Are the Treatment and Prevention of Obesity Different Problems?
When I visited the Pacific island of Nauru in the early 1980s it was populated by the kind of human mastodons who have since become extremely common in the United States and elsewhere. Half of the Nauruans were diabetic, the reason being a combination of genetic propensity, physical inactivity, and a taste for sweet drinks such as Fanta and Chateau Yquem, which they drank in vast quantities. Life expectancy was very low.
A recent edition of the New England Journal of Medicine is largely devoted to the relation of sweet drinks to obesity. It reports, for example, a controlled trial in Holland in which children were divided randomly into two groups, those who received sugar-sweetened drinks and those who received non-calorifically sweetened drinks. The children were aged between 4 and 11, and the parents gave their consent, the children their “assent,” to the experiment, which lasted on average 18 months.
After 18 months, the children who had drunk sugar-sweetened drinks had put on a kilo (2.2 pounds) of weight by comparison with those who had drunk similar quantities of artificially sweetened drinks. Those who had drunk the sugar-sweetened drinks had grown slightly but statistically significantly taller than those who had drunk the artificially sweetened drinks (the Dutch, incidentally, are now the tallest people in the world); when adjusted for the difference in height, the sugar-sweetened drinks accounted for 0.8 kilos (1.7 pounds) of the weight gain.
These results are important for the United States, because the quantities of sweet drinks consumed in the Dutch trial were far lower than those consumed, on average, by American children. They will give some comfort to Mayor Bloomberg in his campaign against sugar-sweetened drinks.
Children used to walk to local schools, play during morning, lunch and afternoon recess, then walk home. After school they often engaged in unsupervised outdoor play. Today they are most often driven or bused to schools that no longer hold recess. After school they watch TV or play video games. We have even heard of parents have had to cops called on them for letting their children be outside with a parent hovering over their every move. Is it an surprise so many are overweight?
Bingo, NC Mountain Girl!
What parents need to do (the gubmint should keep its big fat nose out of it!) is take away all the electronic games, give the kids plenty of chores to do that are physically challenging, and encourage physical play. Problem solved.
If I had fat kids, I would allow them one electronic toy or time waster only, that would be the Wii, and then only buy the games like boxing or tennis.
Mtn Grl, please read Gary Taubes, ” Why We Get Fat”, the same thing that is happening today with Climate Science happened in the sixties with Dirtary Science. Since the middle of the 19th century it has been known that the only way to loose weight is to reduce flower and sugars.
@NC Mountain Girl,
You’re right. Kids these days are raised in small cages, like veal.
It’s the nanny state itself that has largely caused this problem.
More homeschooling is the answer!
See: http://1389blog.com/2012/09/26/we-are-hungry-americas-kids-rebel-against-moochelles-stingy-school-lunches/
Homeschooling dittoes. Hot lunches, running around after lunch, low viral load. And those are just the physical health benefits! It’s the last bastion of true freedom!
Isn’t that height difference surprising and possibly troubling, if you like taller children. I mean troubling if you want to argue for less sugar. I’d want to see the data, if one or two outliers influenced the averages. I’d want to see the whole thing replicated.
When I was a kid, I doubt if drinking an extra cup of sugary soda per day was going to make any difference to a kid’s weight, we got tons more exercise and most had no tendency to fat in any case.
Exsqueeze me, what was the question? Something about treatment versus prevention of obesity. I dunno. As an aging guy whose weight has shifted down to where I want to lose it now, and it doesn’t want to go, well there are many mysteries to life, I guess. I doubt if I eat a third of the calories that I averaged for my first forty-plus years, yet the ten pounds or so I’d like to lose now, stay with me stubbornly. Haven’t had a sugary drink in ten years. Oh, well, I sometimes spritz the iced tea with a little Sprite at the fountain, really for the bubbles.
I am in my fifties. I eat something like one-third of the calories I ate in my twenties; I don’t drink sugar drinks at all, rarely drink juices because of the sugar content and have no interest in cookies, cakes and such. I am still 60 pounds heavier than I was that, with a much higher percentage of body fat, partly due to metabolic problems and partly to the normal shifts to more intellectual, sedentary interests as I get older. If I cut my intake significantly, my energy will go down to the point all I can do is lay in bed, which will cause me to be fatter.
One-size-fits-all medicine is ridiculous, and trying to legislate diets based on statistics is saying “it’s okay if this kills you, as long as it has the result we want.”
