an issue like this seems to exemplify the black-and-white thinking of many conservatives.
I’m quite liberal actually, and no I didn’t say it was always 100% the persons fault
” I agree that certain medications will cause a weight gain” – just in case you missed that part.
I too have a friend with medical issues (thyroid problem for example) that was overweight until surgery on his thyroid, which he then started dropping a lot of the excess weight he had put on.
I guess based on your comments that you feel that 100% of the weight problem in this country is medically related? That’s a tall order methinks.
No, I never said that 100 percent of the problem was medically related. I was responding to claims that the problem is 100 percent “lazy fatty” related, and its not. And, you seem to lean pretty close to that.
No, I didn’t miss your “certain medications” comment. I passed it by because you immediately qualified it by saying “it just seems like it’s just another excuse to blame something on someone else rather than themselves.”
The issues I mentioned? MS isn’t like a thyroid problem; it’s not addressable with surgery. Neither is bipolar disorder. A vasectomy performed too early at 22, even if reversible, can’t have its damages reversed 15 years later.
Sorry if I associated pretty much black-and-white thinking on this issue with political convictions you don’t have. Taking you at your word that you’re “quite liberal,” I encourage you to be more liberal-minded on this issue.
Are you saying that your friends bodies are not subject to the laws of conservation of mass and energy?
Red herring, doesn’t address my observations on medical issues, nor does it address the “tone” issue.
Received and otherwise ignored.
It is not a red herring. You said that there is nothing they can do about their weight gain. That is not true according to conservation of mass and energy.
On the tone issue, I agree that some of my comments have been grossly offensive.
As for my issues with Socratic:
– I lean pretty close to it being ‘lazy fatty’ because I have a hard time believing that the majority of Americans have all suddenly (in the past decade) started developing medical issues which is in turn causing this. What do you think is a fair percentage to put on this? 80% medical/unavoidable and 20% environment surroundings? Perhaps you and I just disagree on percentages?
-I’m not sure what you mean by ‘i need to be more liberal minded’ on the issue. What is your definition of ‘liberal minded’?? To me, that means being open minded and accepting more than one reason/solution/willing-to-look-at-things from another angle. You don’t seem to give much thought to anyone elses suggestions other than your own, which seems rather close minded. I could be wrong.
I just realized the paper that Dr. Novella uses as a reference for the “all calories are equal” hypothesis is from 2003. The latest scientific statement from the AHA and the reference I cite above are more recent and complete. For example the AHA scientific statement concludes:
A prudent upper limit of intake is half of the discretionary calorie allowance, which for most American women is no more than 100 calories per day and for most American men is no more than 150 calories per day from added sugars. (Circulation. 2009; 120:1011-1020.)
http://circ.ahajournals.org/content/120/11/1011.full.pdf
Also my most recent reference is from the highly impactful Nature journal. No address of these points?
Steven also talked about Prof. Mark Haub’s “twinkie diet” in the past.
http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/index.html
For those arguing about one factor being more important than another:
Weight loss or gain is derived from two main factors: Diet and activity. And these will have different effects in different people. This is why you can always find anecdotes that will verify your notion. What we are discussing is that these parameters have changed recently to create an obesity epidemic. People are probably more sedentary AND the food industry has become adept at hiding calories and decreasing satiety. All factors should be acknowledged.
My goal is to enjoy food as much as possible without having to waste my time running marathons to keep my weight. In two hours of strenuous exercise the most you can burn is 400 cals, 500? That’s what 2 or 3 cans of soda? So why would I chose to drink soda empty calories instead of eating a banana? Not to mention the soda makes you more hungry while the banana satiates your hunger.
I keep thinking on the referenced nutritionist that lost weight on a 1800 cal diet of twinkies. That’s about 10 tiny twinkies a day. A miserable diet indeed.
Also contributing are the detrimental metabolic effects of fructose in sugar that have more recently been described and acknowledged by the american heart association that result in diabetes and cardiovascular disease.
In theory what you say is true. If you put an obese person into Hitler’s concentration camp they would lose weight until they were skin and bones. In practice you are incorrect. If an obese person has free will and food they will eat when they are hungry and their genetic makeup will tell then they are hungry. A skinny person will eat as well but not as much and/or will be active enough to counteract any overeating. The problem is not simply one of calories in and excercise as long as the individual has free will. I happen to not be a smoker. I have known smokers who tried to quit and reached a point where they would have done anything for a cigarette. Since I’m not a smoker I cannot understand that. Since you are not obese you cannot understand what drives them. Just as I think quitting smoking is easy you think eating less is easy.
Sucrose (sugar) is about half fructose. It always has been. It was half fructose when we didn’t have an obesity epidemic and it still is. If the fructose in sugar caused obesity it would have caused it 100 years ago or 50 years ago but it didn’t. I don’t understand fructose derangement syndrome any more then I understand Twinkie paranoia. I suppose the next fad/scare will be something else people enjoy. Someone once said that Puritanism is The haunting fear that someone, somewhere, may be happy. I guess food policing is the fear that someone somewhere may be enjoying their food.
You do get there is more sugar now available to us than there has ever been. It is also unprecedented thatblarge quantities are added to all foods. Think about it; how long have frosted flakes been around?
You say people have free will, yet they can’t control how much they eat. Sounds like a contradiction.
But suppose you’re right that people are genetically programmed to overeat and become obese when they have easy access to food and are bombarded with advertisements. Since genetics don’t change everywhere in a couple of decades, the logical explanation of the obesity epidemic would be increased access to food and proliferation of advertisements. Limiting these things should slow down or reverse the obesity epidemic, but because this solution goes against your ideology, you’re going to deny the problem and attribute it to bad statistics, same as with Global Warming.
Your “so-called” solution doesn’t go against my ideology it goes against logic. HOW, exactly, do you limit access to food or advertising? Do you do what the Russians did numerous times in the 20th century and send in troops to take the food then gaurd the borders so the hungry peasants couldn’t leave to find food?? Are you going to repeal the 1st amendment? Exactly how do you propose to “limit” these freedoms??
Somehow we’re able to regulate tobacco and alcohol without sending in troops. Restrict advertisements targeting children, remove junk food from public schools, tax junk food and subsidize vegetables, end corn subsidies, run grocery shuttles for families in food deserts the way some universities run shuttles for students. I don’t know if these solutions would work, but they don’t go against logic.
Do you have better solutions?
How about making cooking and nutrition classes a required subject?
“If an obese person has free will and food they will eat when they are hungry and their genetic makeup will tell then they are hungry.”
What about eating past satiety, to relieve stress, or to get your money’s worth at a buffet, or just because it tastes good?
And even if people did eat only to satisfy hunger, is hunger only satisfied by consuming a certain number of calories, regardless of mass and volume? Do sugary sodas really satisfy hunger? Do people eat less if they drink Coke than if they drink water?
People eat “comfort foods” for depression and other reasons, too. Yet another reason why the people who offer simplistic “solutions” … don’t … get … it.
Obesity is contagious among friends
http://www.nytimes.com/2007/07/25/health/25iht-fat.4.6830240.html
“Science has shown that individuals have genetically determined ranges of weights, spanning perhaps 30 or so pounds for each person. But that leaves a large role for the environment in determining whether a person’s weight is near the top of his or her range or near the bottom. As people have gotten fatter, it appears that many are edging toward the top of their ranges. The question has been why.”
“…people were most likely to become obese when a friend became obese. That increased one’s chances of becoming obese by 57 percent… And the greatest influence of all was between mutual close friends. There, if one became obese, the other had a 171% increased chance of becoming obese too. The same effect seemed to occur for weight loss, the investigators say, but since most people were gaining, not losing, over the 32 years, the result was an obesity epidemic.”
