The Other Pandemic: Obesity

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.

Sources

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.

Food for Thought?

Reliable nutrition research is hard to find – at least the kind of studies that have no obvious conflicts of interest or bias from the food industry. Here are two recent studies that I found that appeared to have some legitimacy and no conflicts of interest. Source: Life Extension

Weight Loss and Breast Cancer Risk

It has been known for some time that excess body weight raises the risk of breast cancer.

Study Method: A large study that included 180,000 female subjects over 50 years of age had their weight assessed three times in 10 years by researchers from the American Cancer Society, the Harvard T.H. Chan School of Public Health, and others. They found that women who lost about 4.4 lbs to 10 lbs. had a 13% lower risk, women who lost 10 lbs to 20 lbs had a 16% lower risk, and those who lost 20 lbs or more had a 25% lower risk.

Women who lost weight, and then regained some of it back, also had a reduced risk of breast cancer compared to women whose weight remained stable.

Conclusions/Authors: “Our results suggest that even a modest sustained weight loss is associated with lower breast cancer risk for women over 50. These findings may be a strong motivator for the two-thirds of women who are overweight to lose some of that weight, one author said.

Source: Journal of the National Cancer Institute, 2019 Dec.

Blueberries and Metabolic Syndrome

Researchers evaluated the effects of blueberry consumption on indicators of oxidative stress (free radicals) and inflammation in patients with metabolic syndrome. Oxidative stress occurs when cells are exposed to more oxidizing molecules (free radicals) than to antioxidant molecules that neutralize them. Over time, it increases the risk of heart disease, type 2 diabetes, cancer and other diseases. Blueberries have been found to have antioxidant functions as a result of phytochemicals called polyphenols.

Metabolic syndrome is a cluster of conditions that includes some combination of high blood pressure, abdominal obesity, high blood sugar, and abnormal lipid profiles (HDL, LDL, trigycerides, total cholesterol). The syndrome is associated with a highly pro-inflammatory environment in the body and a sharp increase of risk for heart disease, stroke, and diabetes.

Method: For the study, one group of patients received a smoothie containing 22.5 grams of freeze-dried blueberries, (about 2 cups of fresh blueberries.) The other group received a placebo smoothie twice a day.

Results: After six weeks, blueberry supplementation markedly decreased oxidative stress in whole blood and monocytes (white blood cells as part of the immune system). Supplemented patients also had a reduced expression of inflammatory markers in the monocytes.

The researchers noted that to their knowledge, this was the first study to yield significant improvements in oxidative and inflammatory parameters in patients with metabolic syndrome just after six weeks of blueberry consumption.

Note: As with all research, one study is not sufficient to form conclusions – the study results need to be replicated.

Looking for more reasons to eat blueberries? A University of Illinois study tested different fruits for the presence of a particular polyphenol that inhibits a cancer-promoting enzyme. Of all the fruits tested, wild blueberries showed the greatest anticancer activity.

Throw them on a salad, in blender with a protein powder, eat them frozen with a dollop of yogurt. Put them on your morning cereal.

How to Avoid Overeating During the Coronovirus “Break”

Many of you are now working at home for the first time. It becomes very easy to realize that when that happens, food is not that far away and I am sure that avoiding snacking and even binge-eating is not that easy. One sign, is that bag of chips always open and at your desk? Before you buy that Peleton or tape the doors to the kitchen cabinets shut, try to exercise a little scheduling and practice the art of mindful eating.

Here is HELP:

The French Diet vs. the Standard American Diet (SAD)

Savor Variety with the French Cuisine

To safeguard one’s heath at the cost of too strict a diet is a tiresome illness indeed.

— Francois Duc de La Rochefoucauld (1613-1680) French writer and moralist.

The French have long known that eating well is a integral part of the whole of French culture. This is reflected in their custom of a set of what is called “global” secrets from an engaging book entitled 30 Secrets of the World’s Healthiest Cuisines by Steven Jonas, M.D. and Sandra Gordon. In addition, the French attachment to the finer foods in life has resulted in them being some of the healthiest, leanest, and perhaps most guilt-free people in the world.

France At A Glance:

Moderate drinking – of course moderation is the key. Everyone knows the hazards of excess drinking. The French drink only with food – no happy hours!!!
Lots of fruits and vegetables
No snacking or dieting – this is important since the typical American eater often binges on snacks when on a very restrictive diet. Chronic dieting has been shown to increase weight gain in some people.
They eat large lunches and often extend and enjoy the lunch hour – no grabbing a carton of yogurt at your desk or going through the drive-thru or visiting the vending machine like the typical American eater.
They resize the supersize. “There is no such thing as a doggie bag in France, since restaurants never give you enough to put anything in it,” one says.
They don’t feel guilty about food. One of their reminders about food – “If you eat too much, the next day you eat less,” they say. They weigh themselves about once a month – if that. However, scale weight can be used as a red flag when weight begins to creep upward.
Take the time to cook properly and use fresh, quality ingredients. You don’t need to be Julia Child, but butter and cream are revered (in moderation, of course). Microwave ovens and can openers are not staple kitchen items.

CLICK HERE.

The Simple Way to Eat?

