<p>Gary Taubes argues that this is completely backwards. He suggests that physiological factors (hormones, genetics) dictate fat storage and that the elevated fat storage forces us to eat more.</p>
<p>To illustrate the concept, consider a 14 year old boy in the middle of rampant growth spurt. His voracious appetite is caused by the rapid growth triggered by hormones. The kid didn’t suddenly become a glutton. The growth spurt is the controling event. The increased appetite is a result of that.</p>
<p>Or consider Robert Lustig’s analogy:</p>
<p>A perfectly balanced individual eating 2000 calories a day and burning 2000 calories a day, maintaining weight. Perfect equilibrium. A little bit of fat is stored each day and then burned off during the overnight hours.</p>
<p>Now, do something to make this individual store 500 extra calories as fat each day. The first thing that is going to happen is that this person is going to start getting fat. 3500 calories stored as fat each week is one pound of fat. Doesn’t take many weeks for that to show up. But, it’s even worse. Now, the person only has 1500 calories of fuel available (the 2000 he’s eating minus the 500 being stored as fat). So, he is not only storing fat, but he is, in effect, feeling starvation. What’s he going to do? Eat more and exercise less. To bring things back into equilibrium he’s got to eat an additional 500 calories a day, increasing to 2500 calories a day. So, whatever we did to suddenly make his body start storing fat just turned him into a glutton and sloth. </p>
<p>Farfetched? Not at all. We already know that there are several hormones that directly regulate fat storage. That’s the primary function of insulin. Change the insulin levels and you change the fat storage/metabolism of the human body. Thyroid levels also have direct correlation with fat metabolism.</p>
<p>There was a reference in the book Brave Girl Eating: A Family’s Struggle with Anorexia to an experiment on weight gain carried out in a prison (where it was easy to control the actual calories being consumed by the subjects of the experiment).</p>
<p>Much to their surprise, some of the prisoners were unable to gain weight, despite a large increase in calories.</p>
<p>So there can be more to weight gain (and loss) than meets the eye, but in general the obesity epidemic is due to eating more of high calorie foods and exercising less.</p>
<p>So are you telling me that hormone changes are unique to Americans? I suppose people in Europe and Asia are affected by drugs, metabolism and hormone disorders, but why aren’t they as obese as Americans?</p>
<p>No. In fact, everything I read suggests that all populations that adapt “the standard Western diet ™” tend to get fatter. His applies to contemporay Asian populations as well</p>
<p>Remember, there is a genetic component to this, too. So the demographics play a role. Lots of things are different in Europe (that is more homogenously caucasian) and certainly in Japan (that is an incredibly homogeneous population). But, as far as I know, obesity is on the rise in both Europe and Asia as well.</p>
<p>BTW, Mexico, the UK, Slovakia, Greece, Australia, and New Zealand all have obestity rates above 20%.</p>
<p>Twenty years ago my German boss came back from a business trip to the US. He’d gone to some all you can eat brunch and was appalled both at the quantities people put on their plates and what they looked like. Imagine what he’d think now! Germans certainly aren’t known for being svelte, but even the big beer drinkers tend to go for their Sunday hikes.</p>
<p>Here’s the Forbes Magazine list of countries ranked by percentange of overweight adults (based on the World Health Organization’s BMI statistics):</p>
<p>Oh, and just so that we are clear on the definitions, I am considered “overweight” by the BMI tables. Here’s a [photo</a> of BMI overweight](<a href=“http://i218.■■■■■■■■■■■■■■■/albums/cc14/hwc_1000/160-1.jpg]photo”>http://i218.■■■■■■■■■■■■■■■/albums/cc14/hwc_1000/160-1.jpg) taken this week. So, like most health scare stories in the media, keep in mind that we are talking about government bureaucrat definitions and measurements that may or may not have much correlation with reality.</p>
<p>This is interesting. It’s generally assumed that overeating coupled with a sedentary lifestyle causes obesity which in turn causes diabetes and all its many complications. But I’ve often wondered whether hormone-disrupting chemicals in the environment might play some role here, interfering with the body’s self-regulating metabolic/fat storage/hunger response mechanisms, leading to insulin resistance and diabetes, and thereby to increased eating. And it could well be that those environmental factors are somewhat different in Europe and Asia than in the U.S.</p>
<p>Some studies have associated elevated levels of bisphenol A (BPA), a synthetic chemical compound found in plastic water bottles, metal can linings (including soda cans), dental sealants, and other products, with Type 2 diabetes and obesity. Other studies have found that BPA both disrupts insulin production and contributes to insulin resistance. The U.S. produces and uses about 40% of the world’s total BPA; its use in baby bottles is banned in Canada and the EU because of concerns about the health effects of neonatal exposures, but not in the U.S. Our consumption of carbonated beverages in plastic bottles and cans is also much higher than in other parts of the world, as is our use of plastic baby bottles. </p>
<p>I don’t mean to single out that particular chemical as the sole culprit, or even as a definitely established culprit in our obesity/diabetes epidemic, but there seems to be enough evidence to have cause for concern. There’s just a lot we don’t know about what endocrine-disrupting chemicals we’re being exposed to, and exactly what their effects are. But I’m glad serious research is being done in this area.</p>
<p>Psychoanalyzing here, but we are a nation of stressed out, depressed anxious people- admittedly a generalization.
