Obesity and Overweight Prevalence for the U.S
cdc.gov
cdc.gov
Then pile on hyper sweet drinks and nutritional misinformation campaigns, and of course Americans are going to be overweight. The worst part is it’s becoming culturally acceptable for children to be overweight. I do not advocate for fat shaming—but there is a limit to my tolerance. Children should not consume anywhere near the amounts of sugar that they do and the pervasive attitude of “just one [soda, ice cream, pop tart, pie slice, muffin, cupcake, cookie] won’t hurt!” is incredibly damaging. Five grams of refined sugar a day. That’s it. That is less than one tenth of a “personal” (16oz / 500ml) bottle of Coca Cola.
We’re poisoning our kids.
More indoor entertainment than ever (Internet, video games)
No free spaces, parking lots for kids and young adults to just go out to walk/play
Took some time for the cumulative effect of all this to show up.
I don't have sources to back this up, but here's some thoughts:
* Gradual changes in types of labor? (From agriculture -> industrial -> office jobs) which are less calorically intensive.
* Changes in food? Calorie-dense food is cheaper and easier to get than ever. People have less free time to cook healthy meals (working more hours, far fewer homemakers, longer commutes, more time spent doin extracurriculars outside the home, etc). As a result, people consume more calories because they're easy to get.
* Health/Food misinformation. The demonization of nutritional 'fat' which lead to it being replaced by sugar, which is even more addictive.
* Changes in drink consumption? Alcohol consumption is up (at least compared to ~25 years ago), and alcoholic drinks area very high in calories.
* Childhood changes due to changes in food and care. More high-calorie, "manufactured" foods introduced earlier into peoples lives sets them up for a lifetime of bad habits and problems that only compound over time.
Personally, I try to eat as healthy as possible and use my nutrient finder (https://kale.world/c) to find high nutrient, low calorie foods, which end up being mostly beans, vegetables and fruits.
edit: I just fed it one of the tasks I've found most frustrating - how to optimize protein:carbs ratio without resorting to meat. Most of the diet advice I've seen on that question is unhelpful, since it emphasizes for "enough protein" and not ratio. But this turned up exactly what I was after.
Fruit and vegetables come to mind.
Freedom to kill ourselves and each other, it seems...
It doesn't take money to eat healthy. It's not that fast food restaurants are the only choice is you don't have money. You can go to a grocery store and eat extremely healthy if you want to.
Those who eat at fast food restaurants all the time are more uneducated than poor (although both things might go hand-in-hand), and might not know how many calories are in a burger or more importantly sodas (I've seen people drinking liters every day).
You can buy an apple instead of a can of coke and save you both a few hundred calories and a few pennies. Nothing to do with money.
Banana (0.25 kg) 0.63 $
Oranges (0.30 kg) 1.04 $
Tomato (0.20 kg) 0.85 $
Potato (0.20 kg) 0.60 $
Onion (0.10 kg) 0.26 $
Lettuce (0.20 head) 0.28 $
Not the best source probably, but by looking at https://www.numbeo.com/food-prices/in/Los-Angeles it doesn't seem like one can easily go broke from buying vegetables.
But, even given that; I can buy a head of lettuce for $1.40. Okay. Or, I could buy an 8 pack of little debbie snack cakes for the same amount. 5 servings of lettuce that has nearly no nutritional substance, and that I have to combine with something else anyway to make it palatable...or 8 servings of convenient, enjoyed food.
If I wanted crunch, I can get a giant bag of tortilla chips for $1, too. Why would I buy a head of lettuce for 40% more, when it takes more work, and more ingredients inflating the price even higher?
> Or, I could buy an 8 pack of little debbie snack cakes for the same amount. 5 servings of lettuce that has nearly no nutritional substance, and that I have to combine with something else anyway to make it palatable...or 8 servings of convenient, enjoyed food.
Right. I would never eat that, though. There are also plenty of ways to make vegetables palatable: eggplants with tomatoes with spices are very tasty, for instance.
I'm also not saying that junk food isn't cheaper, just that healthy food is affordable for everyone.
In contrast the starvation diet the Japanese imposed on their WWII prisoners (from Hong Kong in particular) shortened their lives quite a bit.
With both parents working, less time to prepare meals, we are raising a generation who on average has a lot less first-hand experience with how to cook, and certainly how to cook healthy balanced meals.
Broccoli is $2.93 per 200 Calories. Doritos are 39 cents per 200 calories. That's the issue.
Source: Me
Vegetables aren't subsidized the same way corn is.
This trend of food getting cheaper all the time has led to a real „industrialised“ agricultural sector in Germany. This effect is good for the consumer because an egg costs like 15 euro cents, but it is horrible for the environment and especially for the animals. You just can‘t produce so much cheap food without tremendous sacrifices.
E.g. I buy ecological eggs (not the 'supermarket-ecological' ones) and they cost about 45 cents a piece. That's at least 3 times the usual price.
I cheat by shopping at the local Korean grocery store instead, prices are much cheaper but you have to sort through the produce to make sure quality is up to par.
And you call that cheap.... In my country most vegetables cost below 1$ per kilogram, which is 6 times cheaper. I think this has to do with EU policy of subsidies for farmers.
I haven't seen 0.80 EUR/kg in Germany for vegetables, so I wonder where you live. I've assumed vegetables are rather cheap in Germany due to very high competition. Lettuce is around $1.85 a piece, carrots are 1 EUR/kg or 1.50 EUR/kg when organic. Karfiol is 2 EUR/kg here.
