We’re in a new age of obesity. How did it happen?(theguardian.com)
theguardian.com
We’re in a new age of obesity. How did it happen?
https://www.theguardian.com/commentisfree/2018/aug/15/age-of-obesity-shaming-overweight-people
11 comments
> the food that's most pushed in modern western countries is full of sugars and carbohydrates.
Starting a ketogenic diet really made this frighteningly apparent to me. I had never really looked at carb or sugar counts in foods before. I now have to make sure to have my own snacks with me or nearby if I'm going somewhere other than home for more than a few hours. It's surprisingly hard to find a quick bite that isn't primarily composed of carbs or doesn't have added sugar.
Starting a ketogenic diet really made this frighteningly apparent to me. I had never really looked at carb or sugar counts in foods before. I now have to make sure to have my own snacks with me or nearby if I'm going somewhere other than home for more than a few hours. It's surprisingly hard to find a quick bite that isn't primarily composed of carbs or doesn't have added sugar.
this is exactly what I had in mind when writing my comment. I'm on keto and I've fallen off numerous times in the past because it takes serious effort to maintain. The solution my wife and I have opted for is meal prep (cooking meals in batches) and buying in keto snacks in advance. If I find myself caught short and need to nip to the shops for food on the go, I'm usually restricted to one of 5-6 items in a moderately-sized shop. Even supermarkets might only contain 10 things I can have in the entire place. The dominance of carbs and sugar is truly mind-blowing.
If healthy diets were the default easy option and you had to go out of your way to get access to processed sugary foods, I suspect we'd see a drastically lower obesity rate.
If healthy diets were the default easy option and you had to go out of your way to get access to processed sugary foods, I suspect we'd see a drastically lower obesity rate.
Hah, yeah seriously I was at the airport last week and literally could not find one single item in the convenience store that I could have other than plain water. Even their seltzer water had added sugar...
Miles Kimball has some great blog posts digging into the evidence for this: https://blog.supplysideliberal.com/post/2017/9/21/obesity-is...
Eating 'right' is only half of it. Many folks don't realize that they also should exercise.
They should, but the reducing energy intake takes the least amount of effort by far when it comes to losing weight.
You don't even have to eat "right", just eating less would be enough. For example I still love my pizzas and hamburgers, but I eat smaller portions so the amount of kcals I consume is in line with what I need.
You don't even have to eat "right", just eating less would be enough. For example I still love my pizzas and hamburgers, but I eat smaller portions so the amount of kcals I consume is in line with what I need.
It's literally an equation, calories in = calories out. Any sustained inequality will lead to either eventual obesity or a slow death by starvation.
It's literally not. The human body is much more complicated than that. Repeating this mantra is never going to help anybody.
The most important thing is for people to fix the kind of food they consume so their appetite (hormones) self-regulates. Were people thin in the 1960's because they were counting calories?
https://www.healthline.com/nutrition/debunking-the-calorie-m...
The most important thing is for people to fix the kind of food they consume so their appetite (hormones) self-regulates. Were people thin in the 1960's because they were counting calories?
https://www.healthline.com/nutrition/debunking-the-calorie-m...
From the article, which does also mention the second law of thermodynamics.
> Saying that weight gain is caused by excess calories is true, but meaningless. It tells you nothing about the actual cause.
Most likely people were thin in the 60s because they consumed less calories then we do now.
> Saying that weight gain is caused by excess calories is true, but meaningless. It tells you nothing about the actual cause.
Most likely people were thin in the 60s because they consumed less calories then we do now.
I think you're arguing past each other - magicalhippo is arguing that it's easier, willpower-wise, to eat one less slice of pizza than it is to go to the gym and run on a treadmill for 20 minutes. Either way it's less caloric surplus.
I'm not arguing with anyone. I agree with their comment. They are addressing the 'calorie in' part, and I the 'calorie out' part. Obviously you can't focus only on one and not the other. Limiting intake is sometimes easier, but increasing usage of calories isn't as 'hard' as going to the gym all the time (e.g. walk to work, take stairs, etc)
Then ignore me :^)
[edit]:
> but increasing usage of calories isn't as 'hard' as going to the gym all the time (e.g. walk to work, take stairs, etc)
Not all the time, but given some baseline of activity predicated on having a normal routine that's fairly good (ie including routine exercise like your listed examples), increasing activity further is likely to be more strenuous than lowering consumption. Or in other words, once you're past the quick wins that you can easily integrate into your day you're more likely to get results from decreasing/improving consumption.
