Thursday, December 20, 2007

Obesity: Is it a Form of Malnutrition?

In a presentation at Berkeley in November, Gary Taubes included a quote from the 1967 International Conference on Obesity.

"Even a brief visit to Czechoslovakia would reveal that obesity is extremely common and that, as in other industrial countries, it is probably the most widespread form of malnutrition."

This idea, the obesity is a form of malnutrition, isn't new and there is increasing data pointing to nutrient deficiency as contrbuting to the growing prevalance of overweight and obesity around the world.

How can that be though? Don't a number of studies point to our increasing calorie intake, along with a more sedentary lifestyle, as the cause of our growing waistlines?

While it is difficult to believe that one could be deficient for essential nutrients - vitamins, minerals, trace elements, essential fatty acids, and essential amino acids - while consuming so much food, let's see what the published data tells us.

Back in Janaury I wrote about a study out of Sweden that found four-year-old children already insulin resistant and overweight. One statistically significant finding was that the heaviest children were those consuming the least amount of dietary fat; they were also found to be deficient in vitamin D, iron and omega-3 fatty acids. Yet they were classified as obese. How did they manage to eat too much yet fail to meet nutrient intake levels for health and well-being?

In 2000 a survey of workers at a fertilizer plant revealed that many were overweight and obese - concurrent with their intake of excess calories they were found to be deficient in vitamin A, thiamin (B1) and consumed a poor ratio of mineral salts. The researchers concluded "Hyper-energetic, disbalanced nutrition, and incorrect nutritional-behavioral model are factors that determine the prevalence of overweight and obesity among the workers examined."

A study published last summer concluded that "Vitamin D insufficiency was associated with increased age, BMI, and SBP, and decreased HDL-C."

Just this month, a stunning paper was published examining the presence of micronutriet deficiencies in women. The researcher, Dr. Aswaf "examine[d] the relationship between micronutrient deficiency and the prevalence of mothers' overweight/obesity in Egypt using the 1997 Egyptian Integrated Household Survey. The ordered logit results show an overlap between micronutrient deficiency and the prevalence of mothers' overweight/obesity in Egypt. The odds of being overweight/obese are 80.8% higher for micronutrient deficient mothers than for non-deficient mothers, keeping all other variables constant."

Lastly, and by no means the end of the data we could look at, data published from the NHANES surveys tell us something really interesting - over the last few decades our intake of protein has remained stable, level, not increased; our intake of fats and oils has also remained stable; our intake of carbohydrate has increased - yet deficiency in critical nutrients is increasing amongst the population, with too many Americans failing to meet requirements for Vitamin E, C, A and D, selenium, magnesium and potassium.

With just these few studies, there appears to be a connection between micronutrient intake and excess weight - malnutrition parallel to an overweight or obese body state.

For some time now, I've written about how the dietary recommendations are flawed. They're focused on macronutrient ratios - carbohydrate, protein and fat - with the assumption being that if you follow such an eating pattern, you'll meet micronutrient requirements.

One small problem - even the menus published by the government and medical organizations to provide an example to the public of how to eat are nutritionally deficient for critical essential micronutrients. In fact, I've even posted side-by-side menus that showed the recommended diet compared to a controlled-carb diet was nutritionally inferior to the controlled-carb menu. In such comparisons, I use menus that are published by organizations rather than create them myself to reduce any chance for bias on my part.

So, I wasn't surprised to learn about a new study that Cassandra Forsythe wrote about a couple of weeks ago.

Go ahead - go take a peek - it's worth the read!

9 comments:

  1. Regina,

    As tempting as this theory might be, it seems far more likely to me that the real problem underlying the increase in obesity is genetic damage caused by exposure to the chemicals leaching out of the plastics that now pervade our environment and industrial organic chemical residues in our air, water, and of course, food.

    Children are becoming obese and insulin resistant at ages so young it is not possible that the obesity is the result of eating patterns. We know from animal research that subtle genetic damage will cause this kind of early obesity. We also know that there are something like 20,000 organic additives found in everything from our shampoo to the linings of milk cartons that have never been seriously tested to see what their effect might be on our genes.

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  2. Hi Jenny...

    I think there are many things in play with the growing incidence of obesity, especially in children....and your points are well taken! It's like there is a perfect storm out there of just the wrong things at the wrong time, coming together to create, for lack of a better phrase "utter metabolic chaos" in the body.

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  3. I'm having trouble teasing out cause and effect here. Are we obese because we have nutrient deficiencies, or do we have nutrient deficiencies because we are obese?

    Maybe both obesity and nutrient deficiencies are effects of some other cause? I didn't see the Taubes talk yet, but I have read his book. I thought what he was suggesting is that excessive carbohydrate consumption leads to a state of starvation at the cellular level. That is to say, your body doesn't know what to do with all the extra glucose other than funneling it to your adipose tissue, so your other tissues do not get adequate energy, and you become hungry and tired all the time.

    As for micronutrient deficiencies, it seems to be a one-two punch. The carbohydrate foods that cause obesity are poor sources of many micronutrients, of course. But I believe it's also the case that carbohydrate foods require more micronutrients to be utilized properly, so ingesting them can further deplete an already deficient store.

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  4. Anonymous8:50 AM

    I believe that what makes this mystery so difficult to solve is that there are several factors contributing to the obesity, muddying the waters. But I do also believe that a vitamin or mineral deficiency can cause obesity, for a number of reasons. One could be an ancient genetic reaction to reduced sunlight; preparation for winter, perhaps. Another, just being deficient in any nutrient reduces metabolic efficiency. Chemicals that mimic hormones in the body, such as certain plastics, or phytoestrogens, for example. And from my own observations-when I am deficient in something, one way my body signals this to me is increased hunger. Much to consider on this topic...

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