The cheapest discounters (Aldi) are little bit cheaper.
Up here in Scotland I think we have a good illustration of how obesity can be a cultural problem, especially linked to alcohol. There's a reasonable amount of healthy food available but the traditional preference is all fat, starch and sugar.
Healthy food tends to spoil, and if you're not able to go shopping multiple times a week and have unpredictable availability for meal preparation, you're going to see a lot of spoilage. If 30% of your fresh produce ultimately spoils, your actual cost is 43% higher.
Healthy food requires a degree of planning and execution which takes time and focus. Finding healthy options which are appealing for 3x meals a day is a lot of work if you aren't happy with 1 or 2 standbys every day.
Healthy food is extremely hard to find on the go. If you don't have a kitchen at your disposal generally you are shit out of luck for finding something that is truly healthy. So for example, the quality of my diet is highly inversely correlated with the amount of travel I am doing in a given month.
Making unhealthy choices more expensive through taxes is extremely regressive for many of these reasons.
As for travel, yeah. I started doing a lot more a number of years back and it took me a while to get more disciplined about it. I find it's more about regulating my intake than eating healthy per se. I try to avoid eating just because some food has been laid out for me. And I tend to keep things to one or two full meals a day.
Definitely agree about finding healthy food on the go. Mostly salads.
That's not at all true. I eat healthy, lots of vegetables, beans, lean meat,and so on, and I go shopping only once every two weeks. Apples keep for weeks, ditto cauliflower in the refrigerator, kale, cabbage, tomatoes, and so on. Meat you can freeze. Dry beans keep forever, and plus there is canned goods.Plus flavorings like salsa in a jar. I waste virtually nothing.
And it is cheaper than living off of processed foods, unless you are living off of pure starches like macaroni and cookies.
You do know have to know how to cook. Nothing fancy, just the basics like boiling beans, chopping vegetables, mixing together a bunch of things to get something that tastes reasonably good. And it does take time.
Maybe in California. Certainly not in the eastern US.
Canned vegetables are usually not very nutritious but a lot of frozen vegetables are pretty cheap year-round as well.
You get my point but I think it's more of a culture and convenience thing.
Maybe you have a different experience, having just visited, instead of living here.
addendum: it also depends quite heavily on the area's cost of living, apparently. I just bought a sack of potatoes for $0.40/lb, whereas https://news.ycombinator.com/item?id=16448984 says potatoes in LA are $1.88/lb (nearly 5x as expensive).
If you have a strong food culture that demands fresh ingredients (Italy) then the prices may follow.
An entire new science of how people shop developed in the past few decades. The centermost aisles are prime territory. So, the higher-margin, fast-turnover items get center aisles and medium height (easily seen) shelves. Wholesalers actually pay for placement rights for things like chips and soda -- that's why they are organized by brand rather than product.
Produce gets moved to one end of the store (generally the end nearest the main entrance because produce is low priority for shoplifters.
It depends on where you live. In the U.S. poor and working class neighborhoods often lack grocery stores. The only options are convenience stores where fresh, healthy food is very expensive, availability is limited, and quality is poor. I've read that the problem is on such a wide scale that it significantly impacts health. Cities work at attracting grocery chains to poor neighborhoods.
Try it yourself: Try shopping for groceries in a neighborhood with those demographics in your town. Or just layer a map of income with a map of grocery stores; I think I can predict where you will find the Whole Foods.
http://americannutritionassociation.org/newsletter/usda-defi...
What's the healthiest thing you can get in a 7/11 in the States? An apple? One of those shitty packaged sandwiches that has a slice of ham with a mysterious wad of splooge? A hotdog that's been turning on the spit all day?
Then you realize this is how it is every step of the way. It's a cultural problem. With a lot of the world trailing right behind.
You can blame everything on personal choice, and that might make you feel good, but that doesn't help us solve systemic issues.
I live in Mexico now which has some of the worst obesity issues as well due to their soft drink consumption. They just had a president that was the ex-president of Coca Cola.
> It was during the Fox's leadership of Coca-Cola Mexico that Coke became Mexico's top-selling soft drink, increasing Coca-Cola's sales by almost 50%.
But Mexico still has healthy enough food that's readily available. Getting a bag of chips from 7/11 has to compete with a just-as-cheap taco stand right outside. I find it easy to eat pretty healthy here for that reason. I love some tacos and nopal salad.
Meanwhile in Austin you can't even find a taquero outside of East Riverside.
And, of course, the lack of walkability in the US is horrifying. I don't ever want to live somewhere where I can't walk to a fruit stand or cafe ever again. I think of any time I've felt dullness in my life and every time it was at a point in my life where I had to drive everywhere. Like playing an open-world game and only using fast travel, missing out on all the small interactions that turn out to be the spice of life.
Also, I do feel the store you mention, and similar ones, are de-emphasising veg in favour of higher margin packaged/processed items. Although, they are wildly optimised for each store placement so it is difficult to tell.
Places like Whole Foods have the same problem, of course -- it's also full of sugary drinks and cookies, except they're labeled "organic" and made with "natural sugar cane" or agave, or they're things low/no fat yogurt (containing more sugar than the full fat ones). You can get fat on Whole Foods groceries if you're not super picky.
