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12 Feb 2004 01:43:44 -0000

The Obesity Epidemic

press-release

 

The Institute of Science in Society

Science Society Sustainability

http://www.i-sis.org.uk

 

General Enquiries sam

Website/Mailing List press-release

ISIS Director m.w.ho

===================================================

 

ISIS Press Release 12/02/04

The obesity epidemic and how to beat it

This special mini-series tells you the latest on how metabolic interventions can

make genes work to slim you down.

 

The Obesity Epidemic

********************

Prof. Peter Saunders (p.t.saunders) punctures some myths about obesity

 

Sources for this report are available in the ISIS members site. Full details

here

 

Over the past two to three decades, there has been an alarming increase in

obesity throughout the developed world. In the UK, the proportion of the

population who have a body mass index (BMI) greater than 30 has tripled in

twenty years and now stands at about one in five. Your BMI is your weight in

kilograms divided by the square of your height in metres. If you find it easier

to think in Imperial units, someone who is 5’10 " tall is considered to be obese

if he weighs more than 15 stone, i.e. 210 lbs.

 

Obesity is also on the increase in other countries, including many in Asia where

it has not previously been common. Most alarming of all, it is increasing

rapidly in children.

 

People tend to think about weight chiefly in terms of appearance; but obesity is

first and foremost a health issue. Not only is it bad for us to be less fit and

have more weight to carry around, obesity is also associated with a

significantly increased risk of illnesses such as heart disease and diabetes. In

particular, the recent increase in Type 2 diabetes has been so great and so

rapid that health experts are describing it, too, as an epidemic. Type 2

diabetes is often called " late onset " diabetes because it has typically been a

disease of middle age or beyond, but it is now found in teenagers.

 

What we don’t know about obesity

********************************

As with any health problem, the obvious question to ask is where it comes from.

Why do people become obese? Up to a point, that’s easy enough to understand. We

need energy to keep our bodies going and to allow us to be active, and we get it

from the food we eat. Any energy that we don’t use is stored as fat, which

provides a reserve that we draw on when we are using more energy than we are

taking in. If we take in more energy (usually measured in calories) than we are

using, we gain weight, if we take in less than we are using we lose weight. And

if we keep taking in more than we use, then in the end we become obese.

 

But it’s not as simple as that. If it were, our weight would fluctuate a lot

more than it does. The reason it doesn’t is that the body has mechanisms for

regulating our weight. It controls the amount of energy we take in by making us

feel hungry or sated. It also controls the amount we use by such means as

changing our metabolic rate (the " idling speed " , so to speak).

 

On the whole, it does this pretty effectively. According to the US Department of

Agriculture, the average American consumed 300 calories per day more in 2000

than in 1985. There’s no reason to suppose that Americans are more active now

than they were then, so taking a pound of fat as equivalent to about 3500

calories, Americans should be constantly putting on weight at a rate of about a

pound every 12 days. That’s thirty pounds a year, or three hundred pounds a

decade. In fact, nobody is gaining weight at anything like that rate, which

shows that the body is somehow keeping the balance between input and output

quite well, though in many of us not quite well enough.

 

This also means, by the way, that it is nonsense to say you can lose ten pounds

a year just by leaving out your piece of toast and jam in the morning or by

jogging for fifteen minutes a day. Both are good for you, and both will probably

help you lose weight, but you can’t work out how much just by adding up the

calories and dividing by 3500. It’s a lot more complicated than that.

 

There are many factors involved in regulating body weight and they combine in

complicated ways. Heredity matters, but so does our entire life experience from

the moment we were conceived – and even before that, because of the influence of

our mother’s state of health and what she ate (see " Diet trumping genes " , SiS

20).

 

Physiological systems are also remarkably difficult to manipulate from the

outside. Something may work for a short time and then the body somehow senses

what is happening and finds a way of countering it, which is why many diets work

well but only for a week or two. There may be special interventions that help a

few people with specific problems, but we’re not likely to find a magic bullet

that works for the rest of us.

 

What we do know

***************

Fortunately, we can be reasonably sure we know what are the important factors,

even if we don’t understand how they operate. It comes from a world-wide

scientific experiment that was unintentionally carried out over the second half

of the twentieth century. We have masses of data from several different

populations in which obesity, and the health problems that it brings, have

greatly increased. Unless there has been a significant change in their genetic

makeup in the 50 years since the experiment began, and no one has brought

forward evidence for this, the increase must be due to changes in the

environment and in the way people live.

 

What changes have there been in these countries? Two obviously stand out. First,

their diets have changed. People are eating more and they are eating different

foods. And second, they are exercising less. More people are in sedentary

occupations; more drive where they used to walk.

 

It’s fairly obvious why eating more and being less active should lead to

obesity, and there is now evidence to suggest why changes in what we eat can

also matter. For example, studies have shown that we are sensitive to the amount

of food we consume much more than to its energy content. If we eat foods with a

relatively high energy content – which includes most snack foods – we tend to

take in more energy before we feel sated. The pancreas may also secrete

additional insulin to prevent the blood sugar level from rising, and this can

make us feel hungry again sooner than we otherwise would.

 

Researchers have recently been studying a gut hormone called PYY3-36, which

seems to be a specific signal to the brain to tell us that we have eaten enough.

Foods that we digest quickly produce less of this hormone, which again makes us

likely to take in more energy than we used to or than we need.

