TOPICS IN SCIENCE:
The Obesity Epidemic
Presenter: Marc Nussbaum
“The only way to keep your health is to eat
what you don’t want, drink what you don’t like,
and do what you’d rather not.” ~Mark Twain
“Now there are more overweight people in
America than average-weight people. So
overweight people are now average. Which
means you’ve met your New Year’s
resolution.” ~Jay Leno
Agenda
1. Obesity and its Causes
2. How to eat right and manage your weight
3. Beyond the Government Guides
4. Where to go for more information and
personal nutrition guidance
Write down answers to two questions:
1. Name three to five causes of obesity.
2. Which is the more effective eating style
(diet) for losing and managing weight?
Choose between ‘Low Fat Diet’ (LF) or
‘Low Carbohydrate Diet’ (LC).
What is “Obesity”
Obese = body mass index (BMI) 30 or more
Using kg and cm: BMI= Weight / Height2
Using lbs and inches, a constant of 703 is
necessary so BMI= (Weight x 703) / Height2
Marc: 208 lbs and 5’ 10” tall (70 inches) so;
(208 * 703) / (70” x 70”) = BMI of 29.8
BMI can mislead: 5’ 9”, 200 pound muscle man with
waist = 32” has BMI = 30 but is not obese
Within the 34 OECD countries…
18% adults are obese
18% of 0-15 year olds obese
Over 50% of adults overweight
or obese
In US…
36% adults are obese
36% of 0-15 year olds obese
An additional 28% of women
and 38% of men are overweight
Obesity (2012 data) for OCED member Countries
(Organization for Economic Cooperation and Development)
2012
Obesity
in OECD
Member
Countries
Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults BRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults BRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults BRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% ≥20%
Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults BRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Source: Behavioral Risk Factor Surveillance System, CDC.
Obesity Trends* Among U.S. Adults BRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
2014
"WomenBMIMort" by James Heilman, MD - Own work. Licensed under CC BY-SA 3.0 via Commons -
https://commons.wikimedia.org/wiki/File:WomenBMIMort.png#/media/File:WomenBMIMort.png
Normal
Obese
BMI of 30 carries ~50% increased mortality risk
"MenBMIMort" by James Heilman, MD - Own work. Licensed under CC BY-SA 3.0 via Commons -
https://commons.wikimedia.org/wiki/File:MenBMIMort.png#/media/File:MenBMIMort.png
Complications from Diabetes:
• Stroke
• Kidney disease
• Numbness (neuropathy)
• Frequent urination
• Intestinal issues
• Blindness
• Confusion
• Amputation
Diabetes (Insulin Resistance)
11% of adults are diabetic (26 M)
80% with type II diabetes are obese (21M)
(2010 data)
Cause of Diabetes
Does being fat cause insulin resistance?
or…
Does insulin resistance make you fat?
