Obesity in the news again

The headline in the Reuters news release yesterday is Two-thirds of American adults are too fat: study, and the lead is “CHICAGO (Reuters) – Obesity rates continued to climb in the past year with 23 U.S. states reporting adults in their states are fatter now than they were a year ago, two advocacy groups said on Wednesday.” Obesity leads to heart disease, diabetes and cancer and other diseases, is a major cause for continuing rises in health care costs, debilitates the productivity of those affected with it, and shortens life spans.  The occasion is release of a study entitled F as in Fat: How Obesity Policies Are Failing in America 2009 conducted by the Robert Wood Johnson Foundation and the Trust for America’s Health, So what are some of the main things that can be said about obesity in the US?

Where it is happening:  Obesity is a serious problem throughout the United States but according to the new report appears to be worst in the most staunch “Red States “ The annual ranking of obesity rates in U.S. states found Mississippi continues as the state with the fattest residents, with nearly a third of adults considered obese. The U.S. state has topped the list for the past five years.”  “Three other states — West Virginia, Alabama, and Tennessee — now have obesity rates above 30 percent, according to the report(ref).”  Next-worst states are South Carolina, Oklahoma, Kentucky, Lousiana, Arkansas, Michigan and Ohio, all having a greater than 28.5% current obesity rate.  The State with the best score is Colorado with 18.9%  and the second best is Massachusetts I surmise that obesity correlates negatively with socio-economic status and level of education, positively with poverty and ignorance.  Increasing childhood obesity is an important aspect of the problem and even in Massachusetts 30% of the children are obese or overweight.

Change in obesity:  Despite public education efforts, the obesity pandemic is growing worse.  “The top state in 2009 is Mississippi, which in 2005 was 28.1% obese, and is now 32.5% obese. In 1991, every state was less than 20% obese(ref).”  Michigan is a case-in-point: “Nearly two-thirds of the state is battling either obesity or being overweight, considered a BMI of 25 to 29.9. The obesity percentage has steadily increased since 2005, when 25.3% of the state was obese. The state is now spending upward of $3 billion a year dealing with obesity-related medical issues.” – “About 25% of Michiganders 65 and older are obese(ref).”

Causes of obesity.  There are multiple possible causes for weight gain and obesity.  This article summarizes the better-known causes. 

Eating and lifestyle habits seem to be the two major controllable factors that cause obesity.  It is a question not only of the number of calories consumed but also of the kind of food.  One well-publicized cause is consumption of trans fats and saturated fats in processed foods.  “Trans fats are used widely by the food industry because they are up to 85% cheaper than natural fats such as butter, lard and palm oil. But researchers have repeatedly warned that they act as long-term toxins and have no benefit for consumers.  A recent report from the Food Standards Agency (FSA), which will carry out the new inquiry, said: “The trans fats found in food containing hydrogenated vegetable oil are harmful and have no known nutritional benefits. They raise the type of cholesterol in the blood that increases the risk of coronary heart disease. Some evidence suggests that the effects of these trans fats may be worse than saturated fats. —  However, even though such dangers have been known for nearly two decades, there is no obligation for food manufacturers to display the amount of trans fats on product labels(ref).”  Fast foods, notorious for their content of trans and saturated fats, have been linked to childhood obesity.  According to a 2003 AP report : “(AP)  Every day, nearly one-third of U.S. children aged 4 to 19 eat fast food, which likely packs on about six extra pounds per child per year and increases the risk of obesity, a study of 6,212 youngsters found(ref). 

Physical inactivity, a sedentary lifestyle, is clearly another elective factor leading to obesity as well as a host of diseases(ref)(ref).  “Using data from a large prospective cohort study, the Health Professionals’ Follow-up Study, we have demonstrated that increasing TV watching is strongly associated with obesity and weight gain, independent of diet and exercise. Also, prolonged TV watching is associated with a significantly increased risk of type 2 diabetes. Men who watched TV more than 40 h per week had a nearly threefold increase in the risk of type 2 diabetes compared with those who spent less than 1 h per week watching TV(ref).

Inherited genes is clearly a factor that can lead to obesity.  But so can acquired and inheritable epigenetic changes(ref).  That is, early eating and lifestyle habits can permanently change how a person’s genes respond to food leading to obesity later in life. Such changes may possibly also be inheritable.  Metabolic syndrome is a disease of obesity that affects approximately 47 million adults in the US.  It is characterized by obesity combined with a number of other conditions including high triglycerides, abnormal cholesterol, a general inflammatory condition as identified by C-reactive protein testing, insulin resistance and high blood pressure.  “People with the metabolic syndrome are at increased risk of coronary heart disease, other diseases related to plaque buildups in artery walls (e.g., stroke and peripheral vascular disease) and type 2 diabetes(ref).”  The current thinking is that Metabolic syndrome is likely to have an epigenetic origin.  “The idea that epigenetic changes associated with chromatin remodeling and regulation of gene expression underlie the developmental programming of metabolic syndrome is gaining acceptance(ref).” Also, “The preschool years (age 3-6 years) have been regarded as critical for the programming of energy balance, via the concept of early ‘adiposity rebound’. Children who undergo early adiposity rebound are at increased risk of later obesity(ref).”  I bet that the adiposity rebound effect is epigenetic in nature. Epigenetic changes that tend to promote obesity are scary in that  they are permanent unless ways can be found to get rid of them, and in that possibly they can be inherited.  A simple introduction to epigenetics and epigenomics is contained in my February 2009 blog post Epigenetics, Epigenomics and Aging.

The cultural and psychological forces leading to obesity should not be underestimated.  There is the lure of plentitude.  Not only is excess TV viewing a problem in itself but popular TV programs repeatedly show commercials for generous portions of wonderful-looking fast and manufactured foods, ones likely to be contain large amounts of saturated and trans fats.  Many restaurant chains routinely serve portions double in size of what is needed in a meal.  And I still hear the echoes of my grandmother saying to me when I was a thin boy of 7 “Eat, eat Vincy, eat.  It is good for you. Eat!”

What can be done about obesity?  This is a complicated issue, on the personal level, the family level, the national level and all levels in-between.  And of course the list of things that have been suggested for losing weight seems to be endless.  For those of you tending to be overweight by 10-20 pounds but not really obese like I was 10 years ago, you could try what I did to get myself into normal weight range.  It worked for me and is spelled out in my treatise ANTI-AGING FIREWALLS – THE SCIENCE AND TECHNOLOGY OF LONGEVITY.  In particular, see the combined Lifestyle Regimen and the combined Supplement Regimen.  Besides helping me lose weight, following these regimens helped me feel better, have more energy, have a clearer mind, normalize my lipid scores, and have a better sex life.  And I expect those regiments will also help me live longer, possibly a lot longer.