Friday, September 23, 2005

One Billion Overweight Worldwide

Yesterday the World Health Organization warned that more than 1 billion people worldwide are overweight and that if the trend continues, the number will increase to 1.5 billion by 2015.

“The sheer magnitude of the overweight and obesity problem is staggering,” WHO Assistant Director-General of Non-communicable Diseases and Mental Health Catherine Le-Gal├Ęs Camus said in the warning, issued ahead World Heart Day on 25 September.

Throught the above article, a number of statistics were presented and the rising rates of obesity were stated as being caused by a global shift in diet towards increased energy, fat, salt and sugar intake, and a trend towards decreased physical activity due to the sedentary nature of modern work and transportation, and increasing urbanisation.

More of the same "calories in calories out" explanation. Don't get me wrong, calories do count in the weight gain-weight loss equation, but few are asking the harder question - why are we suddenly eating more calories as our requirement for calories is in decline with less activity? If you look at the data, the situation isn't simply we're moving less while eating the same. Not only are we moving less, we are eating more calories.

Throughout our evolutionary history, we've encountered situations of feast and famine and at no time in the past experienced such a dramatic surge in large segments of the population growing too large.

There have always been, and will always be, a small percentage of the population that are overweight or obese. There have been, and will always be a small percentage of the population that are underweight. These two facts are givens. The real issue is not these two ends of the spectrum populations.

The vast majority of humans, around the world, could be said to be part of the "middle population" - those who, until recently, always maintained a weight within a normal range in conditions other than famine.

Over the last thirty odd years, the focus of the medical and scientific communities and public policy makers has remained "calories in calories out" and "eat less and move more." These are concepts even a child can understand and even though oft repeated, has done nothing to stop the rise of overweight and obesity in the United States or globally.

So, the question begs, is the message ignored or is the message wrong?

Many would contend that the message is simply being ignored. And on some level, I would agree - there are some who simply will not heed any warnings and will not alter eating habits which are leading to their weight gain. But to say that every person - 1 billion people now - are just ignoring the facts and doing nothing to change their overweight condition is ignoring the fact that the calorie theory might be wrong on some level.

Think about that for a moment. What is the likelihood that one billion people don't understand "eat less calories and/or move more"?

Now, what is the likelihood that, given we've had thirty years of this message...if it really was the solution, if it really worked when followed....what is the likelihood we would still be seeing an alarming rise in the rates of overweight and obesity?

With that in mind, I contend that it is not simply the calories, but the type of calories that are far more important in the equation. We have data available from the last thirty years that consistently shows that it is a small minority who successfully are able to lose the weight and keep it off with the "eat less and/or move more" solution. Some will say that the majority who are unable to do so simply stopped following this workable approach and if they would just do it, they too would be successful in losing the weight and keeping it off.

To me, this is a very simple minded perspective that fails to ask why so many fail in their attempts to follow what should be an easy solution. Rather than ask if the problem is the solution, they'll seek to blame the individual who has failed instead of working to find a solution that will work.

It's a good thing that not everyone has tunnel vision about the issue. While still in the minority of those researching the causes and solutions of the obesity epidemic, a number of researchers are finding that it isn't just the calories, but the quality of the calories; the form the calories are delivered in; and the overall quality of the nutrient load provided by the calories.

With one billion people already overweight globally, and that number continuing to grow daily, we need real solutions to reverse this trend. The solution is not a simple "calories in calorie out" equation, but much more complex than that.

In know for myself, simply eating less calories by following a calorie-restricted plan didn't work well. It took a radical change in my diet, from one that was heavy with starches and carbohydrates to one that was rich with nutrients but much lower in carbohydrates to effectively enable weight loss and maintenance of that weight loss. While my diet today would be best described as "controlled carbohydrate," it is still maligned by those making dietary recommendations because, even though it is heavy with vegetables, it lacks what is considered adequate intake of grains; even though it is nutritionally complete from just my food intake, it lacks what is considered a "balanced" variety of all the food groups.

Is there one dietary approach that works for everyone? No

Is there one ratio of carbohydrates to fats to proteins that works for everyone? No

Is there one formula of how many servings each day of vegetables, fruits, meats, nuts & seeds, legumes and fats that will work for everyone? No

Given the fact that there is no one approach that is going to work, it is high time the medical establishment and public policy makers begin to open their minds to the fact that there are a number of ways to approach weight loss and management and stop recommending the single, low-fat, high carbohydrate approach as the solution for the obesity epidemic.

We have one billion people who need access to the information about the various dietary approaches that have been shown to work. We need a working "tool box" of solutions available to physicians and nutritionists to offer their patients instead of the continued "if you just eat less and exercise more" routine that is clearly not working!

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