Actually, Max, the “research” behind that one’s been called into question. Slate had a story about it. Arguably, the original research should never have been published.
http://www.slate.com/id/2298208/
NEJM stands by the original research and rejected the critique of it, go figure.
Sleep Deprivation Doubles Risks Of Obesity In Both Children And Adults
http://www.sciencedaily.com/releases/2006/07/060713081140.htm
The research reviewed current evidence in over 28,000 children and 15,000 adults. For both groups Professor Cappuccio found that shorter sleep duration is associated with almost a two-fold increased risk of being obese.
The research also suggests that those who sleep less have a greater increase in body mass index and waist circumference over time and a greater chance of becoming obese over time.
Professor Cappuccio says:
“The ‘epidemic’ of obesity is paralleled by a ‘silent epidemic’ of reduced sleep duration with short sleep duration linked to increased risk of obesity both in adults and in children.These trends are detectable in adults as well as in children as young as 5 years.”
The problem with a study like this is you don’t really know if the factor you are studying is the cause or a symptom of the problem you are looking at. I would have to see more studies of this before I could accept that less sleep causes obesity.
I would also like to know exactly what the phrase “increased risk of being obese” means. Does it mean that they didn’t actually get obese in the study but the people running the study impuned that they would/did? Aren’t you either obese or not obese? How do you qualify as at increased risk?? Sounds subjective to me.
The part that caught my eye was the next sentence:
“The research also suggests that those who sleep less have a greater increase in body mass index and waist circumference over time and a greater chance of becoming obese over time.”
In other words, people who sleep less when they’re not obese have a greater chance of BECOMING obese.
“a greater chance of BECOMING obese.”! What does that mean? It is almost lawyer-like in that it doesn’t say they became obese. So it is fair to say in this study they did NOT become obese because if they had that would have been the headline. So how, exactly, do you know someone is going to become obese? It still sounds subjective, like when your mom told you “don’t make your eyes cross-eyed or they will freeze like that”. This sounds like hocus-pocus to me; Don’t get less then 8 hours of sleep or you will get fat!
Maybe it’s as simple as; the more hours that you spend awake,the more opportunities you have to eat.
I assume it means a longitudinal study that tracks people over time, as opposed to a cross-sectional study.
Here’s an interview with the study’s author.
http://www2.warwick.ac.uk/newsandevents/podcasts/media?podcastItem=sleep.mp3
I’m sure diminished sleep, after some degree of diminishment, has hormonal effects, which then spill over to metabolism and related issues. The idea makes sense to me.
So, if I want to be snarky to some people above, maybe we’ll have “fatty” stockbrokers because they can’t resist answering their FatBerrys at 3 a.m.
Surely the only metric worth mentioning is if calories taken > calories used = weight gain?
It’s not a disease. Americans just need to stop driving everywhere and stop eating high-fat, high-calorie junk food.
But that is the point. Most Americans are not obese but they drive everywhere and eat high-fat, high-calorie junk food. How can we overlook the obvious. If it was high-fat, high-calorie junk food that was causing obesity then we would all be obese. On the other hand I will agree that if you have a genetic propensity to gain weight then the easy availability of high-fat, high-calorie junk food makes it easy to fulfill your destiny.
The obesity gene(s) had a purpose when we were hunter gatherers and would experience famines on a regular basis. The ability to pack on fat and eat huge amounts of food made you a survivor. This may explain in part why people from cultures which were recently living like hunter gatherers have a higher rate of obesity. I have even heard the theory that the reason more women are obese then men is again so they could survive a famine and also nurse a child at the same time. Both of these theories make sense and are consistent with our current problem of greater obesity.
One thing I noticed about the US is no one walks. The streets are empty unless they’re part of a tourist attraction. Granted this observation was made driving a big ass GMC with corn chips stashed in the console.
I personally believe some people may be time poor and as a result, tend to be more inclined to hit some junk food as opposed to preparing or purchasing something healthy.
Genetics – or more specifically, Epigenetics – fascinating concepts and worth a read: if this is true, we may be in a feedback loop situation, obese and diabetic parents may pass that on to offspring:
http://www.nature.com/ejhg/journal/v14/n2/full/5201567a.html
European Journal of Human Genetics (2006) 14, 131–132. doi:10.1038/sj.ejhg.5201567 Epigenetics: Sins of the fathers, and their fathers Emma Whitelaw
“…Reanalysis showed that the paternal grandfathers’ food supply during mid childhood was linked to the mortality risk ratio of grandsons, but not granddaughters.”
The original study found that grandchildren of Swedes who lived through a famine were less likely to develop heart disease. My first impression was that this was natural selection at work. Healthier people were more likely to survive the famine and pass on their healthy genes. Apparently, the study’s authors took this into account, since they say, “Selection bias seemed to be unlikely.”
http://www.ncbi.nlm.nih.gov/pubmed/12404098
The “famine winter” in the Netherlands, 1944-45, was the first to illustrate a link between these issues. Again, the “simplistic” solution offered by some here fails to recognize the complexity of these issues. It seems that a fetus growing in the womb of a mother on a starvation diet “learns” to reset his/her metabolism to be ultraefficient with food when eating, itself.
Wouldn’t an ultraefficient metabolism cause obesity by wasting less energy and storing the surplus as fat?
A little more on genetics and gene expression; (before I get accused of being batty!)
http://blogs.discovermagazine.com/80beats/2010/10/21/metabolic-sins-of-the-father-fat-dads-may-give-their-kids-diabetes/
The researchers put one of their two groups of male rats on a high-fat diet, the other on a normal one… the high-fat rats put on a lot of weight and began to show symptoms of type II diabetes, like insulin resistance and struggles with metabolizing glucose..
…examine the obese rats’ female offspring. These too had problems regulating insulin and glucose levels. The healthy fathers, however, had correspondingly healthy daughters. ..
.. the father makes his contribution only at conception, while the mother continues to influence an offspring throughout pregnancy. Thus, Morris says, obesity must cause some profound change in gene expression in the father’s sperm.
The prime suspect,… is not a genetic mutation in the sperm’s DNA, but an “epigenetic” alteration in chemical tags on the DNA. These epigenetic tags help determine whether a gene is expressed, and they can be passed on to offspring. During sperm development, which is occurring constantly in the male, epigenetic marks are erased and replaced. Environmental factors such as diet may interfere with this process. ..
…the Nature study found 600 variations in the expression of genes relating to the pancreas in the daughters of fat male rats. But the actual genetic code had not changed, pointing the finger at an epigenetic cause.
Father…fat her…coincidence?
Further to the epigenetic/gene expression theory – under this scenario (above posts) obviously an obese mother would be just as likely to be making a genetic contribution to her offspring’s propensity to be obese and be susceptible to diabetes, but, equally obviously, it is difficult to differentiate that from the effects of an obese mother’s altered metabolism during pregnancy.
Oops – need to retract that last post I think – my memory suddenly niggled me so I checked it out: genetic make-up of oocytes is determined in the embryonic stage – but perhaps we could suspect a similar female influence may occur, but from the grandparent?
Some speculation about epigenetics and baby bottles
http://www.nature.com/scitable/topicpage/obesity-epigenetics-and-gene-regulation-927
“A number of environmental triggers have been shown to affect the behavior of an organism’s epigenome, tipping the balance between methylation or lack thereof, and thus between genes that are ‘off’ and those that are ‘on.’ One suspected trigger is a chemical found in many plastic drink bottles, including baby bottles, called bisphenol A. In one particularly notable study, scientist Randy Jirtle and his group of researchers exposed pregnant mice to bisphenol A and watched as more of their genetically identical progeny developed into yellow, obese mice than would normally be expected (Dolinoy et al., 2007). In Jirtle’s experiment, DNA methylation at the agouti gene sites was decreased by 31%. (DNA methylation was reduced on other genes as well.) These results supported the hypothesis that bisphenol A alters the action of organisms’ epigenomes by removing methyl groups from DNA.
