Obesity: A Four Part Series On The Worldwide Epidemic.

We can no longer single out North Americans when identifying obesity. This article will talk about worldwide obesity, eating patterns, and youth obesity including what we can do about it. Learn more...

Obesity: Worldwide Epidemic?
Grim Statistics

  • Americans (and those in many other modern countries) are suffering from a "fat" epidemic.

  • 55% of American adults are overweight or obese (women = 50.7% & men = 59.4%).

  • More specifically, 22% of U.S. adults are obese (women = 25% & men = 19%).

  • The economic costs of obesity are staggering. Researchers estimate that the financial drain from obesity and physical inactivity is over $90 billion a year, representing 15% of the American national health care expenditure.

  • Americans spend $33 billion per year on products and services to help them lose weight (this includes gym memberships, diet soda, low-cal foods, and dietary supplements).

  • Dietary supplements sales were $16.8 billion in 2000. Ten years ago sales were only $3.3 billion. The fastest growing segment is diet aids.

  • The United States spent $1.2 trillion on healthcare in 1999 and this will increase to $2.6 trillion by 2010, likely because prescription drugs costs will grow by 12.6% per year.

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Epidemic Evidence

It's almost impossible to avoid everyday evidence of the obesity epidemic. Walk down the street, look around at work, or even take note at the gym and you will find that the prevalence of obesity is remarkable.

Just recently, while seated in the top-level seats at a Utah Jazz basketball game, it was painfully obvious that the future health care system in the USA is going to be dramatically overburdened by a generation of obese adults, if it isn't happening already.

Admittedly, to get to the top row of seats in the arena it was a tough climb up 19 rows of steep steps, however it is a sad commentary when one man, perhaps 45 years of age and visibly obese remarked that, "that's enough exercise for the entire week."

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Actually it's not fair to single out North Americans, as even Hungarians, Danish, and Dutch researchers are identifying obesity as a huge problem. All around the world, scientists are attempting to find pharmaceutical and nutritional interventions to combat the problem of obesity.

Even the Chinese are getting fat, likely due to the "McDonald's disease" (the introduction of fast food restaurants and a sedentary lifestyle into their culture). Type 2 diabetes, high blood pressure, and abnormal blood lipid levels are now common in Hong Kong, China and this is closely associated with the increase in obesity.

More importantly, is that these countries are also observing increased obesity incidence in their youth, so it's not just a reflection of the "American" culture, but rather the sedentary lifestyle seen across a generation, in combination with very poor nutritional choices.

However, remember that there have been a number of reasons proposed as a cause of obesity (hormonal, genetic, societal, physiological, psychological, neurotransmitter), and of course some of these overlap.

According to the World Health Organization, the prevalence of obesity has increased so rapidly in many populations that the changes cannot be attributed to changes in genetic inheritance alone.

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Yes.
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Some further recommended reading is the April 2001 issue of Men's Health for a fat-burning workout, as well as future issues of Men's Health magazine, where fitness editor Lou Schuler will take the reader through dietary and training recommendations to fight fat, including a CB Athletics workout!


Obesity & Eating Patterns

obese Both rich and poor North Americans have equal opportunity to become overweight in these days of $5 fast food feasts.

Body fat is simply the storage of excess energy intake from a positive energy balance. Energy balance can be best expressed as the calories (energy) consumed in comparison to the energy (calories) you burn off each day.

Food energy is measured as a calorie, and so is the work that you do during exercise. Therefore, this basic energy equation (calories in vs. calories out) determines whether you gain, lose, or maintain your weight.

You expend energy every minute of the day, although the final amount is obviously determined by your activity level, not to mention your muscle mass (more muscle results in more energy being expended at rest).

Diet-induced thermogenesis (DIT) also contributes to energy expenditure and obese adults often show lowered DIT compared to lean adults. DIT is the amount of energy that your body expends during the digestion, absorption, and utilization of food energy.

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Obese adults that have a low DIT have a more efficient utilization of calories and greater ease of fat accumulation. In less technical terms, this simply means that "naturally thin" individuals (also referred to as individuals with "fast metabolism") use up more energy during these processes and as a result have less energy to store as body fat.

Chronic overfeeding (regardless of whether it is carbohydrate or fat) is associated with obesity, insulin resistance, and elevated blood insulin levels.

Insulin is an anabolic hormone with both good and bad connotations. Fortunately, it can prevent muscle breakdown after exercise and it helps the muscle store glycogen (a fuel for high intensity exercise), however it can also increase the storage of blood free fatty acids in fat cells.

What Does Anabolic Mean?
Anabolic refers to the metabolic process that is characterized by molecular growth, such as the increase of muscle mass. Thus, it means "muscle-building" in most common bodybuilding contexts.

What Is Glycogen?
Glycogen is the principal stored form of carbohydrate energy (glucose), which is reserved in muscles. When your muscles are full of glycogen, they look and feel full.

