Evolution of the Obesity Epidemic Information from Time Magazine, National Geographic Magazine, and other sources

Evolution of the Obesity Evolution of the Obesity EpidemicEpidemic

Information from Time Magazine, National Geographic Information from Time Magazine, National Geographic Magazine, and other sourcesMagazine, and other sources

Exercise and Body CompositionExercise and Body Composition

• Two major factors that lead to obesity:

– Over-nutrition – consuming too much

– Under-expenditure – expending too little energy

Over-nourishmentOver-nourishment

• Increased caloric consumption

• Increased portion sizes

• Eating as entertainment

Exercise and Body CompositionExercise and Body Composition

• Decreased daily energy expenditure– Transportation– Manual Labor– Entertainment

Role of GeneticsRole of Genetics

• About 2/3rds of tendency for obesity is genetic– Factors include

• Low RMR 15%• High RQ (low fat oxidation) 5%• Low spontaneous physical activity (fidgeting) 10%• Other???

• (Ravuzzin, ACSM, 2008)

Ancient HistoryAncient History

• Humans started by living in a world of scarcity.

• To survive they developed the habit of eating everything that tasted good whenever they could find it.


• That's the way it was during 99.9% of human evolution.

• For most of the 7 million years of human existence, life has been "nasty, brutish, and short"

• Thomas Hobbes


• Life expectancy was under 30 years - mainly due to accidents, infection, childbirth, and predation.


• Early diet consisted of fruits, shoots, nuts, tubers, and vegetation - all low in calories - took constant work and eating whatever we found just to stay alive.

• Fruits were highly desirable so we learned to seek fructose and glucose.

EvolutionEvolution• It was some 2.5 million years ago that our

ancestors developed a taste for meat.

• As a result, the human brain became markedly bigger and more complex at the same time.

• We also increased in physical size.

EvolutionEvolution

• Because it's packed with nutrients and calories, meat gave early humans a respite from constant feeding.

• Our ancestors ate a diet composed of lean meats, vegetables, and fruits and worked out almost nonstop.

AgricultureAgriculture

• 150,000 to 100,000 years ago.

• Provided steady source of food.

• No longer hunter/gatherers.

• Farming became major source of food.

AgricultureAgriculture

• Nutritionally the shift away from wild meat, fruits and vegetables to a diet of mostly cultivated grains robbed humans of many of the essential amino acids.

• Still physical exertion was common.

Progress?Progress?

EnvironmentEnvironment

• Our bodies evolved in an environment where food was scare and movement was required

• We now find ourselves in an environment where food is abundant and movement is optional – recent development

Then and NowThen and Now

• In 1700, the average Briton consumed 7.5 pounds of sugar per year.

• In the US, we currently consume 150 pounds of sweetener per year.

OverconsumptionOverconsumption

• Adult women are now eating 335 more calories per day than they did in 1971, while adult men have upped their intake by 168 calories.

OverconsumptionOverconsumption

• We each ate 1775 pounds of food in 2000, up from 1497 in 1970.

• Although it appears we are eating more vegetables, almost 1/3 of these vegetables were iceberg lettuce, French fries, and potato chips.

NowNow

• Rapid change in environment last 50 years compared to previous 50,000 years.

• Removal of physical activity combined with abundance of food.

NowNow

Daily imbalance is on average small: an extra can of soda per day (150 kcal) can add 15.6 pounds per year

Factors Related to ObesityFactors Related to Obesity

• Food producers and the "Fast Food“ industry - if they’re successful, we all eat more

Childhood ObesityChildhood Obesity

• The growth of the fast food industry and increasing portion sizes make it easy for children to overeat

Supersize MeSupersize Me


• “A large fast food meal (double cheeseburger, French fries, soft drink, desert) could contain 2200 kcal, which… would require a full marathon to burn off”

– Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public health crisis, common sense cure. Lancet 2002;360:473-82.


