Obesity threatens to overtake famine as a global killer. How should we tackle it?
It is time we recognized that obesity isn't the killer, it's what is causing it at biochemical and hormonal level that is the problem. Obesity is just the most obvious manifestation of what goes wrong in the human body when we eat a diet we are not set up to handle.
The main problem with our diet is the high level of refined carbohydrates that it now contains. Refined carbohydrates are processed foods which have had most or all of their fiber and nutrients stripped from them. Examples include white flour and sugar and all the many manufactured foods and drinks which contain them. They are often referred to as 'bad' carbs.
The 'good' carbs on the other hand are unrefined carbohydrates. They are natural, whole foods which still contain their original fiber, vitamins, minerals and other nutrients. They include vegetables, nuts and seeds, pulses, whole fruits and whole grains.
Blood sugar/insulin imbalance
When we eat carbohydrates, the process of digestion turns them into glucose. The level of glucose or 'blood sugar' in the bloodstream rises, and in response the pancreas produces the hormone insulin. It is the job of insulin to keep the blood sugar within a limited range. It is also responsible for sending excess blood sugar to the cells to be used for energy or to be turned into fat for storage.
Refined carbohydrates are digested more easily than unrefined carbohydrates. They cause a much higher and faster rise in blood sugar, and a lot more insulin is secreted as a result. If we eat refined carbohydrates too frequently, we can start to produce too much insulin. This throws our metabolism (the way we digest food and use it for energy) out of balance.
This is what happens at biochemical and hormonal level when we are constantly overproducing insulin:
- Energy consumed is preferentially stored in our fat cells, causing us to gain weight more easily
- Fat stored in our cells is 'locked in', making it harder to lose weight despite reducing calorie intake
There are other effects, as well. For instance, we can effectively become addicted to carbohydrate foods, in a vicious circle of eating – too much insulin produced – blood sugar falls too low – feel hungry – must eat more food. For many, refined carbohydrates are an addiction just as much as alcoholism is for others. Until they have the knowledge to break this addiction, expecting them to change their way of eating is as forlorn a hope as expecting an alcoholic to stop drinking without dealing with the chemical addiction first.
The link between insulin imbalance, type 2 diabetes, heart disease and obesity
Constantly high insulin levels can also lead to insulin resistance, where more and more insulin is needed in the cells to produce an effect. Ultimately, the pancreas becomes exhausted and type 2 diabetes is the result. This connection between refined carbohydrates, high insulin levels and weight gain explains why the obesity epidemic is accompanied by an equally worrying rise in the incidence of this type of diabetes. In fact, type 2 diabetes used to be called maturity onset diabetes because it was only seen in older people, but it is now being seen in children, who are showing the effects of a diet full of refined carbohydrates at an ever younger age.
High levels of insulin are also thought by some researchers to cause the damage that leads to heart disease. A high fat diet has been blamed for causing this problem for many years, but recent landmark studies have demonstrated that fat is not the villain it was made out to be. As a result, nutrition experts everywhere are now being forced to re-examine their long-held belief that the only healthy diet is a low fat one.
Not everyone has a problem handling a diet high in carbohydrates. However, researchers think that a significant proportion of the population does - possibly up to 60%. Unfortunately for this group of people, current healthy eating advice to base the diet on carbohydrates simply exacerbates their underlying problem. To make matters worse, dieters attempt to follow the other mainstay of current healthy eating advice, to reduce fat. So they choose foods marketed as 'low fat' and 'fat free', not realizing that such foods are all too often achieved by replacing the fat with sugar or other refined carbohydrates. This results in the crazy situation where such foods are targeted at the very people who are least able to tolerate them.
Although the worst culprits are foods that most people would recognize as unhealthy (such as sweets, sugary cakes and cookies, sugary cola drinks etc) the so-called 'healthy' carbohydrates such as wholemeal bread, wholemeal pasta, brown rice and potatoes may be just as much a problem for people whose blood sugar/insulin balance is particularly unstable.