Root Causes of Obesity Food Intake too high
Too many calories
Too many sugars (carbohydrates)
Too many fats
Calorie burn (exercise) too low
Genetic > metabolic: Higher likelihood if both parents are
obese. The hormone leptin signals the brain to eat less when
body has stored fat
Lack of sleep
Some medications
Psychological factors
Certain diseases
Derived causes of Obesity More restaurant meals (1978: 18% to 1996: 32%)
Larger restaurant portions
High fat foods
Too many and low cost of simple sugars (government subsidies)
Refined carbohydrates
Less smoking
Sweetened beverages
Television Advertising (including sugared beverages)- children who watched
cartoons with food commercials ate 45 percent more snacks
Snack time
Sit time
Reduced sleep
Other sedentary activities: Internet, games, driving
3,300
2,200
24.5% Increase
US Food Supply vs Consumption
Calories per day per person
2,700
3,800
Source: Profiling Food Consumption in America, Agricultural Fact Book (chapter 2)
0
50
100
150
200
1960s 1980s 2000
122 122 114
29 46 67 11
14 15
Poun
ds P
er
Pers
on P
er
Year
20% Increase in Meat Supply From 1960 to 2000
Red Meat Poultry Fish
162 182 195
NOTE: SPOILAGE AND WASTE ABOUT 29%
0
5
10
15
20
25
30
1960s 1980s 2000
10
22
30
Poun
ds P
er
Pers
on P
er
Year
200% Increase in Cheese Supply
Cheese
NOTE: SPOILAGE AND WASTE ABOUT 29%
0
5
10
15
20
25
30
35
1960s 1980s 2000
29
14 8
4
12
15
Gallo
ns P
er
Pers
on
Per
Yea
r
30% Decrease in Beverage Milk Supply
Whole Milk Lower Fat Milk
NOTE: SPOILAGE AND WASTE ABOUT 29%
25
26
27
28
1960s 1980s 2000
28
27
28
Poun
ds P
er
Pers
on P
er
Year
Frozen Dairy Supply Flat
Frozen Dairy
0
1
2
3
4
5
6
7
8
9
10
1960s 1980s 2000
1
7
10
½ P
int
Per
Pers
on P
er
Year
Yogurt Supply (not frozen)
Yogurt
NOTE: SPOILAGE AND WASTE ABOUT 29%
0
10
20
30
40
50
60
70
80
1960s 1980s 2000
14 25
35 21
24
29 17
15
13
Poun
ds P
er
Pers
on P
er
Year
48% Increase in Fat Supply
Salad & Cooking Oils Baking & Frying Fats
Table Spreads
52 64 77
NOTE: SPOILAGE AND WASTE ABOUT 29%
0
50
100
150
200
1960s 1980s 2000
114 123 146
14 17
28
7 11
20
Po
un
ds P
er
Pe
rso
n P
er
Ye
ar
44% Increase in Grain Product Supply
Wheat Flour Corn Products Rice
135 151 194
NOTE: SPOILAGE AND WASTE ABOUT 29%
230
235
240
245
250
255
260
265
270
275
280
1970s 1980s 2000
249
269 279
Poun
ds P
er
Pers
on P
er
Year
(fre
sh e
quiv
)
12% Increase in Fruit Supply
Fruit
NOTE: SPOILAGE AND WASTE ABOUT 29%
0
50
100
150
200
250
300
350
400
450
1970s 1980s 2000
339 353 428
Poun
ds P
er
Pers
on P
er
Year
26% Increase in Vegetable Supply
Vegies
NOTE: SPOILAGE AND WASTE ABOUT 29%
0
20
40
60
80
100
120
140
160
1960s 1980s 2000
98 68 65
15 57
85
Poun
ds P
er
Pers
on P
er
Year
33% Increase in Sweetener Supply
Corn Sweeteners (Mostly High Fructose Corn Syrup)
Cane and Beet Sugar
113 125 150
NOTE: SPOILAGE AND WASTE ABOUT 29%
Putting it Together (adjusted for waste)
1960s 2000 Meat 115 138
Cheese 7 21 Frozen dairy 20 20
Fats 37 55 Grain 96 138 Fruit 177 198
Vegies 241 304 Sweetners 80 107
Milk 192 134
Total Pounds Consumed 965 1,114 Per Day 2.7 3.1
Sleep Affects Body Weight
Nurses’ Health Study, which followed 68,000 middle-
age American women for up to 16 years. Compared
to women who slept seven hours a night, women who
slept five hours or less were 15 percent more likely to
become obese over the course of the study.
Source: Harvard School of Public Health
How Might Sleep Affect Body Weight?
Increasing hunger (hormones)
More time to eat
Decreases physical activity
Lowering body temperature
Choose less healthy diets
Source: Harvard School of Public Health
Hibernation, bird migration, penguins... Forage > gorge > fatten
The Thrifty Gene Hypothesis:
Natural selection favored individuals that could
survive famine by storing energy as fat during times
of abundance
Genetics: Survival of the Fattest
Obesity and Genetics
2007: 80% of the offspring of two obese parents were
obese, in contrast to less than 10% of the offspring of
two parents who were of normal weight.