Time to prepare: fresh foods generally take a lot longer, and a lot more effort to prepare than processed foods. When you've got each available parent working two jobs then this is a huge barrier.
Knowledge of preparation: especially in immigrant populations, not everybody has access to the ingredients they're used to.
Knowledge of nutrition: it's not like life comes with an instruction manual, and if you got little to no nutrition education, you probably don't realize the impact of those empty calories.
Fussy Kids: people who appeasing fussy kids (yeah yeah yeah... the hardos without kids will say you should just force them to eat it. Life isn't so straightforward.)
Waste: this is a huge factor. If you've got a tiny amount of cash and you need to spend it on things that will ensure you wont starve, something that will potentially go bad in a few days is a risky proposition, so you tend to stock up on heavily processed shelf stable items.
Price: Cheap is in the eye of the beholder. You can get a whole bag of chips for the same price as 2 apples. When you have a REALLY borderline income, your "cheap" is a lot different than someone else's.
There's plenty of other factors. Check out the research on it for more info. Really interesting stuff to dig into.
My friends with children basically fall into two camps: one camp that agrees with you and blames their kids, and the other camp that just feeds their kids healthy food because, like your pet dog or cat, can't drive to the grocery store when it refuses to eat its croquetas.
Spending time with the families of my friends, the real issue seems to be with the adults either giving in to their children because they don't want to bother, feeding their children boxed food because they don't have the energy, or feeding their children bad food because they themselves don't eat much healthy food.
I had a classmate in high school who ONLY ate pancakes and fries. He was from a wealthy family and his mother had various supplements she would put in the pancakes to keep him healthy. We went on a week long canoe trip where you obviously can't eat pancakes and fries 24/7. 3 days in, this guy is starving, and for the first time in his life had pasta, trailmix, and eggs.
Children don't have fully developed faculties for reasoning, you can't take a reasonable approach to solving pickiness. Things seem to taste better the hungrier you get, so I think the approach to pickiness is to starve them out.
I have no doubt that a lot of parents have that "my little angel" syndrome that keeps them from disciplining their children, but notice how that doesn't free them from the responsibility nor allow them to blame their kids.
I can appreciate that I was really fortunate to have parents that put in that sort of effort. My mom would also cut up vegetables like turnips for us after school that we would scarf down. They set me up for a healthy lifestyle as an adult that didn't take much effort on my part.
I know a lot of people didn't have those kinds of advantages, so they especially don't come naturally for them once faced with raising children and having to make those decisions themselves.
Seems like not. There are some studies [0][1][2] that show parental control over food intake may result in children's (mostly girls') obesity since it teaches children to ignore their satiety/hunger mechanism and thus overeat.
It may lead to the situation that once grown up, they could keep this habit of leaving the plate empty no matter how full they feel.
[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2045650/
[1] https://www.ncbi.nlm.nih.gov/pubmed/11358344
[2] http://www.dailymail.co.uk/femail/article-2384361/Leading-nu...
Total carbs Sugar Fiber Protein
Froot Loops 86% 34% 10% 6.8%
Granola 72% 18% 14% 10.0%
Froot Loops definitely loses here. The granola has half the amount of sugar.[1] http://smartlabel.kelloggs.com/Product/Index/00038000391187
[2] https://www.instacart.com/whole-foods/products/25454-kind-he...
There's few good reasons to be eating tripe if you live in a city or live in a 'food desert' (spare me) and have a car.
The real problem is the overabundance of crap choices crowding out the sensible ones.
For example, here's Walmart's online store: https://www.walmart.com/all-departments#food--household---pe.... Now look at the categories: Beverages, Snacks & Cookies (listed before meals), Candy & gum.
Ctrl + F for 'fresh', and all I get is flowers. Madness.
By contract, here's Tesco in the UK: https://www.tesco.com/groceries/?icid=dchp_groceriesshopgroc...
Fresh food is top of the list. And three sub-sections are all 'fresh' something.
There's zero reason Walmart can't do the same. Except for the fact that Americans demand soda and 800 different types of cookies, so that's what they're supplied with.
Edit: this submission was bumped from first to the third page within minutes...for whatever reason. Comment to upvote ratio perhaps?
The thing is that, as you suggest, the pre-packaged deli section is bigger than the unprocessed meat section. And then there's the soda aisle, the chip aisle, etc. Shelf space is hugely tilted toward "junk" and other highly processed food.
My regular supermarkets have lots of processed food too of course. (And nothing wrong with a lot of that in moderation.) But it's far less skewed than in the case of Walmart.
We recently just spent a week in Spain. We went to the grocery store and bought a whole cart full of food for like 20 euros. I was blown away. The equivalent amount of food in the US would have easily been like 100 dollars, probably more.
I bet most of the sugar consumed is from things that no one would think contain as much sugar as they do (like--bread, meat, etc.), which is added to make it more palatable.
You're spot on with your second paragraph though. There is a lot of misinformation about nutrition, dieting, and food in general, and it's all aimed at one goal: turning a profit. Sugar is one of the major culprits, but over eating in general in America is an issue.
We need to start health education on a basis of Calories in vs. Calories Out, what healthy bodies actually look like, and dispel the myths of fad dieting and fat-burning-exercise routines/equipment.
Eat a balanced diet, consisting of little to no processed foods, and keep your calories close to your TDEE (or below if you are overweight).