“How long will it be before it tells us what we must eat and drink?” well, at this point, people in North Carolina have to meet certain criteria for lunches they give their kids to take to school, and if they don’t meet the proportions and restrictions set up, the lunch they provided their children has been discarded and a lunch of the schools choosing will be “provided” for them (ie one case where the child’s homemade turkey sandwich was discarded for government-approved chicken nuggets).
“If I cut my intake significantly, my energy will go down to the point all I can do is lay in bed, which will cause me to be fatter.”
Dude, you need to read that Gary Taubes book, STAT.
You got cassic obesity syndrome. Cutting your intake is not enough. The body responds by making you sedentary. In fact, you need to EAT MORE. You are just eating the wrong stuff!
I weigh less now, at 50, then I did as a twenty year old.
Kill it with a spear, dig it up with a stick, or don’t eat it.
I was born in the 50′s and we never had soft drinks. Well, maybe 1x a year at a birthday party or something. Milk for breakfast, lunch, after school snack, and for dinner. It was full fat milk too, and we never got fat.
The United States already spends 40% MORE than it earns, owes $16 trillion in debt and is in the process of slowly printing it’s currency to death via endless QE.
I wonder what will give out first –
1) The American people finally forcing the government to stop growing or
2) Total economic collapse making government smaller as it no longer has the money to fund ANYTHING including food stamps, SS, Medicare, Medicaid, Defence…
The smart money is betting on 2…
My grown children, who are all in good shape, rarely consumed sodas or juice as children. Nearly all of their friends who did consume those on a regular basis either were, still are or became overweight. My kids often point out that all those overweight friends were also the kids who road around in those battery operated minature cars, jeeps or trucks that my kids never had. Coincidence? Probably not.
Re: “But how harmful does something have to be, and how immediate the harm, before the government has the right and indeed the duty to step in?” I hate to quibble with an Englishman about language but governments do not have “rights.” Governments have powers (the source varies). The sentence should be: “But how harmful does something have to be, and how immediate the harm, before it is a proper exercise of government power to step in?”
The cause of the obesity epidemic is the excessive number of carbohydrates in our diet. Since mid-century we’ve been replacing other macro-nutrients (fat and protein) with carbohydrates. Prior generations got the majority of calories from saturated fat (animal fat). Since Ancel Keys successfully and fraudulently vilified saturated fat we’ve gone “low-fat” replacing the high fat products in our diet (butter, full fat milk, bacon, eggs) with lower fat versions. An excess of carbs spike blood sugar causing insulin to be released. Insulin signals our body that we’re still hungry – then we eat more. When consumed fat releases the hormone lipid which signals satiety.
The culprit isn’t just sugar; it’s sugar in combination with other high carb foods (bread, rice, pasta, potatoes) eaten in large quantities. Increase the amount of fat and protein in your diet; decrease the amount of carbs – lose weight. Dr. Atkins knew this 50 years ago.
You appear to be a true believer. And, OMG, you’ve read a book!! Good job. Being fat is about eating too much. Eating in excess of what your bodys’ energy requirement is. If you eat too much, the excess fuel is stored as fat. If you eat too little, your body mobilizes its energy reserves, i.e. fat. I can recall only one guy who beat the system, ate whatever pleased him, considered breathing aerobic exercise, but managed to lose 117 pounds of ugly fat in three months; he divorced his wife. That’s how long it took for the divorce decree to become final.
“Being fat is about eating too much. Eating in excess of what your bodys’ energy requirement is. If you eat too much, the excess fuel is stored as fat. If you eat too little, your body mobilizes its energy reserves, i.e. fat. ”
Wrong.
Your body is not a car. It’s a body. You are not a machine. You are a biological organism.
Food is NOT fuel, and fat is not in response to “too much food”. In fact, some of the fattest people in the world, suffer from too LITTLE food.
Obesity is a growth disorder, caused by the endocrine system being driven out of whack by the crappy modern faux diet. Yes, I have “read a book”. I have read quite a few books.
What can I say? There’s a sucker born every minute.
Spot on!! Your body is an intergalactic spaceship, roaming distant galaxies in search of renewable biofuels (wind power didn’t work out because of the flatus problem). And then there was the case of the 325 pound Tibetan recluse who lived on but three cups of water and six raw yams, who continued to gain weight. These freakish things happen now and again. ps- I’d drop the root beer.
Dutch have a high fat, high cheese, pork, fish diet. Like we did before Surgeon General did the food pyramid to grains and starches, away from fats and meats. Another thing the doo gooder government fuged up and made worse. Bring on Obamacare!