2006: 41 sites on the human genome linked to obesity.
Genes may influence individual response to weight loss.
Agenda
1. The “Obesity Epidemic”
2. How to eat right and manage your weight
3. Beyond the Government Guides
4. Where to go for more information and
personal nutrition guidance
Write down answers to two questions:
1. Name three to five causes of obesity
2. Which is the more effective eating style
(diet) for losing and managing weight?
Choose between ‘Low Fat Diet’ (LF) or
‘Low Carbohydrate Diet’ (LC):
Which is the Best Diet?
Researchers analyzed 53 studies
No significant difference in long term weight
loss between low-fat and high-fat diets*
Best is the one that makes YOU feel full with
less calories
Easy to incorporate into your lifestyle
Provides balanced nutrition
* Source: Dr. Deirdre Tobias, epidemiologist at Brigham and Women's Hospital and Harvard
Medical School. The Lancet Diabetes & Endocrinology journal.
US Government Dietary Guidance
1. U.S. Department of Agriculture (USDA):
USDA Food Guide (MyPlate)
2. U.S. Department of Health and Human Services (HHS):
Dietary Guidelines for Americans
Office of Disease Prevention and Health Promotion
USDA Food Guide History
USDA Current Food Guide: MyPlate (2010)
Activity, Basal Metabolic Rate (BMR) and
Thermic Effect of Food (TEF) Use Food Energy
How many calories do people over
age 50 need each day?
Source: National Institute on Aging
Woman Man
Not Active 1,600 2,000
Somewhat
Active
1,800 2,200 - 2,400
Active 2,000 - 2,200 2,400 - 2,800
ChooseMyPlate.gov
MyPlate Daily Servings (Inactive Person)
Women Men
Fruit 1 ½ cups 2 cups
Vegetable 2 cups 2 ½ cups
Grain 5 oz equiv 6 oz equiv
Protein 5 oz equiv 5 ½ oz equiv
Dairy 3 cups 3 cups
Oils 5 teaspoons 6 teaspoons
Est Cal
(calculated)
1500 1800
MyPlate Equivalent to… Or…
1 cup fruit 1 cup fresh ½ cup dried
1 cup vegetables 1 cup raw or cooked 2 cups leafy greens
1 oz grains 1 slice bread, a cup cereal ½ cup rice, ½ cup pasta,
½ cup cooked sereal
1 oz protein 1 oz cooked meat, poultry
or fish
¼ cup cooked beans, 1
egg, ½ oz nuts
Dairy 1 cup milk, yogurt or
soymilk
1.5 oz cheese
Oils 1 teaspoon
Health and Human Services (HHS):
• Published every 5 years
• Guidelines included in class handout
2010 Dietary Guidelines for Americans (January 31, 2011)
Agenda
1. The “Obesity Epidemic”
2. How to eat right and manage your weight
3. Beyond the government guides
4. Where to go for more information and
personal nutrition guidance
Harvard School of Public Health:
“While calcium and dairy can lower the risk of osteoporosis and colon cancer,
high intake can increase the risk of prostate cancer and possibly ovarian cancer.”
“Limit milk and dairy foods to no more than one to two servings per day. More
won’t necessarily do your bones any good—and less is fine, as long as you get
enough calcium from other sources. Calcium-rich non-dairy foods include leafy
green vegetables and broccoli, collards, bok choy, Tufu, fortified soy milk, beans,
and supplements.”
Milk
lth
Protein Carbs Fat
Calories per
gram
4 4 9
Harvard Healthy
Eating Plate
Sugars- 'ose'
Sugars- ‘ose’ Glucose, AKA blood sugar (a monosaccharide): Preferred energy source for
muscles and brain, used directly by all cells. Triggers insulin release. Also
can be stored.
Fructose, AKA fruit sugars (a monosaccharide): Must be metabolized in liver
into blood triglycerides. Does not simulate leptin production so you don’t get
‘stop eating signal.’ Does not trigger insulin release but is encourages fat
storage. Fresh fruits have 5-10% by weight.
