Everyone is shaking their head in disbelief. Me included. The latest JAMA paper on obesity trends in the US says that as of 2016, more than 4 in every 10 adult women are obese. Not overweight. Obese. That means a BMI greater than 30.
The nutrition world, health "experts" and policy makers seem to be at a loss. And I'm sure the 42% of middle aged adults that are obese are also at a loss, and frustrated with their inability to shed extra weight - however hard they may be trying to improve their health.
Obesity is intimately linked to diabetes, and as a cause of mortality is hopelessly under-reported at 2.9%. An obese diabetic who has a fatal heart attack is seen to have died from cardiovascular disease. More than 25% of the US adult population over 64 is diabetic. A significant proportion of their deaths would be attributable to metabolic disease.
I believe our flawed nutritional guidelines are driving this epidemic. Almost all increased weight stems from increased insulin as the root cause. Insulin tells our body to store fat. Chronically increased insulin is also the driver of pre-diabetes and diabetes. The last 4 decades of increasing obesity is I believe linked to chronic population-wide increased levels of insulin, which are linked to what we eat, and what we eat is linked to nutritional guidelines.
Three things are making a remedy difficult:
1) Fear of fat,
2) traditional food pyramid with an overweight carbohydrate base, and
3) the continued obsession with calories.
Recently I overheard a teacher tell young children not to take any "salami sticks" as a snack for a hike in the forest as it contained too much fat. She believes and acts on incorrect information, and a sad irony is that she was also significantly overweight.
Last year a landmark study of nutrition and mortality and cardiovascular disease in 18 countries with more than 135,000 individuals found a significant association between mortality and cardiovascular disease, and the amount of carbohydrate as a % of total energy intake. The PURE study, published in the Lancet, also showed an inverse association between the amount of total fat as a % of total energy intake and mortality and cardiovascular disease. The study concluded : "Removing current restrictions on fat intake but limiting carbohydrate intake (when high) might improve health. Dietary guidelines might need to be reconsidered in light of consistent findings from the present study."
This very controversial area of nutrition clearly needs attention to determine the best evidence is to justify the best guidelines – unbiased by agriculture, food and other powerful lobbies with vested interests. If we don't it's simply unfair.
The British Medical Journal is a significant and important "neutral" voice in this discussion. They will soon publish over a dozen key articles addressing many of the core topics in nutrition. Swiss Re is sponsoring these articles for open access and hosting a landmark launch event in June. More than 200 of the world's top researchers, clinicians, policy makers and experts will meet to debate and hammer out the evidence – where we are, what we know, what evidence is best and what else is needed to answer these questions going forward.
To work for a company that is playing a significant role in improving global health in this way is a privilege indeed. Watch this space!
We might still turn the obesity trend around.
Category: Funding longer lives: Health/medicine, Longevity risk