Tag Archives: obesity

Idea Soup

Sugar Is Bad For You, Really? Really!

 

sugar moleculesIn case you may not have heard, sugar is bad for you. In fact, an increasing number of food scientists will tell you that sugar is a poison, and that it’s time to fight the sugar oligarchs in much the same way that health advocates resolved to take on big tobacco many decades ago.

From the Guardian:

If you have any interest at all in diet, obesity, public health, diabetes, epidemiology, your own health or that of other people, you will probably be aware that sugar, not fat, is now considered the devil’s food. Dr Robert Lustig’s book, Fat Chance: The Hidden Truth About Sugar, Obesity and Disease, for all that it sounds like a Dan Brown novel, is the difference between vaguely knowing something is probably true, and being told it as a fact. Lustig has spent the past 16 years treating childhood obesity. His meta-analysis of the cutting-edge research on large-cohort studies of what sugar does to populations across the world, alongside his own clinical observations, has him credited with starting the war on sugar. When it reaches the enemy status of tobacco, it will be because of Lustig.

“Politicians have to come in and reset the playing field, as they have with any substance that is toxic and abused, ubiquitous and with negative consequence for society,” he says. “Alcohol, cigarettes, cocaine. We don’t have to ban any of them. We don’t have to ban sugar. But the food industry cannot be given carte blanche. They’re allowed to make money, but they’re not allowed to make money by making people sick.”

Lustig argues that sugar creates an appetite for itself by a determinable hormonal mechanism – a cycle, he says, that you could no more break with willpower than you could stop feeling thirsty through sheer strength of character. He argues that the hormone related to stress, cortisol, is partly to blame. “When cortisol floods the bloodstream, it raises blood pressure; increases the blood glucose level, which can precipitate diabetes. Human research shows that cortisol specifically increases caloric intake of ‘comfort foods’.” High cortisol levels during sleep, for instance, interfere with restfulness, and increase the hunger hormone ghrelin the next day. This differs from person to person, but I was jolted by recognition of the outrageous deliciousness of doughnuts when I haven’t slept well.

“The problem in obesity is not excess weight,” Lustig says, in the central London hotel that he has made his anti-metabolic illness HQ. “The problem with obesity is that the brain is not seeing the excess weight.” The brain can’t see it because appetite is determined by a binary system. You’re either in anorexigenesis – “I’m not hungry and I can burn energy” – or you’re in orexigenesis – “I’m hungry and I want to store energy.” The flip switch is your leptin level (the hormone that regulates your body fat) but too much insulin in your system blocks the leptin signal.

It helps here if you have ever been pregnant or remember much of puberty and that savage hunger; the way it can trick you out of your best intentions, the lure of ridiculous foods: six-month-old Christmas cake, sweets from a bin. If you’re leptin resistant – that is, if your insulin is too high as a result of your sugar intake – you’ll feel like that all the time.

Telling people to simply lose weight, he tells me, “is physiologically impossible and it’s clinically dangerous. It’s a goal that’s not achievable.” He explains further in the book: “Biochemistry drives behaviour. You see a patient who drinks 10 gallons of water a day and urinates 10 gallons of water a day. What is wrong with him? Could he have a behavioural disorder and be a psychogenic water drinker? Could be. Much more likely he has diabetes.” To extend that, you could tell people with diabetes not to drink water, and 3% of them might succeed – the outliers. But that wouldn’t help the other 97% just as losing the weight doesn’t, long-term, solve the metabolic syndrome – the addiction to sugar – of which obesity is symptomatic.

Many studies have suggested that diets tend to work for two months, some for as long as six. “That’s what the data show. And then everybody’s weight comes roaring back.” During his own time working night shifts, Lustig gained 3st, which he never lost and now uses exuberantly to make two points. The first is that weight is extremely hard to lose, and the second – more important, I think – is that he’s no diet and fitness guru himself. He doesn’t want everybody to be perfect: he’s just a guy who doesn’t want to surrender civilisation to diseases caused by industry. “I’m not a fitness guru,” he says, puckishly. “I’m 45lb overweight!”

“Sugar causes diseases: unrelated to their calories and unrelated to the attendant weight gain. It’s an independent primary-risk factor. Now, there will be food-industry people who deny it until the day they die, because their livelihood depends on it.” And here we have the reason why he sees this is a crusade and not a diet book, the reason that Lustig is in London and not Washington. This is an industry problem; the obesity epidemic began in 1980. Back then, nobody knew about leptin. And nobody knew about insulin resistance until 1984.

