topics in science: the obesity epidemic...means you’ve met your new year’s resolution.” ~jay...

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

https://en.wikipedia.org/wiki/Body_mass_index

https://en.wikipedia.org/wiki/Body_mass_index

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%




No Data <10% 10%–14%




No Data <10% 10%–14% 15%–19%




No Data <10% 10%–14% 15%–19% ≥20%




No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

"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


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


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


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


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


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


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


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


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”





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)

http://www.choosemyplate.gov/sites/default/files/printablematerials/SelectedMessages.pdf#page=1

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

https://www.supertracker.usda.gov/createprofile.aspx

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



3. Beyond the government guides



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






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

topics in science: the obesity epidemic...means you’ve met your new year’s resolution.” ~jay...

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