“Robert Goldstein, a hedge fund manager in New York, was getting huge cravings for sweets when he came across a tropical plant called Gymnema sylvestre that works a little like methadone for heroin addicts.” What does that have to do with “big food”? Too much, I’m afraid.
“Obesity is an extremely complex, multifactorial disease, with many of its most harmful effects arising from hormonal stimulation. Adipose tissue is an endocrine organ, and more than a hundred different hormones are produced by fat cells. As the cells expand with weight gain, production increases. Some of these hormones cause inflammation or trigger blood-clotting mechanisms, while others raise blood pressure or lead to insulin resistance, for example. Obesity affects virtually every body system and is associated with more than 200 medical conditions.”
Snacking has become a popular habit among children and teenagers At the same time, overweight and obesity have reached huge proportions, affecting young individuals. Snacking has been considered one of the main contributors to overweight because of the increased consumption of energy-dense, high-sugar, high-fat foods.
Snacking is promoted by food ads to children and adolescents and one look at our supermarket foods completes the picture. When I taught nutrition courses at the college level, most of my students would come to class with their favorite bag of snacks in hand. Ironically, the class objectives were hopefully to learn about healthy diets. It was hard to compete against the influences of the “big food” industry ubiquitous in our food environment.
No wonder we have an obesity problem. Don’t count on the latest Dietary Guidelines 2020 for help. Enough said?
“Artificial preservatives used in many processed foods could increase the risk of inflammatory bowel diseases and metabolic disorders, according to research published on 25 February in Nature1. In a study done in mice, chemicals known as emulsifiers were found to alter the make-up of bacteria in the colon — the first time that these additives have been shown to affect health directly.”
The search continues for what factors in the Standard American diet (SAD) can be implicated beyond the amount alone that people consume, that are causative of the current obesity/diabesity epidemic.
Researchers continue to look at the lengthy ingredient lists on ultra-processed foods. As Western-type diet are utilized more and more globally, their obesity rates continue to rise. Is there a connection?
The last I checked, the U.S. is still facing an epidemic other than Covid -19 – one that has been in some degree affecting a large percentage of the population (40%) for quite some time – obesity. Obesity has even been named as a risk factor for the Covid pandemic. About 70% of us are overweight with about 40% classified as obese. One in 10 have diabetes type 2. Type 2 diabetes most often develops in people over age 45, but more and more children, teens, and young adults are also developing it.
Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 88 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 84% don’t know they have it.
A feature of this month’s issue of Nutrition Action Health Letter titled Why We Overeat by Bonnie Liebman should be important for all of us who eat food found in the Standard American Diet (SAD). It will ultimately affect all of us with increased health care costs.
As a researcher at the National Institutes of Health, Kevin Hall explains: “We’re trying to understand the properties of our food environment that regulate appetite and cause people to overeat and gain body fat”. Based on several well designed studies, his group found “only one diet led people to gain weight and gain body fat, Hall says, and that diet is the ultra-processed-food diet.”. Examples of ultra-processed foods include breakfast cereals, pizza, soda, chips and other salty/sweet/savory snacks, packaged baked goods, microwaveable frozen meals, instant soups and sauces.
“Companies are all about maximizing the allure of their products” says Michael Moss, a prize winning former New York Times reporter whose recent book is titled: Hooked, Food, Free Will, and How the Food Giants Exploit Our Addictions. It all begins with three major ingredients: Salt, Sugar, and Fat, also by Moss.
“The industry came up with the term “bliss point” to describe the perfect amount of sugar in a drink or food that would please most Americans. Not too little, not too much”
“In snack foods like potato chips, 50% of the calories typically come from fat which gives them that melt in your mouth phenomenon, which so much ultra processed food has. You hardly even have to chew it.”
“Salt is the flavor burst because it’s often on the surface of the food and the first thing that touches the tongue”.
But wait! There are other factors.
“Fat plus carb foods with high concentrations of both fat and refined carbohydrates like chocolate, ice cream French fries, pizza, cookies and chips are the foods that most people find most irresistible”, says Ashley Gearhardt, associate professor of psychology at the University of Michigan.
Other factors that aid in making the consumer choose ultra-processed foods can include:
Variety, speed (unprocessed food often takes more chewing), advertising (especially TV ads),
Cost. The food industry goal is to make their products as inexpensive as possible for the consumer.
Snacking: “The food industry has developed more and more products that can act as the fourth meal of the day.” Just look at the abundance in the snack aisles.
What To Do
One way is to concentrate more on nutrient dense foods then on calorie dense foods — of course this increase requires adding fruits and vegetables.
Another good source on how to curb your ultra processed food intake is presented by Barbara Rolls, director of the Laboratory for the Study of Human Ingestive Behavior at Penn State, who wrote the Ultimate Volumetrics Diet.
