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November 21, 2021

Obesity has become an epidemic.

Here’s the trend line for rising overweight (including obesity) rates in adults aged 15 – 74 years:

obesity chart

According to the World Health Organization (WHO), global obesity rates have tripled since 1975. During the year 2016, more than 1.9 billion adults were overweight. Out of them, nearly 650 million were obese (1).

Body Mass Index is the ratio for weight-to-height and is used to classify obesity.

According to WHO, someone is overweight if they have a BMI between 25 and 30. Obesity is a BMI greater than 30 (1).

Obesity puts your overall health at jeopardy. It makes you prone to countless other health conditions like diabetes, heart diseases, and even cancer.

You are 28 times more likely to develop diabetes if you have a BMI of more than 30. The risk is 93 times greater if you have a BMI of more than 35 (2). Also, obesity increases the risk of fatal heart disease by up to 30 percent (3).

But why is there an obesity epidemic? Why is 47 percent of the United States population expected to be obese by 2030 (4)?

Here we identify the top 4 reasons as to why there is an obesity epidemic.

 

  1. The ‘Fat Dilemma’

    Historically, we have been on the wrong foot with fat intake.

    Even in the most widely accepted dietary guidelines, the fat intake has been linked to an increased risk of weight gain. Most of the guidelines emphasize on the restriction of the total daily fat intake (5).

    Most of these guidelines miss out on differentiating between good and bad sources of fat.

    Most of the previous guidelines have linked saturated fat to an increased risk of obesity and other health ailments. Turns out, most of these arguments are based on poor scientific backing.

    Countless meta-analyses have proved that a diet rich in saturated fat is not linked to weight gain or other health problems. In fact, RCTs have proven that a diet based on saturated fats might offer protection against cardiovascular and metabolic diseases (6, 7).

    Instead, the type of fat that is implicated in weight gain, as per research, is the Trans-fat.

    Trans fats are industrially created to increase the shelf life of food items. In most of the Westernized countries, the average intake of Trans fats is higher than recommended by WHO (8).

    Recent meta-analyses have found convincing evidence for Trans fats being the reason for weight gain.

    Trans fats achieve that by increasing the level of hormones like ghrelin that increases appetite. It also promotes insulin resistance that triggers fat and weight gain (9).

    Key Takeaway: We have been focusing on the wrong type of fat. What we need is to cut back on the intake of Trans fats.

  2. Our Endless Addiction to Sugar

    Sugar intake, especially fructose, is perhaps the biggest culprit for weight gain that we have always ignored.

    Considering the sugar epidemic, the World Health Organization has suggested reducing the daily sugar intake to 5 percent of the daily caloric intake. Previously, the recommended intake was 10 percent of the daily caloric intake (10).

    In the U.S., average daily sugar intake in adults range between 14.5 and 22 percent of the total caloric intake, which is far more than the recommended intake (11).

    Sugars, especially fructose, lead to weight gain in a number of ways.

    Normally, when you eat food, your brain increases the production of leptin (hunger-suppressing hormone) and decreases ghrelin (hunger-promoting hormone).

    When you consume fructose-based foods or beverages, it does not suppress ghrelin or increase the production of leptin. As a result, you always hungry and end up consuming more calories (12).

    Insulin is a hormone that helps in the breakdown of sugars and fat metabolism.

    Insulin resistance is a state when your body cells do not respond to the action of insulin. It disrupts sugar and fat metabolism and leads to weight gain.

    If you consume fructose-based beverages, it promotes insulin resistance and weight gain (12).

    In fact, you can actually get addicted to sugars. The reason you go ‘sugar bingeing’ and have a sweet tooth is that sugars are just as addictive as drugs like cocaine.

    Researchers have found that consuming sugars trigger the release of dopamine in the brain. Dopamine is a brain chemical that creates a feeling of happiness (13).  

    Sex is one of the strongest emotional drives. But researchers have found that animals can become addicted to sugar intake. The addiction can become so strong that they would prefer eating sugar than having sex (13).

    Key Takeaway: Sugar consumption is even a bigger risk factor for weight gain compared to the consumption of Trans fats. 

  3. Reduced Physical Activity- Taking It Easy

    Our lifestyle has become more sedentary than it was ever before.

    As per WHO recommendations, adults should do at least 150 minutes of moderate intensity workout per week (14).

    We could burn our calories by a little workout but most of us are headed in the opposite direction.

    At work, most of us click and scroll instead of running around and sweating. Once the work is done, we take it easy still more.

    Why walk when you can drive back home? Why walk to the shopping mall when you can shop online?

    According to the Center for Disease Control and Prevention (CDC), only 23 percent of Americans get enough exercise (15).

    A combination of a well-balanced diet and physical activity is the proven way of weight loss. However, research has also demonstrated that exercise alone can lead to sustained weight loss (16).

    Physical activity does not only lead to immediate weight loss but has lasting health benefits as well.

    Adequate physical activity promotes weight loss, improves the sensitivity of body cells to the action of insulin, make your body system more efficient in the utilization of calories, and regulates your appetite as well (16).

    Key Takeaway: A sedentary lifestyle promotes weight gain and increases the risk of countless diseases like cardiovascular conditions. Adequate physical activity is crucial for maintaining an ideal body weight.