The implications of this discovery are staggering. With the rise of obesity in Americans coinciding with the widespread use of bisphenol A in everything from water bottles to dental sealants, one can’t help wondering whether there is a causal connection. Yet, Jirtle himself is the first person to say that such an association cannot be definitively demonstrated until evidence shows that bisphenol A indeed affects the expression of the human genes involved in obesity.”
The very fact that BPA has been around a long time and we are all exposed to it works against the theory. If your theory were true either we would all be obese diabetics OR those of us who are opbese diabetics would have clear evidence of massive exposure to BPA. Neither of these is true. (excuse me I just took another drink of water from my BPA contaminated plastic bottle.)
On the other hand if obesity and diabetes were genetic we would find numerous cases where each generation in a family has one or both conditions AND we would find entire races of people with very high and very low rates of one or both conditions. Both of these are are true.
If obesity and diabetes were just genetic we would find identical twins always sharing these problems.
http://www.diabetes.org/diabetes-basics/genetics-of-diabetes.html
“Genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease at most only half the time. When one twin has type 2 diabetes, the other’s risk is at most 3 in 4.”
I think you are confusing genetics with fate. It is not an absolute like the genes that give you blue eyes. If it were then all diabetics would have identical progression of the disease and identical outcomes. In fact diabetes is a death sentence for some and simply an inconvenience for others. The genes give some people the propensity to have diabetes but it is not absolute. Just as your genes might give you the propensity to be 6 feet tall but a poor diet may leave you 5′ 6″.
Well then I think we agree that genes and the environment play a role, but what’s causing the obesity epidemic in the last several decades?
Seems most likely to be “all of the above” …. Very obviously there are genetic differences between individuals, equally obvious is the easier access to large amounts of easily digestible energy. Related to that is a ever more sedentary lifestyle ( we don’t have to farm to get those carbohydrates, or hunt to get our protein).
Add to that the epigenetic/gene expression theories, and the role of BPA in gene expression, and you could theorize we had a cascade of factors. (and surely you can’t write off something like BPA as an “all or nothing” proposition, when you are dealing with different genetic make up/ susceptibility, different levels of exposure, different external complicating factors such as amount of exercise and diet).
Note, there is nothing simple about genetics and heritability: we have dominant genes, recessive genes, partially recessive genes, genes which may or may not be expressed depending on ‘switching’,which may be from external factors, or other genes. Some things may be dependent on combinations of genes, all of which are subject to the all of the aforementioned.
So sure, genetics play a part. But it ain’t simple genetics.
The problem with citing BPA as a cause of anything is there is ZERO evidence of any problem with BPA. It is a totally manufactured outrage not unlike the alar scare. Some people with little else to do make blind guesses about some chemical “possibly” being harmful and others pick up the meme and run with it long before there is any science to prove it.
Oh. Thank you.
That’s quite clear then.
(I’ll just ignore all those silly publications)
Look for legitimate science and not hysterical pseudo-science.
One thing I don’t understand; It would appear that the very same people who oppose BPA where there is no evidence of harm also encourage the widespread use of fluorescent lights which have a known harmful chemical in them.
Another example is the same people who oppose dams because dams kill salmon favor wind power which kills birds.
How about the hyper-scare about nuclear power because of the damaged nuclear power plants in Japan which so far has caused zero deaths but at the same time are unaffected by the 20,000 plus people who died in the tsunami that caused the damage.
It would appear that this is a lame attempt at a tu quoque that’s too vague to be of any use.
So much wrong.So little time.Sigh…
And an interesting twist on the diabetes Type II story: recent interesting development:
http://www.emaxhealth.com/1275/vitamin-d-may-reduce-risk-type-2-diabetes
“…43 percent lower risk of type 2 diabetes was associated with levels greater than 25 nanograms per milliliter (ng/mL) compared with the lowest blood levels, defined as less than 14 ng/mL….”
“…meta-analysis included data from eight observational cohort studies and 11 randomized controlled trials that involved diabetes and measuring vitamin D …”
Mitri J et al. European Journal of Clinical Nutrition 2011; doi: 10.1038/ejcn.2011.118
How do you like this one?
http://www.medscape.com/viewarticle/710099
“Moderate alcohol consumption is associated with a decreased risk of type 2 diabetes in the general population, but little is known about the effects in individuals at high risk of diabetes,” write Jill P. Crandall, MD, from the Albert Einstein College of Medicine, Bronx, New York, and colleagues from the Diabetes Prevention Program Research Group.
Fascinating and a bit surprising (but I like the concept, I knew I didn’t drink enough!)
“…At any level of insulin sensitivity, higher consumption of alcohol was associated with lower insulin secretion. In the metformin and lifestyle modification groups, higher alcohol consumption was associated with lower incidence rates of diabetes (P < .01 and P = .02 for trend, respectively). These associations remained significant after adjustment for multiple baseline covariates but were not observed in the placebo group…."
Your horse may win the Kentucky Derby. Your son or daughter “may” become president. Higher levels of vitamin D “may” prevent (fill in whatever health problem is getting the most attention).
The problem with these kinds of statements which are generally backed up by conjecture and guesses is they are useless or worse then useless. Frankly I have more faith that your horse will win the Kentucky derby.
And one individual “may” discount every other hypothesis and decide she is the only one who has any answers. Your statement above is ludicrous, an unrelated to science.
There is very good evidence presented in those articles, but you discard it out of hand? I don’t know if the Vit D story will become a significant part of the obesity debate, but I am not yet quite arrogant enough to discard out of hand any new hypothesis. (especially those with backing data!)
I’m fascinated. Would you mind explaining what you DO actually believe? Is it that absolutely everything comes down to genetics? There are no external factors involved? Or there are, but most of those you discount, because you just…um…”know”?
And do you understand how scientific process works? A hypothesis is established (usually from some observations, review and re-analyse available literature and trial data which may contain evidence supporting the new hypothesis. Then run some trials attempting to prove(or disprove)the hypothesis. And, once considered proven, keep observing publications closedly for confounding factors, or even better answers.
One of the great fascinations of scientific discovery is seeing older ideas debunked, theories overturned and revised, and completely new or more complete explanations arising.
Those who think they already have all the answers do not add to the progression of science in any way.
Calorie theory is weak.
The obesity epidemic began when the government and “experts” started preaching low fat to the masses, about 1980. Food companies took fat out and put sugar and carbs in. Food content explains both the timing and magnitude of the obesity epidemic. It’s the carbs.
Here is a discussion of a technical paper that explains why calorie theory is not the whole story-
http://dietforhumans.com/2011/07/30/obesity-and-energy-balance-is-the-tail-wagging-the-dog/
Carbs raise insulin. Insulin is a fat-storage hormone.
If there were “very good evidence” then they would have used “will” not “may”. You may someday figure this out but I doubt you ever will.
Yep. I guess they intend to do, and will do further work on it. They are not quite so absolute in their statements as some. Unfortunately biological systems are subject to many sources of variation, so very often it is correct to state that “data indicates…”, or “..x… may be involved..” You touch on one of the complication at times in your comments – genetic variation.
Usual practice is to read and analyse data, and arrive at a a personal opinion on it’s value. Best to not discard it because it contains the word “may”. As more data accumulates, opinions may firm, or change.