“What they knew was, when they took the fat out they had to put the sugar in, and when they did that, people bought more. And when they added more, people bought more, and so they kept on doing it. And that’s how we got up to current levels of consumption.” Approximately 80% of the 600,000 packaged foods you can buy in the US have added calorific sweeteners (this includes bread, burgers, things you wouldn’t add sugar to if you were making them from scratch). Daily fructose consumption has doubled in the past 30 years in the US, a pattern also observable (though not identical) here, in Canada, Malaysia, India, right across the developed and developing world. World sugar consumption has tripled in the past 50 years, while the population has only doubled; it makes sense of the obesity pandemic.

“It would have happened decades earlier; the reason it didn’t was that sugar wasn’t cheap. The thing that made it cheap was high-fructose corn syrup. They didn’t necessarily know the physiology of it, but they knew the economics of it.” Adding sugar to everyday food has become as much about the industry prolonging the shelf life as it has about palatability; if you’re shopping from corner shops, you’re likely to be eating unnecessary sugar in pretty well everything. It is difficult to remain healthy in these conditions. “You here in Britain are light years ahead of us in terms of understanding the problem. We don’t get it in the US, we have this libertarian streak. You don’t have that. You’re going to solve it first. So it’s in my best interests to help you, because that will help me solve it back there.”

The problem has mushroomed all over the world in 30 years and is driven by the profits of the food and diet industries combined. We’re not looking at a global pandemic of individual greed and fecklessness: it would be impossible for the citizens of the world to coordinate their human weaknesses with that level of accuracy. Once you stop seeing it as a problem of personal responsibility it’s easier to accept how profound and serious the war on sugar is. Life doesn’t have to become wholemeal and joyless, but traffic-light systems and five-a-day messaging are under-ambitious.

“The problem isn’t a knowledge deficit,” an obesity counsellor once told me. “There isn’t a fat person on Earth who doesn’t know vegetables are good for you.” Lustig agrees. “I, personally, don’t have a lot of hope that those things will turn things around. Education has not solved any substance of abuse. This is a substance of abuse. So you need two things, you need personal intervention and you need societal intervention. Rehab and laws, rehab and laws. Education would come in with rehab. But we need laws.”

Read the entire article here.

Image: Molecular diagrams of sucrose (left) and fructose (right). Courtesy of Wikipedia.

 

Idea Soup

The How and Why of Supersized Sodas

Apparently the Great Depression in the United States is to blame for the mega-sized soda drinks that many now consume on a daily basis, except in New York City of course (sugary drinks larger than 16oz were banned for sale in restaurants beginning September 13, 2012).

[div class=attrib]From Wired:[end-div]

The New York City Board of Health voted Thursday to ban the sale of sugary soft drinks larger than 16 ounces at restaurants, a move that has sparked intense debate between public health advocates and beverage industry lobbyists. When did sodas get so big in the first place?

In the 1930s. At the beginning of the Great Depression, the 6-ounce Coca-Cola bottle was the undisputed king of soft drinks. The situation began to change in 1934, when the smallish Pepsi-Cola company began selling 12-ounces bottles for the same nickel price as 6 ounces of Coke. The move was brilliant. Distribution, bottling, and advertising accounted for most of the company’s costs, so adding six free ounces hardly mattered. In addition, the 12-ounce size enabled Pepsi-Cola to use the same bottles as beer-makers, cutting container costs. The company pursued a similar strategy at the nation’s soda fountains, selling enough syrup to make 10 ounces for the same price as 6 ounces worth of Coca-Cola. Pepsi sales soared, and the company soon produced a jingle about their supersize bottles: “Pepsi-Cola hits the spot, 12 full ounces, that’s a lot. Twice as much for a nickel, too. Pepsi-Cola is the drink for you.” Pepsi’s value-for-volume gambit kicked off a decades-long industry trend.

Coke was slow to respond at first, according to author Mark Pendergrast, who chronicled the company’s history in For God, Country, and Coca-Cola: The Definitive History of the Great American Soft Drink and the Company That Makes It. President Robert Woodruff held firm to the 6-ounce size, even as his subordinates warned him that Pepsi was onto something. By the 1950s, industry observers predicted that Coca-Cola might lose its dominant position, and top company executives were threatening to resign if Woodruff didn’t bend on bottle size. In 1955, 10- and 12-ounce “King Size” Coke bottles hit the market, along with a 26-ounce “Family Size.” Although the new flexibility helped Coca-Cola regain its footing, the brave new world of giant bottles was hard to accept for some. Company vice president Ed Forio noted that “bringing out another bottle was like being unfaithful to your wife.”

The trend toward larger sizes occurred in all sectors of the market. When Coca-Cola partnered with McDonald’s in the 1950s, the original fountain soda at the restaurant chain more closely approximated the classic Coke bottle at seven ounces. The largest cup size grew to 16 ounces in the 1960s and hit 21 ounces by 1974.

