History of obesity. In Denmark.

“The origins of the obesity epidemic may be further back than we thought”

A recently published paper concluded that the rise of obesity began earlier than conventionally assumed. (See article summarizing study: The Origins of Obesity in Science.)

"This study revealed that continuous steady increases since the interwar period in the upper percentiles of the BMI distribution preceded the obesity epidemic, with an almost similar pattern in the children and the young men." (published paper)

I agree with some of the criticisms of the study and conclusions, such as population sample=1 (Denmark). Is this trend replicated in other countries? 

Another comment from a biostatistician that “slow and steady increases in obesity don’t necessarily indicate an earlier onset of the epidemic [of obesity]”. A proper data pool for that would require data before 1930’s. 

A statement from the original published paper confirms my observation over the years traveling this country: “The acceleration of the obesity epidemic has been stronger in rural and provincial areas than in densely populated urban areas, which was seen already in the beginning of the rise of prevalence in obesity in Danish young men during the 1960s.”

And, like anything involving human behavior, the contributions are multifactorial.

The high prevalence of obesity in people of all ages in rural Ohio was a shock when I moved there in late 2001. 

During a conversation on this subject with a man (late 20’s) that I was training, he commented that as agriculture became industrialized it required less physical activity by all family members. However, the culture of food and eating amongst farm families remained the same: calorically dense food, especially fats, and large portions during meals. 

Consequently, while activity levels decreased, the energy balance became very skewed towards a positive high caloric net balance. Which, over time, results in increased body mass.  

We can see an eventual similar trend in urban areas over time, albeit slower. My hypothesis is that most rural families used to grow their own food, meat and vegetables/grains. So they had an almost guaranteed supply of food and energy. 

Urban people had to purchase all their food (and still do). Purchasing power for food was based on their incomes and other debts (rent, etc). History worldwide has shown that wealthy people always have had almost unrestricted access to food. For many centuries, being overweight was a social sign of being affluent. 

It was only during the last half century when increasingly more people began moving from rural to urban communities. Industrial agriculture and food processing caused a large shift in the nutritional content and availability of food, and the culture of food. 

As Gary said that day, “People of Ohio still love their corn and pork, and there is plenty of it here. But now everyone has desk and ‘standing still’ jobs. And the kids don’t play as much; they’re glued to their phones and video games.”

The obese 'horse' and the diabetic cart

The link leads to an interesting article by a biology scientist. I especially appreciate his discussion of models for obesity. However, he shifts from criticism of the standard model, mouse, to using that of bear. Which may or may not be more useful.

Regardless, he, too, falls into the same pit as so many others: the 'bandaid' approach. Putting the cart (solution) before the horse (cause). Or, putting a bandaid over the wound without addressing the causes (which are multifactorial).

Universally neglected is how to educate, encourage and motivate humans to eat less and increase activity. The solutions, such as behavior modification and choices, could solve many of the associated issues with obesity and diabetes: weight gain, dysfunction of insulin sensitivity and glucose regulation, concomitant and/or subsequent metabolic illnesses (inflammation, cardiac dysfunction, etc).

Why does the medical and scientific communities ignore the psychology of eating and sedentary lifestyles? No drugs or animal models will magically solve these dysfunctions. Let's start with healing the horse first, then we can address the cart. 

Image by Rachel Sumpter

No Single Diet for a Big Planet

The increasing pressure for everyone to convert to a vegan diet smacks of ignorance and righteousness. Yes, that includes scientists, and shame on them.

This stated universal solution for the health of everyone on this planet and all the ills of climate change is fraught with negligence to the fact that not every person can subsist in good health on a vegan diet. Nor is it necessary (some bold scientists have published data on why).

While the public, and many scientists, claim that adopting a vegan diet is the most important way to lose weight, be healthy, reverse climate change, and treat the planet better, there are reasons to believe this isn’t always the case. Despite the prevalent binary thinking and judgement of our Western society, fad science, and culture, there is no one, universal, de facto “right” diet for everyone. Our genetics, physiology, medical history, economic status, food accessibility, and aesthetic tastes are vastly varied. Absolutisms are rarely absolute.

Many people have food sensitivities and/or allergies: allergies to peanuts, gluten-related disorders (including wheat allergy and insensitivity to fructans), intolerance to yeast and/molds (such as in leavened breads, beer and several cheeses), phytates in m,any legumes and vegetable (taboo for people prone to kidney stones), “onion intolerance” (sensitivity to ingestion, even dermal exposure, to one or more plants in the Allium family), fructose malabsorption (bad things happen when eating even a small amount of most fruits), legume (including soybeans) intolerance/allergies, and the list goes on. People with these sensitivities and allergies may be unable to commit to a vegan diet without jeopardizing their overall health.

Another topic rarely seen in the lay media, and uncommon in the scientific literature, is the nutrient efficiency of a diet containing even a small amount of animal products - meat, milk, yogurt, cheese, eggs. By comparable weight, animal food products contain more protein (especially in the context of complementary amino acid profile), bioavailable minerals, and energy than any non-animal product. 

The cautionary point here is that most of the consumed energy is in the form of lipids, aka ‘fats,’ especially cholesterol. Primates -yes, us, too- evolved to store dietary fat for emergency energy in cyclic periods of famine. However, in our modern world of convenience and accessible plenty, we no longer need as much, and eat too much of it. Also, removing excess fat and eating naturally lean meat is an alternative.

The loud proclamation that everyone should embrace a vegan diet is unwarranted and impossible for many people. Nor should the reason of significantly reducing our carbon footprint be justification for imposing guilty consciousness. Some people just can't adopt a vegan diet. Moreover, a universally adopted vegan diet will not solve the demand for food and reverse climate change. 

Research at the USDA-Agricultural Research Service found that removing animal protein from the diets of many people would increase nutrient deficiencies that have been associated with certain health risks, like cardiovascular disease. Mary Beth Hall, animal scientist and one of the study researchers  at the U.S. Dairy Forage Research Center, comments in a press release,

“Different types of carefully balanced diets — vegan, vegetarian, omnivore — can meet a person’s needs and keep them healthy, but this study examined balancing the needs of the entire nation with the foods we could produce from plants alone. There’s a difference between what’s possible when feeding one person versus feeding everyone in the U.S.”

More importantly we should put more emphasis on growing some of our own or buying locally produced food, learn to make better food choices, eat balanced meals of both vegetables and animal products, plan meals centered around seasonally available foods, and stop piling so much food on our plates. 

Oh, and spending less time on our devices, in our vehicles, and getting off our butts and moving around around would not only reduce our appetite, improve our health, and possibly shrink that carbon footprint. Add supporting informed policy change at the local, state and national levels, too.