• On days that children and youth eat fast food – they consume an extra 126 kcals/day (P<0.0001)

– Bowman S, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast food consumption on energy intake and diet quality among children in a national household survey. Pediatrics, in press.

Twenty Worst Foods in AmericaTwenty Worst Foods in America


• Sugar-sweetened beverages contribute to childhood obesity incidence


• “For each additional serving of sugar sweetened beverage consumed, both BMI (0.243 kg/m2; P=0.03), and incidence of obesity (odds ratio 1.60; P=0.02) increased.”

– Ludwig DS, Peterson KE, Gortmaker SL. Lancet 2001, 357:505-8


• Television and video/film production and distribution industry - if they’re successful we all watch more

NowNow

• Advertisers constantly telling us to "eat this now".

• Obesity increases as industrialization increases.

A Widening ProblemA Widening Problem

• In a historical first, there are now as many overnourished people as undernourished around the world.

Why are we fatter?Why are we fatter?

• Here's the recipe for obesity on such a global scale: – Take technology—cars, washing machines,

elevators—that reduces physical exertion.

– Increase calorie consumption, courtesy of increasing prosperity.


• Add television, computers and video games.

• Stir in the intensive marketing of candy and fast food, and you have the makings of an epidemic.


• In countries where the food supply has been unstable, people are getting fat despite far less abundance than in the United States.


• The implication?

• Newly industrialized nations in Asia, Africa, the Caribbean, and Latin America may develop even higher rates of obesity-related health problems than in the U.S.


>24%

20-24

15-19

10-14

0-9

No data


• North AmericaStates with the highest obesity rates—Mississippi and Alabama—are in the South. The more affluent and outdoorsy western states of Colorado and Utah have the lowest rates. South AmericaAs Latin America becomes more developed, supermarkets stocked with processed foods have become the norm, rising from 20 percent of food retail during the 1980s to 60 percent in 2000.


• EuropeCandy, fast food, and sweetened cereals account for more than half the food ads in ten European Union nations. In the U.K. snack food consumption rose nearly 25 percent in five years. AfricaIn some parts of Africa obesity afflicts more children than malnutrition. In Tunisia the urban population is shifting from traditional healthy whole grain breads to white bread.


• AsiaIn Shanghai, roads once filled with pedestrians and cyclists are now congested with cars. KFC opened a drive-through restaurant in Beijing in 2002, with more to come. OceaniaPacific Islanders have always valued hefty physiques. Now their shift away from local foods to a high-fat, Western diet has made them among the world's fattest people

NowNow

• The Puget Sound ferries in Washington have increased the width of their seats from 18 to 20 inches to allow squeeze-in room for bigger bottoms.

NowNow

• In Colorado, an ambulance company has retrofitted its vehicles with a winch and a plus-size compartment to handle patients weighing up to half a ton (1000 lbs).

NowNow

• An Indiana manufacturer of caskets now offers a double-oversize model - 38 inches wide, compared with a standard 24 inches.

DiscriminationDiscrimination

• In one study at Michigan State University, undergraduates said they would be more inclined to marry an embezzler or cocaine user than an obese person.

DiscriminationDiscrimination

The Stigma of Childhood ObesityThe Stigma of Childhood ObesityCan be devastating…Can be devastating…

• An obese child’s quality of life is similar to the life of a child diagnosed with cancer, which has been determined as the lowest quality of life score.1

The Stigma of Childhood ObesityThe Stigma of Childhood Obesitycan be devastating…can be devastating…

• Adolescents who are teased about their weight are 2 to 3 times more likely to have suicidal ideation and attempts compared to adolescents who are not teased about their weight. 2

The Stigma of Childhood ObesityThe Stigma of Childhood ObesityCan be devastating…Can be devastating…

• Obese children and adolescents are 4 times more likely to experience impaired school function when compared with healthy children and adolescents. 1

• Obese children and adolescents have been found to miss an average of 4.2 days of school during the month. 1

