Kids Bigger by the Decade

Just to show you how bad the childhood obesity numbers are getting, a recent study highlighted the problem among our nation's kindergartners. Research conducted by the RAND corporation showed that today's children are heavier than their counterparts of the 1970s and 1980s, and that these children run a real risk of becoming obese as adults.

The researchers analyzed data on nearly 6,000 white, black and Hispanic children who participated in the Early Childhood Longitudinal Study--a nationally representative sample--and had their height and weight measured over nine years, in kindergarten, first, third, fifth and eighth grades. They found that nearly 40% of kindergartners had a BMI in the 75th percentile, which means that they are heavier than 75% of their peers. This number is up from 25% in the 1970s and 1980s, when the growth charts were developed by the U.S. Centers for Disease Control and Prevention.

Although the 75th percentile is not by any means overweight or obese, it does show that, in general, children are getting bigger. Overweight (85th-95th percentile) and obese (>95th percentile) numbers for children did increase as well, however, to 28% and 12% respectively, up from 10% and 5% in each category. The largest gains were seen in Hispanic children and black girls.

Experts are unsure of the reasons for these findings but believe that readily available and convenient high-fat, high-sugar and highly caloric snack and processed foods, and less physical activity due video games, TV and less outdoor play time are all potential contributors.

The significance of these findings are not only that the number of overweight and obese children is on the climb, but that a large portion of children are on their way to blowing up, as signified by the high numbers in the 75th percentile. Without a doubt, overweight and obese children should be attended to, but a real danger lurks with these potential bigger kids, those in the 75th percentile, and the direction they might go as they grow.

Less children were on the lower weight end, too--about 14% were in the lowest fourth for weight compared with 25% in earlier generations and 18% were in the second lower quartile compared with 25% in earlier generations. While having some pluses, primarily less underweight and malnourished children, it merely shows how society, as a whole, is blowing up.

I still contend that these numbers are due to the types of foods Americans eat regularly. Processed foods, in my opinion, are the worst, since they are sold a wholesome foods in supermarkets and grocery stores. But too many are relying on fast foods, which is just hamburger joints, but delis, pizza, bagel shops, taco stands, and the list goes on and on. If it's not whole, natural foods and you are not preparing them at home, then it's fast food, period. Not good for the health, and certainly not good for the waistline.

Parents you have a responsibility to feed your tykes good food. They will eat junk food on their own--no need to have it around the house. And frozen, canned and packaged food isn't any better, no matter what the label says. If you ain't cooking it--it's crap. Nuff said.

Some Evidence on Obesity Model

I've been getting harangued for weeks by a severely wounded ego-centric proponent of the I'm-so-desperate-to-be-right approach to intellectual discourse, that I am finally giving in and providing some support for my thoughts on obesity. The blog stalker has insisted that I prove the validity of my thoughts on obesity, and so I will provide some evidence, but let it be known that this is the last response I will make to the ramblings.

In the most recent issue of the International Journal of Obesity [Volume 35, Issue 10 (October 2011)], no less than every article supports my position:

• On the causes of obesity:

Overweight and obesity are the results of an enduring positive energy balance, that is, when energy intake is larger than energy expenditure. Hence, overweight and obesity prevention requires effective intervention programmes targeting behaviours that contribute to both sides of this energy balance. These so-called energy balance-related behaviours include dietary behaviours (for example, consumption of fruit and vegetables, or sugar-sweetened beverages), sedentary behaviours (for example, television (TV) viewing or computer use) and physical activity behaviours (for example, sports or active commuting to school).

Interesting, calories in vs. calories out (boldface emphasis mine), and not one thing about hormones or genetics. That's because it's science, stupid.

• On parents needing to get involved because increased physical activity (PA) at school only is met with greater inactivity outside of school:

The PA of children seems to compensate in such a way that more activity at one time is met with less activity at another. The failure of PA programmes to reduce childhood obesity could be attributable to this compensation.

Duh!  Parents are responsible for their children especially when they see them blowing up.

