One of the most pressing health issues in developed countries is obesity. It is central to our fitness failure. This is the second post in my series on Global Issues: Human Health that is part of a survey of the issues designed to help seekers find their own way to make a difference. The video above is rather shocking. It may convince you about the dangerous relationship between our love affair with corporate profits and the ill-health that is making our health care costs skyrocket.
For a more academic view, you will want to view the videos from The Skinny on Obesity, produced by the University of California. Robert Lustig presents the first video in the series, An Epidemic for Every Body. You will discover the problems caused by eating too much sugar and why the high fructose corn syrup found in almost all processed and “fast” foods is a leading cause of the current epidemic of obesity and disease. Together, these videos might be enough to prompt you to make a change in your own life!
What can you do? Here are just a few suggestions for how to reduce sugar in your diet:
- Get rid of sugar-containing drinks (especially soda) and minimize fruit juices
- Increase fiber in your diet with natural foods (many boxed cereals are laced with sugar and corn syrup)
- Wait 20 minutes for second portions (satiety signals are at the end of your intestine)
- Buy screen time for your kids with physical activity
Eating natural whole foods such as meat, fruit and vegetables will support your health and contribute to eliminating sugar and refined carbohydrates at the same time.
Fructose may be the culprit, but the evidence supporting this hypothesis is controversial. A more holistic view is that we live in a “toxic environment” (see Food Fight by Kelly Brownell). High fructose corn syrup likely contributes to our problems, but we are better off examining a constellation of issues, including increased portion size. I remember going in the late sixties to a very special place near my father’s office in Detroit that served huge one-quarter pound hamburgers. Once or twice a year we might splurge and buy one on a Saturday, for lunch. Now, you can buy a hamburger with three such patties.
Lest you think obesity is a problem only for wealthy countries, consider this story from the United Nations Poverty and obesity: a new epidemic and this recent journal article: The emerging epidemic of obesity in developing countries. How is obesity related to malnutrition? This blog post from the UN, Overweight and malnourished, has some answers. It is possible to be obese and hungry at the same time; see The Obesity-Hunger Paradox and The Obesity Paradox.
Obesity and malnutrition are the most obvious signs of poor fitness. Personal fitness encompasses the health of our bodies, minds, and spirits. It includes all those practices we engage in during our everyday lives and those we choose to do to remain healthy, outside the realm of doctors, drugs, and hospitals. Being fit makes our own lives better and reduces the costs of health care. Poor fitness has become an epidemic problem for children, and Michelle Obama is leading a program to do something about it by getting kids outside and moving.
Hints for Further Research
The peptide hormone ghrelin helps make our hunger pangs go away, but we do not feel full until food reaches the end of our intestines, which release peptide YY. These hormonal signals are critical to ensuring that we do not get too fat. If we attempt to circumvent these natural signals with unnatural foods and eating patterns, we will contribute to our overweight problem.
Similarly, exercise itself can have beneficial effects on weight control. Part of this is the result of the increased basal metabolic rate of the physically fit and part is due to hormonal influences of exercise. High stress shifts our behavior to overeating. Mental stress makes us hungry. Exercise reduces stress. The relationships are an interesting area for further research.
Episode 5 of Skinny on Obesity brings us back to maternal health by emphasizing the importance of good nutrition for women of child-bearing years and during pregnancy and lactation. Especially important in the global perspective is the lack of critical nutrients. Lack of iodine and protein-calorie deficiency can cause serious mental impairment. A lack of iron causes anemia in mothers, a leading cause of maternal death during childbirth. An article from the Journal of the American Dietary Association, Poverty, Obesity, and Malnutrition: An International Perspective Recognizing the Paradox outlines the issues.
An interesting twist on the call for natural foods are special supplements designed in the laboratory to restore the malnourished. The United Nations World Food Conference of 1974 declared Spirulina “the best food for the future.” Is supplementation with micronutrients better than providing healthy, natural foods? You can answer that question for yourself, but my current thinking is that special supplements are good for emergency relief while we work to develop long-term nutrition supplies based on local, natural foods.
High fructose corn syrup has caused a great deal of controversy. Why is fructose bad? Is high fructose corn syrup worse than sucrose? Glucose stimulates insulin release from the beta islet cells of the pancreas, but fructose does not. Fructose is metabolized primarily in the liver. Once inside the liver cell, fructose can enter the pathways that provide glycerol, the backbone for triacylglycerol. So, even though the glycemic index of fructose is low, it may contribute to obesity.
Milk, meats and most vegetables have no fructose; only 5–10% fructose by weight is found in fruits such as grapes, apples and blueberries. Honey and molasses and common dried fruits have a content of less than 10% fructose sugar. One argument that our problems stem from the high levels of fructose found in corn syrups is the correlation between increasing numbers of overweight individuals and the increase in high fructose corn syrup since its introduction in 1974. The confounding variable is the increase in sugar consumption over the same time. Even so, an alarming issue is the extent of subsidies for food sources that are less than health and the high cost of health foods. See, for example Apples to Twinkies 2012 from US PIRG. We need to pay attention to these trends.
A research group at Princeton tells us fructose is bad. Even so, the American Medical Association and their experts at the American Journal of Clinical Nutrition disagree, although you can find articles in the same journal that take a different stance. Is the group at Princeton right? They propose that it may be the imabalance of higher fructose in corn syrup that is the culprit.
A very recent article from the Annals of Internal Medicine repeats the mantra that calories are the culprit and not fructose. The problem is that both fructose use and calorie counts have increased dramatically over the past fifty years. At the same time, consider the source. WebMD is adamantly opposed to the fructose hypothesis and the health system profits from our ill health, just as the military-industrial complex profits from our fear of terrorism. Fears in both camps are in their self-interest to preserve. Consider as one example Food without Thought: How U.S. Farm Policy Contributes to Obesity.
The Lancet recently published a series of their articles on obesity. Especially interesting is the metabolic syndrome, a group of health problems that include diabetes and heart diseas. “Obesity travels with those diseases” which account for some 75% of health care expenditures. The United Nations see this as a challenge of epidemic proportions even in developing world, even more so than infectious diseases.