Why is obesity prevalent now compared to 100 years ago or 1,000? and why is it also prevalent in the western developed nations but not less developed ones?
The answer to these questions is wonderfully short and simple. Where obesity is prevalent two things have changed and completely disrupted the normal balancing act that the pre-existing cultures and lifestyles depended on.
For the first time in history food is never scarce and activity generally is.
That is the message I have been left with after years of research.
This article has been particularly hard to write because obesity is such a complicated condition and topic in itself. I have been preparing for years and my notes are extensive but the purpose of my current series of articles is on simplicity and brevity. That is a real challenge when there is so much I want to say but, as is often the case.
For now I have put together my notes and thoughts into a few pages. It’s not perfect but it is a decent first effort. Over time I will improve it but I doubt the essential concept will change much.
Humans have been around long enough for the trends to be pretty clear. There have always been big people but only recently have so many been big. The reasons must therefore be recent. The question is which changes matter and which don’t. I feel we only focus on half the puzzle at best. Unfortunately this exacerbates the problem instead of improving it.
Is it genetic?
No. Trying to understand this complex problem I considered the disease and mortality rates of people who move between nations. Those who adopt the new culture suffer the diseases of that culture. Those who keep their old ways have their old diseases. So, while there will always be a genetic influence to all disease. Obesity has become prevalent because the way many people are living these days encourages it.There are of course hundreds of reasons that people become obese. The foods they eat, where they live, all sorts of things but all this existed 100 years ago and people weren’t obese. We are still the same humans that live then, we just live differently. We cannot be more stressed now or work harder now because most people used to work 6 days a week. Back then people really did have to work all the hours just to put food on the table. They didn’t have tvs, cars, holidays, and definitely no welfare state. So I can’t see that we have it any worse. In fact my point is that humans like all life have evolved to expect tough conditions. Every so often we have it easy but in general life is tough. That’s actually what our bodies expect and what my research tells me.
Is it lifestyle?
Yes. What has the last 100 years brought? Labour saving tools and perpetual feast.
Ok, so this isn’t exactly news. You’ve heard this before. The problem is all the misinformation out there. It confused me too. Particularly some experts opinion that exercise couldn’t possibly help you lose enough weight because 1KG of fat contains 9,000 calories and walking, running or jogging 1 mile burns just 100 calories (give or take). Hardly enough to dent that kilo right?It depends how you look at it. Burning 100 calories a day for a year will lose half a stone (4kg) of body fat. Now we’re talking. It’s always been clear to me that people gain weight slowly in most cases. A little here, a little there. It may seem fast but in fact just adding half a stone a year for four years would add two stone. Enough for most people to notice. Of course you would add a lot more if it were 200 or 300 calories per day. The important thing though is that day by day this is such a slow process it’s very hard to notice and even harder to figure out exactly why this is happening and how to stop it.
That’s why I’ve been researching so long. I really wanted to understand what is happening. Not just from the science but from the day to day challenges of a normal life. I needed to consider all the conflicting information and see what really worked both for me and for others.
What I can’t do in this post is explain everything. That will take a long time. So I will give a summary and share the basic logic. Over time future articles will show you how the rest of the story is told throughout my blogs. I just haven’t tied them all together yet. This is part of that process.
The core of this story is about addressing myths and misinformation. So lets look at the two myths I started this post with so you can see why the truth is so hard to find.
Do we eat too much?
The answer is both yes and no. Of course all of us eat too much at some point. Food addicts like me eat too much often. Yet, in fact this isn’t the first period in history that enough food was on the table. Some generations have had plenty others haven’t. There have always been gluttons like me and every other type of behaviour but widespread obesity has never been a problem before. I’ll get to that later but in reality are we actually all eating too much? No. The government data shown in calorie and nutrient intake over time shows we are eating less than ever at the same time that we’re getting bigger. The results are very clear. In 1942, during war time the UK on average ate 2269 calories per day. This figure rose after the war to 2650 calories per day in 1963 and has then steadily fallen to as low as 1750 calories per day in the year 2000. So food intake can’t explain obesity alone because the less we are eating the faster we are getting obese.