• That feeding your child crap disrupts their physiology to such a degree as to promote obesity:

Lower insulin sensitivity at childhood may predict subsequent total and central adiposity gain at adolescence. These findings enhance the role of insulin sensitivity as a target of obesity prevention already from the first decades of life.

Or in other words, don't let your children eat junk food.

•  That fat parents breed fat kids:

Children whose both parents were overweight or obese both before pregnancy and after 16-year follow-up had a strikingly high risk of overweight at age 16 years...parents’ long-term overweight (BMI 25 kg m⁻² before pregnancy and after 16-year follow-up) was the strongest single predictor.

I almost can't believe that anyone would need proof of this.

• That drinking sufficient water helps decrease and/or maintain healthy weight:

Consuming the recommended daily amount of water for children could result in an energy expenditure equivalent to an additional weight loss of about 1.2 kg per year...water drinking could assist overweight children in weight loss or maintenance, and may warrant emphasis in dietary guidelines against the obesity epidemic.

• That hormonal changes are the result of fat deposition (obesity) and not the cause:

Too much abdominal (visceral) fat increases an individual's risk of developing insulin resistance and other metabolic disorders. In a Perspective, Hug and Lodish discuss the unexpected finding that blood levels of a hormone produced by visceral fat, called visfatin, correlate with obesity.

Okay, that particular study is from a different journal, but I couldn't resist (and one more from same journal)

But back to the International Journal of Obesity:

Conclusion: Hormone (serum visfatin) levels are influenced by body fat content in obese children

•  On overeating being one significant factor in obesity:

An association between children's body mass index (BMI) and overeating has been established...overeating, impulsivity and reward responsiveness were significantly associated with childhood BMI. Mediation analysis revealed that impulsivity and reward responsiveness equally and significantly predicted BMI indirectly through overeating.

The single most idiotic argument I've heard is that overeating is not a cause of obesity--precisely why this will be my last response to such nonsense. I cannot discuss an idea with someone if we don't speak the same language.  Denying the most basic knowledge we have about physiology puts us on different planets.  Conversation over.

• That eating fast food (FF) regularly leads to obesity:

The teenagers who ate at FF restaurants consumed more unhealthy foods and were more likely to have higher BMISDS than those teenagers who did not eat frequently at FF restaurants. 

• That prosperity leads to obesity:

Ethnic minority groups in Western European countries tend to have higher levels of overweight than the majority populations for reasons that are poorly understood. ..Conclusion: Contrary to the patterns in White groups, the Dutch ethnic minority women were more obese than their English equivalents.

It's only poorly understood because the right questions aren't being asked.  Essentially the study shows that culture alone isn't definitive.  However, I propose that it's the change in culture, particularly entering an environment where conveniences abound.

• That junk foods promote overeating due to chemical and high sugar content:

...higher preferences for sweet and fatty foods compared with the other two groups. Food preferences were also related to all overeating measures, which in turn accounted for a substantial proportion of the variance in BMI...The associations reported in this paper are important from a public-health perspective because of the abuse potential of sweet-fat foods and their strong relationship with obesity.

And that's that. As I've said before, Mr. Stalker, I don't do peoples' research for them. But because you showed such diligence in asserting yourself, I thought I would finally accommodate. I didn't have to go far for supporting articles--one journal, sir, was all I needed. That's because what we know about obesity isn't in need of an overhaul, therefore most of what I put forth is BASIC. What is needed is a halt to the notion that the individual isn't responsible for his or her own weight, and that they are powerless because of their genetics or hormones.

So as I said, I'm done. I will post a few more promised pieces on obesity in the future, and then I move on.

Obesity Goes Where the Money Goes

I wanted to address something I touched on last post--obesity as a condition of prosperity.  The obesity epidemic that we are witnessing today in western society is only possible in an environment of abundance.  I am not talking individual wealth here, but prosperity of nations; and American obesity statistics, and pretty much that of the rest of the world, support this claim.  Obesity is rampant in North America and Europe, with Japan and South Korea having the highest rates in the east.