A study in 2017 by Rolls randomly assigned women with obesity to either eat less fat or eat less fat and eat more fruits and vegetables for a year. After a year, the fruit and vegetable eaters had lost more weight (17 pounds) than the other group (14 pounds), and they reported being less hungry.
“We eat with our eyes and our brain, If we see a big portion, that sets us up to feel more satisfied. If a plate looks half empty, that sets us up to feel hungry”, says Rolls.
All in all, be aware and mindful of what you eat. Mindless eating can be habit forming as usually we pay little attention to what and how much food we are eating. Studies show that we eat more macaroni and cheese while watching TV than while listening to music.
Lays potato chips dares us with the challenge: “bet you
can’t eat just one”.
“Stay away from the gigantic calorie counts in most restaurant food, whether it’s sit down or fast food. Cook your own food whenever possible. Stick with water, coffee, tea, or other calorie free drinks.”
“Don’t let multinational corporations dictate your diet and your health.” It’s up to you to make those choices.
Bonnie Liebman. Nutrition Action Healthletter, Center for Science in the Public Interest, April, 2021.
Michael Moss. Salt Sugar Fat: How the Food Giants Hooked Us. Random House, 2014.
The obesity news just keeps getting worse. Along with obesity, many people suffer from diabetes type 2 or pre-diabetes. Type 2 diabetes accounts for 95% of all cases in the United States. It occurs when the body cells lose their sensitivity to insulin, a condition called insulin resistance, or when the amount of insulin secreted is reduced.
Type 2 is considered to be a result of genetic and lifestyle factors such as a diet high in refined carbohydrates or when a person follows a sedentary lifestyle. The incidence is higher among some minority groups. Type 2 may also occur as part of a combination of conditions called metabolic syndrome that includes obesity, elevated blood pressure, altered blood lipid levels (HDL LDL triglyerides). These factors increase the chance of developing heart disease, stroke, and diabetes.
Often, diabetes type 2 can be prevented if caught early in the disease and with the proper lifestyle modifications. There is a great need in the U.S. for this type of intervention. Ask your doctor for any available information on Prevention Programs in your area or medical community, for example, a certified diabetes educator(CDE), registered dietitian (RD) or a certified health coach.
Source: Smolin and Grosvenor. Nutrition: Science and Applications, 3rd Edition.
New world wide estimates of the number of people in our current obesity epidemic is the topic of the following article dependent of current trends.
The Obesity/Diabesity Pandemic
Obesity is a major risk factor for the development of type 2 diabetes mellitus, so much so that the epidemic is often called diabesity. It has been described as one of the most important crises that has invaded our public health system.
Global Statistics, Source: Lancet
- Since 1980, the number of adults with diabetes worldwide has quadrupled from 108 million to 422 million in 2014.
- Diabetes is fast becoming a major problem in low and middle-income countries.
- From 1980 to 2014, the prevalence of diabetes more than doubles for men in India and China.
- Half of adults worldwide with diabetes in 2014 lived in five countries: China, India, USA, Brazil and Indonesia.
So what are some solutions?
The standard American diet is in much need of an overhaul and our national food systems need to change if we wish to reverse or at least slow down this trend. Many say that it would take the same determination as the campaigns to change behaviors that were utilized during the campaigns against smoking.
Prevention awareness should be first on the front lines of treating the people with prediabetes that can often be reversible using lifestyle modifications. There are already some prevention models in the community; however, these should be expanded so that they become more easily accessible to more people. The Diabetes Prevention Program (DPP) uses intensive behavioral therapy to help people lose a little bit of weight (typically 5-10%). When this program is followed, the number of people progressing to have diabetes comes down by more than half. In people over 60, the reduction was 70%.
Nutrition education should be incorporated into the school system in the early years to help young children understand the importance of knowing where our food comes from and why nutritious foods are the best choice. They can be taught about balanced eating, calories, reading labels and grocery shopping. Nutrition education can also be offered at the middle and high schools’ levels by returning to a revamped and modernized home economics course in the curriculum.
A lingering problem has existed for many primary care physicians for many years in that they say they were never adequately prepared in nutrition principles in medical schools. In a survey of family physicians (2009), two thirds said that dealing with extremely obese patients is “frustrating “and one-half said treatments are often ineffective. This is reflected by a lack off obesity training.
Shockingly, another survey in 2010 of 140 doctors revealed that nearly one-third were not even familiar with the American Diabetes Association (ADA) prediabetes guidelines. Only 6 percent were able to identify all 11 risk factors and on average, the doctors could only identify just eight of the warning signs. Only 17 percent knew the correct laboratory values for blood glucose and only 11 percent said they would refer a patient to a behavioral weight loss program.