[div class=attrib]Read the entire article after the jump.[end-div]

[div class=attrib]Image: Big Gulp. Courtesy of Chicago Tribune.[end-div]

Environs

A Link Between BPA and Obesity

You have probably heard of BPA. It’s a compound used in the manufacture of many plastics, especially hard, polycarbonate plastics. Interestingly, it has hormone-like characteristics, mimicking estrogen. As a result, BPA crops up in many studies that show adverse health affects. As a precaution, the U.S. Food and Drug Administration (FDA) several years ago banned the use of BPA from products aimed at young children, such as baby bottles. But evidence remains inconsistent, so BPA is still found in many products today. Now comes another study linking BPA to obesity.

[div class=attrib]From Smithsonian:[end-div]

Since the 1960s, manufacturers have widely used the chemical bisphenol-A (BPA) in plastics and food packaging. Only recently, though, have scientists begun thoroughly looking into how the compound might affect human health—and what they’ve found has been a cause for concern.

Starting in 2006, a series of studies, mostly in mice, indicated that the chemical might act as an endocrine disruptor (by mimicking the hormone estrogen), cause problems during development and potentially affect the reproductive system, reducing fertility. After a 2010 Food and Drug Administration report warned that the compound could pose an especially hazardous risk for fetuses, infants and young children, BPA-free water bottles and food containers started flying off the shelves. In July, the FDA banned the use of BPA in baby bottles and sippy cups, but the chemical is still present in aluminum cans, containers of baby formula and other packaging materials.

Now comes another piece of data on a potential risk from BPA but in an area of health in which it has largely been overlooked: obesity. A study by researchers from New York University, published today in the Journal of the American Medical Association, looked at a sample of nearly 3,000 children and teens across the country and found a “significant” link between the amount of BPA in their urine and the prevalence of obesity.

“This is the first association of an environmental chemical in childhood obesity in a large, nationally representative sample,” said lead investigator Leonardo Trasande, who studies the role of environmental factors in childhood disease at NYU. “We note the recent FDA ban of BPA in baby bottles and sippy cups, yet our findings raise questions about exposure to BPA in consumer products used by older children.”

The researchers pulled data from the 2003 to 2008 National Health and Nutrition Examination Surveys, and after controlling for differences in ethnicity, age, caregiver education, income level, sex, caloric intake, television viewing habits and other factors, they found that children and adolescents with the highest levels of BPA in their urine had a 2.6 times greater chance of being obese than those with the lowest levels. Overall, 22.3 percent of those in the quartile with the highest levels of BPA were obese, compared with just 10.3 percent of those in the quartile with the lowest levels of BPA.

The vast majority of BPA in our bodies comes from ingestion of contaminated food and water. The compound is often used as an internal barrier in food packaging, so that the product we eat or drink does not come into direct contact with a metal can or plastic container. When heated or washed, though, plastics containing BPA can break down and release the chemical into the food or liquid they hold. As a result, roughly 93 percent of the U.S. population has detectable levels of BPA in their urine.

The researchers point specifically to the continuing presence of BPA in aluminum cans as a major problem. “Most people agree the majority of BPA exposure in the United States comes from aluminum cans,” Trasande said. “Removing it from aluminum cans is probably one of the best ways we can limit exposure. There are alternatives that manufacturers can use to line aluminum cans.”

[div class=attrib]Read the entire article after the jump.[end-div]

[div class=attrib]Image: Bisphenol A. Courtesy of Wikipedia.[end-div]

BigBang

Weight Loss and the Coordinated Defense Mechanism

New research into obesity and weight loss shows us why it’s so hard to keep weight lost from dieting from returning. The good news is that weight (re-)gain is not all due to a simple lack of control and laziness. However, the bad news is that keeping one’s weight down may be much more difficult due to the body’s complex defense mechanism.

Tara Parker-Pope over at the Well blog reviews some of the new findings, which seem to point the finger at a group hormones and specific genes that work together to help us regain those lost pounds.

[div class=attrib]From the New York Times:[end-div]

For 15 years, Joseph Proietto has been helping people lose weight. When these obese patients arrive at his weight-loss clinic in Australia, they are determined to slim down. And most of the time, he says, they do just that, sticking to the clinic’s program and dropping excess pounds. But then, almost without exception, the weight begins to creep back. In a matter of months or years, the entire effort has come undone, and the patient is fat again. “It has always seemed strange to me,” says Proietto, who is a physician at the University of Melbourne. “These are people who are very motivated to lose weight, who achieve weight loss most of the time without too much trouble and yet, inevitably, gradually, they regain the weight.”

Anyone who has ever dieted knows that lost pounds often return, and most of us assume the reason is a lack of discipline or a failure of willpower. But Proietto suspected that there was more to it, and he decided to take a closer look at the biological state of the body after weight loss.