But wait, what about the rising powers of China and India?  They are experiencing rapid economic growth, but have they an obesity epidemic?  According to a recent report, extreme fatness is making its way to India.  As India's economy grows, the middle class increases as well, and western fast food companies are smelling opportunity like they haven't since, well, 1950s America.

And which demographic do you suppose the fast-food industry is targeting?...You got it--youngsters.  Let's go to the Hop... Reports disclose that one in three children in private schools in New Delhi are obese compared with one in ten in government schools.


"Obesity is emerging in India which has serious implications for metabolic health in the future," says researcher Seema Gulati. "Schoolchildren are attracted to the way it (junk food) is advertised," she said. "They feel it is something that is high status. They want to try it out."

Exactly...convenience, good taste, high status, western, bourgeois, you know...you've been there America, but now look atcha: 30% obesity in most states.  That's not overweight...that's obese...and it's crazy.  And I'm certain the trend will continue in the East, as Asian countries get more powerful.

Brazil is there already, and India is on its way...China anyone?  We'll see.  A major 2010 study called "The Rise of Asia's Middle Class" by the Asian Development Bank warned that in the next 20-30 years Asia will be faced with "an increasing number of chronic diseases on a scale previously unseen".

Obesity is a natural consequence of prosperity.  As money flows, so does the drive for convenience, and nothing more convenient than ready-made food for the go.  Wealth comes from work--lots of it--and this means limited time.  We Americans know that lifestyle all too well--the burning candles, chasing sensory stimuli and seeking greater and greater conveniences--and how it can lead to greater excesses.  Ultimately these excesses cause problems, like rising chronic diseases and epidemics of addiction: food, drugs, sex, and so on.

Hey I'm not knocking any of it...just pointing out the truths of the bigger picture.  We can waste time looking for new and novel causes of obesity--heck, lots of money to be made there--but if we really wish to make a dent in the obesity numbers, then understanding how the condition arises and develops over time is a hell of a lot more useful than trying to create new fantasies about genes and hormones, especially as we see it unfolding in other cultures mirroring our own.  Let's put two and two together, find real solutions to help those that truly want them, and then maybe we might even pave the way for others to understand and resolve their own issues.  But it won't happen anytime soon if we continue to foolishly blame outside forces when the problem is completely man-made.

Meet Ultra-Bad Cholesterol

You've heard of "good" cholesterol and "bad" cholesterol--now meet their wicked stepbrother, "ultra-bad" cholesterol...so bad, it forms stickier plaques, and makes its carrier even more susceptible to heart disease and stroke.  Who's got this badass sticky-plaque cholesterol?  Diabetics.  But before you think that's not you...let me add prediabetics to the mix as well.

British scientist have found the super-sticky cholesterol by essentially recreating in the lab.  By glycating low density lipoproteins (LDLs), that is, by adding sugar groups to the molecule, they turned the "bad" LDLs into "ultra-bad" MGmin-LDLs.  The added sugar groups change the cholesterol's shape, making it stickier and more likely to attach to blood vessel walls.  Once cholesterol sticks to the arterial walls, the plaques narrow the lumen (space), reducing blood flow and thus increasing the probability of heart attack or stroke.  Diabetics and prediabetics are at risk due to the higher levels of sugar circulating through the blood.

Of course, the discovering scientists (University of Warwick in the UK) and the medical community is excited because the findings uncover how a common type 2 diabetes drug, metformin, fights heart disease by blocking the transformation of normal LDL into the super-sticky LDL.  Which of course means greater possibilities for new drugs.

But my interest is from a different angle.  It's for me to stand on a soap box and say: Please people, listen, decrease your sugar intake or remove it from your diets altogether.  Processed sugar is one of the greatest health impediments of the modern world.  The number of illnesses and organ diseases attributable to excess sugar in the diet are astronomical.

While in doctor school, I read 1,500 pages of pathology text required for the curriculum, and it was my observation that excess sugar (along with tobacco and alcohol use) is one of the primary causes of disease in contemporary civilization.  And our foods are filled with it.  Sugar is in everything!  From cookies and cakes, to sauces, meats, breads, cereals, soups, stews, children's food...and the list goes on and on.