[edit]:
> but increasing usage of calories isn't as 'hard' as going to the gym all the time (e.g. walk to work, take stairs, etc)
Not all the time, but given some baseline of activity predicated on having a normal routine that's fairly good (ie including routine exercise like your listed examples), increasing activity further is likely to be more strenuous than lowering consumption. Or in other words, once you're past the quick wins that you can easily integrate into your day you're more likely to get results from decreasing/improving consumption.
Yea totally agree with your edit/point. I was originally advocating for adoption of the quick wins, since I still see lots of folks who want to lose weight but couldn't be bothered to, for example, walk up a flight of stairs (despite being physically capable of doing so).
this is covered in the article. Lack of exercise is surely contributing to obesity, but not as much as bad eating habits. A good run could burn off 500 kcal but a relatively small amount of sugar/carbs will negate a lot of that. There's an argument for increasing basal metabolic rate through exercise but countering a bad diet with a high BMR is making things harder for yourself needlessly.
I think the most fascinating thing about this is the study that said it was happening to lab animals with controlled diets, also.
Pet hypothesis: It takes a large amount of energy to maintain our body temperature. What if one cause is the spread of climate control. AC and affordable indoor heat mean we don't spend much energy on thermal regulation.
Pet hypothesis: It takes a large amount of energy to maintain our body temperature. What if one cause is the spread of climate control. AC and affordable indoor heat mean we don't spend much energy on thermal regulation.
I don't know, looking at this obesity map[1] I don't see much of a difference between northern/southern states. If anything there are more southern states with extreme (35%+) obesity. Doesn't mean it doesn't contribute partially though. It's also very crude data.
[1]: https://stateofobesity.org/adult-obesity/
[1]: https://stateofobesity.org/adult-obesity/
Here's a graph with the prevalence of AC by region. It could also be related to the affordability of heat (my grandparents kept the house very cool). I have no idea if there's something to this, but interesting to poke at.
https://www.eia.gov/consumption/residential/reports/images/a...
https://www.eia.gov/consumption/residential/reports/images/a...
I'm middle-aged, and even out in the sticks we had window air-conditioning. And affordable indoor heating has been a thing since long before I was born. Yet oddly enough, previous generations weren't butterballs. I didn't play a lot of Nintendo growing up, though.
An interesting hypothesis, but I think it easier to point to sedentary lifestyles and poor Western diets before I go off on a tangent like that.
An interesting hypothesis, but I think it easier to point to sedentary lifestyles and poor Western diets before I go off on a tangent like that.
How does that explain the study showing weight gain in labratory animals with controlled diets?
Interesting. I never heat or cool my house (other than opening the windows), and while not being particularly careful with my diet, I've never had any weight issues. I think your hypothesis merits further investigation.
I would guess it's more like environmental temperature leads to behavioral changes that then affect the average energy expenditure.
I think what I'm worried about is approaching ketosis with skepticism. Are people wrong on this? I hope not. Specifically, I remember growing up and hearing about Weight Watchers, Atkins, and a number of other trendy diets, and for some these approaches worked.
But it doesn't seem to be universal. And I don't know how much of it is personal choice and commitment or dietary reality. Are people really overeating and saying "no" less, or are our foods inherently more calorie dense? I suspect maybe it's both? I'm not sure.
The latest talk on the Internet seems to be that to burn fat, rather than just reducing caloric intake, a more effective combined effort would be to put your body in ketosis.
That being said, I grew up on being taught out of outdated health textbooks in charter school from the 70s with food pyramids. I remember the largest part of the food pyramid from the 90s being bread, cereal, rice & pasta. All foods you would religiously avoid by today's advice for weight loss.
But it doesn't seem to be universal. And I don't know how much of it is personal choice and commitment or dietary reality. Are people really overeating and saying "no" less, or are our foods inherently more calorie dense? I suspect maybe it's both? I'm not sure.
