Evolution of the obesity epidemic
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Evolution of the Obesity Epidemic. Information from Time Magazine, National Geographic Magazine, and other sources. Exercise and Body Composition. Two major factors that lead to obesity: Over-nutrition – consuming too much Under-expenditure – expending too little energy. Over-nourishment.

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Evolution of the Obesity Epidemic

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Evolution of the obesity epidemic

Evolution of the Obesity Epidemic

Information from Time Magazine, National Geographic Magazine, and other sources


Exercise and body composition

Exercise and Body Composition

  • Two major factors that lead to obesity:

    • Over-nutrition – consuming too much

    • Under-expenditure – expending too little energy


Over nourishment

Over-nourishment

  • Increased caloric consumption

  • Increased portion sizes

  • Eating as entertainment


Exercise and body composition1

Exercise and Body Composition

  • Decreased daily energy expenditure

    • Transportation

    • Manual Labor

    • Entertainment


Role of genetics

Role of Genetics

  • About 2/3rds of tendency for obesity is genetic

    • Factors include

      • Low RMR 15%

      • High RQ (low fat oxidation) 5%

      • Low spontaneous physical activity (fidgeting) 10%

      • Other???

        • (Ravuzzin, ACSM, 2008)


Ancient history

Ancient History

  • Humans started by living in a world of scarcity.

  • To survive they developed the habit of eating everything that tasted good whenever they could find it.


Ancient history1

Ancient History

  • That's the way it was during 99.9% of human evolution.

  • For most of the 7 million years of human existence, life has been "nasty, brutish, and short"

    • Thomas Hobbes


Ancient history2

Ancient History

  • Life expectancy was under 30 years - mainly due to accidents, infection, childbirth, and predation.


Ancient history3

Ancient History

  • Early diet consisted of fruits, shoots, nuts, tubers, and vegetation - all low in calories - took constant work and eating whatever we found just to stay alive.

  • Fruits were highly desirable so we learned to seek fructose and glucose.


Evolution

Evolution

  • It was some 2.5 million years ago that our ancestors developed a taste for meat.

  • As a result, the human brain became markedly bigger and more complex at the same time.

  • We also increased in physical size.


Evolution1

Evolution

  • Because it's packed with nutrients and calories, meat gave early humans a respite from constant feeding.

  • Our ancestors ate a diet composed of lean meats, vegetables, and fruits and worked out almost nonstop.


Agriculture

Agriculture

  • 150,000 to 100,000 years ago.

  • Provided steady source of food.

  • No longer hunter/gatherers.

  • Farming became major source of food.


Agriculture1

Agriculture

  • Nutritionally the shift away from wild meat, fruits and vegetables to a diet of mostly cultivated grains robbed humans of many of the essential amino acids.

  • Still physical exertion was common.


Progress

Progress?


Environment

Environment

  • Our bodies evolved in an environment where food was scare and movement was required

  • We now find ourselves in an environment where food is abundant and movement is optional – recent development


Then and now

Then and Now

  • In 1700, the average Briton consumed 7.5 pounds of sugar per year.

  • In the US, we currently consume 150 pounds of sweetener per year.


Overconsumption

Overconsumption

  • Adult women are now eating 335 more calories per day than they did in 1971, while adult men have upped their intake by 168 calories.


Overconsumption1

Overconsumption

  • We each ate 1775 pounds of food in 2000, up from 1497 in 1970.

  • Although it appears we are eating more vegetables, almost 1/3 of these vegetables were iceberg lettuce, French fries, and potato chips.


Evolution of the obesity epidemic

Now

  • Rapid change in environment last 50 years compared to previous 50,000 years.

  • Removal of physical activity combined with abundance of food.


Evolution of the obesity epidemic

Now

Daily imbalance is on average small: an extra can of soda per day (150 kcal) can add 15.6 pounds per year


Factors related to obesity

Factors Related to Obesity

  • Food producers and the "Fast Food“ industry - if they’re successful, we all eat more


Childhood obesity

Childhood Obesity

  • The growth of the fast food industry and increasing portion sizes make it easy for children to overeat


Supersize me

Supersize Me


Childhood obesity1

Childhood Obesity

  • “A large fast food meal (double cheeseburger, French fries, soft drink, desert) could contain 2200 kcal, which… would require a full marathon to burn off”

    • Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public health crisis, common sense cure. Lancet 2002;360:473-82.