The use of the word “may” was neither accidental or simply being careful not to overstate the facts. It was lawyerese to be able to give the impression of a cause and effect without all that pesky proof that a true scientific study requires. I believe the deception was intentional and that is the point I am trying to make. You believe there was no fraud at all and somehow “may” is acceptable.
You seem to have a little trouble understanding some of the wording of scientific articles. Allow me to help if I may:
Re your comment above:
“…“a greater chance of BECOMING obese.”! What does that mean?…”
I’d suspect the publication in question was a systematic review and meta-analysis, similar to, or part of the 470,000 subject review below. (the data in this instance was from 28,000 children and 15,000 adults) I’d presume cases are interviewed, followed over a period of years, and individual rate of weight gain are noted over those years. Apparently more weight is gained in those who are short of sleep.
But guess what, not everyone responds in exactly the same way (genetic differences, (again!) environmental differences, etc).
So the researcher can’t say “everyone WILL become obese” – he simply does some pretty simple maths and calculates the chance that will occur (and subjects that to some slightly more complicated statistical analysis).
Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies Cappuccio1 etal European Heart Journal Volume32, Issue12 Pp. 1484-1492.
This was a systematic review and a meta-analysis: The researchers searched for data from studies that had continued for at least 3 years: “…Overall, 15 studies (24 cohort samples) included 474,684 male and female participants (follow-up 6.9–25 years), and 16 067 events (4169 for CHD, 3478 for stroke, and 8420 for total CVD)…”
From that they concluded “If you sleep less than six hours per night and have disturbed sleep you stand a 48 per cent greater chance of developing or dying from heart disease and a 15 per cent greater chance of developing or dying of a stroke…”
a snippet: “…Lack of sleep produces Ghrelin which, among other effects, stimulates appetite and creates less leptin which, among other effects, suppresses appetite. However … more research is needed to understand the mechanisms by which short sleep is linked to chronic conditions of affluent societies, such as obesity, diabetes and hypertension…”
Yeah, that troublesome English language. Words have meaning and either someone inadvertently says something or they intentionally says something. In this case what I believe happened (and happens far too often in studies on human health and diet) is that predicably some people are affected by factors that generally do not affect the majority of people. If we selected 20,000 Americans and subjected them to 1 hour of Southwestern sunshine in July I would predict that there would be a greater chance of becoming sunburned. But in fact about 40% of the population would be sunburned simply because of their Northern European heritage while the rest would likely not be sunburned but would merely become more tanned and acquire vitamin D. Could I then use the results and the poorly worded outcome to predict the outcomes for everyone??? Wouldn’t it be far more honest to state that people who sunburn easily are suprisingly sunburned as a result of prolonged exposure to the sun. Conversely wouldn’t it have been more honest for the researchers to say that people with a propensity to be obese were slightly more likey to become obese if they didn’t get enough sleep??? And maybe even point out that a majorit of people did NOT become obese as a result of less sleep. But NO! They choose instead to hype their “study” and through the creative use of the English language make a statement that neither conveys good information nor clearifies the issue.
Countrygirl statements and questions in inverted commas:
“… that predictably some people are affected by factors that generally do not affect the majority of people….”
This is true. And usually it is this sort of thing that trials are attempting to demonstrate. It only becomes predictable when you have some data.
“…20,000 Americans and subjected them to 1 hour of Southwestern sunshine in July I would predict that there would be a greater chance of becoming sunburned…. But in fact about 40% of the population would be sunburned …while the rest would likely not be sunburned but would merely become more tanned and acquire vitamin D….”
Indeed, you will have proven your hypothesis and show that people are more likely to become sunburned if you stand them in the sun. And furthermore, you will have some statistical data showing what proportion of a population of that make-up will become sunburnt. If you have been meticulous your set-up and recorded the races and skin types of your subjects, you will be able to draw further conclusions as to susceptibility to sunburn of people of different races and skin types. If you have been even more meticulous and had a way of measuring degree of sunburn (ie, 20,000 individual measures instead of simply proportions of two large groups) you will really be able to do some strong statistical analyses. (It’s always a nice feeling when you are able to make more out of your data than the original trial design intended).
“…Could I then use the results and the poorly worded outcome to predict the outcomes for everyone???…”
Yes, you certainly could, for a similarly structured population.
“..Wouldn’t it be far more honest to state that people who sunburn easily are suprisingly sunburned as a result of prolonged exposure to the sun….”
You certainly could draw that conclusion and make that statement from those trial results. However, I’m not sure anyone would think it surprising.
“…. wouldn’t it have been more honest for the researchers to say that people with a propensity to be obese were slightly more likely to become obese if they didn’t get enough sleep???….”
It may in fact be very likely that that is the case. They probably can’t prove or disprove that from their data as there is not enough information recorded there to indicate the ‘propensity to be obese’.
But, their conclusion remains true: From those sets of data, people who were sleep deprived were more likely to gain weight, than people who had more sleep. This is a statement of fact – cause and effect is a matter for discussion and further investigation.
“….And maybe even point out that a majority of people did NOT become obese as a result of less sleep…”
Science does not rely on first past the post voting principles. Take two large groups of people (say, 20,000 per group, balance them for race and skin type) – Stand one group in the sun for an hour, keep the other group in inside. Let’s say 40% of that “sun exposed” group became sunburnt, whilst none of the “indoor” group did. Our data indicates that sun exposure leads to an increased likelihood of becoming sunburnt. We won’t ignore that data because 60% (a majority) of the group didn’t become sunburnt. We can certainly make the statement that the majority of the group did not become sunburnt, but the proportion that did become sunburnt is equally important in the discussion, and could not be ignored. Moreover, as that was the whole point of our trial, of course this effect on this “minority” would be the main topic of discussion.
Somehow you failed to grasp the point. In any population and certainly in any diverse population their will be individuals with unique characteristics, genetic or otherwise, that make them react differently then the majority. There may indeed be people who cannot tolerate fructose or dairy products. If you conduct a study where that particular food is tested there will be a measurable result negative or positive. However that result ONLY applies to the portion of the population with the indicated characteristics and not to everyone. It is a failing in our schools and statistics itself that we don’t know this simple fact. I am not diabetic so I can eat sugar and soft drinks and whatever all day long and not suddenly develop diabetes. I am not obese and even though I eat four times a day and eat whatever I feel like eating I will not become obese. You can cite whatever study you want to but without the common sense and knowledge of statistics you need to understand these studies you will draw the wrong conclusions. I am arguing that the people conducting the studies in general choose to do these studies to put their particular biases out there and lo and behold their studies confirmed their biases. Presumably these studies were performed by people who should understand statistics so I can only conclude the fraud in the results was intentional. It reminds me of that old joke where a educator was asking for more money for teachers and schools because even after all the money spent so far half the students were still below average. Sadly this lack of understanding of statistics and how to use the results is predominate in our society.
“… In any population and certainly in any diverse population their will be individuals with unique characteristics, genetic or otherwise, that make them react differently then the majority. …..However that result ONLY applies to the portion of the population with the indicated characteristics and not to everyone…”
Correct. It is for this reason we need large studies and do statistical analyses. If everyone reacted in exactly the same way, and to the same degree, (and we knew that) then we’d only have to study one person to reach our conclusion.
However, if we ignore statistical evidence (say, that for a certain age group, having a caloric intake of than x calories daily, will result in 20% of the normal population falling into a (defined) “obesity bracket”), because we personally know one person who has that intake, yet is not overweight, then we are indicating we don’t comprehend the meaning and purpose of statistical analyses, and are probably incapable of drawing any valid conclusions from scientific data.