The role of nutrient deficiencies in obesity
Nutrient deficiencies also play an important part in fueling obesity. Unfortunately there is a misconception that most people who get enough to eat are well nourished. This is not the case. Even those on a so-called balanced diet may be lacking in important nutrients. Not only do individuals differ in their ability to absorb, synthesize or use a particular nutrient, but foods today commonly contain nutrient levels far inferior to what the text book says. This is due to problems such as widespread soil depletion, storage times and practice and seed selection for color and flavor rather than nutrient content.
Depressed metabolism, 'starvation mode' and yo-yo dieting
Other aspects of our metabolic processes must also be taken into account in any effective anti-obesity strategy. For instance, the body is designed to become more fuel-efficient if it receives less food. So reducing calories has to be done very carefully to avoid depressing the metabolism and causing the body to go into 'starvation mode', where it maintains the same weight on less and less calories. Unfortunately, most official advice on losing weight simply ignores this critical issue, consigning dieters to a lifetime of failed diets and ever-increasing weight.
A better strategy for combating the obesity epidemic
In conclusion, we are on a road to nowhere whilst we persist in the belief that overweight people simply eat too much or don't exercise enough, and that this is due to lack of willpower, gluttony, sloth or unresolved emotional issues. The current simplistic focus on reducing calories and fat and doing more exercise will never be an effective strategy for tackling the obesity epidemic. It fails to recognize that many complex biochemical and hormonal factors are involved, and that one size doesn't fit all. Instead, the following principles should form the basis of a successful long term strategy for reducing obesity:
- Recognize that for many people, focusing on reducing refined carbohydrates rather than calories or fat is the way to reduce weight and maintain it in the long term. (For these people, this will have the added advantage of significantly reducing the risk of diabetes - by tackling its cause.)
- Recognize that for those who are addicted to carbohydrates, no amount of advertising, educating or cajoling will work unless they are first helped to break their addiction.
- Promote vegetables equally with fruits. (Fruits are easier to persuade people to eat but their high fructose content may not be handled well by carbohydrate-intolerant people and in any case vegetables can provide the full range of nutrients and fiber found in fruits.)
- Recognize that malnutrition (not to be confused with undernutrition) is a factor to be taken into account.
- Recognize that not all fats are 'bad' and that a fat-free or low fat diet is not a healthy diet.
- Promote increased intake of the 'good' fats such as omega-3 fatty acids, encourage the food industry to stop using the very worst of the 'bad' fats (hydrogenated or partially hydrogenated oils) and educate the public about their dangers.
- Recognize the value of nuts and seeds. The fat phobia of recent years has made this an unjustly neglected class of foods, high in many important nutrients including the 'good' fats which studies now tell us we should be eating more frequently, not avoiding.
- Stop foods being advertised as 'healthy' or 'low fat' if their usual fat content has been replaced by sugar (whether glucose, cornstarch or any other of its 'hidden' forms).
- Allow breakfast cereals and bars to be promoted as healthy only if they are high fiber and wholegrain without added sugar.
- By all means oblige fast food restaurants to state the number of calories on packaging, preferably with an indication of what percentage of daily calories this represents for the average child/adult. But avoid classifications such as 'low calorie' or 'low fat' which only confuse or mislead - each food should be seen in the context of the individual's overall diet. Labeling should also include carbohydrates for those who need to watch these.
- Determine to break the current vicious circle where manufacturers add sugar (or sweeteners) to foods such as baked beans or sliced ham to make them more appealing. The consumer gets the 'taste' for this level of sweetness, the manufacturers then add further sweetness to make their product sell better than the next brand, thus fueling a general carbohydrate addiction amongst consumers who are unaware of what is happening. In this environment, it is almost impossible for a 'no sugar' brand to break into the market.
- By all means encourage exercise as an important part of a healthy lifestyle and improving general levels of fitness. But recognize that this will not resolve the widespread hormonal and biochemical imbalances that lie at the root of the obesity epidemic.
- Promote better understanding of the crucial role good nutrition plays in health and weight control by requiring the subject to be taught in schools.
- Ensure children are taught how to prepare simple, healthy meals for themselves before they begin their adult lives.
More detailed explanation of the concepts outlined in this article can be found in the book Why Can't I Lose Weight, available from www.dietplateau.com