Category Archives: Overweight & Obesity

h/t Bustednuckles

Nuff said.

Steve Parker, M.D.

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An article in the Journal of the Academy of Nutrition and Dietetics found an association between overweight/obesity and consumption of ultra–processed foods in U.S. adolescents.

The study looked at 3,600 adolescents who reported their food intake over a 24-hour period. The results are pretty strong: the more ultra-processed food consumed, the greater the odds of overweight and obesity.

Jan at The Low Carb Diabetic blog reported that:

Ultra-processed foods make up ‘two-thirds of calories consumed by children and teens’
Experts from Tufts University in Massachusetts studied two decades of dietary data to 2018 and found that the amount of calories young people consumed from ultra-processed foods jumped from 61 per cent to 67 per cent.

I’m not paying for the JAND scientific report so I don’t know how they defined ultra-processed foods. The definition varies quite a bit over time, by researcher, and by research goals. From the U.S. National Library of Medicine:

The definitions [of ultra-processed foods] used in 2009, 2010, 2012, 2014, and 2016a represent the definitions used from publications devoted solely to that purpose and are heavily referenced in the literature on ultra-processed foods. The definitions used in years 2015, 2016b, and 2017 are from articles that focused on the relation between ultra-processed food intake and public health nutrition, in which definitions of ultra-processed foods are presented in detail in the article. The first definition alludes mainly to the use of both food additives and salt in food products (6). The second introduces the putative impact of ultra-processed foods on accessibility, convenience, and palatability of ultra-processed foods (8). Subsequently, the definitions become longer and include more elements. Thus, the third definition builds on previous definitions but introduces 2 new angles (9). One is the nonavailability of ingredients used in ultra-processed foods from retail outlets such as supermarkets, and the second introduces food additives as the most widely used ingredients, in numerical terms, in the manufacture of ultra-processed foods. The next definition now introduces the role of food fortification as a defining element of ultra-processed foods (4). Further definitions introduce new elements such as the importance of foods synthesized in a laboratory, based on organic materials such as oil- and coal-based additives and flavoring compounds (10), a specification for the minimal number of ingredients to be found in these foods (5), and then an emphasis on the inclusion of salt, sugars, oils, and fats as a starting point for defining ultra-processed foods. This definition gives details of specific categories of food additives and highlights how the intended use of these additives is to imitate sensory qualities of fresh or minimally processed foods (group 1) or to specifically disguise undesirable qualities of ultra-processed foods (11). The final definition from 2017 (12) is quite similar to that used in the 2016b publication (11).

If you want to dive deep, you can download a list of ultra-processed food examples from that NLM article. I didn’t. But I figure the way to avoid over-processed foods is to eat food closer to the way God made it rather than man-made.

Steve Parker, M.D.

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From the Journal of Obesity:

…. 10-year weight gain is substantially greater in US women compared to men. On average (±SE), women gained 5.4 ± 0.3 kg and 9.2 ± 0.4 percent of their initial weight over the previous 10 years, whereas men gained 2.6 ± 0.2 kg and 3.8 ± 0.3 percent of their initial weight. In general, compared to US men, women gained about twice as much weight (kg) and 2.4 times more weight expressed as a percent of initial weight, over the previous 10 years. Fourth, 10-year weight gain is significantly higher in Non-Hispanic Blacks than in other racial groups, especially NH [non-Hispanic] Black women. Moreover, 10-year weight gain is significantly lower in Non-Hispanic Asians compared to other racial categories.

If you think in pounds instead of kilograms, like me, note that 1 kg = 2.2 lb.

Since 2000, U.S. obesity in adults has increased from 30% to 42% of the population. This doesn’t even include suspected pandemic-related weight gain.

Mean 10-year weight gain was 4.2 ± 0.2 kg or 6.6 ± 0.2% of initial body weight within the United States. 

The incidence of severe obesity had increased from 5% in 2000 to almost 10% now. (The article likely defines “severe obesity” but I didn’t catch it in my quick scan.)

Not enough Americans are reading and implementing my Advanced Mediterranean Diet!

Steve Parker, M.D.

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Not Kevin Hall

At Scientific American:

Nutrition researcher Kevin Hall strives to project a Zen-like state of equanimity. In his often contentious field, he says he is more bemused than frustrated by the tendency of other scientists to “cling to pet theories despite overwhelming evidence that they are mistaken.” Some of these experts, he tells me with a sly smile, “have a fascinating ability to rationalize away studies that don’t support their views.”

Among those views is the idea that particular nutrients such as fats, carbs or sugars are to blame for our alarming obesity pandemic. (Globally the prevalence of obesity nearly tripled between 1975 and 2016, according to the World Health Organization. The rise accompanies related health threats that include heart disease and diabetes.) But Hall, who works at the National Institute of Diabetes and Digestive and Kidney Diseases, where he runs the Integrative Physiology section, has run experiments that point fingers at a different culprit. His studies suggest that a dramatic shift in how we make the food we eat—pulling ingredients apart and then reconstituting them into things like frosted snack cakes and ready-to-eat meals from the supermarket freezer—bears the brunt of the blame. This “ultraprocessed” food, he and a growing number of other scientists think, disrupts gut-brain signals that normally tell us that we have had enough, and this failed signaling leads to overeating.