Scientists will almost NEVER say something WILL or WILL NOT happen (except perhaps in the precise areas of physics or chemistry, but we are talking largely about biological systems here) because almost everything is measured and statistically analysed, and the stats are primarily done to measure the odds that the result occurred simply by chance.
You presumably do know that even a highly significant result (p=.01) carries the meaning that there is a probability that the result could occur by chance. “p= .01″ is stating that there is a one percent chance, that given the different groups in the trial, with NO differences in treatment, the difference in that measured parameter in question could still have occurred in 1% of trials. (ie, if you measured two defined and balanced trial groups 1000 times, in approximately 100 of the results you would see the same degree of difference to that measured in the trial, purely by chance).
When I see a trial result showing (for example) “…43 percent lower risk of type 2 diabetes was associated with levels greater than 25 nanograms per milliliter (ng/mL) compared with the lowest blood levels, defined as less than 14 ng/mL….” I do not then think I will reduce my own risk of getting type II diabetes by 43% if I keep my serum Vit D levels over 25 ng/litre. I KNOW that it means for the group surveyed there was evidence of a lower incidence of Diabetes Type II occurring where higher serum levels were present.
I have not noted any sign of “fraud” in the data discussed on this blog post. In every case they simply state what the data shows, then discuss the possible ramifications of the observed results. Some of these studies may likely be repeated with different results, some will be repeated with similar results. Some will be subject to other lines of investigation (chemical experiments, biological models etc).
Eventually some reasonably solid conclusions will be reached. But in almost every case, the story never stops – as more influencing factors, more complex signals and feedback mechanisms are unearthed over time.
All in all, a fascinating process.
typo correction: 10 replaces 100
(ie, if you measured two defined and balanced trial groups 1000 times, in approximately 10 of the results you would see the same degree of difference to that measured in the trial, purely by chance).
Further corrections:
“p= .01″ is stating that there is a one percent chance, that given the different groups in the trial, with NO differences in treatment, the difference in that measured parameter in question could still have occurred in 1% of trials.
Reword as: “p= .01″ is stating that … for the different groups in the trial, with NO differences in treatment, the difference in the measured parameter in question could still have occurred in 1% of trials, purely by chance.
You are still getting it wrong. If a study, no matter how large, had 10% of the population with diabetes then the study will absolutely show a result indicating whatever the variable are that it affected those with diabetes. This is inevitable. However to conclude that the results apply to the 90% without diabetes is incorrect at best and fraud at worst. If you have diabetes then diet will absolutely affect your symptoms and the damage the disease causes. If you do not have diabetes then the very same diet will not have any effect and will not give you diabetes. Simple as that. You are still trying to claim the study proves that diet CAUSES diabetes and you are hiding behind the art and science of statistics itself. Kind of “by golly the computer says this so it must be so. The study is flawed IF they are trying to prove what they have concluded. I am assuming they are intelligent people and have skill and experience doing what they do. Therefore they knew or should have known the study is flawed and I can only conclude the fraud is intentional. I am not so sure about you. I think you are unaware of the fraud and not knowledgeable about diabetes and thus are simply mistaken. Hard headed but mistaken.
Perhaps this discussion only continues for so long because we are arguing about different topics:
“…You are still trying to claim the study proves that diet CAUSES diabetes…”
Not at all. I think everyone here accepts that there are major underlying genetic predispositions to both Type I and Type II diabetes. This is quite clear by the differing frequencies of the diseases occurring in different racial groups, and in families. It is not however, simple genetics – there is not just a “diabetes gene” which is either ‘on’ or ‘off’.
Likewise, I think most here accept there are major genetic factors involved in the propensity to become obese. This is likely to be even more complicated in terms of the genes involved than is the heritability of diabetes.
I saw our major point of contention being your instant dismissal of research (accompanied by plausible clinical theories) showing that Vit D may be a factor in Diabetes Type II, that sleep deprivation may be a factor in Diabetes Type II and in obesity, that BPA may be a factor in genetic changes (epigenetic change) and hormonal regulation of bodily processes, and that environmental factors affecting parents and grandparents may contribute to genetic changes (epigenetic theory again). There is a substantial amount of published supporting evidence on each of these factors. Certainly I would not dismiss them out of hand because an individual makes an unsupported statement dismissing them.
Another point would be that you seem to contend that there is a single switch involved in obesity. People either have “that gene” and will become obese if they consume energy in excess of their requirements, or don’t, and can therefore eat whatever they like, and will never become obese.
Whereas I hold the position that there are probably a very wide range of factors involved in obesity, some of which are genetic, but even these may be switched on or off by external (environmental) factors. I believe that given a certain population of people, and control over the proportions of energy, protein and fibre in their diets, and their level of physical activity, we could push the whole population towards obesity if we so wished. That does not mean every single person will gain (for example) exactly 10 kg of fat. I would expect the degree of weight gain to fit a normal curve: Some would gain a massive amount; some would gain a moderate amount, etc., right down to those few individuals who would gain nil. This, of course, would be governed by their genetic makeup, and their appetite. Overall, with greater energy intake, lower protein intake, and restricted exercise, the whole population would become fatter.
That the (US) population now has a greater daily caloric intake, and the proportion of the population that is obese is increasing was the basic statement of the original blog post. But I think even acceptance of that data is a point of disagreement?
Re the Vit D/diabetes publication – it was not just a guess, or comment, or whim, or vague idea on their part – they actually went out and analysed data:
“…data from eight observational cohort studies and 11 randomized controlled trials that involved diabetes and measuring vitamin D…”
This (below) is enough of an explanation for me. I’m glad this subject came up, I for one will be trying to steer clear of HFCS. Nice work (2004) and the title says it all:
http://jcem.endojournals.org/content/89/6/2963.full.pdf+html
Dietary Fructose Reduces Circulating Insulin and Leptin, Attenuates Postprandial Suppression of Ghrelin, and Increases Triglycerides in Women.
KAREN L. TEFF etal The Journal of Clinical Endocrinology & Metabolism 89(6):2963–2972
People are obese because they eat too much crap passed off as food. Vegitalbe oil (industrial seed oils) and boxed processed foods like breakfast cereal. Just stick to Real Food not created in a lab (vegitables, meat, fish, some fruit and berries, olive oil and vinigar for dressing homemade, butter, and coconutoil, nuts) and you ‘ll be fine. Been doing this for 5 years and it works for me. Lost 30 lbs and cured a blood sugar problem.
And the vitamin D for health is not conjecture. See http://www.grassrootshealth.net/
There is some data that seems to implicate fructose as being problematic for some people. The data does not support the theory that sucrose cause the same problems. HFCS is essentially sucrose. As I pointed out before the “high fructose” part of the name was a result of the belief at the time (a fad like so many other fads) that since fructose was the sugar found in fruits it was thus “natural” and good. It was a marketing ploy for a new product. If you are unable to understand that HFCS is basically table sugar with enough water to make it a heavy syrup then you will (not “may”) for ever be afraid of it.
Sucrose is bad too, but because HFCS is cheap, it’s added to everything.
Many people have fructose malabsorption, which is lessened with added glucose, but the problems we’re talking about are with fructose metabolism, not absorption.
“sucrose is bad too”!! Why? Sucrose is made up of equal parts of glucose and fructose. it is pure energy to your body. The fructose is converted to glucose in your body and the glucose is what powers your muscles and brain. 100% of the carbohydrates you eat are converted to glucose to power your body. What part of that is “bad”???
“but because HFCS is cheap, it’s added to everything.” That is partly true. But equally important to food producers is that HFCS is in a liquid form that makes it much easier to use in their processing. The HFCS could have been dried and it would then crystalize into table sugar (sucrose). There is nothing magical or evil about HFCS it is essentially table sugar in syrup form.