It starts early…It starts early…

• Low self esteem is not a characteristic in inner city obese African American children or obese preschool children. 3

• Levels of self esteem of preschool children do not differ between non obese and obese children, but upon entering school this feelings change substantially. 3

Negatively affects school aged Negatively affects school aged children and adolescents…children and adolescents…

• 4-11 year old children describe obese peers has “ugly”, “selfish”, “lazy” “stupid”, “dishonest”, “socially isolated” and subjects of teasing compared to their average weight peers who were described as “clever”, “healthy”, “attractive”, “kind”, “happy”, “socially popular” and a “desirable playmate”. 4

• Overweight adolescents are more likely to be isolated and peripheral to social networks then their normal weight peers. 5

Negatively affects school aged Negatively affects school aged children and adolescents…children and adolescents…

• Social marginalization is more pronounced in white non Hispanic adolescent girls. 5

• 90% of 9-11 year old overweight children believe that teasing and harassment from their peers would end if they could lose weight and 69% felt that if they were thinner they would have more friends. 6

It is also seen in homes, schools It is also seen in homes, schools and clinical settings…and clinical settings…

• 30.0% of adolescent girls and 24.7% of adolescent boys report being teased about their weight by their peers. 2

• 28.7% of adolescent girls and 16.1% of adolescent boys report being teased about their weight by someone in their families. 2

• 14.6% of adolescent girls and 9.6% of adolescent boys report being teased about their weight by both their peers and family members.2

It is also seen in homes, schools It is also seen in homes, schools and clinical settings…and clinical settings…

• Parents communicate to their children negative stereotypes about obese children. 7

• Parents of overweight children are criticized and feel that they are guilty and to blame for their child’s obesity. 6

• On implicit and explicit measures, health professionals labeled obese people as “lazy”, “stupid” or “worthless”. 8

Perception vs RealityPerception vs Reality

Who do we think we are or strive to be?

vs

Who we actually are?

Mr and Ms America?

Mr. And Ms. AmericaMr. And Ms. America

Conan the GovernorConan the Governor

Jack NicholsonJack Nicholson

Jack NicholsonJack Nicholson

Denise RichardsDenise Richards

• What this leads to is body disatisfaction

Eating DisordersEating Disorders

Progress?Progress?

• By contrast, among people who still live in conditions most like those of our distant Stone Age ancestors - Maku or Yanomami of Brazil - there is virtually no obesity at all.

NetherlandsNetherlands 3030 18 18 5 5 45 45 GermanyGermany 1212 22 22 16 16 4949EnglandEngland 8 8 12 12 14 14 6262ItalyItaly 5 5 28 28 16 16 4242CanadaCanada 1 1 10 10 14 14 74 74 USAUSA 1 1 9 9 3 3 8484

Modal Travel in Urban Areas:Modal Travel in Urban Areas: Europe and North America Percent of Trips by Europe and North America Percent of Trips by

ModeMode

Transportation Quarterly 1997; 51:31Transportation Quarterly 1997; 51:31

PublicPublic CountryCountry BicycleBicycle WalkingWalking TransportTransport CarCar

Distribution of Hours of TV Per Day:Distribution of Hours of TV Per Day: NHES Youth Aged 12-17 in 1967-70 and NHES Youth Aged 12-17 in 1967-70 and

NLSY Youth Aged 12-17 in 1990NLSY Youth Aged 12-17 in 1990

0-10-10-10-1 1-21-21-21-2 2-32-32-32-3 3-43-43-43-4 4-54-54-54-5 5+5+5+5+

TV Hours (Youth Report)TV Hours (Youth Report)

Tsunami of Health Care Tsunami of Health Care

Tsunami of Health CareTsunami of Health Care

Cardiovascular Disease

Diabetes Mellitus

Glucose Intolerance

Overweight and Obesity

Sedentary Lifestyle

Documents

Evolution of the Obesity Epidemic Information from Time Magazine, National Geographic Magazine, and other sources