  4. Our Eating Practices

    The two most common reasons for weight gain are our eating practices and lack of physical activity- something termed as the ‘hegemony of the two’ (17).

    Some eating practices leading to weight gain are as follows:

    Engineered Junk Food: The fast food and processed items we are so addicted to eating today are engineered to make you addicted to them.

    The ‘convenience foods’ are rich in Trans fats, salt, sugars, preservatives, and chemicals. All of these factors contribute to weight gain (18).

    Stress-Addiction Cycle: Stress is a powerful modulator of our eating habits and choices.

    Why do you think you prefer chocolates, fast food, and fizzy drinks over healthy alternatives when you are stressed?

    The chronic stressors in life increase the level of cortisol in your body. With time, your body becomes resistant to the action of leptin and insulin.

    This cycle of stress, cortisol increase, leptin and insulin resistance, and increased food intake leads to weight gain (19).

    Aggressive Food Marketing: Junk foods are marketed quite aggressively.

    Most of these tactics even use unethical ways to sell unhealthy items and market them as something healthy.

    Multi-national chains and brands spend billions of dollars on advertising their products (20).

    These brands can go to every length to sell their products.

    The Era of Abundance: Did you ever wonder how our ancestors managed to live a healthy and active lifestyle and never gained weight?

    Our ancestors ate when they needed to, never ate junk, and were extremely active physically.

    What do you see at every street corner? You see McDonald’s, KFC or other fast food chains.

    Fast food is everywhere now. The outlets display the most tempting food.

    Moreover, fast food is cheaper than whole and healthy foods.

    That’s the combination of these elements that make you prefer fast and junk food over healthy alternatives.

Key Takeaway: Our society in general is flooded with junk and processed foods. It is generally quite hard to eat healthy.

Conclusion and Recommendations

If we want to reverse the obesity epidemic on a global scale, we need to keep the following things in mind:

  • We need to reconsider our understanding of healthy eating.
  • We need to cut back on trans fats instead of saturated ones.
  • The main focus should be on eating a balanced diet containing nuts, grains, fruits, and vegetables.
  • Added sugars is the number one evil that has contributed to this epidemic. The sugar intake should be kept to the minimum.
  • Emphasis should be put on doing 60 - 90 minutes of moderate intensity workouts every week.
  • It doesn't take hard work and drastic lifestyle changes to achieve a balanced weight. 

References

  1. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  2. Ann Smith Barnes. The Epidemic of Obesity and Diabetes. Tex Heart Inst J. 2011; 38(2): 142–144.
  3. John Kwagyan, et al. OBESITY AND CARDIOVASCULAR DISEASES IN A HIGH-RISK POPULATION: EVIDENCE-BASED APPROACH TO CHD RISK REDUCTION. Ethn Dis. 2015 Spring; 25(2): 208–213.
  4. https://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf
  5. https://health.gov/dietaryguidelines/2015/resources/2015-2020_dietary_guidelines.pdf
  6. Beulen Y, et al. Quality of Dietary Fat Intake and Body Weight and Obesity in a Mediterranean Population: Secondary Analyses within the PREDIMED Trial. Nutrients. 2018 Dec 19;10(12). pii: E2011
  7. Russell J de Souza, et al. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ. 2015; 351: h3978.
  8. Shauna M Downs, et al. The Impact of Policies to Reduce trans Fat Consumption: A Systematic Review of the Evidence. Current Developments in Nutrition, Volume 1, Issue 12, 1 December 2017, cdn.117.000778
  9. A K Thompson, et al. Trans fatty acids and weight gain. International Journal of Obesity volume 35, pages 315–324 (2011)
  10. Elyse S. Powell, et al. Added sugars intake across the distribution of US children and adult consumers: 1977–2012. J Acad Nutr Diet. 2016 Oct; 116(10): 1543–1550.e1.
  11. Mauro Fisberg, et al. Total and Added Sugar Intake: Assessment in Eight Latin American Countries. Nutrients. 2018 Apr; 10(4): 389.
  12. Rodrigo Martins Pereira, et al. Fructose Consumption in the Development of Obesity and the Effects of Different Protocols of Physical Exercise on the Hepatic Metabolism. Nutrients. 2017 Apr; 9(4): 405.
  13. Nicole M. Avena, et al. Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev. 2008; 32(1): 20–39.
  14. https://www.who.int/dietphysicalactivity/factsheet_adults/en/
  15. https://www.cdc.gov/nchs/data/nhsr/nhsr112.pdf
  16. Carla E. Cox. Role of Physical Activity for Weight Loss and Weight Maintenance. Diabetes Spectr. 2017 Aug; 30(3): 157–160.
  17. Emily J. McAllister, et al. Ten Putative Contributors to the Obesity Epidemic. Crit Rev Food Sci Nutr. 2009 Nov; 49(10): 868–913.
  18. MOHAMMADBEIGI, et al. Fast food consumption and overweight/obesity prevalence in students and its association with general and abdominal obesity. J Prev Med Hyg. 2018 Sep; 59(3): E236–E240.
  19. Cizza, et al. Beyond fast food and slow motion: Weighty contributors to the obesity epidemic. J Endocrinol Invest. 2012 Feb; 35(2): 236–242.
  20. Mary Story, et al. Food Advertising and Marketing Directed at Children and Adolescents in the US. Int J Behav Nutr Phys Act. 2004; 1: 3.



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