This shocked me when I found the data source and you’d be right to say I’ve carefully picked my source. That’s true. I’ve picked the government data set that they carefully compile independently of the food industry at tax payers expense so they can make decisions on the health service and other areas from good data. The point is that this is the best data the UK government has to offer and it uses it to make big decisions. So either it is good data or they don’t know what they’re doing. I believe it is correct because the government is very used to compiling data and ensuring it is correct. I found it because while study Sociology I was taught the value of government data. I learned that it is compiled by experts in compiling data. The specific criteria do change over time as standards improve but it’s focus is on being fair and reliable because it underpins all government decisions.
I’m not the only one coming to this conclusion a quick google for nutshist the dataset I used I found lots of results including a public health catastrophe where verner wheelock seems to have the same view as me. Similarly experts question saturated fat guidelines echoes much of the criticisms I have heard of the current explanation for tackling obesity.
Are we active enough.
Absolutely not. Le me explain why inactivity explains this apparent paradox. That we are eating less yet getting fatter. It starts with what I explained earlier. 100 calories per day adds up to 36,500 (100 x 365) calories per year. For thousands of years humans and all other species have had to work hard to meet their basic daily needs. From tilling the land and hunting to more recent options of walking to the shops and working in factories. Most of life involved labour. Only the lucky few could avoid this. Henry VIII of England epitomised this. The modern western illnesses have for thousands of years afflicted those fortunate enough not to have to work hard. These days we all enjoy this lifestyle and so we are afflicted with the same illnesses.So the answer is quite simple. Depending on how active you were you could easily burn an extra 100 calories just popping to the shops and back. Maybe an extra 50-100 calories cooking/cleaning/working and then maybe a hundred or more getting to and from work. As I’ve shown you this all adds up. Being so active makes it harder to end the day with too many calories that must be stored. These labour saving devices simply make it easy to put on weight.
Though I don’t see these devices as the problem. I use them all the time. I’m a software developer and techie and I can’t get enough of them. They have made modern life so much more fun and interesting than it used to be . We now have it so good we are just unprepared for it. We don’t replace the activity we have lost in our lives. For thousands of years we’ve not had enough food but plenty of activity. In only a couple of generations that eternal fact has been reversed. See it that way and it’s no wondering we’re taking so long to adjust to the new way of life.
Modern lives, balanced attitudes
So my search has been for simple solutions to adjust life to fit now. What I see is that most people aren’t in control of their weight making them worried and stressed. The information out there is more confusing than helpful and we often do more harm than good trying to fix the problem in the first place. So it’s about putting myself and those I care about in control so obesity does not rule their lives.Now that I have explained the basic idea you can see how it can explain the french paradox which is often used an example of a lifestyle and diet that is healthy because it suits the culture it is part of. Basically French cuisine is known for going against current wisdom that bacon must be bad and saturated fat must be avoided. Food is rarely the problem, instead the attitude towards food is generally at fault.
I read a fascinating book by a cook explaining what a typical meal is like in France. The contents of the plate weren’t the emphasis. They eat what they want to eat and they don’t like to rush. This is the same attitude that rules all the areas that are famed for their healthy lifestyle. Including mediterranean, italian and japanese culture. The diet varies but the attitude doesn’t. Each meal is an event. It is not rushed but enjoyed. It is an opportunity to share the day with others and have a little fun.
What I have found when I do this for myself is that I am more satisfied with my food. I don’t suffer with cravings because I can indulge when I want. I don’t overeat because I build food into my life and celebrate it when its there. It sounds a bit fanciful but it follows our basic nature. These attitudes to food are all about balance. Restoring your body and filling your life. Instead of just eating like an addict.