The latest talk on the Internet seems to be that to burn fat, rather than just reducing caloric intake, a more effective combined effort would be to put your body in ketosis.
That being said, I grew up on being taught out of outdated health textbooks in charter school from the 70s with food pyramids. I remember the largest part of the food pyramid from the 90s being bread, cereal, rice & pasta. All foods you would religiously avoid by today's advice for weight loss.
All that matters for weight loss (and weight gain) is calories in and calories out (CICO).
All of the "special" diets that people propose work on this principle. They simply take different approaches to try to make "eating less" easier.
Certain foods make you feel fuller than others, so some people have success changing their diets to include more of those foods. Other people have success just eating less of what they eat now without changing their diet.
As far as I know, the keto diet is designed to treat epilepsy in children. There is no current scientific consensus that keto helps with weight loss compared to any other diet with a similar CICO.
I'm sure people are researching it right now so that could change, but we know enough about how the laws of physics and the human body work to know that whatever is happening, CICO is the basis of it.
All of the "special" diets that people propose work on this principle. They simply take different approaches to try to make "eating less" easier.
Certain foods make you feel fuller than others, so some people have success changing their diets to include more of those foods. Other people have success just eating less of what they eat now without changing their diet.
As far as I know, the keto diet is designed to treat epilepsy in children. There is no current scientific consensus that keto helps with weight loss compared to any other diet with a similar CICO.
I'm sure people are researching it right now so that could change, but we know enough about how the laws of physics and the human body work to know that whatever is happening, CICO is the basis of it.
I'm a little confused about their numbers - they say we currently consume an average of 2,130 kilocalories a day, but in 1976 the average was 2,590 kilocalories.
Unless people were doing an absurd amount of additional exercise in 1976 (like running multiple miles every day), how is it mathematically possible that people are more obese now but eat less on average?
The article seems to imply that it's because we eat differently than people in 1976 (more sugar and what not), but as far as I know calories in -> calories out is the only factor in weight gain/loss aside from uncommon hormonal issues.
Unless people were doing an absurd amount of additional exercise in 1976 (like running multiple miles every day), how is it mathematically possible that people are more obese now but eat less on average?
The article seems to imply that it's because we eat differently than people in 1976 (more sugar and what not), but as far as I know calories in -> calories out is the only factor in weight gain/loss aside from uncommon hormonal issues.
His current number (2130) comes from the UK's “Family food datasets”. The first thing you see when you open up the UK nutrient intake spreadsheet is this message:
> It is a widely recognised characteristic of self reported diary surveys such as Family Food that survey respondents tend to under report their purchases (and any derived nutrient intakes based on purchased quantities are also likely to be underestimates). Empirical comparisons of sales and duty data for alcohol in particular suggest that reported alcohol consumption could be 40-60 per cent lower than the reality. For other food and drink, reporting is likely to be closer to actual purchases, but underreporting is likely to feature and some food types may be underreported to a greater extent than others.
Here's a paper that critiques the survey results in detail: http://38r8om2xjhhl25mw24492dir-wpengine.netdna-ssl.com/wp-c...
> It is a widely recognised characteristic of self reported diary surveys such as Family Food that survey respondents tend to under report their purchases (and any derived nutrient intakes based on purchased quantities are also likely to be underestimates). Empirical comparisons of sales and duty data for alcohol in particular suggest that reported alcohol consumption could be 40-60 per cent lower than the reality. For other food and drink, reporting is likely to be closer to actual purchases, but underreporting is likely to feature and some food types may be underreported to a greater extent than others.
Here's a paper that critiques the survey results in detail: http://38r8om2xjhhl25mw24492dir-wpengine.netdna-ssl.com/wp-c...
Hahaha so that research is one big collective "I don't even eat that much" self-delusion.
I did want this article to be correct and to have a quick fix for obesity, but I guess I have to go back to my diet :(
> calories in -> calories out is the only factor in weight gain/loss aside from uncommon hormonal issues.
This is not the case. A helthy person could eat a diet of same energy content and, and end up more or less fat, dependent of what the food was.
Also, it's worth noting, that insulin resistance is in fact a hormonal issue, though a common one. Insulin regulates fat metabolism.