There should be an increased access to professional treatments. Medical professionals not trained in obesity management should refer their patients to outside providers such as dietitians, exercise trainers, behavior therapists, psychologists, or the new concept of health coaches. These providers should be trained, certified, and credentialed to protect the public from unscrupulous treatments and to provide quality care. Reimbursement of qualified health professionals needs to be enhanced to keep patient volume high and lessen out-of-pocket expenses.
We have become a nation of non-cooks and prefer to have our meals prepared by someone else. Encourage home cooking and home kit meals to help to counter using fast foods and packaged highly processed meals loaded with calories, fat, sugar and salt.
Educate the public on food labeling including ingredient lists. Beware of food companies that promote products with a “health halo” meaning exaggerated claims made that appear to make unhealthy foods seem healthy because of an added nutrient or ingredient. Corporations also mislead consumers with their labeling, so they include four different types of sugar to keep sugar from being listed as the first ingredient. This is misleading to the consumer when attempting to make wise food choices.
Stop corporate-government partnerships and diminish lobbying.
“Lately, the food industry (Big Agriculture, Big Meat, and Big Food ) has been highly implicated in this epidemic. This includes the advent of ultra-processed foods. “To sell these foods, companies bombard us with billions of dollars in ads, normalize eating junk food, and make it available 24/7, everywhere, and in large amounts at remarkably low cost.”
Source: “Against the Odds: Why our food system makes it tough to eat healthy, Nutrition Action Healthlettter November, 2020.
The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is funded by myriad food companies such as Coca-Cola, PepsiCo and Kellogg’s. The dairy industry has a long history of influencing the food pyramid and Dietary Guidelines. A good example is the placing of a glass of milk on the MyPlate Logo. Often this practice only serves the dairy industry and not necessarily the consumer.
Another health organization guilty of taking in millions from food companies is the American Heart Association. They offer a “Heart – Check logo for a price: $5, 490 to $7,500 that is renewable for another fee annually. The product has to be low in fat, saturated fat and cholesterol to gain this “honor.” However, some products such as Boar’s Head processed meats have the logo and still may still contain high levels of sodium. If the AHA were sincere in their efforts to help consumers choose healthier foods to rein in obesity/diabetes, they would realize that research has shown that a 1.8 oz. daily serving of processed meat raised the risk of diabetes by 19 percent and heart disease by 42 percent. Most current dietary recommendations emphasize a reduction in processed meats (my emphasis).
Bottom Line: It will take a concerted effort from government, politics, industry, communities, and consumers and the perpetrators of our obesigenic culture to begin to change this trend.
Is Super- sizing Leading to Super- sized Americans?
Many Americans are eating a good deal more food than needed and it appears that rising rates of obesity are partly related to increased portion sizes.
Supersizing fast food can double or triple the caloric content of the foods compared to their regular sized counterparts. A single, supersized meal including a cheeseburger, large fries, and thick shake provides more calories (about 2200) then many people need in a day. Larger portions don’t cost restaurants much more than smaller portions, they increase sales volume, and they encourage people to eat more.
Among adults, a 50% increase in portion sizes of meals has been found to increase daily energy intake by 423 calories.
Frequent dining at fast food restaurants (three or four more times per week) that primarily serve burgers and French fries is associated with a higher intake of calories, soft drinks and fat and a higher risk of overweight and obesity than frequent use of full-service restaurants. On a positive note, some restaurants have recently begun to offer smaller portion sizes or small plates and healthier menu options than in the past.
Do you feel guilty if you do not eat healthy foods? Most of us don’t but there are people who now comprise a group exhibiting a new eating disorder called orthorexia.
The following article by Mark Bittman may put this eating pattern in a reasonable perspective. The Bottom Line? Enjoy food but make healthy choices (most of the time). This philosophy as stated by Bittman is refreshing – Seems to resemble the traditional diet of the French – the Good Life Savored.
“Eating well is an integral part of their national heritage. To say the French know their food is an understatement and it has been said that even their children are serious “foodies” with two-hour multi course lunches (not uncommon in France)” – all this without guilt. Contrast that with the typical American with a quick drive-through grabbing a burger with fries and eating them in the car with some snacking throughout the day. The French also maintain their weight with little dieting, calorie counting or snacking.” They simply say: If you eat too much one day, cut back the next day. Pretty simple advice but it seems to work (at least for them).
Source: 30 Secrets of the World’s Healthiest Cuisines. by Steven Jonas, M.D, and Sandra Gordon.
Note: Obesity rates in France are among the lowest in Europe, but have been increasing steadily. The increase has been attributed to an increased adoption of the Western diet or Standard American Diet.
In France, almost 40% are overweight (including obese). You can contrast that with the U.S. at 70% (overweight and obese).