*  *  *

At the end of the 19th century, most Americans lived in rural areas, and nearly half made their living on farms, where fresh or only lightly processed food was the norm. Today most Americans live in cities and buy rather than grow their food, increasingly in ready-to-eat form. An estimated 58 percent of the calories we consume and nearly 90 percent of all added sugars come from industrial food formulations made up mostly or entirely of ingredients—whether nutrients, fiber or chemical additives—that are not found in a similar form and combination in nature. These are the ultraprocessed foods, and they range from junk food such as chips, sugary breakfast cereals, candy, soda and mass-manufactured pastries to what might seem like benign or even healthful products such as commercial breads, processed meats, flavored yogurts and energy bars.

Wasn’t David Kessler, M.D., saying the same things ten years ago?

Here’s another new theory from me: If you had to kill and butcher your own animals, you’d eat less.

Steve Parker, M.D.

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…in an article at The Guardian. He thinks the trend start in 1976.

Why?

So what has happened? The light begins to dawn when you look at the nutrition figures in more detail. Yes, we ate more in 1976, but differently. Today, we buy half as much fresh milk per person, but five times more yoghurt, three times more ice cream and – wait for it – 39 times as many dairy desserts. We buy half as many eggs as in 1976, but a third more breakfast cereals and twice the cereal snacks; half the total potatoes, but three times the crisps. While our direct purchases of sugar have sharply declined, the sugar we consume in drinks and confectionery is likely to have rocketed (there are purchase numbers only from 1992, at which point they were rising rapidly. Perhaps, as we consumed just 9kcal a day in the form of drinks in 1976, no one thought the numbers were worth collecting.) In other words, the opportunities to load our food with sugar have boomed. As some experts have long proposed, this seems to be the issue.

Source: We’re in a new age of obesity. How did it happen? You’d be surprised | George Monbiot | Opinion | The Guardian

Contrary to the above, we in the U.S. have been eating significantly more calories over the last 50 years. I’m surprised George didn’t mention the dramatic increase in industrial seed oil consumption over same time frame.

The problem cannot be reduced to sugar consumption alone.

Steve Parker, M.D.

Your average Americans

There’s no shortage of speculation as to why 70% of us in the U.S. are overweight or obese. A few possibilities include:

• we’re too sedentary
• we eat too many carbohydrates
• we eat too much fat
• our foods are over-processed
• we eat away from home too often
• we eat too many industrial seed oils
• our water and food are contaminated with persistent organic pollutants that disrupt our endocrine systems

I was reading an article at Nutrition Today and came across this graph of calorie consumption change from 1971 to 2004 (or 2000?):

The verbal summary is from this article cited by the cited by the Nutrition Today authors: During 1971—2000, a statistically significant increase in average energy intake occurred. For men, average energy intake increased from 2,450 kcals to 2,618 kcals, and for women, from 1,542 kcals to 1,877 kcals. So men’s daily calorie intake went up by 168, and women’s by 335.

The original article I read states, alternatively, that men’s daily caloric consumption rose from 2450 to 2693, a gain of 243. I can’t explain the discrepancy between 243 and 168, nor why 2004 is in the graph instead of 2000.

Maybe you don’t think an extra 168 calories a day is much. If you believe in the validity of the Energy Balance Equation, those 168 daily calories will turn into  17.5 pounds of fat in a year unless you “burn them off” somehow. If you weigh 150 lb (68 kg), you can burn those 168 calories by doing a daily 15-minute jog at 5.5 mph (8.9 km/hr). But you ain’t gonna do that. (I’m not getting into a debate about validity of the equation now; for another perspective, read Lyle McDonald.)

But year 2000 was a long time ago. How much are Americans eating now? According to a 2016 report from Pew Research Center:

Broadly speaking, we eat a lot more than we used to: The average American consumed 2,481 calories a day in 2010, about 23% more than in 1970. That’s more than most adults need to maintain their current weight, according to the Mayo Clinic’s calorie calculator. (A 40-year-old man of average height and weight who’s moderately active, for instance, needs 2,400 calories; a 40-year-old woman with corresponding characteristics needs 1,850 calories.)

Bottom line? We’re eating more than we did in 1970. Which could explain why we’re fat. Unless we’re burning more calories than we did in 1970. Which I doubt.

Steve Parker, M.D.

PS: In scientific literature, kcal is what everybody else calls a calorie.

I heard about this phenomenon years ago. It’s good to remember that obesity isn’t a simple straightforward process. Like Fanatic Cook, I wonder about pollution as a cause.

“A dramatic rise in obesity has occurred among humans within the last several decades. Little is known about whether similar increases in obesity have occurred in animals inhabiting human-influenced environments. We examined samples collectively consisting of over 20 000 animals from 24 populations (12 divided separately into males and females) of animals representing eight species living with or around humans in industrialized societies. In all populations, the estimated coefficient for the trend of body weight over time was positive (i.e. increasing). The probability of all trends being in the same direction by chance is 1.2 × 10 [to the minus 7th power]. Surprisingly, we find that over the past several decades, average mid-life body weights have risen among primates and rodents living in research colonies, as well as among feral rodents and domestic dogs and cats. The consistency of these findings among animals living in varying environments, suggests the intriguing possibility that the aetiology of increasing body weight may involve several as-of-yet unidentified and/or poorly understood factors (e.g. viral pathogens, epigenetic factors). This finding may eventually enhance the discovery and fuller elucidation of other factors that have contributed to the recent rise in obesity rates.”

Source: Canaries in the coal mine: a cross-species analysis of the plurality of obesity epidemics