But the main flaw in the "calories in, calories out" meme isn't correctness - the main flaw is that it focuses on the wrong thing. Our food consumption is driven by our feeling of satiety and other hunger regulating hormones. It's possible to eat less than your body wants to by exerting willpower, but it's not sustainable for the vast majority of people.
This is not the case. A helthy person could eat a diet of same energy content and, and end up more or less fat, dependent of what the food was.
Also, it's worth noting, that insulin resistance is in fact a hormonal issue, though a common one. Insulin regulates fat metabolism.
But the main flaw in the "calories in, calories out" meme isn't correctness - the main flaw is that it focuses on the wrong thing. Our food consumption is driven by our feeling of satiety and other hunger regulating hormones. It's possible to eat less than your body wants to by exerting willpower, but it's not sustainable for the vast majority of people.
> A helthy person could eat a diet of same energy content and, and end up more or less fat, dependent of what the food was.
Could you point me in the direction of more information about this? It is contrary to everything that I've read on the topic so far (which, to be fair, hasn't been that much).
Could you point me in the direction of more information about this? It is contrary to everything that I've read on the topic so far (which, to be fair, hasn't been that much).
There are many things that fall under that. Let me rattle of a few off the top of my head: (1) diet composition affects how eagerly your body stores energy in fat (related to sugars & insulin) - see eg https://www.physiology.org/doi/abs/10.1152/ajpendo.00283.201..., (2) different foods take varying amounts of energy to digest in the body (eg proteins and high fiber foods vs fast carbs), (3) the body's metabolic rate partly depends on how you eat and starts to conserve energy if you have long periods between meals, (4) your diet and rythm of meals also affects your general feeling of activity which can make you a couch potato or a evening walk person, (5) check out the research on intermittent fasting and ketogenic diets.
But this is not the main problem with the calories-in-calories-out meme; the main problem is that the feeling of hunger and appetite counts, not calories eaten. Satiety feelings are what regulates food intake in most people. Counting calories is not a solution to the obesity epidemic because continuously exerting willpower against your natural feeling of appetite is not sustainable for the vast majority of people.
But this is not the main problem with the calories-in-calories-out meme; the main problem is that the feeling of hunger and appetite counts, not calories eaten. Satiety feelings are what regulates food intake in most people. Counting calories is not a solution to the obesity epidemic because continuously exerting willpower against your natural feeling of appetite is not sustainable for the vast majority of people.
Ex-fat person here. 14 stone at 14 years of age.
I stopped eating so much and took up regular exercise.
I am no longer fat.
I stopped eating so much and took up regular exercise.
I am no longer fat.
Out of curiosity, what is the socio-economic level, education level, and relative health of your parents? That is statistically a stronger contributor to a child's health than the desire to simply lose weight.
Hi folks,
I am a bit confused about a citation given in this opinion piece and ask for your help. In paragraph 5, the author mentions the effect of manual labor and cites an article published in the International Journal of Surgery Oncology. In this article they state that:
"Adults working in unskilled manual profession are over 4 times more likely to be classified as morbidly obese compared with those in professional employments",
and they show a graph to support this. However, the graph seems to show the opposite. I looks like males who perform manual labor have a lower prevalence of obesity than those of non-manual labor. Am I reading this wrong?
I am a bit confused about a citation given in this opinion piece and ask for your help. In paragraph 5, the author mentions the effect of manual labor and cites an article published in the International Journal of Surgery Oncology. In this article they state that:
"Adults working in unskilled manual profession are over 4 times more likely to be classified as morbidly obese compared with those in professional employments",
and they show a graph to support this. However, the graph seems to show the opposite. I looks like males who perform manual labor have a lower prevalence of obesity than those of non-manual labor. Am I reading this wrong?
You're not wrong. The graphs (figures 7 and 8) don't match the numbers. I think the graphs are mislabeled.
But even if the graphs are mislabeled, the numbers don't agree with the statement. The 2010 data for prevalence of obese men shows an increase from 27% to 29%... without error bars given. In what world does that translate to "over 4 times more likely to be classified as morbidly obese"?
I wrote a blog about addressing this a while ago: https://www.subu.io/post/176259843689/one-step-from-the-farm
Granted I have a greater than normal calorie burn right now, it still has been an amazing switch to move away from highly processed stuff. Keto was too painful for me to try (I need the carbs for cycling), So this one. It has been great while giving me enough energy to keep my habit!