Exercise for long-term health (physical and mental), not weight loss binges.
It's really that simple.
The correlation looks a lot firmer when you look at overweight rates compared to population density or walkability instead of trying to just coarsely bucket it into "urban/suburban/rural".
I think people underestimate how much walking or physical activity they’d need to do to counterbalance the calorie surplus they have on a daily basis. You’d literally need to be fast walking for hours and hours a day. Cars don’t help, but walking for an extra 3-4hrs a week isn’t the major factor here. It’s the pound of cheese you had melted on everything, or the 24oz Cola.
Everything you list is simple, but nearly impossible for most people to stick with for life. It's not a matter of education, it's the fact that implementing that plan is physically and emotionally painful and wears most people down inside of a week or two.
http://www.espn.com/espn/story/_/page/bodyreecehamilton/just...
New York City is perhaps one of the most walkable cities in the world. It's also a place where you absolutely do not need a car and the majority of residents don't have a car. Yet 34% or New Yorkers are overweight and 22% are obese.[1]
The BMI statistic for the EU are none too encouraging either. [2]
[1] http://www1.nyc.gov/site/doh/health/health-topics/obesity.pa...
[2] http://ec.europa.eu/eurostat/statistics-explained/index.php/...
Given that its a reference for one of the great "walking cities", I think it disputes the OPs assertion "the design of American cities" and "car culture" are substantial contributors.
In other words whether one walks or or drives to McDonalds probably matters very little.
EDIT: Haha, apparently the HN crowd is very quick to point out inconsistencies since the original comment has been up 2 minuites and there are already 3 comments pointing the same thing (and counting)
I agree NYC should be better but a number of problems are present there:
1. Cultural. I haven't been there for two years, but people use the subway, not the bike lanes. And I remember as recent at 2010 taxis were very prevalent, although slightly less so last time I was there. Though that could be Uber. The walkability of a city isn't just its density, it's its zoning, the width of its streets, the expected work hours. NYC is fast food, finance, media. Though they're still better off than the average American, they are no Amsterdam.
2. They have many of the problems that most American cities have: Dirt cheap unhealthy food and sugar consumption rates that are unhealthily high.
3. Many people come to NYC to make it. If they're coming from the rest of America they're coming in overweight.
The bike lanes are actually quite busy. This was true two years ago as well. It has also been steadily increasing with the increase in the number of Citibikes. The NYC DOT even has stats that support this [1]
>"They have many of the problems that most American cities have: Dirt cheap unhealthy food and sugar consumption rates that are unhealthily high."
There's also shortage of affordable and healthy options in just about every neighborhood.[2] There's also plenty of Whole Food and fruit and vegetable are present outside most bodegas.
>"Many people come to NYC to make it. If they're coming from the rest of America they're coming in overweight."
That's is a pretty absurd statement. People come for all kinds of reasons and they generally bring their A game if trying to "make it."
[1] http://www.nyc.gov/html/dot/html/bicyclists/cyclinginthecity...
[2] https://www.timeout.com/newyork/restaurants/the-best-healthy...
This should have been:
There's also NO shortage of affordable and healthy options in just about every neighborhood.[2]
A recent tweet from him:
Most comprehensive analysis of macronutrients vs. lifespan, fatness, health in mice. High fat + high carb + low protein = highest body fat. High fat + high carb + high protein = highest insulin. High carb + low fat + low protein = longest lifespan.
https://twitter.com/whsource/status/965330116468502529There is an air of certainty about low carbs permeating our culture right now that is not justified by the evidence at all. The Kitavans today get 70% of their calories from potato and have no diabetes or metabolic syndrome.
Look up Ray Peat for a good argument in favor of sugar. Plenty of people are thriving on high sugar diets.
For my own part, I've consumed 1300 or so calories of sugar a day for 20 years and my biomarkers are 99th percentile. I'm very consistent about resistance training and I don't overeat, both factors likely dwarfing my sugar intake.
Of course, obviously that's an anecdote, but I would caution anyone who automatically judges someone else for their sugar consumption. You might be wrong about sugar and, more importantly, you might be wrong about sugar paired with a particular person's genes or other lifestyle factors.
Because of my high sugar consumption, I eat relatively low fat and protein. What if that's better for you, assuming you don't overeat?
Guyenet is somewhat in favor of the hypothesis that sugar increases fatness, but he thinks it's because humans are susceptible to the "unnatural" increase in food reward that adding extra sugar induces, not because sugar is toxic in and of itself.
I don't really see the correlation. In Brazil, obesity is commonly associated with lower incomes, and if you were to correlate with the transportation system usage patterns there, one might misguidedly conclude that public transit usage is related to obesity. It seems more logical to make a correlation with lack of food variety (in both cases, cheaper food tend to be heavy on carbs and fats) and sedentary lifestyle
Food is much, MUCH cheaper. Not a big difference at the grocery store for whole produce and raw ingredients (though it is cheaper). But the processed foods, premade stuff, deserts, drinks, etc? A fraction of the cost.
Restaurants are also much, much cheaper. Where I used to work, going to the sit down restaurant next door downtown brought me down 20-25 bucks. A similar restaurant downtown where I now live has equivalent food for 8-10 bucks. I make 4 times my Canadian salary and pay a lot less taxes, so effectively, it's virtually not worth it for me to cook, if my only constraint was money.
