FOOD, FACTS and FADS

Exploring the sense and nonsense of food and health


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The Obesity Epidemic: Why?

Diet and Health: With key to the calories. Lulu Hunt Peters, 1918

By Sally J. Feltner, PhD, RDN

In 2013, the American Medical Association House of Delegates approved a resolution classifying obesity as “a disease state with multiple pathophysiological aspects requiring a range of interventions.” We now accept the fact that obesity can lead to diabetes, heart disease, and cancer risks.

Today, 2.1 billion people – nearly 30% of the world’s population – are either obese or overweight, according to new data from 188 countries. The U.S. Centers for Disease Control and Prevention analysis said, “About 38 percent of U.S. adults aged 20 and older are obese as are more than 17 percent of children aged 6 to 11, federal data shows.”

“The global problem affects all countries, income levels, age groups and accounts for over 3-4 million deaths a year with estimated health costs of over $2 trillion a year.” (International Journal of Obesity).

There is no one cause. Many people still continue to blame the obese person’s lack of willpower and insist that if they just ate less and moved more, their weight would not be a problem. This may explain some cases of obesity, but how could more than 2 billion people worldwide begin to make poor choices about their food intake and allow themselves to become fat. Moreover, this upward trend earnestly began in the late 1980’s and has continued to the present. Obesity rates were just 13.4% in 1980 but reached 34.3% by 2008. So what happened to cause this sharp rise? – More than likely a lot of things.

In 2016, an article by Bruce Y. Lee, Associate Professor of International Health at Johns Hopkins Bloomberg School of Public Health succinctly describes his opinions on what factors changed to help create this epidemic. He states that obesity is a result of the breakdown of three major systems that include biological, social, and environmental factors.

Biological Systems

Our metabolic systems have been affected to some extent by non-stop dieting. A plethora of fad diets and exercise gimmicks grew into a huge obesity industry. Diet books topped Amazon and best seller lists while the supplement industry went berserk over worthless and sometimes dangerous weight loss aids. Americans responded and when surveyed, a large majority of respondents said they were “on a diet.”

Even TV reality shows (The Biggest Loser) resulted in weight loss that lowered the metabolism of almost all participants gained back their hard-fought  loss. As each weight loss attempt occurs, the cycle of weight loss/regain occurs over and over again. The body is threatened by a perceived starvation state and attempts to prevent it by putting forth metabolic and hormonal mechanisms to alleviate the threat. Obesity research has shown that nearly 95% of dieters regain their weight loss in a few years.

Social Systems

Social media, friends and family, cultural beliefs, TV advertising, and personal responsibility are all important in shaping our behaviors about eating, appearance, and body image.

Advertisements in the media have promoted the obesity epidemic by making claims that their products will magically transform your body into a svelte image and allow you to finally wear that bikini you bought years ago and that weight loss is easy. Most weight loss diets promise success by showing us before and after pictures of supposedly successful weight losers. What they do not say but disclaim in the small print that you usually can’t read is that results don’t always occur as presented. Most weight loss programs do not include an exercise component nor do they offer any behavioral counseling. Almost all have no disclosure about their success rates of weight loss and maintenance.

Environmental Systems

Determining what a healthy diet consists of is difficult enough – opinions abound and debates continue. This results in confusion and misinformation for the average consumer. They tend to give up on just what exactly is the best way to eat.

So many individuals are exposed to reliance on cheap foods found in the fast food industry. They may live in food deserts defined as parts of the country usually found in impoverished areas devoid of easy access to fresh fruit, vegetables, and other healthful whole foods. This is largely due to a lack of grocery stores, farmers’ markets, and other healthy food choices.

The food industry has been instrumental in developing ultra-processed foods that hardly resemble “real” foods. Snacking has become a national pastime and is dominating several of the inner aisles of the supermarkets. Snacks are abundant in every gas station, convenient store, or vending machine that tempt you to increase their profits.

Additionally, the food industry promotes the intake of sugar, fat and salt by attempting to reach what they call “the bliss point,” defined by the precise amount of sweetness that makes food and drink most enjoyable. You can find the results in the sugary cereals and sweetened beverage aisles in the supermarkets.