Granted I have a greater than normal calorie burn right now, it still has been an amazing switch to move away from highly processed stuff. Keto was too painful for me to try (I need the carbs for cycling), So this one. It has been great while giving me enough energy to keep my habit!
Really simple. Humans weren't made to sit on their ass all day. Obesity used to happen to the nobility too. Physical labor is niche now.
Indeed. We can tinker with diets and nag people to eat less until the cows come home, but humans are engineered to do physical activity at least half the day and that's not easy to replace.
> More alarmingly, according to a paper in the Lancet, more than 90% of policymakers believe that “personal motivation” is “a strong or very strong influence on the rise of obesity”.
This is the "calories in, calories out" meme. It's very bad.
This is the "calories in, calories out" meme. It's very bad.
Can you suggest an alternative theory for the rise of obesity, other than prolonged caloric surplus?
Sugar: The Bitter Truth https://www.youtube.com/watch?v=dBnniua6-oM
Dietary caloric surplus is a solid, time-tested explanation for rising obesity that people, like the author of this article, just don't like. There are a variety of reasons that people eat more and move less now than previously, but ultimately it's the caloric surplus that causes obesity.
From the article:
> So here’s the first big surprise: we ate more in 1976. According to government figures, we currently consume an average of 2,130 kilocalories a day, a figure that appears to include sweets and alcohol. But in 1976, we consumed 2,280 kcal excluding alcohol and sweets, or 2,590 kcal when they’re included.
On the other hand, the UN's Food and Agriculture Organization data shows a very clear upward trend in per capita calorie supply in the US (since 1961) and the UK (since 1982).
https://ourworldindata.org/grapher/daily-per-capita-supply-o...
https://ourworldindata.org/food-per-person#the-global-perspe...
Per capita calorie supply means the calories delivered to the household for each person. It doesn't account for food not eaten.
From the article:
> I have found no reason to disbelieve the figures.
Meanwhile, I clicked through the “government figures” link in the article and downloaded the “UK - household and eating out nutrient intakes” file. The file itself tells you to be skeptical of the numbers therein:
> It is a widely recognised characteristic of self reported diary surveys such as Family Food that survey respondents tend to under report their purchases (and any derived nutrient intakes based on purchased quantities are also likely to be underestimates). Empirical comparisons of sales and duty data for alcohol in particular suggest that reported alcohol consumption could be 40-60 per cent lower than the reality. For other food and drink, reporting is likely to be closer to actual purchases, but underreporting is likely to feature and some food types may be underreported to a greater extent than others.
> Although such surveys are completely confidential, respondents may under report for a range of reasons, from self consciousness to simply forgetting to record purchases. 'Top up' and eating out purchases are probably more likely to be missed than the main household shop. There is no evidence to say whether levels of underreporting have changed over time but it is plausible that changes in household shopping and eating patterns may have contributed to increased underreporting.
> Users should bear this issue in mind, when considering trends in estimated intakes and the values for individual years. For example the downward trend in energy intake estimates can appear counter-intuitive at face value given other evidence on the prevalence of obesity. Factors affecting obesity and other health issues are complex. Family Food trends are broadly consistent with other sources, such as the National Diet and Nutrition Survey, which also show reported energy intake in decline, although NDNS intakes are also known to be underreported.
Furthermore, obese subjects are more likely to under-report intake and over-report activity. Example: https://www.ncbi.nlm.nih.gov/pubmed/1454084
From the article:
> A paper last year in the International Journal of Surgery states that “adults working in unskilled manual professions are over four times more likely to be classified as morbidly obese compared with those in professional employment”.
“International Journal of Surgery” links to this paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5673154/ The paper cites “UK Parliament. Select Committee on health—third report. 2004”, available here: https://publications.parliament.uk/pa/cm200304/cmselect/cmhe...
The committee report says (§1 ¶38):
> 38. In common with most public health problems the impact of obesity mirrors many other health inequalities. Men and women working in unskilled manual occupations are over four times as likely as those in professional employment to be classified as morbidly obese.[28] The Health Survey for England has shown that in 2001 amongst professional groups 14% of men and women were obese, compared to 28% of women and 19% of men in unskilled manual occupations.[29]
I'm unable to track down the text of references [28] and [29].