Sugar in EVERYTHING. Food that used to be a little bit sweet (not necessarily health, but not the end of the world) is drenched in sugar. I have to be careful when I get an orange juice in case its sugar added. A milkshare at the local icecream shop has way more sugar. Sugar sugar sugar EVERYWHERE.
Ordering food is also way easier, with formerly Foodler, GrubHub, Doordash, etc. I have no idea if those services became common up north after I left, but that was a big change, being able to order from 100 different restaurants at any point in time, sometimes in the middle of the night, with a few mouse clicks.
The portions: Cheesecake Factory exists up north, but it's not considered normal. Here, while the portion sizes are certainly above average, they aren't exactly unique either. You have Outback and the like all service you enough food to last you 3 days.
I also find it a lot more common to have fatty or sugary snacks at the office, and soft drinks, etc.
I'll shamefully admit I have zero self control when it comes to food. I have a sweet tooth like no other. But the price and availability constraints in my hometown stopped me from going overboard. For a while I was pretty much flush at my "recommended" weight. After I moved here? Things got really bad for me.
Taking it one step further though... I think about my forebear farmers. When I would hear my grandmother talk about the huge meals they would eat daily, you'd think they were all 300 pounds and died of heart disease by 40. Instead, they were trim and lived into their 80s and 90s. The reason being that they were physically active all day long on the farm. In a modern services economy though, we have to go to a gym, go for a run, IE: build physical activity into our day. After a long work day, this is a mental challenge for many people just as much as a time challenge. So, in many ways it's an artifact of the transition away from the farming / industrial economy of the past that many segments of the population have simply not addressed.
Exercise and good food are good for you (diabetes and heart disease are bad) but in terms of weight what matters is pure number of calories consumed. This has been true from everything I've read on the subject and what I've seen from my own underweight failures and triumphs to gain weight.
Americans just eat too much, for a variety of reasons.
My goal weight is 200. I've got 100 to go and I've lost 40 so far. I got there because of the sugar and depression, but I thought it was important to note that 200 for me is going to be incredibly skinny. I don't think it is practical for most people to maintain that.
Will Autonomous Cars & Mobile Gyms Help With America's Obesity Epidemic: https://medium.com/@nicolaerusan/will-autonomous-cars-mobile...
Def, the nutritional issues are still there & so are the issues around communal activity - but I think for a lot of people I know who have long commutes to work, the opportunity to exercise in transit would be compelling.
Most coastal States have regular rates among rich countries (albeit still high). 23.1% of Californians are obese, which is a lower rate than France, Ireland, and most of Western Europe.
There's a completely different story in the South, where more than a third of Mississipi's population is obese.
It's not just "low will power" even if that explanation makes 30% of people smug.
Price of an Arizona Iced Tea 23oz can = $0.99
Price of the average bottle of water 16 oz = $1.50
Any poorly educated individual wouldn't understand the health implications of gulping 70g of liquid sugar when the only available data points to make food decisions are price and flavor.
People aren't really that ignorant, they make choices, often driven by short term desire. The corporations get this, but I feel like you are using poor as a synonym for stupid. We gotta stop treating poor people like they are dumb helpless animals, it gives them no agency.
Someone uneducated will not understand this well. It's not about being stupid or being poor either. You don't hear people blaming their problems on sugar...
I consume sugar products because they are delicious (dopamine release). However, I have the knowledge and education to make a conscious decision about moderation. I know how to read a food label. I know how to calculate the amount of sugar in a product. I know these things because I got access to education that allowed me to understand this.
No fucking Iced Tea Can is telling you that. You know what is telling you? Price: 99 cents, Flavor: Great... There's your problem. It's not about being stupid. It's about not having enough data to understand the implications of those decisions.
Uneducated people don't know about caloric guidelines or recommended processed sugar intake. The only mental filter for consumption of any edible product is its availability and personal flavor appeal.
Source: https://www.naturalnews.com/037153_food_industry_chicken_fil...
I went to a restaurant the other night. I ordered chicken marsala. I ate my meal, and when I felt I was getting full I stopped eating. I had two meals worth of food left.
Fat people want more food, so more restaurants put out bigger portions than is healthy. The same is true of prepared and pre-packaged foods. And with high-calorie, salt, fat and carb laden snack foods everywhere you look, you can keep eating all the time, everywhere you go. Find yourself in a place where they don't sell food? Don't worry, here's food made to take everywhere you go, so you can be constantly eating.
(Defined in the footnote on page 222)
When he was on recruiting duty, every year they attended a conference. Every year, there was an insurance guy there. Every year, every one in the office was pronounced overweight according to their height and weight charts.
The army offers a tape test as an alternative if you can't pass weight. It is sometimes necessary to prove that bodybuilders are all muscle. My ex and his office mates were not so muscular that they needed to rely on a tape test. They were still pronounced overweight by the insurance guy every year.
6'4" is a statistically rare height. I believe BMI is less valid for the extremely tall and extremely short. That doesn't mean it isn't useful when viewing the whole population.
For an individual, BMI + a waist measure is a better indicator. Your brother probably isn't overweight, unless he has low muscle mass and a large waist - but that individual anecdote does nothing to argue against the population level validity of BMI.
This assumes a relatively symmetric distribution of heights and weights though, right? I'm curious if the tails for which BMI is individually invalid are equally populated. Basically, are short, fat people as common as tall, thin people?