It’s not ok ( or healthy) to smoke, it’s not ok ( or healthy) to drink to excess, but we HAVE to eat to function, and I think that we tell ourselves that a little treat of a frappachino ( who knows how many calories) or a pastrami sandwich instead of a salad (or a salad with two tablespoons of ranch dressing), is the * least* we deserve.</p>
<p>And yet, the non-obese Asian populations are not on the low carb diets that you advocate. Of course, they are way more physically active than people in rich countries, or rich people in their own countries whose diets are becoming more like rich country diets, so their calories in versus out is in balance. All of the low fat versus low carb versus etc. diet ideologies just come down to various attempts to control calorie intake versus consumption (mostly with poor rates of compliance and success over the long term, though some individual have certainly been successful with many of these strategies).</p>
<p>The problem with the psychoanalysis angle (essentially the “gluttony and sloth” hypothesis of “bad” behavior) is that it does not explain the rise in infant obesity.</p>
<p>Actually, the reality in the US is that few “BMI overweight” people are muscular athletes without the increased health risk that excess body fat brings (a few more are muscular, but also fat). Most “BMI overweight” people are actually overfat, so BMI definitions of obesity do approximate reality on a population scale in the US. Where BMI definitions of obesity fail is in individual assessment, since healthy muscle gain increases weight.</p>
<p>Waistline (measured at navel level) / height is probably a better measure of obesity-related health risk, both on a population level and an individual level (ratio generally should be less than 1/2 for health; athletes are often smaller). However, it is not commonly measured or recorded in a medical context, unlike height and weight (from which BMI is calculated).</p>
<p>First of all, I think we can agree that, in general, Asian people are genetically smaller than American caucasian and black and Latino/a people. I don’t think we can ever overlook the genetic component. Especially since BMI a very simplistic ratio of weight and height.</p>
<p>Second, Robert Lustig’s hypothesis is that the Asian diets have traditionally been low in sugar. If he is correct that the liver metabolism of excess fructose leads to insulin resistance, then excessive fructose consumption, especially in large dose vehicles like soda and fruit juice, could be the kind of dietary change that triggers fat storage and obesity. He points to the fact that, as recently as 1960, the standard portion size of Coca Cola was a 6 ounce bottle. The standard container is now a 20 ounce bottle. The low fat jihad also resulted in the replacement of fat in prepared food products with sugar. And, that the invention of HFCS drove the price of sugar down making its use more prevalent in a wide range of prepared foods.</p>
<p>I think there are lots of reasons. Portion size has increased dramatically – anyone ever eaten at a Cheesecake Factory or Claimjumper where one meal could feed a family of four for at least a full day? Also, food has become far more convenient. When I was a teenager, back in the dark ages, if I wanted a snack, I had to cook it. The toaster oven was a major convenience, but it still took several minutes to toast bread and melt cheese on it. Now you can reheat anything instantly in a microwave and eating is just so much easier. There are tons of snacks available – healthy ones as well as non-healthy - that just involve tearing open a wrapper. What about the fattening coffee drinks at Starbucks? Our parents drank coffee, maybe with a dollop of milk or cream, but this generation can pack hundreds of calories in on a trip to Starbucks. </p>
<p>Then there is the fact that everyone was more physical a generation ago. Right now I am sitting on my couch with my laptop and my phone is right next to me. If it rings, I don’t have to move to pick it up. When I was a kid, every time the phone rang, it meant getting up and walking across the house to answer it. If I wanted to adjust the volume of the TV or change the channel, it meant getting up and walking across the room. I rolled down the window of a car manually. I know these sound like little things, but the expenditure of calories adds up; just as that latte every day adds calories, the ease of modern life causes fewer calories to be burned just doing routine things. A net gain of 100 calories added every day makes an impact over time.</p>
<p>Along the lines of “supersizing,” I’ve sometimes wondered if the advent of the warehouse superstores - like Costco - have contributed to our rising obesity rates. It seems that when you go there, just about everyone has their carts overfilled with giant packages of food and drink. When the folks get home with their Costco haul, I wonder if they’re inclined to eat more food, just because it’s there. Oh, and I’ve noticed that most of us make sure to get our hotdog or pizza and soda before we head out of Costco’s doors;).</p>
<p>Of course, this type of claim ignores that fact that going from a 6oz bottle to a 20oz bottle goes from 70 calories to 235 calories or something like that. HFCS may be slightly worse at the margins than ordinary sugar (which itself is half fructose, half glucose), but the main effect of the increased soda consumption is simply many more calories consumed easily without satiety.</p>
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<p>No, that is not what happened in the US. Since the 1970s, fat consumption did not go down; it remained about the same. Carb / sugar consumption did go up, contributing to increased calorie intake. Whatever low fat messages there were did not actually cause people to reduce their fat intake; they merely held fat intake steady, while increasing carb / sugar intake.</p>
<p>Lustig disagrees that HFCS is worse than sugar. Nutritionally identical. No difference. The only difference is that HFCS is much cheaper and has driven down the cost of sweeteners including sugar.</p>
<p>Right. Carb/sugar intake (especially as a percentage of total calories) has increased. I believe that the entire per capita calorie increase is the result of increased carb/sugar consumption. That kind of make you think that maybe increased carb/sugar consumption is the problem!</p>
<p>What I find interesting about the Forbes list of “fattest countries” is the distance between the United States at #9 (74.1% overweight) and Canada all the way down at #35 (61.1%). That’s a big difference. I should have thought our lifestyles and diets similar enough that we’d be closer. Any explanations? Sure, we eat more McDonald’s, but they eat more poutine (don’t ask). They play more hockey but we play more basketball. Ethnic composition might have something to do with it, but that much?</p>
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