If your arguement is that all sugar is bad then don’t eat fruits and vegetables.
Deja vu all over again
https://skepticblog.org/2011/07/25/whats-causing-the-obesity-epidemic/#comment-59581
I know that food producers like HFCS because it makes things cheaper and easier for them. Same reason they like artificial colors and flavors. Put them all together, and you get “blueberry” muffins that contain no blueberries.
Fruits are healthy despite the sugar. You could eat almost 3 cups of blueberries to get the same amount of sugar as in one can of Coke, but you’d also get about half the daily recommended fiber and vitamin C, plus other antioxidants.
Your comment “You could eat almost 3 cups of blueberries to get the same amount of sugar as in one can of Coke, but you’d also get about half the daily recommended fiber and vitamin C, plus other antioxidants.” really hits the mark but not for the reasons you might think. What you said was absolutely true. But suppose, like almost all Americans, your diet is more then adequate what then happens to all that fiber and vitamin C, etc.? Why it is pushed out the other end of course. Your arguement would be significant if our diet was missing the vitamins and minerals we need but if it is not then food becomes merely energy (true if you eat too much it becomes fat). So again my point is that can of coke doesn’t hurt you and to claim it is bad for you or poisonous or somehow shgortens your life etc is simply BS. That is the whole point: Eat a diverse and balanced diet and you can indeed pretty much eat what you want to. There are no bad foods but there are some bad diets. Stay away from fad diets and don’t listen to people who try to convince you that the latest fad will allow you to live forever.
Misstating the argument: “If your argument is that all sugar is bad then don’t eat fruits and vegetables.”
1. Excess sugar is bad. (not all)
2. Does not matter where it comes from.
2. It is open to debate as to whether some sugars are worse than others.
Excess anything is bad. It is subjective.
It is quite possible that some sugars are worse then others but far more likely that it is a definable individual health problem and not something that applies to everyone. Just as some people have a lactose intolerance others may have an intolerance to certain sugars. To try to advise people with normal health to avoid certain sugars would be as foolish as telling us all to avoid milk.
Excess water is bad. Excess anything is bad. So the first statement is pretty much meaningless.
Does it matter where it comes from? Absolutely! I will not eat sugar that comes from the toilet! DUH! Sucrose is sucrose. It is a chemical with a very exact chemical makeup. Once you have sucrose it cannot matter where it came from.
As for the second “2”: Possibly. I believe that it is possible that some people have a health problem such that fructose causes them problems. I also believe that there is a certain amount of “me too” when it comes to fad diseases with poorly defined symptoms. But it still comes down to if you have a health problem where eating a certain food or a certain diet is bad for you then don’t eat it!!! But the advice does not work the other way around, i.e. if you don’t have the health problem in question then not eating a certain food won’t protect make a difference.
I am not afraid of sugar or HFCS. I am not afraid of supermarket vegetables or refined foods. I don’t fear french fries or fast food. I am amused and befuddled by the many food biases out there. But I am even more amused by the rationalization people will stoop to in order to defend their particular biases.
Yes, we all have our biases and beliefs, largely based on our knowledge, experience, and the information and data we choose to believe.
However, in your own case, you simply call your biases/beliefs “facts”, not realising that they too are opinions.
“…I am not afraid of sugar or HFCS. I am not afraid of supermarket vegetables or refined foods. I don’t fear french fries or fast food. I am amused and befuddled by the many food biases out there….”
I am new to this website, so I hope I don’t offend any protocol. In the interest of avoiding personalities, I am addressing my comments to a rural female who has been a prolific contributor to this thread. I am surprised to find so much input lacking in critical thinking on a skeptic blog. To address just a few points:
– Obese people are obese because they have a genetic predisposition to obesity. Obesity is becoming a rapidly increasing problem as % of the total population. Therefore genetically predisposed people are becoming a higher % of the population. Therefore obesity predisposed people have a much larger propensity to reproduce than non obese people, or evolution is making another rapid leap causing non predisposed people to have predisposed offspring.
– Diabetes causes obesity, not the other way around. Therefore type 2 diabetics are secretly diabetic, without symptoms of diabetes before they become obese. When they lose sufficient weight, the symptoms disappear, but not the type 2 diabetes.
– American caloric intake has increased in parallel with increasing obesity. Therefore obesity is causing the increased caloric intake.
– Obesity is much more prevalent in some cities and states than others. Therefore a genetic predisposition to obesity is linked to some geographic preference.
– Obesity among Americans of French or Italian descent is much more common in the USA than it is among their counterparts in France or Italy. Therefore people with a predisposition to obesity are more likely to emigrate than those without the predisposition.
– People with a predisposition to obesity can only avoid obesity by subsisting on a starvation diet. Therefore, as long as they are not obese they are clearly suffering from starvation.
One could go on and on.
There is some probability that people are distributed along a spectrum of what I will call “meatbolic efficiency” for lack of another word, and people who become obese may usually have high metabolic efficency and therefore require fewer calories for a given weight and activity level. However, they do not become obese unless they consume more calories than they need. Period. Those lucky enough to have an inefficient metabolism can consume many more calories without weight gain. However they would probably be the first to die in a time of famine.
I think it is well accepted that the stomach sends signals of satiety to the brain when it receives some minimum level of food, but with a significant delay time. If one eats slowly, the brain gets the message before excess consumption takes place, assuming a stomach not greatly enlarged by obesity. If one eats too rapidly, one can easily eat too much before the brain gets the message. Obesity is a result of chronically eating too much, too fast.
At the personal level my constant weight daily caloric intake is only 60% of what is normally recommended by the average charts for my height, weight, gender, age and activity level. I have made a practise of eating slowly and little. I am not overweight, and show no signs of starvetion.
All of rural female’s rationalizations are simply a set of excuses for the undisciplined obese. That said our society promotes overeating in everything from billboard advertising, to putting the bakery goodies at the entrance of the supermarket, to huge restaurant portions, to oversized prepackaged food packages to etc, etc.
Murray, your attempt at parody fell short.
You are partly correct that there are more people in the U.S. with a propensity to be obese. It is common in Mexican and African American people and there are indeed more of them as a percentage today then there was in a previous baseline.
Your point that we consume more and some of us become obese is 100% accurate. That’s the point!! If you have the propensity to become obese and you have all the food you could want then you will become obese. However you and most others who post here failed to notice that most Americans are NOT obese and they too have all the food they could ever eat available to them. The simple reason is they do not have the genes that would make them or allow them to become obese.
Most people with diabetes do not discover it until they are adults. Most of them discover it when they go to a doctor with a specific complaint, like obesity. The doctor recognizes the symptoms and the family history so they test for diabetes. At this point it is common for them to think, “gee, I didn’t have diabetes until I got fat and now I have it so getting fat gave me diabetes”. So common in fact that even some doctors will believe this but they should know better. The truth is they had diabetes from birth and eventually either because of diet, lifestyle, aging or bad luck they become symptomatic. Then they discover that a specific diet and excercise will help their condition. In fact for many diet and excercise will eliminate their symptoms and allow them to live a fairly normal life. So suddenly it is clear that a bad diet “gave” them diabetes and a good diet made it go away. the only problem is it isn’t true. They are still diabetic and it will likely be the cause or major factor in their death someday, they are merely keeping the symptoms at bay.
I can assure you if you do not have diabetes eating big restaurant portions and bakery goodies won’t give it to you.
If you are consuming 60% of the recommended calories then you are on a fad diet. Good luck with your experiment.
There are so many holes in your arguments! First, where is your scientific evidence? This blog supports strongly the idea of science based medicine. Science based medicine says that obesity causes type 2 diabetes. Please provide your contrary reference.