People do not cook anymore leading to procuring your meals outside the home. Restaurant portions have become gigantic compared to what they were in past decades. For example, a typical serving of theater popcorn was 270 calories (5 cups) in 1970 compared to now that is typically 630 calories (one tub). Some restaurant meals contain as many calories as we need in an entire day. The average U.S. intake increased 455 kcal/day, a 20% increase from 1970 to 2009. (Dr. Stephen Guyenet, The American Diet, 2012). From research studies we have found that the more food that is put in front of people, the more they eat. We now are familiar with the term “supersize” and the concept of “all you can eat buffets.”

The complexities of the obesity epidemic/pandemic are impossible to fully comprehend as well as their need to be “fixed” to reverse or at least slow down the trend. There are some solutions to accomplish this but they will require much cooperation between politics, community, medicine, research, government, and the public.

If America’s obesity trend continues at its current pace, all 50 states could have obesity rates above 44 percent by 2030, according to a new report from Trust for America’s Health and the Robert Wood Johnson Foundation. Although important, we need to stop just focusing on what we eat, but equally important on how we eat to fix what contributed to the epidemic in the first place.


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Don’t Diet, Live It

Anyone who has battled a weight problem know what it is like to feel guilty about every bit of food they eat.  They become obsessed with every new diet fad that come along especially those that promise unrealistic results and/or quick fixes. They can resort to eating a single food for days or choose foods that promise fat-burning properties. They follow the latest diet from the last issue of a tabloid from the supermarket. They may lose weight initially for a while, reach a plateau and give up to pursue another ill-fated attempt.  Dieting in itself can promote weight gain since with each attempt, your body adjusts to prevent weight loss.  The following article gives a more common sense and realistic approach.

CLICK HERE.


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Dieting Fatigue?

It appears that interest in weight loss is waning. People want to embrace a more positive approach to food, diets and dieting instead of obsessing about weight loss. They are becoming more involved in food and healthy lifestyles instead. This a plus for the concept of Health At Every Size approach.  Good news.

CLICK HERE.


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Weight Regain with the Biggest Losers

Weight Changes

A new study from the “Biggest Loser” supports the unfortunate result of losing weight and the body’s reluctance to maintain  that weight loss. It is a long article, but has many lessons to learn about long-term weight loss. Check out a previous post  on this topic HERE.

CLICK HERE.


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A Dietary Timeline – An Update – 1825 to 2016

Lindlahr

This post is an update to a previous post that depicted the history of diets and dieting and how they changed over time.  It shows how women’s body image, food gurus, medical associations, the food supply and ultimately the food industry through lobbying has affected our eating habits  for over a century.

DIET HISTORY TIMELINE

1825

A French lawyer named Brillant-Savarin said in a publication entitled The Physiology of Taste:  “More or less rigid abstinence from everything that is starchy or floury” is a cure for obesity.

1830

Sugar consumption, mainly as molasses) had increased in the U.S. to 15 pounds per capita.

1863

William Banting lost 65 pounds on a high fat, carbohydrate restricted diet and subsequently published, Letter on Corpulence, Addressed to the Public. He based his success on the advice of his physician, Dr. William Harvey.

1880 – 1910

One out of three people lived on a farm and ate from what they raised and grew there – today with 300 million people, only about 1% do so. The risk of getting type 2 diabetes was 1 in 30 in a lifetime – now it is 1 in 3. (CDC estimates). Butter consumption was 18 pounds per capita and deaths from heart disease was below 10% – In 2000 it was below 4 pounds and now heart disease mortality is about 40% eating concocted supposedly healthier alternatives – e.g. margarine.

1900’s

In the late 1800s and early 1900s, a man named Wilbur Atwater conducted experiments in which he calculated the number of calories in various diets, and collected people’s feces to determine how many calories were wasted. Based on these experiments, Atwater concluded that proteins and carbohydrates have about 4 calories per gram, fats have 9 calories per gram, and alcohol has 7 calories per gram.