Beginning in 2009, he and his team recruited 50 obese men and women. The men weighed an average of 233 pounds; the women weighed about 200 pounds. Although some people dropped out of the study, most of the patients stuck with the extreme low-calorie diet, which consisted of special shakes called Optifast and two cups of low-starch vegetables, totaling just 500 to 550 calories a day for eight weeks. Ten weeks in, the dieters lost an average of 30 pounds.

At that point, the 34 patients who remained stopped dieting and began working to maintain the new lower weight. Nutritionists counseled them in person and by phone, promoting regular exercise and urging them to eat more vegetables and less fat. But despite the effort, they slowly began to put on weight. After a year, the patients already had regained an average of 11 of the pounds they struggled so hard to lose. They also reported feeling far more hungry and preoccupied with food than before they lost the weight.

While researchers have known for decades that the body undergoes various metabolic and hormonal changes while it’s losing weight, the Australian team detected something new. A full year after significant weight loss, these men and women remained in what could be described as a biologically altered state. Their still-plump bodies were acting as if they were starving and were working overtime to regain the pounds they lost. For instance, a gastric hormone called ghrelin, often dubbed the “hunger hormone,” was about 20 percent higher than at the start of the study. Another hormone associated with suppressing hunger, peptide YY, was also abnormally low. Levels of leptin, a hormone that suppresses hunger and increases metabolism, also remained lower than expected. A cocktail of other hormones associated with hunger and metabolism all remained significantly changed compared to pre-dieting levels. It was almost as if weight loss had put their bodies into a unique metabolic state, a sort of post-dieting syndrome that set them apart from people who hadn’t tried to lose weight in the first place.

“What we see here is a coordinated defense mechanism with multiple components all directed toward making us put on weight,” Proietto says. “This, I think, explains the high failure rate in obesity treatment.”

[div class=attrib]Read the entire article here.[end-div]

[div class=attrib]Image courtesy of Science Daily.[end-div]

Idea Soup

Why Are the French Not as Overweight as Americans?

[div class=attrib]From the New York Times:[end-div]

PARIS — You’re reminded hourly, even while walking along the slow-moving Seine or staring at sculpted marble bodies under the Louvre’s high ceilings, that the old continent is crumbling. They’re slouching toward a gerontocracy, these Europeans. Their banks are teetering. They can’t handle immigration. Greece is broke, and three other nations are not far behind. In a half-dozen languages, the papers shout: crisis!

If the euro fails, as Chancellor Angela Merkel of Germany said, then Europe fails. That means a recession here, and a likely one at home, which will be blamed on President Obama, and then Rick Perry will get elected, and the leader of the free world will be somebody who thinks the earth is only a few thousand years old.

You see where it’s all going, this endless “whither the euro question.” So, you think of something else, the Parisian way. You think of what these people can eat on a given day: pain au chocolat for breakfast, soupe a? l’oignon gratine?e topped by melted gruyere for lunch and foie gras for dinner, as a starter.

And then you look around: how can they live like this? Where are all the fat people? It’s a question that has long tormented visitors. These French, they eat anything they damn well please, drink like Mad Men and are healthier than most Americans. And of course, their medical care is free and universal, and considered by many to be the best in the world.

… Recent studies indicate that the French are, in fact, getting fatter — just not as much as everyone else. On average, they are where Americans were in the 1970s, when the ballooning of a nation was still in its early stages. But here’s the good news: they may have figured out some way to contain the biggest global health threat of our time, for France is now one of a handful of nations where obesity among the young has leveled off.

First, the big picture: Us. We — my fellow Americans — are off the charts on this global pathology. The latest jolt came from papers published last month in The Lancet, projecting that three-fourths of adults in the United States will be overweight or obese by 2020.

Only one state, Colorado, now has an obesity rate under 20 percent (obesity is the higher of the two body-mass indexes, the other being overweight). But that’s not good news. The average bulge of an adult Coloradan has increased 80 percent over the last 15 years. They only stand out by comparison to all other states. Colorado, the least fat state in 2011, would be the heaviest had they reported their current rate of obesity 20 years ago. That’s how much we’ve slipped.

… A study of how the French appear to have curbed childhood obesity shows the issue is not complex. Junk food vending machines were banned in schools. The young were encouraged to exercise more. And school lunches were made healthier.

… But another answer can come from self-discovery. Every kid should experience a fresh peach in August. And an American newly arrived in the City of Light should nibble at a cluster of grapes or some blood-red figs, just as the French do, with that camembert.

[div class=attrib]More from the article here.[end-div]

[div class=attrib]Obesity classification standards illustration courtesy of Wikipedia.[end-div]