Given what I have shared you will see that in all healthy populations activity is built into their life and avoiding food isn’t. They emphasise fun and relaxation when it comes to food and activity. Much of what they do goes against prevailing wisdom but it works for them. It should make us question our wisdom. Going back to my central question Do we really know it all yet?
Activity is medicine
But good health does not just come down to calories. As much as people like to simplify, it is far more complicated than that. Moving your body has many more benefits than just burning calories.Peter Attias view is that the obesity crisis is hiding a bigger problem. Peter suggests that insulin resistance causes obesity and diabetes. Not the other way around. Everything I have seen and heard tells me the same. The fix for obesity is inherently linked to the fixed for insulin resistance and diabetes.
The exciting thing for me is that I am slowly compiling a neat simple list of things activity does to our bodies that improves our health and protects us from disease. From reversing insulin resistance, combating Heart Disease and Diabetes, Dementia and Alzheimers even Cancer. At the same time I am finding that the scientific and medical establishment are waking up to these benefits. The lancet even describes the modern era as a pandemic of physical inactivity. The consistent message is that of survival of the fittest
So I am excited because I am finding that being more active helps with far more than just obesity. I agree with Peter Attia but as a doctor his background doesn’t encourage an emphasis on activity. That is why medicine is lagging behind. The infrastructure focuses on food as a cure because for all time that has been the most effective treatment for all manner of problems. Until now, lack of activity has been linked to very few common ailments. So medicine has had no need to understand it. Ok, so hopefully now you’re convinced that being more activity is the way. Either way I’d like to hear your views. It’s a very complicated topic and I have taken a specific view. There are many other views to consider as well. Many have been discussed in other articles on this site. I just wanted to consider the one thing that effects us all. Inactivity is that one thing. It is getting harder and harder to be active enough to be healthy.
Evolving an active life
So the big challenge is actually about being more active. Particularly if you are obese. So I prefer to look at it a different way. Rather than setting a big inspiring goal and potentially setting yourself up to fail if you don’t make it. I prefer to simply improve any part of my life in small steps one day at a time. I just compare the difference between what I would have done to what I will do and then what I did. That means finding a way to stand for 5-10 minutes more than yesterday. I don’t have to leave the house or do anything out of the ordinary if I don’t want to. I can just cook, clean, reorganise the house, do some DIY. The point is that I’m actually doing things I need to and hopefully want to get done while being more active in the process.
I always look for ways to solve two problems with one action. The common message is to do something separate from your normal life. The result is that something will have to make way for it. Often you miss off something fun or important, or instead it is the activity that you drop. That is what I did for years. Now that I build activity into my life it’s become easy and normal.
Your body is constantly looking for cues from you about what it should prepare for. That is the key. By moving around you tell it that it needs to be good at moving around. This means controlling water, sugar, salt, fat, blood pressure and all sorts of other things because activity is a challenge to the body. It needs to prepare for it. That is actually what I learnt in my sports science degree. I didn’t realise it then but activity is an important challenge that we, as hunters and gatherers, have evolved to expect. Without it we fall apart.So now I just enjoy both the modern world of shopping online and not having to lift a finger saving my energy for making the garden somewhere fun, keeping the house organised, cooking up great meals, going out for a meal. Each option adds activity so I move more. I also play tennis and run around a lot but that’s because I love it. It took me a long time to find out exactly what worked for me.
Find the activity in things you love
I’ve focused on two relatively simple things because they are the essence of who we are. We are supposed to hunt for and gather food. Now that this process has become so easy for us we get to decide how to challenge our bodies and give them the diet of exercise that they need, expect and crave.
So the question is simply, what do you love doing. How can you do it more. Is it dancing, shopping, cooking, travelling. Being more active will help you do these things and finding the activity in the things you love will make your life healthier.
I choose Henry VIII as the headline image because living like a King used to be the only way to obesity it was a rare problem to have. Now that we all live like kings we need to understand what this really means. We want to keep the fun while overcoming the pain and inherent problems.Let me know if this article helps, what challenges you face and any other comments you have.