Sucrose, AKA table sugar from cane or beets (a disaccharide): Breaks into
glucose (used) and fructose (usually stored as fat which is encouraged by
the insulin released in response to the glucose.
High Fructose Corn Syrup, made from corn starch (two monosaccharides)-
Contains fructose and glucose. Linked to obesity and diabetes.
Other disaccharides: Lactose, in milk and cheese
Sugars Daily Limit Recommendations
Women Men
6 teaspoons 9 teaspoons
24 grams 36 grams
~ 100 calories ~ 150 calories
6% for 1,600 calorie diet 7.5% for 2,000 calorie diet
Note: One can Coke contains 11 teaspoons sugar
2. USDA Recommendation (July 2015): 10% of calories
1. Harvard School of Public Health (15 year study ended 2014):
“participants who took in 25% or more of their daily calories as sugar
were more than twice as likely to die from heart disease as those
whose diets included less than 10% added sugar.”
3. American Heart Association:
Taxing Sugar-Sweetened Beverages
A nationwide penny-per-ounce tax on sugar
sweetened beverages would reduce
consumption by 24 percent—and would raise
nearly $80 billion in revenue over a five-year
period.
What is a Whole Grain?
Seeds were plentiful but difficult
to digest
Crushed whole-kernel grains >
whole-grain powder (whole grain
flour)
Filter out the Germ to avoid
spoilage > starchy white (white
flour)
Crushed grains act like sugar in
the body
What is a Whole Grain?
AACC (American Association of Cereal Chemists) definition:
"Whole grains shall consist of the intact, ground, cracked or
flaked caryopsis (seed: pronounced ‘carry-op-sees’), whose
principal anatomical components - the starchy endosperm,
germ and bran - are present in the same relative proportions as
they exist in the intact caryopsis.“
A whole grain is a cereal grain that contains the germ,
endosperm, and bran, in contrast to refined grains, which retain
only the endosperm.
Look for "wholegrain wheat flour" or "whole-wheat flour") but…
if two ingredients are listed as grain products but only the
second is listed as wholegrain, the entire product may contain
between 1% and 49% non-wholegrains. Avoid added sugars
(corn starch).
What is a Sprouted Bread?
Also a whole grain bread
Processing: Grains are allowed to germinate (put
out shoots and grow) by soaking in water at warm
temperature
Using some starch, enzymes are released,
breaking down proteins and carbs increasing
percent of vitamins
Some made with barley, oat, lentils (legumes):
vegetarians get more complete proteins
Not much of advantage vs. whole grain breads
Healthy Eating for Seniors (Georgia Department of
Health): 6m 50s
“Today, more than 95% of all chronic disease is
caused by food choice, toxic food ingredients,
nutritional deficiencies and lack of physical
exercise.” ~Mike Adams
Mike Adams the "Health Ranger," is
a consumer health advocate,
investigative journalist and director of
Natural News Forensic Food
Laboratory.
Agenda
1. The “Obesity Epidemic”
2. How to eat right and manage your weight
3. Beyond the Government Guides
4. Where to go for more information and
personal nutrition guidance
Resources USDA MyPlate info, recipes and SuperTracker to customize calories needed
and diet:
http://www.choosemyplate.gov/
BMI Calculator:
http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm
Others:
http://health.gov/dietaryguidelines/2010/
http://www.uspreventiveservicestaskforce.org/
TOPICS IN SCIENCE
The Obesity Epidemic
Presenter: Marc Nussbaum
1. BMI Chart
2. Obesity by country
3. USDA MyPlate
4. Myplate daily servings targets
5. MyPlate carts of fruits, vegetables, grains, protein, dairy, fats
6. Calories per day range table
7. Sugar intake recommendations
8. Website links
9. HHS 2010 Dietary Guidelines for Americans Executive Summary
Contents:
November 2015
Thank You