Through evolution, faced frequently with food shortage, those of our progenitors who survived were those who could get along on the least food. Except for a few genetic throwbacks we all have a predisposition to obesity, but as you point out, the majority of us don’t become obese, so the predisposition is not the cause, it is merely an enabler.
Most Europeans also have all the food they want also, but obesity is far less prevalent. They have a long culture and tradition of eating less and enjoying it more.
Way back in the early 1960s when I travelled frequently to Taiwan and Hong Kong, you never saw Chinese children who were even overweight, let alone obese. Now they have Coke, and Pepsi, and MacDonalds, and KFC and Fritolay etc, and plump children are quite common. They didn’t suddenly develop a predisposition to obesity.
You don’t believe that obesity is on a major increase among “whites”. What planet are you on?
No, I am not on a fad diet. I eat a normal diet, but I eat less and enjoy it more. Its not hard to do, and it avoids all of the discomforts and illnesses of obesity.
The only point you have right is that obesity is enabled by the fact that we have more food available than we need.
The biggest problem I have with the obese is that they are by far the major cause of our Medicare cost problem, which you can confirm for yourself by a little googling (but you won’t), and it bothers me that their selfish self indulgence puts an undue cost on the rest of us, threatens to reduce our benefits unnecessarily, and demands no extra payment from them.
Believe what you will, but the only cause of obesity is chronically taking in more calories than you need.
The tragedy is that for those who are obese at a young age, they do have a problem, almost an inpossibility, to control their weight as adults and we are creating an epidemic of obese children. The children have neither the knowledge, the foresight, the motivation or the willpower to prevent that from happening. They develop obesity as a result of irresponsible parents and amoral food purveyors.
They grow up handicapped with an inability to enjoy life to its fullest, an assurance of discomfort and illness that was avoidable, and a short life expectancy. If people consciously inflicted such harm on there children by any other means they would be treated as criminals. But your kind excuse it as some kind of inevitability. For shame!!
Diabetes is inheirited not a result of eating too much. It is simply a fact that for most people who have diabetes the first time they discover it is after their eating habits make their symptoms worse. Science in fact agrees with this.
You could not be more wrong. We do not all have a propensity for obesity and you can prove that any day with facts on the ground. Most people are not obese and most people eat whatever they want to eat. Obese people in general cannot lose their excess weight no matter how hard they try. They are often abel to lose weight on a starvation diet but invariably put it back on within five years.
Obesity in Europe is quite similar to obesity among Americans of European descent.
Most Chinese do not have good access to food but they do have some obesity and it is growing. Mao was obese and that was years ago. I don’t think he ate at McDonalds.
Obesity statistically is on the rise. Partly because of a change in the way we define it about 1998. That change made Mel Gibson obese (by definition) overnight.
You clearly don’t know what a fad diet is. Choosing to eat 60% of your calories is a fad. Good luck.
People with diabetes are 2.5 times more likely to die of a heart attack. Perhaps you should attack them for increasing medicare costs.
If overeating caused obesity we would all be obese. While it is technically true that an obese person takes in more calories then they use it is an incredibly ignorant assessment of the problem. An obese person takes in more calories then they use because their genes force them to. It is indeed an old survival trait that was created by thousands of years of famines and inferior food supplies. It is genetic.
Children of the obese will be obese. I suppose that statists will succeed in kidnapping these children from their parents and raising them in a McDonalds free environment. So the reslut will be that 20-30 years from now these children of the obese who were taken from their parents will once they become adults achieve the weight their genes predict. What will your arguement be then???
Diabetes is a disease, not a definition of a certain genetic make up.
A disease is defined by clinical symptoms. Those who have a genetic predisposition to this disease, may show clinical symptoms if they are on a certain diet, and sometimes are able to eliminate those symptoms by changing their diet.
At that point they no longer have the clinical symptoms of the disease, but their genetic make-up remains the same.
And, this genetic predisposition is very complicated. Some studies show other risk factors to be better predictors of diabetes.
Study Suggests Non-Genetic Factors are Better Type 2 Diabetes Risk Predictors than Genetics
“…5,135 participants … for a median period of 11.7 years, starting between 1985 and 1988…”
http://www.genomeweb.com/node/931552?hq_e=el&hq_m=597431&hq_l=1&hq_v=801ab16e2f
“…The Cambridge model had 19.7 percent sensitivity for detecting type 2 diabetes cases in the Whitehall cohort based on a five percent false positive rate, while the Framingham model had 30.6 percent sensitivity. The gene count score, meanwhile, detected 6.5 percent of cases at a five percent false positive rate and 9.9 percent of cases at a 10 percent false positive rate…”
diabetes is indeed a disease. It is also passed along through your genes. If you have diabetes you may or may not have obvious symptoms but you still have the disease. It can be managed through diet, excercise and lifestyle. It is not always the same in all people and it is progressive in that it tends to get worse as you age. The majority of people who are diabetic are unaware they are diabetic. As they age and the symptoms begin to be more obvious one or more of the symptoms usually brings them to a doctor where they are diagnosed. If you do not have the disease then eating sugar, junk food or getting obese will not give you diabetes. If you do have the disease then eating sugar, junk food or getting obese will make your symptoms worse. This is why so many people think that eating sugar, junk food or getting obese “causes” diabetes. You can argue about this all day long it won’t change the facts.
I have a friend with sickle cell anemia. It is genetic. He didn’t know he had it until he was in his 30’s. He is in his 60’s now and this disease causes the medicare system considerable expense. His complications are serious and his life expectancy is not good. It was not caused by his diet or his lifestyle. It is genetic like so many diseases.
Sickle cell anaemia is one of the simplest examples of a heritable disease. A simple recessive gene.
If you have one copy of the gene, you don’t have the disease. If you inherited a copy from each of your parents, you will have the disease.
“Propensity to become obese” or “Propensity to become diabetic” are traits not governed by a single gene pair.
In this survey
http://www.genomeweb.com/node/931552?hq_e=el&hq_m=597431&hq_l=1&hq_v=801ab16e2f
the researchers monitored 20 different alleles, and were still only able to predict diabetes type II occurrence with a 6.5% sensitivity.
Countrygirl said :
“If overeating caused obesity we would all be obese.”
False. Some people have a different genetic makeup, and are less likely to gain weight in spite of high energy intakes.
Yeah Countrygirl doesn’t seem to have much in the way of information to back any of her claims up, which is really quite annoying.
“We do not all have a propensity for obesity and you can prove that any day with facts on the ground.” -let’s see it.
“Obese people in general cannot lose their excess weight no matter how hard they try.” – you have a link for this?
“Most Chinese do not have good access to food ” – really?
“You clearly don’t know what a fad diet is. Choosing to eat 60% of your calories is a fad. Good luck.” – if someone doesn’t manage to eat their ‘2000’ calories per day, it’s a fad diet to you? Wow.
“An obese person takes in more calories then they use because their genes force them to.” – again, really? You have any links for this one either?
“Children of the obese will be obese.” – this one was the best. Links please.
After reading most of your posts Countrygirl i realize that for the most part you are just trolling, especially with the ‘you couldn’t me more wrong’ attitude while not actually backing up anything you’re saying. Most of the other posters on here actually spend time looking up answers, you just seem to be pretty hell bent on (pardon the pun) – having it your way. I mean, take something as goofy as ‘the biggest loser’ on TV. Although I don’t watch it every season, I do see some people who eat for psychological reasons (death in the family, emotional issues, etc). They talk about how they eat for comfort, etc. And in turn they become obese. But maybe we’re all wrong and you’re right. I dunno.