1900

Lillian Russell, a stage actress and singer born in 1861. was repeatedly mentioned known as one of the most beautiful women on the American stage.” At the peak of her fame, Russel weighed approximately 200 pounds and was celebrated for her curvaceous figure. She was described ” a particularly robust and healthy creature, who takes good care to remain so.” By today’s standards, her weight would be classified as “obese”.

1911

Proctor and Gamble introduced Crisco – a highly hydrogenated vegetable fat and cheap alternative to lard – the primary cooking fat at the time. The advantage to the manufacturer and the cook was a longer shelf life but provided a multitude of hundreds of pounds of unhealthy trans fatty acids.

1913

The twenty-seventh President of the United States, William Howard Taft reportedly was stuck in the White House bathtub due to his massive girth.

1918 Lulu Hunt Peters, an American doctor wrote the first known diet book, Diet and Health with a Key to the Calories. It was a best seller with over 2 million copies sold. She was the first to mention that cutting calories was an effective weight-watching tool. Her success was more than likely prompted by the new body image of women as being slender, or “thin was in”.

1920

Sugar consumption reaches 100 pounds per capita in the U.S.

1930

Margarine consumption reaches 2.6 pounds per capita. By 1957, margarine consumption increased to about 9 pounds – surpassing butter for the first time ever.

1934

A blood test for cholesterol was developed.

1937 – The Debate Begins (aka What’s going on here?)

Columbia University biochemists David Rittenberg & Rudolph Schoenheimer demonstrated that dietary cholesterol had little or no influence on blood cholesterol. This scientific fact has never been refuted.

Cholesterol in food has no affect on cholesterol in blood and we’ve known that all along.”  These are the words of Professor Ancel Keys, American Heart Association board member and author of The Seven Countries Study who, in retirement, recanted the idea that dietary cholesterol raises blood levels. His recant has been greeted with silence. Keys studied 22 countries, but chose data from only seven.  He also excluded France with high fat and low rates of heart disease. Due to this, his observational study was considered to be flawed.

1950  – 1955

Dietary emphasis on fats and cholesterol in the diet became a hot topic due to Ancel Key’s flawed study and in 1955; President Dwight Eisenhower had a heart attack.  His twice-daily press conferences focused on his cholesterol levels and he was put on a low fat diet.  Dietary fat also became the villain for weight gain.

1957

Margarine outsold butter for the first time – more trans fat and an increase in omega-6 fats shown to be inflammatory to the body tissues. Some animal research had suggested that omega-6 fats alone encourage weight gain.

1961 – Let the Diet Books Begin

Calories Don’t Count was published by Dr. Herman Taller.  The low-calorie diet is a humbug, he declared.  A native of Romania, he studied medicine in Italy and became a Brooklyn obstetrician-gynecologist specializing in natural childbirth. He was also a dieter whose weight ballooned up to 265 lb. on a 5-ft. 10-in. frame. Previously, a cholesterol researcher suggested an oily substance to help bring down his high cholesterol level. Taller also found that he was losing weight–65 lb. in 8 months–even while consuming 5,000 calories a day.  The oily substance was a polyunsaturated fat that was claimed to stimulate the body to burn fat. Taller therefore recommended a high-fat diet supplemented by polyunsaturated safflower oil capsules high in omega-6 linoleic acid.  Back in the 1960’s vegetable fats were new and everyone wanted them to be a new health food.  This has not been supported in the last 50 years of research.

The American Heart Association adopted the well-known low-fat diet that began an era of fat maligning and the glorification of low fat foods.  Dieters began to count fat grams daily.  However, during our national experiment with a low-fat diet, people continued to pile on the pounds every decade.

1978

High fructose corn syrup enters the sweetener market. By 1985, 50 percent of the this sweetener was consumed in America.

1980 -1990

Obesity levels had remained between 12-14 percent from 1960 to 1980. After 1980 and then again in 1990, obesity grew dramatically until today when every state has obesity rates over 25 percent.  Type 2 diabetes is now reported to have a 1 in 3 lifetime risk.

1992

The Food Guide Pyramid was introduced, recommending 6-11 servings of breads, cereals, rice, or pasta a day without mentioning whole grain options.  Fats and oils were restricted without mentioning healthy fats versus less healthy ones.