Childhood obesity2

Childhood Obesity

  • On days that children and youth eat fast food – they consume an extra 126 kcals/day (P<0.0001)

    • Bowman S, Gortmaker SL, Ebbeling CB, Pereira MA, Ludwig DS. Effects of fast food consumption on energy intake and diet quality among children in a national household survey. Pediatrics, in press.


Twenty worst foods in america

Twenty Worst Foods in America


Childhood obesity3

Childhood Obesity

  • Sugar-sweetened beverages contribute to childhood obesity incidence


Childhood obesity4

Childhood Obesity

  • “For each additional serving of sugar sweetened beverage consumed, both BMI (0.243 kg/m2; P=0.03), and incidence of obesity (odds ratio 1.60; P=0.02) increased.”

    • Ludwig DS, Peterson KE, Gortmaker SL. Lancet 2001, 357:505-8


Childhood obesity5

Childhood Obesity

  • Television and video/film production and distribution industry - if they’re successful we all watch more


Evolution of the obesity epidemic

Now

  • Advertisers constantly telling us to "eat this now".

  • Obesity increases as industrialization increases.


A widening problem

A Widening Problem

  • In a historical first, there are now as many overnourished people as undernourished around the world.


Why are we fatter

Why are we fatter?

  • Here's the recipe for obesity on such a global scale:

    • Take technology—cars, washing machines, elevators—that reduces physical exertion.

    • Increase calorie consumption, courtesy of increasing prosperity.  


A widening problem1

A Widening Problem

  • Add television, computers and video games.

  • Stir in the intensive marketing of candy and fast food, and you have the makings of an epidemic.


A widening problem2

A Widening Problem

  • In countries where the food supply has been unstable, people are getting fat despite far less abundance than in the United States.


A widening problem3

A Widening Problem

  • The implication?

  • Newly industrialized nations in Asia, Africa, the Caribbean, and Latin America may develop even higher rates of obesity-related health problems than in the U.S.


A widening problem4

A Widening Problem

>24%

20-24

15-19

10-14

0-9

No data


A widening problem5

A Widening Problem

  • North AmericaStates with the highest obesity rates—Mississippi and Alabama—are in the South. The more affluent and outdoorsy western states of Colorado and Utah have the lowest rates.South AmericaAs Latin America becomes more developed, supermarkets stocked with processed foods have become the norm, rising from 20 percent of food retail during the 1980s to 60 percent in 2000.


A widening problem6

A Widening Problem

  • EuropeCandy, fast food, and sweetened cereals account for more than half the food ads in ten European Union nations. In the U.K. snack food consumption rose nearly 25 percent in five years.AfricaIn some parts of Africa obesity afflicts more children than malnutrition. In Tunisia the urban population is shifting from traditional healthy whole grain breads to white bread.


A widening problem7

A Widening Problem

  • AsiaIn Shanghai, roads once filled with pedestrians and cyclists are now congested with cars. KFC opened a drive-through restaurant in Beijing in 2002, with more to come.OceaniaPacific Islanders have always valued hefty physiques. Now their shift away from local foods to a high-fat, Western diet has made them among the world's fattest people


Evolution of the obesity epidemic

Now

  • The Puget Sound ferries in Washington have increased the width of their seats from 18 to 20 inches to allow squeeze-in room for bigger bottoms.


Evolution of the obesity epidemic

Now

  • In Colorado, an ambulance company has retrofitted its vehicles with a winch and a plus-size compartment to handle patients weighing up to half a ton (1000 lbs).


Evolution of the obesity epidemic

Now

  • An Indiana manufacturer of caskets now offers a double-oversize model - 38 inches wide, compared with a standard 24 inches.


Discrimination

Discrimination

  • In one study at Michigan State University, undergraduates said they would be more inclined to marry an embezzler or cocaine user than an obese person.


