Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Monday, February 08, 2016

The Obesity Conundrum

"You wouldn't choose to be called every name in the book, you wouldn't choose to worry that, every time you walk into a restaurant, who's watching?"
Marty Enokson, 400 pounds, Edmonton paralegal

"There's been a lot of regulation of junk foods and fast foods. But we had a nagging suspicion that maybe we're asking too much of these foods. We don't really know how to get people to lose weight and to keep it off."                       David Just, co-director, Cornell Center for Behavioural Economics, Child Nutrition Programs
"Many people are asking what's wrong with being what is framed as 'obese', medically. Maybe that's the new normal."
Daniel Sellen, anthropologist, University of Toronto

 Chloe CushmanIllustration by Chloe Cushman

A huge study whose results saw publication in 2015 involved close to two million Brits aged from 55 and older, concluding that the incidence of dementia decreased right along with every increase in the BMI category. It was discovered in this study that being underweight in middle age (carrying on to old age) was where the increased risk of dementia occurred.

On the other hand obesity as a indicator of increased risk of heart disease, diabetes and early death, appears to be an established reality, although it doesn't hold true for everyone who is 'morbidly' obese. Dr. Arya Sharma with the University of Alberta believes that modest amounts of excess weight do not auger for a poor outcome. His Obesity Staging System grades obesity on a scale of zero to four, his scale accounting as well for the presence of disease.

Patients, his team discovered, in stages 0 or 1 are in fact at lower risk of dying from cardiovascular disease or coronary heart disease than those of normal weight. People with a history of weight cycling -- struggling to lose large amounts of weight and then re-gaining what they'd lost are those whom they isolate as being at higher risk of fat-related complications.

Health scientists now appear to agree that the highest death risks occur at the extremes; severely underweight, and grossly overweight. Based on 97 studies involving close to three million people, a review was published in Canadian Family Practice showing that a BMI below 20 or above 30 represents those extremes. BMIs of 20 to 24 (normal) to 25 to 30 (overweight) represent the lowest mortality risk.

A study published in December by Cornell University researchers found no relationship between how much sugared soda, candy and fat-and-salt-laden fast foods subjects ate, that 95 percent of Americans eating all these health-forbidden products do not, in fact gain weight hugely as a result of these choices. The study found that overweight, obese and including severely obese people tended to consume no more junk food than people of normal weight.

Excluded from that grouping, however, were those with a BMI of over 40. Another study found that we have added about 30 calories of sugar daily to diets since the 1970s, but a greater change was an additional 500 calories that our overall diet consumed in grains and fats. Health scientists speak of the Paleo diet, concentrating on meat, fish, vegetables and fruit with no grains, dairy or processed foods.

With that caveman-type diet, we would be leaner and our gut microbia more balanced, naturally regulating appetite and consumption.

Additionally, many researchers remain convinced that basic genetic endowments account for how we will behave, and remains the thrust toward obesity. To genes they ascribe an 80 percent responsibility of weight gain. Which among the 21,000 genes that represent the human body playing a role in "food-seeking behaviour", satiety, cravings, and how fat is stored and distributed have not yet been recognized.

Moreover, the risk itself has changed as time marches on. Researchers discovered that people born before 1942 had no demonstrated association between risk variant and obesity while those born afterward did. We are, it seems biologically determined to behave in certain ways by nature, in the mechanics of survival. Cutting back on portions triggers an anti-starvation response, slowing metabolism and raising ghrelin (the hunger hormone).

A recent study in the American Journal of Public Health observed that the chances of an obese person attaining "normal" body weight came to one in 210 for men, and one in 124 for women. Another study published by York University researchers indicated that at present, just to maintain the same weight, people need to work harder than they did in the past. "Our study results suggest that if you are 25, you'd have to eat even less and exercise more than those older, to prevent gaining weight" according to Jennifer Kuk, the study's co-author.

Which sounds pretty well as though we are still evolving. We were once hunter-gatherers and nature equipped us to be able to store energy as fat when food was plentiful, to prepare us for leaner times when food became scarce, to stave off starvation. Then we became farmers, and then factory workers and food became more available, so that stored fat stayed where it was since lean times had evaporated with history.

And, since 1980, obesity has more than doubled, advancing even in China, India and North Africa.

As yet, no "cure" for overeating and resulting obesity has been discovered; only a wide variety of "diets" all claiming to represent the answer to health, lost weight and longevity. While we munch away and collectively become more obese, more threatened by diabetes, coronary artery disease, and other debilitating and fateful illnesses complicating the quality and longevity of our existence.


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