I really wish someone would address sweet tea as a sweet drink! It’s exactly the same calorie content and sugar content as soda and yet it never seems to get addressed. Can you still get ginormous sweet teas at theatres in NYC? (Not that they even know what sweet tea is up there). The only saving grace is probably the antioxidant value of black tea preparation, if it’s done correctly. Also while I am ranting I have to say that I think the USDA’s decision to remove chocolate milk from school offerings is wrong. I know it’s higher in calories but it seems to be a good way to encourage children to get the benefits of dairy and even the benefits of cocoa, if made with cocoa (was it? Who knows?)
I give my daughter whole milk with a sprinkle of Ovaltine to get her to drink it. She is at a good weight now, but we got in this habit because she was underweight and I figured any way to get it in her would be good. I think she may have my husband’s genes. He has trouble keeping weight on him. She is also a very picky eater, so I try to focus on foods that have high density nutrition. She would eat fruit all day if I let her. Getting her to eat meat is almost impossible.
Aspartame gives me severe headaches. It is a fact that it is bad for me. I know this is not a scientific conclusion, but it does not mean that it is not true.
It’s easy to blame one product that seems to be in everyone’s hands as the culprit, but something happened 50 years ago that changed everything; women left the home and went to work somewhere else. When women left the kitchen, fast food appeared on the dinner table.
French fries can be made at home, but it’s a long process. A stop at the drive-thru window can bring immediate bags of fatty, greasy and oh, so good fries to the diner. Pizza, once an ethnic treat at parties, became the basis for dinner and all it required was a phone call and someone to answer the door.
The roasted chicken that used to be Sunday dinner suddenly became an everyday fried food sensation.
Women who used to have time to make a healthy beef stew or a roast chicken, now had to come up with fast and filling meals from commercial outlets. When oatmeal and scrambled eggs became too time consuming for breakfast, the hands reached out for sugared cereals and breakfast pastries.
We learned to love the sweet or salty, fatty foods that are so convienent and cheap.
Bingo.
And now noone even knows how to cook.
I do not know one woman who is my peer in the kitchen, or is even close. I never open a can, never use prepackaged foods, everything from scratch (or as nearly as one can get).
Lately I’ve been teaching women to bake bread. They are amazed to find how simple it is, and cost-effective, if one buys the flour from the right places. Over $5 a loaf for decent bread?
PLEASE!
All these dopey yuppies with Kitchen-aid mixers that do all the work, and they never even turn them on. They have $50,000 kitchens and always eat out.
Fools. We’re simply surrounded by them.
Yah, they put up some new apartments right in back of mine, with kitchens twice the size, fancy Viking ranges, stainless steel – and who knows if they’re ever used at all. Rents of course twice mine as well. Tiny rooms. Huge closets!
Modern life.
It’s not really a matter of outlawing, more one of dosage. Imagine if restaurants competed for clients by doubling the size of their alcoholic beverages.
Competitors stayed on top by tripling the size. Most of us are fine with legalized alcohol, but at a certain point if businesses change the norm, when a “small” beer is what used to be four beers, we would begin to see a rise in alcohol related consequences, from accidents and dui’s to cirrhosis.
I don’t like to see diet and politics mixed up. Dieticians have a tendency to change their commandments over time. So, please, no police power for dieticians.
The big eye opener for me was the so called paleolithic diet. I tried it and right away I noticed that cutting out the bread and rice made me better. No doubt different people need different diets.
So therefore, we should certainly listen to the docs, but they should not given police power.
I recommend “Why We Get Fat: And What to Do About It” by Gary Taubes. The big problem is too much carbohydrates in our diets. Calories-in, calories-out, and exercise are not the answer. The medical consensus opinion is dead wrong, sadly.
university of San Francisco department of endocrinology study showed the fructose corn syrup is received by the body like alcohol and it goes straight to fat.it doesn’t satiate the hunger or satisfy the thirst, so you tend to eat and drink more.
unless you do some kind of exercise that reaches your lactate threshold you will never burn that fat off. aerobic versus anaerobic exercise, running vs video games. i guess that is the choice.
It’s the carbs, folks. Both refined and unrefined.
I was a skinny kid before my mother adopted the ‘healthy’ USDA recommended diet for the family. I was fat by age 11. I tried every diet under the sun (calorie restriction, medically supervised, grapefruit diet, Dolly Parton diet, weight watchers, physician’s weight loss diet, etc.) except the Atkins diet. At 34 years old I was obese at over 280 pounds.
Tired of being fat and not feeling well, I decided to risk the unhealthy and worthless Atkins diet. I’m 45 now and weigh 167 pounds. I have felt better the last 11 years than than I did anytime during the previous 20.
