Obesity: five facts

[pocaracas]

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We all know, from all the campaigns, that energy rich foods are the culprits here... calories that go unspent turn to fat, to put it simplistically.

Actually, it does depend a lot on the type of Calories you eat.

In the olden days, there was also something which we'd call exercise: hunting and gathering required walking, running, picking things up, carrying, etc... physical activity.
Nowadays, exercise if faked, but it works for those who start it before going over the limit of obesity, as Aractus explained.
The obese seem to be, pretty much, hopeless.. they can improve a bit, but it's a daunting chore. The pre-obese have it easier and I think it's at them that the policies are aimed.

Although that's true, it doesn't explain the fact that office workers in the 1940's-1960's who did the same amount of exercise as office workers today were non-obese, nor does it explain the fact that Japan's office workers who get little exercise continue to be non-obese.

So, what's in food that get you fat?
Well... fat does the trick. Eat pork, bacon and other fatty meats and fish, and you're ingesting fat directly. duh!

You don't ingest dietary fats (lipids) directly, the fatty lipids are broken down into free fatty acids before being absorbed from the small intestine.

"Some of the glucose is converted to lactic acid by astrocytes, which is then utilized as an energy source by brain cells, some of the glucose is used by intestinal cells and red blood cells, while the rest reaches the liver, adipose tissue and muscle cells, where it is absorbed and stored as glycogen (under the influence of insulin)."

Fructose, however, "after absorption, [...] enters the hepatic portal vein and is directed toward the liver." In the liver it is metabolized and then stored nearby....gut fat.

That's not entirely accurate. Just about every living cell in the human body can use glucose as energy, and for this reason it's the Liver's job to keep the blood-glucose level in equilibrium (generally 3.6 to 5.8 mmol/l).

The body's glycogen stocks are used to keep blood glucose levels constant. The body can only store about 2,000 kcal in glycogen. It's true that the Liver produces glycogen from excess glucose, but that itself is not fat storage - fat storage is the storage of lipids not glycogen. One the body has reached its capacity of glycogen storage, excess glucose that has to be removed from the liver is instead used to synthesise fatty lipids and hence stimulates fat storage.

Fructose, like all carbohydrates and alcohol that is not glucose, ultimately has to be converted to glucose to be used as energy (except by the liver which can burn fructose, galactose, and ethanol for its own energy). The fact that fructose, galactose, and ethanol have to be converted by the liver into glucose is what leads into the theory that excess fructose in the diet stimulates fat storage. It seems logical because when you think about it, if you've just eaten a meal high in sugar then your pancreas will secrete insulin and your liver will flush the glucose out of the bloodstream and make glycogen. While it's at it it also has to remove the fructose - but glucose levels are high so should it produce more glucose from the fructose or instead use it to make fatty lipids? Research done by Robert Lustig and his colleagues suggests this is true (watch "the skinny on obesity" on youtube).

He did get one of his facts wrong though in "skinny on obesity" - he claimed that "there is no food stuff on the planet that has fat and carbohydrate at the same time - except for fructose", however milk contains both fat and carbohydrate at the same time. Meat also contains both fat and some carbohydrate. He would have been correct if he said "no plant-based food stuff ..."

He also got another fact wrong when he said "and when your pancreas can't produce enough insulin it produces diabetes". That description is correct for type-1 diabetes, but it isn't driven at all by obesity or over-consumption of sugar. Type 2 diabetes is caused by insulin resistance, where the cells that respond to insulin have shut down their receptors, and obesity is the primary cause of it. He also missed the opportunity to mention that the overproduction of insulin may cause pancreatic cancer (seems logical to me).

So, eat this not that... but what is this?
A first step is to avoid all sodas. Tap water, in most developed countries is good... and cheap... the cheapest hydration source in most homes. Sure it tastes of nothing, but you drink to to sate thirst, not because it tastes good. And water is the number one liquid for thirst.

Yep, and you can also safely drink diet soft-drink, and milk. According to Mozaffarian et al. 2011, all those are safe when it comes to weight long-term, and 100% fruit juice had only a small weight-gain effect (certainly a lot smaller than the other diet factors). Avoid coca-cola, and all other non-diet soft-drinks, and don't put sugar in your tea or coffee.

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Thanks for the corrections and increased accuracies!

I forgot to mention fruits.
Fruits, so people are told, contain fructose.... which makes fructose seem a "good" kind of sugar.... so good, in fact, that last week I saw it for sale on the "healthy" aisle of the supermarket: 1kg of fructose... can't recall the price... white sugary granules... looks like normal sugar, to me.
Anyway, we've evolved to appreciate the sweetness from prehistoric sources of sugar: fruits and honey. Honey wasn't that easy to get to, because of... you know... bees and their stings. Fruits were just there for the taking... each in their season! And fruits have something else: fibre.
That fibre doesn't get assimilated, but rather promotes intestinal flow, thus keeping some nutrients from being absorbed.... fructose too!
Of course, you can complement your sugar intake with fibres from some other source, typically, doctors will tell you to eat your veggies which are the main source of such fibres in our present day diet.
But kids don't seem to like them... and then they grow up still not liking them... and then they don't teach their kids to eat their veggies, because they themselves never liked them.... and (of course, not only because of this!) you arrive at today's UK and US levels of obesity... and growing!
In the meantime, Japan eats a lot of fish and a lot of veggies... just look at sushi!
But kids do like sugar. oh yum yum yum!
Go figure... it's the parents' fault!


Now, for something completely different.
I was a bit confused by the statement you quoted "when your pancreas can't produce enough insulin it produces diabetes". I thought diabetes was a condition, not a hormone or substance.
And, if I understood it correctly from your explanation, type 1 diabetes happens because the pancreas shuts down and stops producing insulin, while type 2 is when the body becomes insulin resistant and, no mater how much of it the pancreas produces, it will never work as intended.... did I get this right?

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It isn't an excuse, it's science. Put simply: when obese people lose weight they feel terrible and then they regain the weight and now we know why, and it isn't their fault. Your victim-blaming approach is wrong.

Well, technically, it's their bodies, and they ARE their bodies, so it's their fault. You may say it's not their conscious fault, though.

Also, if they didn't buy so much food to have around the house, they would probably not indulge in their constant hunger.... if food wasn't so abundant... specially junk food, the kind that you can take everywhere and just keep snacking and snacking and snacking.
One tiny example of how the industry encourages you to snack like this:
- When I went to the UK, and I wanted to get a pack of crisps at Tesco, all I could get was a pack of 6 smaller packs, 6 individual doses, let's say. And what do people do with these packs? They get home, open on the the small packs and eat them... their small, they're enough for a meal, but not enough for snacking, so they get another one... and another one... and another one... Almost without noticing it, you've eaten 4 or 5 small packs, about 30g each... and it feels like it wasn't that much! Just 4 tiny packs! full intake: 30x4 = 120g.
In Portugal, you get 200g packs, some are 150g, but are just as large (that's a different consumerism problem). You open your 200g pack and you know that's way more than one dose. That's enough for a family of 6's meal. Still, you open it for snacking... and just go on taking crisps from it.... at some point, you notice you're half way through... "damn, I ate too much"... close the pack and store it. Full intake = 100g.
Still.... The World Health Organisation has this week warned that child obesity is fast becoming the norm in Europe, with Portugal one of the continent’s worst performers. (this is the parents' fault!... and it starts)

Since I'm going on about servings, it's also good policy to serve your plate in the kitchen and only put the plates on the table, not the pan or wherever you cook. That way, you eat one dose, one plate, and that's it... it's a hassle to refill the plate so you only really do it if you're really hungry... if it's just gluttony, you'll refrain.