It also limits fat mobilization (the release of fat from fat cells to be used for energy production). So even if you are consuming a low-calorie diet but still consuming a diet that promotes high insulin levels (i.e. lots of high-glycemic carbohydrates), you may have difficulty losing body fat.

obesity
Unsure Of The Evidence?
Just Look Outside.

There is evidence that "high-glycemic" carbohydrates are best avoided by those seeking to lose weight. High-glycemic carbohydrates are refined foods such as processed cereals, cookies, pasta, white rice, cakes and other processed goods high in sugar. The term high-glycemic refers to the rapid increase in blood sugar that these foods cause after ingestion because they are rapidly absorbed.

In a recent study in the American Journal of Clinical Nutrition (71: 901-907, 2000), researchers found that after only 6 days, subjects eating low-glycemic foods lost more body fat than subjects eating high-glycemic foods. Also, the group eating the low-glycemic foods had a higher metabolic rate and a lower rate of snacking on sugary foods.

From 1994-1996, Americans consumed the equivalent of 82 grams of high-glycemic carbohydrates per day from added sweeteners, which was about 16% of total calories.

Adolescents had the highest intake, about 20% of calories, with soft drinks accounting for a third (!) and table sugar, syrups and sweets, sweetened grains, and milk products providing the rest. That translates into almost 330 calories of sugar per day! Eliminate this from your diet and you have the potential to lose 1 pound of fat (generally considered to be 3500 calories) in 10 days.

fat man
The Prevalence Of Obesity
Continues To Rise.

While the prevalence of obesity continues to rise, controversy remains as to the specific causes of this trend. What about the phenomenon of winter fat?

Roberts et al. (2000) determined that the weight gain during the 6-week winter period from American Thanksgiving through New Year averaged only 0.8 lbs. However, weight gain was greater among individuals who were overweight or obese, and 14% gained more than 5 lbs over this time period. Among the entire population, weight gain during the 6-week holiday season explained 51% of annual weight gain.

So, it appears that most weight gain does occur during the holiday period and by early March there was a recorded net weight gain of approximately 1-1.5 lbs (Robert et al., 2000). If you do that every year you can see how "the pounds creep up on you."

In another study, Yanovski et al. (2000) found a similar trend and therefore American adults should expect to see a net weight gain - winter fat! In conclusion, it looks like holiday weight gain really is the important contributor to the rising prevalence of obesity that many people often make it out to be, even though absolute values for weight gain in this study were less than anticipated.


Youth Obesity

Obese child According to some statistics, up to 25 percent of American children are overweight. Where did things go so drastically wrong that we should end up with so many youths being classified as overweight?

Is it really just the PlayStations and the massive consumption of high-sugar foods? Are these the only reasons for obesity? Should we be satisfied with these answers, accept them, and move on to the next problem?

Is this lifestyle really any different than the ones that a large percentage of adults live out daily at their desk jobs? Why isn't every adult obese? Oh wait, didn't you just read that over 50% of adults are obese?

Apparently our original hypothesis is correct - that the PlayStations and sugary snacks are likely to blame, and correspondingly, the office computer and doughnuts are to blame for the situation many adults find themselves in.

From the American Diabetes Association comes this report: "Our children and teens are becoming more overweight and at greater risk for disease." A recent survey showed that increasing numbers of American children and teens are overweight, continuing a trend that began two decades ago.

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It is believed that overweight children are at a higher risk for diabetes, cardiovascular disease and other serious health problems. In a related story, a growing number of children and teens were diagnosed with Type 2 diabetes. Obesity (from a combination of a sedentary lifestyle and poor eating habits) and genetics are to blame, according to the American Diabetes Association.

Most important are the long-term health implications for adolescent obesity. There is a clear association between obesity and the development of non-insulin dependent (Type 2) diabetes (Kannel et al., 1996).

In 1998, 10.5 million Americans were diagnosed with diabetes (90% Type 2). It was suggested that it costs $11,000 per year in health care for each individual with diabetes compared to $2500 per year for non-diabetics (Harris, 1998).

Obesity is also a serious risk factor for type 2 diabetes, coronary artery disease, hypertension, and others. Researchers have also found that a strong relationship between fatness and CHD risk factors in adolescents and they concluded that the primary prevention of CHD during childhood should therefore concentrate upon preventing or reversing undue weight gain (Boreham et al., 2001).

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So where is the answer to our problem of obesity? Where can one start to change? Researchers at Boston Children's Hospital have concluded that the chances of a child developing obesity rises significantly when they increase their daily servings of sugar-sweetened drinks.

According to the study, published in The Lancet (a medical journal), even a mild increase in daily soft drink consumption (high glycemic carbohydrates) gives a child a 60 percent greater chance of becoming obese. However, an increase in diet soda consumption made the children less likely to become obese.

Daily participation of high school P.E. (physical education) classes in the United States has decreased from 42 to 25%. Furthermore, many coaches complain about the lack of overall athletic ability displayed by kids today despite the incredible performances by individual athletes. Adolescents need to find some sort of regular physical activity because it is essential for sedentary young adults to get moving.