BTW, my doctor hates low carb-high fat diets and harps on me to adopt the recommended healthy. He also says I’m one of the healthiest people he’s ever seen. Sigh.
Dump your doc. It’s the only thing they understand.
‘dump your doc’; great advice. FYI; most docs cringe when a new 300 pound hippo waddles into the exam room. You’ld be doing doc a favor by not showing up.
Fat people are fat because they eat too much. This is not a difficult concept. If you would like to lose weight, eat less.
This is nonsense and you are profoundly ignorant. Please read Why We Get Fat and What We Can Do About it by Gary Taubes.
Ya Thunk??? Well, I’ve been attending to the fat disadvanged gang for years. And you know what????? They, to a one, abdicate any responsiblity for their fattitude. Their standard response is ‘you wouldn’t believe how little I eat’.. And you know what??? I don’t. If you put down the fork, you’ll lose weight. Otherwise clap your hands and save a fairy.
I’m overweight. Its not from high fructose corn syrup, or flour, or some other food demon… I got that way after breaking my shoulder which cut back on my physical activity, but I did not cut back on my calorie intake. Shoulder is better now and I got real tired of being fat. I did two things:
I got more exercise via a stationary bike.
I cut my daily calorie intake to an average of 2,000 calories a day. I also cut back on fruit / veggie intake (still eat a lot of both) and added more protein. Found it gave me more energy and made it easier to eat less.
I have dropped 11 lbs in the past couple of months, which puts me a little more than 1/3 of the way to my ideal weight. For me at least, it was about disciplining myself to work out and stop stuffing my face.
I could not agree more with Stacy in NJ and a few others arguing the same points. Mr. Dalrymple (and most other posters here spouting conventional wisdom about diet and exercise, etc. ), who I greatly respect based upon much of his past social commentary, like all physicans also needs to read Taubes’ Book “Good Calories, Bad Calories” before he pontificates one more word on this subject. It seems pretty clear for a hundred reasons to Taubes and me and any other intelligent person that reads his book that the cause of obesity in modern humans is a hormonal disorder, specfically relating to the hormore insulin, caused by a great increase in the carbohydrates from all sources in our society’s diets since the 70′s. Taubes also convincingly aruges that summation of scientific evidence to date also shows, and seems obvious if you think about it, that exercise and calorie restriction also do not work over time for weight (i.e, fat) reduction. When I was growing up in the 60′s and 70′s exercise and dieting (aka calorie restriction) were rare things. Now our country is obsessed with both, huge industries have grown up to serve both interest, and we are fatter than ever.
Regarding the study mentioned I have not read it, but the hypothesis it seems to be testing seems likely to prove nothing because we have no information on the type or quantity of the other carbohydrates or other nutrients the subjects ate, let alone the effects of artifical sweetners on growth hormones in children.
As for my personal anecdotal story, I have been happily low carbing / paleo living for 5 years or so and now never ever give a thought to restricting the quanity of what I eat. I also wiegh 40 lbs less than what I weighed during my 30′s and 40′s, have lost my asthma, sleep apnea, acid reflux and beginning arthritis, and feel better than ever. Exercising, which sometimes I do and sometimes I don’t, makes me stronger and hungrier but has little or now effect on how much I weigh or how I feel.
‘I haven’t been able to exercise’ is the No. 1 excuse I hear from lardoland. Here’s a bit of news, chubbies; if you were to jog one mile, you might burn off 100 – 125 calories. One pound of body fat represents @ 4,000 calories. Now for the rocket science; if you managed to jog 35 miles or so, you’ld burn off @ 4,000 calories. Losing weight is 75% diet. If you cut 400 calories from your daily diet but didn’t jog one inch, in ten days you’ld burn off the same 4,000 calories. P.S.; walking to the fridge does not qualify as aerobic exercise. So, all of you gravity challenged folk, stop kidding yourself; eat less, live a bit longer.
I lost 30 lbs. by sitting on my couch, watching tv, and stuffing my face with proper food. You are full of crap.
I lost 30 lbs. by sitting on a couch, watching tv, and stuffing my face with PROPER food. I didn’t move an inch. Excersise is too keep you fit, or a hobby. It will NOT help you lose weight. Indeed, some folks on the paleo diet, get heavy, after losing tons of weight. But it comes back as MUSCLE. And they look great.
I can just imagine Xiadong sitting on his couch, stuffing his face as his muscles ‘grow’. What is wrong with this picture?? Why can’t I stop laughing???
The biggest mistake regarding obesity is considering it to be a single condition. There is no single way to prevent obesity and no single way to treat obesity because it has multiple causes.* The federal government’s dietary guidelines suck because they prevent obesity only in a subset of people and CAUSE obesity in other subsets (such as most people with a family history of adult onset diabetes mellitus).