Not bad for a metric that can be easily computed at home.
https://www.nytimes.com/interactive/projects/cp/summer-of-sc...
I moved to SF which is a relatively fit city. Going back home in the Midwest I am shocked by the number of people who are overweight. Fat is normalized there. It wasn’t until I lived in a health conscious area and checked my own BMI that I realized how skewed my image of a healthy person was. In the Midwest if you are active you are considered healthy, even if you are overweight. It’s not until you are 100lbs overweight are you considered fat. And this doesn’t even touch the HAES mentality.
Mating behavior here seems to follow the norm. Fat people tend to date/marry fat people, and healthy people mostly stick with other healthy people.
That said, an average to low-normal BMI can certainly get comments. I'm smack in the middle of the healthy BMI range, and not exceptionally muscular or anything else that would distort that. Living in and visiting friends in flyover country I get comments like "you're too skinny", "you need to eat more", and so on. No one is particularly judging me, there's just a shifted sense of average where BMI ~21 feels like the low end of the range.
(And of course they're not exactly wrong; eating Midwestern food and living in a driving-centric suburb had the predictable effect on my weight, so on some level thinner people there are behaving unusually.)
From the abstract:
> National and international health organizations have focused increasingly on a perceived obesity epidemic said to pose drastic threats to public health. Indeed, some medical experts have gone so far as to predict that growing body mass will halt and perhaps even reverse the millennia-long trend of rising human life expectancy.1 In response to such concerns public health agencies across the world have sprung into action, searching for policies or incentives to mitigate the alleged ‘disease’ of obesity.
> Yet even as the volume of alarm grows louder, a growing number of researchers, drawn from a broad array of academic disciplines, are calling these claims into question. The authors of this article come from this latter group. In our view the available scientific data neither support alarmist claims about obesity nor justify diverting scarce resources away from far more pressing public health issues. This article evaluates four central claims made by those who are calling for intensifying the war on fat: that obesity is an epidemic; that overweight and obesity are major contributors to mortality; that higher than average adiposity is pathological and a primary direct cause of disease; and that significant long-term weight loss is both medically beneficial and a practical goal. Given the limited scientific evidence for any of these claims, we suggest that the current rhetoric about an obesity-driven health crisis is being driven more by cultural and political factors than by any threat increasing body weight may pose to public health.
https://www.usnews.com/opinion/blogs/policy-dose/articles/20...
That said, the section on health outcomes is not hugely compelling. The "normal weight has worse outcomes" studies (particularly the famous NEJM one) have a significant set of problems.
NEJM simply didn't use the same bucketing as common parlance, so bucketed comparisons (as opposed to BMI ones) are basically meaningless.
More broadly, these studies are generally correlational, which produces serious issues regarding patients suffering from diseases. Eating disorders have very high mortality and often cause low weights, while conditions like cancer and neurodegenerative disease often cause both mortality and low weight. Without correcting for that, you're actually noticing trends like "late stage cancer patients are both skinny and sick".
I'll have to go and dig up references, but I thought the current state of research suggested that among otherwise-healthy patients, especially men in middle age or older, health outcomes noticeably worsened beyond the middle of the overweight category?
"Although a recent meta-analysis suggests that overweight individuals have significantly lower overall mortality than normal-weight individuals, these data are likely to be an artifact produced by serious methodological problems, especially confounding by smoking, reverse causation due to existing chronic disease, and nonspecific loss of lean mass and function in the frail elderly." https://www.ncbi.nlm.nih.gov/pubmed/24628815
"Utilizing novel models of visceral obesity, numerous studies have demonstrated that the relationship between visceral fat and longevity is causal while the accrual of subcutaneous fat does not appear to play an important role in the etiology of disease risk." https://www.ncbi.nlm.nih.gov/pubmed/23764746
Mexico: "Obesity and overweight have a strong effect on the incidence of T2D;this, combined with the large impact of diabetes on adult mortality, generates increases in mortality that translate into losses of 2 to 3 years of life expectancy at age 50." https://www.ncbi.nlm.nih.gov/pubmed/26172231
1988–1994 54.9
1999–2000 64.1
2001–2002 65.6
2003–2004 66.5
2005–2006 67.3
2007–2008 68.3
2009–2010 69.2
2011–2012 69.0
2013–2014 70.7
When I was in the best shape of my life from my mid 20s to my mid 30s, working out 12 hours a week (part time fitness instructor and a runner) with a body fat of 12% (measured with calipers) and a 29-30 inch waist, I was according to the BMI calculations 30 pounds overweight. Even now weighing 10 pounds more and I'm considered "obese", I wear a size 30 regular cut pants.
Where exactly am I suppose to lose 40 pounds from? Realistically, I need to lose about 15.
Another, broader question is this: what are the health impacts of various body compositions?
See also "Medical Myths Doctors Believe":
https://www.amazon.com/Medical-Doctors-Believe-Michael-Ancho...
At your best shape you still had 5% lower you could go on your bodyfat, assuming you are male. It can be rather stricking, I used to be 208lbs and didn't feel like I was overweight at all. Got into endurance sport and dropped to as low as 165. (normally hover around 175 now that I'm not hardcore about it) I can look at pictures and see now where it went, but couldn't have imagined it before.
I think a lot of people in America suffer from skewed expectations. The kind of body mass that is healthy is perceived as sickly and unrealistic at this point. Yet it used to be common, or is common in other parts of the world.