Was a new diet part of your 2020 resolutions? Great, but forget the new fads, diet pills, and starvation deprivation. There are many of the old diets still around- keto, paleo, Whole 30, NutriSystem, Jenny Craig to mention a few. Just look at the magazine covers at the supermarket checkout – keto seems to have taken over all the others. The keto diet is quite restrictive, difficult to maintain and the long-term effects are not known. There is little evidence that this type of restriction, although shown to be effective for weight loss, may not be a lifestyle choice for most people. Is there a better way? In my opinion, yes. The best diet is one you can live with and with a few adjustments compatible with the foods you choose. The best diet is one that with a little guidance and knowledge, is decided by you.

The following article is worth looking at if you want a simple approach. All you need is a plate, a bottle of water, real food and of course, your commitment. And even better, this plan lets you be in control in following a reasonable and evidence-based plan that can fit easily into your lifestyle.

The article speaks for itself and provides a few links to add to the basics, i.e. some things you need to know like a guide to non-starchy vegetables. Oh, you may have to give up fast food and processed foods for a while. But, you may be glad when you realize that you will feel a lot better (and healthier) and the effort will be well worth it.

Don’t get me wrong – I don’t want to say that weight loss itself is easy – it ‘s hard work but worth it when your goals are either weight loss or just changing to a healthier lifestyle. That is why this plan is appealing. it is straightforward and makes sense.

So join the new “non-diet” approach that will help you lose some pounds but even better, eating for health. That is what eating should be about, not body image, eating disorders and food restriction. Learning how to eat rather than just what to eat is the answer (my opinion). ENJOY!!

One more thing – Always consult a registered dietitian, certified nutritionist, and your primary physician to discuss any dietary change to make sure it is nutrient dense. Also make sure you have no underlying medical problems like high cholesterol, hypertension, pre-diabetes, diabetes or digestive issues, for example.

CLICK HERE.

Portion Distortion: Then and Now?

Portions are out of control in the Standard American Diet. Do you know how much food you ate yesterday? If you had meat what size of serving of meat? Whatever happened to the single burger? Few people are aware of how much food they eat. Portion sizes of today’s food tends to exceed standard serving sizes due to our past experiences at family meals, the size of servings at restaurants, supersize meals, large bakery products and larger cups of soft drinks all contribute to the problem.

Typical portion sizes and calorie content of foods in the marketplace versus calorie content and portion sizes 25 years ago.

Food	Portion size Calories 25 years ago	Marketplace portion sizes Calories now
Bagel	3- inch diameter, 140 calories	6 -inch diameter. 350 calories
Cheeseburger	4.3 ounces, 343 calories	7.1 ounces, 535 calories
French fries	2.4 ounces, 210 calories	6.9 ounces, 610 calories
Soft drink	6.5 ounces, 85 calories	20 ounces, 820 calories
Muffin	1.5 ounce, 167 calories	6.5 ounce, 724 calories

CLICK HERE

You Have Lost the Weight: Now What?

Weight loss may be achieved by using any method that people can live with preferably with the least calorie restriction possible. People who follow a weight loss regimen that restricts either fats or carbohydrates may lose the weight, but they tend to gain it back after they abandon the diet itself. In other words, people refer to “going on a diet” will often declare “going off a diet”. The hard part is keep the weight off or avoid binge-eating and possible weight gain that often results in what is commonly called “yo-yo dieting.” Why do so many people end up dieting and dieting and losing the same pounds over and over? The hard part of weight maintenance needs to be part of the treatment.

One way that has some science backing is the practice of mindful eating. The following describes this approach and may be the go- to method for weight maintenance.

CLICK HERE.

Living in Our Diet Culture

Lately I have begun to read the experiences of primarily women who have lived the diet culture. Most of their accounts are heart-breaking and present to other young women a glimpse into the world of weight loss. Many never recover and their dieting habits continue throughout life.

This particular account caught my attention since she is only 22 years old and already understands and seems to have realized the dieting activities all too well. I thank her for her input.

Just in case you’re a little rusty in metrics, In the article, she states at age 13 her weight and height as 70 kg (154 lbs) and her height in cm. as 1.67 cm (around 5’5″). This weight/height results in a Body Mass Index of 25.6 (just at the cutoff for the normal weight category but hardly overweight (in the article she states a few pounds overweight)

The article makes some excellent points:

Women have a tough time meeting the standards of body image in our society and often find it nearly impossible- we are always about 5 pounds overweight or 5 pounds underweight, never perfect and either judged by others or ourselves.

Many dieters self-report binge-eating which is common among people who attempt to follow a restrictive diet and also may suggest incidences of a sort of food addiction syndrome. There is an established binge-eating disorder characterized by the following:

Rapid consumption of extremely large amounts of food (several thousand calories) in a short period of time.
Two or more such episodes of binge-eating per week over a period of six months.
Eating in secret.
Lack of control over eating or an inability to stop eating during a binge.
Post-binge-eating feelings of self-hatred, guilt, depression or disgust.
Eating until uncomfortably full.

It is estimated that 10-15% of people enrolled in commercial weight-loss programs suffer from this disorder.

CLICK HERE.

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 a 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. Otherwise patient volume high and they 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 are 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.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.

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).

There is bad news on rising obesity rates – read about them HERE.

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.