All good points CJG.
Exactly!! Some people have a different genetic makup!!! That’s what I’ve been saying all along.
You seem to contend that there is a single switch involved in obesity. People either have “that gene” and will become obese if they consume energy in excess of their requirements, or don’t, and can therefore eat whatever they like, and will never become obese.
Whereas there are probably a very wide range of factors involved in obesity, some of which are genetic, but even these may be switched on or off by external (environmental) factors.
Given a large group of people, and control over the proportions of energy, protein and fibre in their diets, and their level of physical activity, we could push that whole group towards obesity if we so wished. That does not mean every single person will gain (for example) exactly 10 kg of fat. I would expect the degree of weight gain to fit a normal curve: Some would gain a massive amount; some would gain a moderate amount, etc., right down to those few individuals who would gain nil. This, of course, would be governed by their genetic makeup, and their appetite.
Overall, with greater energy intake, lower protein intake, and restricted exercise, the whole population would become fatter. A greater number of people in that group would become obese.
Not a “single switch”. In fact it is probably two or more different things.
I’d suspect genetic factors behind obesity to be far more complex than diabetes type II, and that is very complicated.
As noted in comments above, researchers monitoring 20 alleles believed to be associated with Diabetes Type II were only able to predict the disease with a 6.5% sensitivity: (5,135 participants over a median period of 11.7 years)
http://www.genomeweb.com/node/931552?hq_e=el&hq_m=597431&hq_l=1&hq_v=801ab16e2f
“…Exactly!! Some people have a different genetic make-up!!! That’s what I’ve been saying all along….”
Yep, and this difference in genetic make-up will fit a normal curve (should you find a way to quantify it)
Propensity to gain weight will also fit a normal curve.
Yep, and given enough of an excess of carbs (energy intake) and a reduction in exercise, most of a group (not all!) will gain weight, and a greater proportion will become obese.
(Ref: discussion in original posting by Steven Novella)
“However, if book sales are any indication, millions of people tried low-carb diets, and they do not appear to have struck upon the secret of easy weight loss.”
I’ve lost 50 lbs on low-carb…and I can still eat large quantities of food and not gain anything because of it. Its not an easy diet to stick to though…everything has high fructose corn syrup, sugar, or some other type of carbohydrate. Starting out was rough because sugar is addicting. I had to get use to unsweetened tea and coffee, not drinking sodas, staying away from quick microwave foods. I’ve been doing it for over a year and I maintain my weight. I can pig out on carbs for a week and not gain anything. A lot of people just don’t have the will power to stay low-carb when the entire world around them is high carb.
An interesting aside:
Re high protein diets:
Nutrition in pigs is very well explored and measured.
We can precisely determine the various nutritional requirements for different genotypes, and feed them to make them grow most efficiently, and to achieve a targeted amount of muscle and fat.
We formulate to a lysine/energy ratio (which is a bit of a misnomer, it is really an amino acid/energy ratio, but all the amino acid components of the diet are provided as a ratio to lysine, so lysine is used as the reference. Plus we end up with a ratio of grams of digestible lysine to megajoules of energy (or calories, if you are American) – a slightly clumsy measure).
But, once we have established (via trials) the optimum requirements for that genotype, we can push them towards fatness by decreasing the lysine:energy ratio. (less protein, more energy)
Furthermore, we also know that they will become leaner (measured by back-fat, or in more precise trials, fat dissection of carcasses) and less feed efficient if we increase the Lysine/energy ratio.
Of course, there are minor differences in genetic make-up even across a defined genotype (breed) and not all animals respond in precisely the same manner. The data tends to fit a normal distribution curve. (I should not have to make this statement, but feel I must).
The mechanism is known, the body will excrete this excess protein – and de-aminating protein and excreting nitrogen takes energy.
My point – it is interesting that the body fat reducing potential of high protein diets in humans was debated for so long, when there is good evidence out there.
(One important proviso, however – the pig work is primarily done in the adolescent stage of growth – production animals are sold at the point of sexual maturity. The mechanism still applies after maturity).
But, to clarify – if you are daily consuming a massive excess of energy, adding couple of steaks to the mix and continuing the same energy intake will very likely not make a measurable difference to your obesity problem. High protein diets help because they are filling (slow digestion, and more heat is generated by the process of digestion and de-animation).
The pig work, in contrast, is pretty finely balanced. ;-)
correction above – de-amination not de-animation!
De-animation works pretty well for weight loss too,I have heard ;)
Ha ha! Yep, that’ll work every time!
The evolutionary story is perhaps pretty simple.
Some of our more monkey-like ancestors probably sought out fruits, because their taste-buds favoured the sweetness of fructose (by the way, have you ever been in a lab that ran out of sugar (for the coffee!) and have gone and go some glucose for a quick substitute? – One teaspoon of glucose in your coffee can hardly be noticed – it is must be the fructose component our taste buds are after!).
Those who liked fruits, put on a bit more fat, so more of them, and less of their non-sweet-tooth brethren, survived the next hard time.
Eventually, the vast majorty of the population became primed for the ‘fructose taste’. Our problems arose with our discovery of the process of refining sugar (sugar cane and sugar beet were just too full of fibre to ever gorge on!).
So now, instead of slowly released glucose from complex carbohydrates prompting a trickle of insulin, and occasional fructose feasts (fruits = seasonal!) being stored away as abdominal fats, we can now overload our insulin secretion mechanisms every day, and also get a daily overload of fructose.
I guess the type II diabetes story is a ‘negative evolutionary consequence’ – that ability to quickly store a bit of energy is no longer an advantage, and the system had not developed to cope with constant insulin spikes.
Corporate food producers are in the business of growing their revenues by at least 5% a year (producing a healthy meal has not traditionally been high on their list of motivations). I suspect they fully understand the ‘addictiveness’ of sweetness, and this, combined with the fact that sugar has been a particularly cheap commodity for decades, means they have been adding it wherever they can.
Fructose is much, much sweeter than glucose. Fructose can only be initially metabolized in the liver resulting in the production of some undesirable metabolites like uric acide, which in turn promotes gout.
The way food companies study and take advantage of food addition was documented in the book “The end of overeating” which has been mentioned before. Not surprisingly they are the same companies that understood addiction to cigarrettes.
Thanks Somite – I really appreciated your early posts on this, re the pathways of fructose metabolism – something I was not aware of. Which is quite amazing when you consider what a huge part of our diet it has now become.
I’d love to run an energy balanced trial on pigs, using a sugar based diet vs a grain based diet (ie balanced for energy and amino acids and all other components). We have run high sugar diets in young pigs on occasion (commercially) simply because sometimes batches were available cheaply, and the computer formulation would pull it in. (Based on our specification assumptions that energy is energy).
But I now suspect if we closely monitored abdominal fat and other fat in older slaughter age pigs (assuming pigs process fructose as people do) we’d find an increase due to the fructose component.
Easy trial to do, but I don’t know who’d fund it.
I’ll check that book out, too.
Anytime marke. Nutrition was one of my favorite classes at vet school.
If “healthy” meals would sell they would certainly produce them. Some fast food outlets have introduced so-called “healthy” meals and most of it gets thrown out, people don’t want it. Odds are that whatever it is you think is healthy doesn’t taste very good.
Recent PRI article and audio on “How fast food rewires our brains”
http://www.pri.org/stories/health/how-fast-food-rewires-our-brains5456.html
The history of the American tradition of popcorn at the movies.
http://live.gourmet.com/2011/02/the-history-of-popcorn-the-movies/
Other places don’t have that. You might eat a sandwich during intermission at a play, but you don’t sit there eating popcorn and candy and washing it down with soda.