If you want to read more here is a list of some of the research this article was based on.
- How activity and exercise improves your health
- The lancet have run a series of articles on obesity
- effect of physical inactivity on disease worldwide Seminal article giving stats on the cause of disease through inactivity
- Our world in data: The global distribution of health impacts from obesity contains a wide range of data and charts
- Exercise and obesity: Tracy J. Horton and James O. Hill Cambridge University Press
- reviews the metabolic effects of exercise, specifically with respect to energy and fat metabolism, and how this may relate to the long-term control of body weight
- losing weight: food addiction linked to obesity
- obesity 101 very short explanation of why fat is considered the main problem in obesity.
- lymph cholesterol and heart disease: how they could be related.:incomplete but useful. Introduces possible immune system role. Leads to the idea that cholesterol is part of the bodies repair response. High cholesterol simply reflects a high demand for repair. Very different from being a cause. More a symptom of heart disease..
- The men who made us fat a typical expose on the food industry. I found it biased only focusing on what the presenter felt was relevant. /assuming that food must be everything.
- Feast and Famine: Is that what our bodies expect? having too much food all the time is a health risk. That’s a key reason being obese is a health risk. It implies your body isn’t removing faulty cells and you’re storing toxins.
- High levels of fat lead to high levels of oestrogen. Oestrogen encourages breat cancer to grow, in fact it is used in laboratories to grow breast cancer cells.
- Heart disease and diabetes: Move out of their way: Seminal article linking CHD, Diabetes and insulin resistance.
- What factors make us kick the bucket
- get busy living or get busy dying
- Interesting news in today’s Telegraph from @lauradonnlee showing 1/3 people do not eat healthily because of the cost http://www.telegraph.co.uk/health/healthnews/10568652/Obese-Britons-would-rather-be-fat-than-change-their-ways.html …
- more exercise helps
- food addiction linked to obesity
- Why walking is good for you
- Dismissing kids’ feelings can lead to emotional eating, obesity: study
- Dr Joseph Lightfoot @JosephLightfoot Dec 20 Physical activity, children and schools. A must read. http://bjsm.bmj.com/cgi/content/long/bjsports-2013-093018v2 … #education #physicalliteracy
- Reversing the obesity epidemic in young people: building up the physical activity side of energy balance
- Overweight, obesity, and outcomes: fat mass and beyond: excess bodyweight is associated with increased cardiovascular morbidity and mortality and overall mortality due to disorders such as cancer, sleep apnoea, and Alzheimer’s disease
- Impact of exercise training without caloric restriction on inflammation, insulin resistance and visceral fat mass in obese adolescents: a study investigating whether exercise has health benefits even without calorie restriction. The answer: it does.
- Low chance of obese people recovering normal body weight: A large (200k+ participants) recent (2004-2014) study on chance of obese patient returning to normal weight simply shows that weight loss programs only work for a minority of people. Most have small losses or none over 5 years. More effective approaches are needed.
- Why COVID-19 is more deadly in people with obesity—even if they’re young: Deep analysis of the reasons more serious effects of COVID-19 in those with obesity.
- Relationship between COVID-19 deaths and morbid obesity: A study backing up the above article.
- Ultra-processed foods: it’s not just their low nutritional value that’s a concern I notice how no mention is made of activity and movement because nutrition is always considered the main and often only factor to be import in metabolism, obesity and weight loss.
- Plant-based burgers: should some be considered ‘junk food’?
- Protein’s Pull: The Dietary Dynamics Driving Obesity: Growing Evidence Supporting the Protein Leverage Hypothesis. The “protein leverage” hypothesis suggests that humans consume more food when dietary protein is diluted, especially with modern processed diets. This behavior is increasingly seen as a major contributor to the obesity epidemic. Integrated research is vital for effective interventions