Significant progress at preventing and treating obesity will not occur unless medical researchers, clinicians, clinical pharmacologists, and nutritionists identify the different causes of obesity, figure out which people have what type of obesity, and develop appropriate prevention and treatment plans for each type. (The only thing that is helpful in all types of obesity is exercise, but the optimum exercise plan varies with the type of obesity.)
* This same problem of lumping diseases together partly explains why atherosclerotic diseases (myocardial infarctions and strokes) are still the commonest killers. Lowering cholesterol helps only a subset of people with atherosclerosis.
You are what you eat. Eat less.
If you’re wantng to know that cause of the obesity epidemic–you’re looking at it right now. It’s that computer you’re sitting in front of. If you sit in front of it longer the 1 hour per day odds are that you are over weight, and this of course goes for kids too.
When I was growing up we drank every bit as much soda as they do today. We ate every bit as much candy and mcdonalds. We watched al to of TV. But we played all day. I repeat, we PLAYED all day. We didn’t sit our fat arses in front of computers.
The other ingredient is HFCS-high fructose corn syrup. I get that correlation does not equal causation, but merely being fat shouldn’t give little boys a set of moobs. I repeat, MOOBS!
And that HFCS–you’re paying for it with every tax dollar you pay. Agricultural subsidies. I know you know what Im talking about, so I don’t need to repeat myself.
Having lived in the south for at least 20 years, this study is very believable. Southerners and cola are one with each other. Because I came from an occupied country during WWII, cola was not heard of let alone sugar to put on food. I never acquired a taste for the fizzy drinks and as a result never had them in my home for my son to drink. We are both thin. Also we are both physically active.
You state your opinion with such passion. Too bad it’s passionately ignorant.
In Texas our obesity rates have risen with the rise in the mestizo displacement of whites. I do not know if it is a coincidence; I haven’t looked to find if there’s a breakdown by race. Maybe a commenter here knows.
Obesity is caused by overeating. Obesity and food addiction should be treated like the other addictions. When food is the only reward, the only pleasure, then the rest of that life needs to be expanded, not the jelly rolls.
On the other hand, to become obese, try the obesity diet of quick empty carbs,startch, high sugar, and hardened fats. To gain enormous weight eat ice cream, sodas,fried breads,and mashed potatoes. Alcohol is also calorie rich.
Frantic C.McCann, from the age of seven, consumed a twelve pack of Coca Cola every day of her life. She eschewed the health foods of the moment, loved fatback, lard sandwiches with mayonaise, bacon cheeseburgers, HoHos, Rocky Road ice cream, and put salt on everything. And smoked two packs of unfiltered ciggies a day. She was a bit overweight, but was big boned. Sadly, she died unexpectedly when the zip line she was on separated over the Chatahooche gorge. Nevertheless, she fully enjoyed the eleven years the Lord gave her.
A meal without a base of pasta, rice or potatoes is unsatisfying. That’s why all this talk about eating only animal protein and veggies (other than potatoes) will never work for all but fanatics. People want to be satisfied by a meal and that doesn’t mean being stuffed but it does mean having a feeling of fullness, a feeling that a meal without carbs doesn’t provide. The only thing that works is portion control. Not that portion control is easy since it involves breaking an old habit and acquiring a new one. But, given time, it can be done.
A bit of a straw man there.
The “Paleo” diet has advanced from what you state. Many eat rice, potatoes, and even the occasional scone! It’s about getting rid of the constant, every minute of every day munching of crappy faux food. I eat dairy, steak, chicken, rice, milkshakes, potatoes, strawberries, fruit, and a scone and a root beer once a week. AND the occasional Milky Way!
If your not satisfied with that, you got issues.
Apparently the author is unaware of the latest findings about the effects of added sugars on brain function and the addictive properties thereof. See the video: “Sugar, the Bitter Truth”
http://www.youtube.com/watch?v=dBnniua6-oM
The author blithely suggests that if the drinks were laced with amphetamines then there would be something to talk about. Everything short of that is a lack of “personal responsibility”. Well, the effects of sugars in soft drinks are exactly the same in terms of neurotransmitter changes in the brain are EXACTLY the same as those seen in addictive drugs.
In addition, soft drink manufacturers, including Pepsico, use genetically engineered taste enhancers that mimic the psychoactive properties of addictive drugs. Some of these products were obtained from cell lines originally derived from human fetal stem cells. If you don’t believe me, Google it.
Ah, the infamous ‘Twinkie defense’.