It tells me that my correct weight according to BMI is anywhere from 118 to 159. Now, I know if I weight 159lbs, I'd be fat. 118 doesn't seem especially healthy to me either - I'm at my lowest weight ever right now, 128lb, and my clothes are hanging off me like I'm a skeleton. All the other calculations are telling me 134-138 are right for me, which matches my normal weight. I think I'm down right now because I've been weight training and not taking in enough extra calories to gain weight, but if I lose any more weight than this I'm gonna start chugging olive oil or something. No way am I going down to 118.
Also, why isn't dietary adjustment the first-line treatment for high cholesterol?
For long term maintenance, they're definitely recommended. Near EOL is a bit different, but I don't know the guidelines.
> Also, why isn't dietary adjustment the first-line treatment for high cholesterol?
It is, but only in conjunction with medication. It seems that having a poor diet (e.g. high saturated fats) has long-lasting effects on cholesterol levels, and short-term dietary changes do little to "repair the damage", so to speak. Additionally, we know very little about what other factors affect HDL/LDL levels. For example, for a long time, there was concern that dietary cholesterol had an impact on serum levels, but I believe now the consensus is that this is false.
Cholesterol is complex, and while its role in disease is what gets attention, it's a vital compound with a number of downstream effects. In most cells, it acts as a modulator of membrane structure and function: absolutely crucial aspects of every cell's job, regardless of what tissue they're in. My point is twofold: first, statins likely have unknown "off-target" effects on cholesterol synthesis throughout the body (which potentially speaks to the life expectancy issue); and second, the comorbidity of high cholesterol and obesity is likely more complex than "bad diet."
Of course, keep in mind that having a "good diet" in the cholesterol sense (low saturated fats, possibly low dietary cholesterol) has been shown to be a good idea regardless. It's temporary changes to diet that seem ineffective, at a population level.
> When you are in a place where it's eat food that gives you no vitamins, no protein, no micronutrients, etcetera, or eat food that does not give you enough basic breakdown of glucose to get your body through another day, you do not have the luxury
as i said before, Beans especially are very well balanced, super high in fiber, protein and micronutrients.
I've also noticed that the muscle-building culture is much, much smaller in the rest of the world than America. So while I'm sure we have a lot more fat people, we also have a lot more buff people, both of which are contributing to this percentage.
Many HAES-advocates, for example, would claim they're extremely healthy despite weighing 300lbs+. Any poor effects are just coincidental, and the weight is not a cause.
The best way of discovering how healthy somebody is? Perform an autopsy. Beyond reporting on aches, pains, lumps, worn out joints, the simple fact is people can appear very healthy right until they drop dead. Blood tests, CT-scans, etc, can be used to look at very narrow metrics, but they don't tell give a useful "healthy vs. non-healthy" response.
I have a clean diet, but do eat a heavy animal fat diet. Though all my meat comes from a local small farm e.g., I was able to watch the pig grow from a baby to right before it was slaughtered. I saw them feed the pigs (6 in total) 15 gallons of goats milk etc...
The beef I got was done a similar matter but a slightly larger farm - which was grass finished. While I eat a meat heavy diet, I feel great, the best I have in my entire life (I am 32 years old).
I also tested my cardio recently via swimming and I was able to swim 500 yards in 11 minutes. Not breaking records but felt good enough. Though I did notice swimming is more form and I basically muscle my way through the water i.e., I don't have good swim form.
Could I loose some weight? I am certain I could and probably be a little healthier. However, the feeling of being strong is incredible and I don't wish to give that up.
Don't forget that muscle is denser than fat - a flabby 169lb is going to have more body volume than a fit 169lb.
Any muscular sprinting/non-endurance athlete is probably going to be classified as overweight.
Here's something to think about: spindly Usain Bolt is 6'4" and 207lbs - which puts him at just over edge of "overweight" which is 25 BMI.
https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi...
I have to wonder if our sedentary lifestyle, processed foods (with additives examined under an ignorant lens), stress (income inequality, constant stimulation, glowing objects being the center of our lives), are wrecking our microbiomes and other broader systems from a VERY young age, or causing other systems-level changes that make it hard to correct with behavior changes in adulthood.
Because ultimately, even when people get educated, get active, eat better, etc -- the trends aren't reversing.
* Percent of adolescents aged 12-19 years with obesity: 20.6% (2013-2014)
* Percent of children aged 6-11 years with obesity: 17.4% (2013-2014)
* Percent of children aged 2-5 years with obesity: 9.4% (2013-2014)
Also when you grow with a lot of fat people around you you don't even know how normal weight looks. I noticed this last time in Paris. I had completely forgotten how normal weight looks.
Paris is leaner than the French average, but you were probably still seeing a population with a fair amount of overweight people. Just, less overweight than what you're used to.
Seeing Paris 110 years ago would be a shock. (On many levels, but certainly on the average body composition level).
I have a book by Georges Hebert, who was an influential fitness instructor in France about 100 years ago. In it, he has pictures of French peasants shirtless, and some African tribesmen and women. They are in a form that today would be considered "unrealistic".
I can't find any of the peasant pictures online, but here are a couple of examples of the Africans:
https://actionlondaise.blogspot.ca/2016/03/georges-hebert-ce...
http://ayeparkour.blogspot.ca/2012/02/tracuers-of-legend-geo...