Discrimination1

Discrimination


The stigma of childhood obesity can be devastating

The Stigma of Childhood ObesityCan be devastating…

  • An obese child’s quality of life is similar to the life of a child diagnosed with cancer, which has been determined as the lowest quality of life score.1


The stigma of childhood obesity can be devastating1

The Stigma of Childhood Obesitycan be devastating…

  • Adolescents who are teased about their weight are 2 to 3 times more likely to have suicidal ideation and attempts compared to adolescents who are not teased about their weight. 2


The stigma of childhood obesity can be devastating2

The Stigma of Childhood ObesityCan be devastating…

  • Obese children and adolescents are 4 times more likely to experience impaired school function when compared with healthy children and adolescents. 1

  • Obese children and adolescents have been found to miss an average of 4.2 days of school during the month. 1


It starts early

It starts early…

  • Low self esteem is not a characteristic in inner city obese African American children or obese preschool children. 3

  • Levels of self esteem of preschool children do not differ between non obese and obese children, but upon entering school this feelings change substantially. 3


Negatively affects school aged children and adolescents

Negatively affects school aged children and adolescents…

  • 4-11 year old children describe obese peers has “ugly”, “selfish”, “lazy” “stupid”, “dishonest”, “socially isolated” and subjects of teasing compared to their average weight peers who were described as “clever”, “healthy”, “attractive”, “kind”, “happy”, “socially popular” and a “desirable playmate”. 4

  • Overweight adolescents are more likely to be isolated and peripheral to social networks then their normal weight peers. 5


Negatively affects school aged children and adolescents1

Negatively affects school aged children and adolescents…

  • Social marginalization is more pronounced in white non Hispanic adolescent girls. 5

  • 90% of 9-11 year old overweight children believe that teasing and harassment from their peers would end if they could lose weight and 69% felt that if they were thinner they would have more friends. 6


It is also seen in homes schools and clinical settings

It is also seen in homes, schools and clinical settings…

  • 30.0% of adolescent girls and 24.7% of adolescent boys report being teased about their weight by their peers. 2

  • 28.7% of adolescent girls and 16.1% of adolescent boys report being teased about their weight by someone in their families. 2

  • 14.6% of adolescent girls and 9.6% of adolescent boys report being teased about their weight by both their peers and family members.2


It is also seen in homes schools and clinical settings1

It is also seen in homes, schools and clinical settings…

  • Parents communicate to their children negative stereotypes about obese children. 7

  • Parents of overweight children are criticized and feel that they are guilty and to blame for their child’s obesity. 6

  • On implicit and explicit measures, health professionals labeled obese people as “lazy”, “stupid” or “worthless”. 8


Perception vs reality

Perception vs Reality

Who do we think we are or strive to be?

vs

Who we actually are?


Evolution of the obesity epidemic

Mr and Ms America?


Mr and ms america

Mr. And Ms. America


Conan the governor

Conan the Governor


Jack nicholson

Jack Nicholson


Jack nicholson1

Jack Nicholson


Denise richards

Denise Richards


Evolution of the obesity epidemic

  • What this leads to is body disatisfaction


Eating disorders

Eating Disorders


Progress1

Progress?

  • By contrast, among people who still live in conditions most like those of our distant Stone Age ancestors - Maku or Yanomami of Brazil - there is virtually no obesity at all.


Evolution of the obesity epidemic

Modal Travel in Urban Areas:

Europe and North America Percent of Trips by Mode

Public

CountryBicycleWalkingTransportCar

Netherlands30 18 545 Germany 12 22 1649

England 8 12 1462

Italy 5 28 1642

Canada 1 10 1474 USA 1 9 384

Transportation Quarterly 1997; 51:31


Evolution of the obesity epidemic

0-1

1-2

2-3

3-4

4-5

5+

Distribution of Hours of TV Per Day:NHES Youth Aged 12-17 in 1967-70 and NLSY Youth Aged 12-17 in 1990

TV Hours (Youth Report)


Tsunami of health care

Tsunami of Health Care


Tsunami of health care1

Tsunami of Health Care

Cardiovascular Disease

Diabetes Mellitus

Glucose Intolerance

Overweight and Obesity

Sedentary Lifestyle


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