 

The Atkins diet, in which you are supposed to avoid carbohydrates altogether and

the South Beach diet, in which you avoid only those carbohydrates that cause the

blood sugar to rise rapidly, are also based on attempts to take advantage of the

way that the body reacts differently to different sorts of foods and not just

because of the number of calories (see " How carbohydrates make fats " , this

series).

 

In both diets, of course, there is the additional factor that people on almost

any diet tend to eat less than they did before. And just eating less does seem

to be important. A typical French meal includes lots of fat and carbohydrates,

yet only about 7% of the French are obese, compared with 22% of Americans. When

some American scientists collaborated with a group from the CNRS (the major

research agency in France) to investigate this apparent paradox, they eventually

concluded that the chief difference between the two countries is simply that

portion sizes are much smaller in France.

 

What can be done

****************

There’s still a long way to go before we understand how our body weight is

regulated, but fortunately we don’t have to know that to start combating the

obesity epidemic. If it was caused by changes in life style, and the evidence is

clear that it was, then the obvious way to tackle it is also by changes in life

style. That doesn’t mean trying to go back to where we were 50 years ago, but it

does mean taking action.

 

When, eventually, governments have concluded that smoking has a serious adverse

effect on health, they have not banned it outright. Instead, they have made it a

general policy to reduce the amount of smoking, and have introduced a number of

different measures aimed at achieving that aim. They have restricted

advertising, insisted on health warnings, sharply increased the tax on tobacco,

and banned smoking in many public places and encouraged other organisations to

do the same.

 

They should do the same in the fight against obesity. It’s not a matter of

closing down McDonalds or making Coca Cola a prohibited substance. Instead, the

government should take steps to encourage people to adopt a healthier life

style, and above all not to make it difficult for those who want to do that for

themselves or their children.

 

For example, they should ban advertisements for food during the times when

children are most likely to be watching television (see Box). Schools should

provide proper, healthy meals. They should not have vending machines selling

soft drinks or snack foods, or get involved in schemes that promote the sale of

such foods.

 

--------------------

Why Junk Food Adverts Promote Bad Health

 

A lot of advertising is devoted to pushing the foods that contribute to obesity.

In particular, they are heavily advertised on the television and specifically in

connection with programmes that children watch, except in the relatively few

places (such as Sweden and Quebec) where this is forbidden. This is especially

worrying partly because of the great increase in childhood obesity and partly

because the food habits we acquire when young tend to persist throughout our

lives.

 

Representatives of the food industry naturally disclaim any responsibility. They

argue that it’s parents that decide what their children eat. Advertising, we are

assured, has no effect. It may sound odd that they are spending millions of

pounds on something that they don’t think helps them make money.

 

We’ve heard this sort of story before, from the tobacco companies. They insist

they should be allowed to keep on advertising cigarettes, because – so they say

– the ads do not increase the number of smokers. All they influence is choice

among brands. No one is tempted to take up smoking because of tobacco

advertisements, but some who are already smokers may move from one brand to

another.

 

That sounds a bit far-fetched, but suppose it were true. It still wouldn’t apply

to food advertising because there is important difference between tobacco and

food. We don’t all smoke but we do all eat.

 

The tobacco companies explain that the huge amount each of them spends on

advertising is not wasted because it can lead people to prefer their products

over the others on offer. But in the case of foods, that’s precisely what we are

worried about. We don’t need ads to make us take up eating. The question is

about preferences, and if the advertisements can change these – as the tobacco

manufacturers claim and as the food manufacturers must also believe or they

wouldn’t spend so much money on advertising – then it is wrong to allow ads

aimed at making us, and even more so our children, choose foods that are bad for

our health.

---------------------

 

That’s on the input side. On the output side, we should be encouraging people to

walk and to use public transport. A standard recommendation is that people

should take about 30 minutes of exercise five times a week. Many of us can do

that by walking briskly to and from the bus stop on our way to work instead of

getting into the car and driving there. Measures to improve public transport can

also be measures to improve health, and that’s before we include the benefits in

terms of cleaner air and fewer road accidents. Above all, we should encourage

children to walk to school – which also means putting in place measures to make

the journey safe.

 

There have always been obese people, and it may well be that drugs or other

special treatments have something to offer them. But the hard scientific data,

accumulated through 50 years of over-eating and under-exercising by millions of

people, tells us that we can make a major impact on the problem by eating less,

exercising more and avoiding the high energy fast foods and junk foods that have

been spreading from country to country and bringing obesity with them. Best of

all, there are no harmful side effects from eating less and exercising more.

 

That’s only common sense, but it is also what good science tells us. We mustn’t

confuse science simply with " high tech " ; they aren’t at all the same thing.

 

 

===================================================

This article can be found on the I-SIS website at

http://www.i-sis.org.uk/ObesityEpidemic.php

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===================================================

CONTACT DETAILS

The Institute of Science in Society, PO Box 32097, London NW1 OXR

telephone: [44 20 8643 0681] [44 20 7383 3376] [44 20 7272 5636]

 

General Enquiries sam

Website/Mailing List press-release

ISIS Director m.w.ho

 

MATERIAL IN THIS EMAIL MAY BE REPRODUCED IN ANY FORM WITHOUT PERMISSION, ON

CONDITION THAT IT IS ACCREDITED ACCORDINGLY AND CONTAINS A LINK TO

http://www.i-sis.org.uk/

 

 

 

 

 

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