2000

Soybean oil has 70 percent of the edible fat market in the U.S.  Lard consumption is less than 1 pound.  Sugar consumption in the U.S. 150 pounds per capita. Butter consumption is less than 4 pounds per capita.

2004

After 50 years of Egg-beaters, low fat cheese, margarine, skinless chicken breasts, and highly processed soy and Canola oils, and two Food Guide Pyramids and 11 releases of the USDA Dietary Guidelines,  one third of Americans are obese; 25 percent are diabetic or pre-diabetic.

2005

Food Guide Pyramid is revised to My Pyramid with little dietary changes and was criticized for its misunderstandings and format.

2008

Sugar consumption is now 160 pounds per capita. Compare that to the 15 pounds per capita in 1830.

2011 No More Pyramids

A simplified MyPlate is introduced as the latest attempt at Food Guides. My Plate recommended 30% of the plate as grains, 30% vegetables, 20% fruit and 20% protein. A small circle represents dairy.

2015-16  The 2015 Dietary Guidelines were presented with little changes based on the latest research. Here is what they said and what they should have said.

  • This is a big change  For the first time, our national health authorities are urging Americans to limit sugar to no more than 10% of daily calories. In a 2,000-calorie diet, 10% is 200 calories—the equivalent of about 12½ teaspoons of sugar. Yet we average 20 teaspoons a day.
  • It is not in the guidelines! Based on scientific evidence that’s been accumulating for decades, dietary cholesterol (as opposed to blood cholesterol) just isn’t any concern anymore.
  • For the first time, there is no limit on total fat. However, the advice to limit saturated fat is still in there—even though the evidence that saturated fat leads to heart disease has turned out to be pretty weak..
  • An original report associated with the new guidelines called for cutting back on red meat, especially processed meat, but the final official guidelines due to the lobbying of the meat industry wanted its message weakened.
  • Fish. This got specific for the first time—aim for at least eight ounces a week, in part to get its heart-healthy nutrients such as omega-3 fatty acids.
  • The original report called for including sustainability issues in the guidelines—which would mean eating more plant-based food and less animal-based foods. But the USDA administration omitted that idea, too.

The Future?

About 287 people per 100,000 had heart attacks in 2000. By 2008, the rate had dropped to 208 heart attacks per 100,000. Deaths from heart attacks also declined. That is good news. Something must be going right – but what is it? Many think it is due to technological advances in the diagnosis and treatment of heart disease.

What’s going on?

In 2010,  the American Journal of Clinical Nutrition published a landmark report that has turned current fat recommendations upside down. The verdict from the study is that “there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk for heart disease.’’

Over the same period, the use of drugs to treat high blood pressure and high cholesterol increased quite a bit. Meat consumption has been declining for the past few decades. However, the gains could be short-lived. In the last decade the prevalence of Type 2 diabetes has increased by almost a percentage point. Over the same period, obesity has increased by three percentage points. If that trend continues, heart disease rates may again rise.

Unless we have been infected by a yet to be discovered obesity virus, we have a national eating disorder that needs to be fixed. Big food has made quite a mess of our food supply. Is saturated fat the culprit it was made out to be?  Can excess refined vegetable oils, sugar or fructose be to blamed?

Will our food culture ever be able to return to a diet of whole, real foods to replace the refined, processed, chemical-laden foods forced upon us by the food industry? Will the experts in the AHA, the USDA and big food ever get it?  Do not count on it. The solution may just have to rely on getting the message to consumers with more reliable nutrition education who then may make more demands for a healthier and safer food supply.

 


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The Melting Pot of Nutrition

Today there are so many opinions as to what is the best diet, what are superfoods, how should we eat, how can I lose weight and keep it off – it makes your head spin.  The following article by Dr. David Katz discusses this dilemma.  And it is problem – who is right or wrong?  It seems that almost everyone that eats food has their own, often strong, opinions about diet and nutrition and due  to the internet the plethora of information and misinformation is available  to us like never before.

CLICK HERE.