Obesity & Exercise

It's much easier to maintain a healthy level of low body fat than it is to lose 10-15% body fat and 30 lbs or more. But it can be done. Pick up any fitness publication these days and you will find amazing transformation pictorials. Check the timeline. It may have taken these people 3 months, 6 months, or even a year, but these people have made incredible journeys.

Were they less busy than other overweight individuals? Are people too busy with appointments? If that is a problem, individuals should schedule an appointment 2-4 times per week with the gym just like it was any other business meeting.

Spend a half-day on the weekend shopping for an accomplished personal trainer that can give you a program that requires only 2-4 hours per week. C'mon, 2-4 hours per week, who can't spare that?

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What type of exercise should you do? As mentioned, the more muscle mass you have, the more energy that will be spent at rest due to an increased resting metabolic rate. Next, you have to do lots and lots of running or biking right?

Well, no, not necessarily. Aerobic exercise certainly is beneficial to a healthy cardiovascular system and is important for the performance of some sports and it is likely one of the best methods for obese individuals to lose weight. If nothing else, it should improve some health parameters.

Aerobic endurance exercise has traditionally been used in the treatment of type 2 diabetes but its effects on long-term glycemic control is small. Researchers found that resistance training helped increase muscle mass and improve long-term glycemic control in an elderly type 2 diabetic population (Eriksson et al., 1997).

Chronic exercise training in diabetic rats was associated with reductions in basal glycemia, and such reductions did not occur in sedentary diabetic groups (Farrell et al., 1999). Therefore, exercise programs should focus on increasing muscle mass because muscle in the prime user of blood glucose.

Tremblay et al. (1994) showed that vigorous exercise (HIIT - high-intensity interval training) favors negative energy and lipid balance to a greater extent than exercise of low to moderate intensity (traditional aerobic exercise). Moreover, the metabolic adaptations taking place in the skeletal muscle in response to the interval program appear to favor the process of lipid oxidation.

What Does HIIT Stand For?
High Intensity Interval Training.

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This study compared traditional endurance training against high-intensity interval training. Even though the interval training expended less energy per training session, the subjects lost more body fat than those performing regular endurance training.

If you are super busy, simply split your training time in half or thirds. A 15-minute walk two times a day plus as little as 15 minutes of resistance training can pay off. Aim to burn more and more calories every exercise session.

Up the intensity! Yearn to lift 5 lbs more weight this week, or get another 2-3 reps per set. Improvement will equal results. Don't get put off by the people that do have 2 hours to train. Realize there is a point of diminishing returns... think about it, unless you are a competitive athlete, are you really getting much more from spending 45 minutes running as opposed to 30 minutes?

Very soon you will realize that there is nothing to slipping in some fitness to your workday.

You set goals for retirement savings, for business performance, for golf scores, so why not some fitness goals? You get professional plumbing help, you have a professional cleaner clean your clothes, so what's wrong with asking a fitness professional to fine-tune your body?

What one of these people can teach you in 1-2 hours is something that will last a lifetime! Not sure who to go to? Surprisingly, the CB Athletic Consulting network is growing to the point that there is someone in almost every area that can be recommended to take you to a better workout!

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When visiting the CB Athletic's website, please check the exclusive links section because these people are the best or email for a professional in your area.


Conclusion

To be optimistic, it is simply a problem of education and exercise, moderation and muscle mass, teaching and training. For the amount of commercial time an adult sits through during an hour of prime time TV (about 15 minutes), one could easily read an article from a fitness magazine detailing and outlining a fitness regimen for success against weight gain.

Surely, in this society that allows one to operate fitness equipment while watching television, there is an opportunity to fight against fat. There are 168 hours in a week. If you train, that only takes 2-4 hours, plus 1-2 hours for travel and showers, etc. That still leaves you approximately 160 hours for work, friends, family, sleep, and - yes, even T.V.!

References:

  1. Boreham, C., et al. Fitness, fatness, and coronary heart disease risk in adolescents: the Northern Ireland Young Hearts Project. Med. Sci. Sports Exerc. 33: 270-274, 2001.
  2. Eriksson, J., et al. Resistance training in the treatment of non-insulin-dependent diabetes mellitus. Int. J. Sports Med. 18: 242-246, 1997.
  3. Farrell, P., et al. Hypertrophy of skeletal muscle in diabetic rats in response to chronic resistance exercise. J. Appl. Physiol. 87: 1075-1082, 1999.
  4. Harris, M. Diabetes in America: Epidemiology and Scope of the Problem. Diabetes Care 21: c11-c14, 1998.
  5. Kannel, W., et al. Effect of weight on cardiovascular disease. Am. J. Clin. Nutr. 63: 419S-422S, 1996.
  6. Roberts, S., et al. Holiday weight gain: fact or fiction? Nutr. Rev. 58: 378-379, 2000.
  7. Tremblay, A., et al. Metabolism 43: 814-818, 1994.Yanovski, J., et al. A prospective study of holiday weight gain. N. Engl. J. Med. 342: 861-867, 2000.