(The top photo on the second link is Hebert)
If people are not motivated to eat healthy, what are you supposed to do? Perhaps this goes back to educating your family on healthy eating, consequently if everyone were doing that, we'd see a trend of increased concern for healthy eating.
Virta Health is one I've seen.
And the Robert Johnson Wood Foundation is working on this cause: https://www.rwjf.org/en/our-focus-areas/topics/childhood-obe...
--
Diet seems crucial.
Obesity isn't really helped by exercise. (https://www.vox.com/2018/1/3/16845438/exercise-weight-loss-m...)
"Significant weight loss was observed with any low-carbohydrate or low-fat diet. Weight loss differences between individual named diets were small. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight." (Many diets work. Most important is optimizing for one that will be continued long term / rest of their life)
https://www.ncbi.nlm.nih.gov/pubmed/25182101
--
Overweight-obesity is also a top 3 preventable cause of death for US people (and many other nations).
https://www.hsph.harvard.edu/news/press-releases/smoking-hig...
About 1 in 12 of total deaths each year in the US can be attributed to the person being overweight or obese.
~7x more Americans die each year due to obesity/overweight than due to opioids. (Though opioid deaths are rising much faster.) https://www.drugabuse.gov/related-topics/trends-statistics/o...
--
What causes obesity?
The "greatest contributor to weight gain" is eating more calories than are burned. (https://www.nichd.nih.gov/health/topics/obesity/conditioninf...)
It seems that food types do play into this - in part because eating 1000 calories of sugar will leave you much hungrier than eating 1000 calories of fat, so while in theory you've eaten the same amount of calories, in reality the sugar eating person will probably eat more the rest of the day.
- food quantity
- genetics
- physical activity or lack thereof
- food quality and make-up (plant / animal for instance)
- and an addictive element thrown in for some individuals
- microbiome activities
- epigenetics
- what you eat at a young age
On mouse models, these high fat high protein diets have improved brain functionality. http://www.cell.com/cell-metabolism/fulltext/S1550-4131(17)3...
Biggest issue effecting health is obesity which puts strains on your internal organs.
If you listen to people who have had success with low-carb and/or keto diets, their comments almost always discuss how the way they feel about food changed. They weren't hungry and they felt more energetic. Just about 0 of them mention spending time tracking calories consumed or measuring calories expended.
*I read this analysis a decade ago, so I can't really find it to share.
The CDC calculations basically assume 100% of us are sedentary.
I don't know about other people, but I only spend a small percentage of my day actually eating, needing, or hungry enough to sit down and eat. I've got a whole day not including sleep to do so much more! Food is good, but I want to have some fun, see things, explore, meet people, relax and not eat.
The libertarian and contrarian in me doesn't care what someone weighs, or how they choose to life. So extrapolating to a larger population, or society, I still fail to see how being collectively overweight is a negative in and of itself if there were no damaging burdens created because of that.
In fact, I think we need to subset the 70.7% population to weed out the "innocously fat".
We know certain things in society have an impact on how overweight people get.
Identifying and fixing those things is worthwhile.
No one is insinuating that we should force people to become fit or anything, as you imply here.
Extrapolating it to society means that healthy people have to subsidize the unhealthy, so it's extremely unfair to those who chose to invest in their health. So being 'contrarian' in this context is just being wrong, ignoring evidence and contributing nothing to the discussion.
I was made fun of at lunch in my youth for bringing things like whole carrots and canned garbanzo beans and turnips/radishes.
Adopting a more active lifestyle could benefit your personality decades from now (bps.org.uk)
Want lower blood pressure? Lower your weight.
Want higher testosterone and lower estrogen? Lower your weight.
Want lower cholesterol? Lower your weight.
Lower diabetes risk? Lower your weight.
Healthier gallblader, liver and kidneys? Lower your weight.
Reduce back pain? Lower your weight.
Aid sleep apnea? Lower your weight.
[1] https://en.wikipedia.org/wiki/Fructose#Cardiometabolic_disea...
https://www.hsph.harvard.edu/obesity-prevention-source/obesi...
Overweight is defined as body mass index (BMI) greater than or equal to 25, based on the NHANES variable, Body Mass Index.Obesity and the fat epidemic will bankrupt the US health care system.
Sooner than later, weight must be tied directly to out-of-pocket health care costs, via premiums, taxation, tax credits, or some other financial incentive and/or penalty combination for horrendous lifestyle decisions. Maybe go the Japanese route with a metabo law too. Obviously merely being an unhealthy glutton with high disease propensity and increased mortality is not a motivator for the majority of populace, so make them pay for their bad choices the same way someone who speeds frequently pays higher car insurance.
In some cases, certain diseases/medications can cause a very small weight gain but nothing significant.
"Obesity is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile BMI (based on the variable BMXBMI) using cutoff points from the 2000 CDC growth charts for the United States: Methods and development. NCHS. Vital Health Stat 11(246). 2002. Available at: http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf. Excludes pregnant girls."
Almost everyone I know is "overweight" by this metric, which, as it turns out, means they are healthier (in terms of less likely to die from any-cause overall) than their thinner peers.
Show me the bell curve of longevity versus body-fat percentage, and what percentage of Americans are 1-sigma past the right side of the peak of that curve. Even body shape, for example, is a much better indicator of all-cause mortality than BMI. E.g. http://absi-calc.appspot.com/