But please note this other very interesting thing that the committee report says (§2 ¶67):
> It is certain that obesity develops only when there is a sustained imbalance between the amount of energy consumed by a person and the amount used up in everyday life.
I wonder why the article doesn't quote that?
Occam's Razor says that obesity comes from eating too much and moving too little, and that articles like this come from wishful thinking and ignoring the evidence.
From the article:
> So here’s the first big surprise: we ate more in 1976. According to government figures, we currently consume an average of 2,130 kilocalories a day, a figure that appears to include sweets and alcohol. But in 1976, we consumed 2,280 kcal excluding alcohol and sweets, or 2,590 kcal when they’re included.
On the other hand, the UN's Food and Agriculture Organization data shows a very clear upward trend in per capita calorie supply in the US (since 1961) and the UK (since 1982).
https://ourworldindata.org/grapher/daily-per-capita-supply-o...
https://ourworldindata.org/food-per-person#the-global-perspe...
Per capita calorie supply means the calories delivered to the household for each person. It doesn't account for food not eaten.
From the article:
> I have found no reason to disbelieve the figures.
Meanwhile, I clicked through the “government figures” link in the article and downloaded the “UK - household and eating out nutrient intakes” file. The file itself tells you to be skeptical of the numbers therein:
> It is a widely recognised characteristic of self reported diary surveys such as Family Food that survey respondents tend to under report their purchases (and any derived nutrient intakes based on purchased quantities are also likely to be underestimates). Empirical comparisons of sales and duty data for alcohol in particular suggest that reported alcohol consumption could be 40-60 per cent lower than the reality. For other food and drink, reporting is likely to be closer to actual purchases, but underreporting is likely to feature and some food types may be underreported to a greater extent than others.
> Although such surveys are completely confidential, respondents may under report for a range of reasons, from self consciousness to simply forgetting to record purchases. 'Top up' and eating out purchases are probably more likely to be missed than the main household shop. There is no evidence to say whether levels of underreporting have changed over time but it is plausible that changes in household shopping and eating patterns may have contributed to increased underreporting.
> Users should bear this issue in mind, when considering trends in estimated intakes and the values for individual years. For example the downward trend in energy intake estimates can appear counter-intuitive at face value given other evidence on the prevalence of obesity. Factors affecting obesity and other health issues are complex. Family Food trends are broadly consistent with other sources, such as the National Diet and Nutrition Survey, which also show reported energy intake in decline, although NDNS intakes are also known to be underreported.
Furthermore, obese subjects are more likely to under-report intake and over-report activity. Example: https://www.ncbi.nlm.nih.gov/pubmed/1454084
From the article:
> A paper last year in the International Journal of Surgery states that “adults working in unskilled manual professions are over four times more likely to be classified as morbidly obese compared with those in professional employment”.
“International Journal of Surgery” links to this paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5673154/ The paper cites “UK Parliament. Select Committee on health—third report. 2004”, available here: https://publications.parliament.uk/pa/cm200304/cmselect/cmhe...
The committee report says (§1 ¶38):
> 38. In common with most public health problems the impact of obesity mirrors many other health inequalities. Men and women working in unskilled manual occupations are over four times as likely as those in professional employment to be classified as morbidly obese.[28] The Health Survey for England has shown that in 2001 amongst professional groups 14% of men and women were obese, compared to 28% of women and 19% of men in unskilled manual occupations.[29]
I'm unable to track down the text of references [28] and [29].
But please note this other very interesting thing that the committee report says (§2 ¶67):
> It is certain that obesity develops only when there is a sustained imbalance between the amount of energy consumed by a person and the amount used up in everyday life.
I wonder why the article doesn't quote that?
Occam's Razor says that obesity comes from eating too much and moving too little, and that articles like this come from wishful thinking and ignoring the evidence.
Overall it seems like a fundamental issue with the "food ecosystem" we surround ourselves with, and the types of food that it encourages us to eat. You could even include in that the inclination to treat eating as a chore to be performed instead of cooking and food as part and parcel of a fulfilled life, leading to products like soylent that promote themselves as a least-inconvenient meal.