Fast food is laden with sugar.  But be not afraid...here, wash it down with a soda.  Yes, the American drink of champions!  I know I'm a freakin' bummer, but somebody has to say it.  Drop the sugary, frosted, high fructose corn syrup-laden CA-RAP before your arteries get filled with super-sticky MGmin-LDLs.  Dang!  Seventy-nine million people in the United States today have prediabetes.  Freakin' duh!

Let me put it in perspective: You know how you think the guy or gal you see smoking a cigarette is going to have a heart attack one day?  Now you can do the same for the soda drinker.  Think about it.

Childhood Obesity Not Linked to Location

I wrote a post back in March questioning some conclusions from a Columbia University and UC Berkeley study stating that fast-food restaurants located near schools increases childhood obesity. While I didn't deny the data, I certainly disagreed with the authors' conclusion that banning fast food joints near schools would decrease obesity in children. Well a new study has just been released that closes the lid on the fast-food ban argument. In fact, it shows that the presence of fast food restaurants has no effect on childhood obesity at all.

According to research conducted at Indiana University-Purdue University Indianapolis, which looked at a decade of data on more than 60,000 children aged 3 to 18, living near a fast food restaurant had little effect on weight gain. And surprisingly, living instead near a supermarket stocked with fresh fruit and vegetables wasn't associated with lower weight either. These results go against anecdotal data that have led some to believe that the types of food choices in a neighborhood have an effect on weight gain.

The study looked at details such as both sick- and well-doctor visits, changes in a child's address, annual food-service establishment inspection data, aerial photographs of neighborhoods and crime statistics over time. This study provides more accurate data since it was collected over a period of ten years and not a single year as in previous studies. As an interesting side note, living near recreational facilities was associated with lower childhood weight.

Well, all I can say is...I figured. C'mon folks, temptations are all around us, all the time. Does anybody really believe that not having a fast food restaurant near their home will prevent them from getting fast food? I mean, everybody knows that crack addicts come from every neighborhood, right?--even travelling into dangerous neighborhoods to get their goods, right? What's the difference with junk food?

Listen, staying away from junk is an issue of upbringing. You either learn fast food is junk, or you don't--you think it's food. Whether you've got a dozen fast food restaurants in your hood, or zero, if you think fast food is a viable dietary choice, then you'll find it when you want it. And it'll show in your waistline...your kids, too.

Fast Food Fascism

I don't mean to be obnoxious...well, OK, yes I do, but I couldn't help but notice today while lunching at The Cheesecake Factory the young girl at the table across from me enjoying a pizza (a large one solely for her) and a very large coke. Wow! As I watched this intriguing display of gluttony, I wondered: Health officials are really banging their heads trying to figure out the childhood obesity epidemic? Duh!!!

I, for one, do not blame the makers of junk food for the epidemic--temptation is all around all the time; discipline is a virtue. So I don't really applaud any research that proves junk food leads to obesity, like the latest study out of Columbia University and UC Berkeley, which showed that fast food restaurants near schools increase obesity rates. You don't say. That's where our research dollars are going? And do you think video arcades near schools lead to more sore thumbs? May I repeat--Duh!!!

Even worse is that the esteemed opinion of the researchers is that banning fast food restaurants will decrease obesity? Will it? Not without also banning Doritos, or Pop Tarts, or Dominos, or Frosted Flakes, or wait...how about Coke?!?! That's right, is the government ready to ban the biggest culprit of obesity in the modern world, soft drinks? Seeing that Coca Cola is one of the biggest companies on the planet, I doubt it.

Fast food is the new tobacco. Like smoking yesterday, indulging in fast food is getting blasted from all angles. Instead of calling it like it is--an educational issue, an upbringing issue, a cultural issue, a discipline issue--let's just play victim and blame the fast food itself. People don't get fat, buckets of chicken do.

It's not that I am so enthralled with fast food that I must defend it, or the businesses selling it; I just don't like the government stepping in and minimizing my choices of eateries. I don't personally make Taco Bell my first choice in grub, but I'll eat it in a pinch. And it's not like there's no benefit to fast food. You know if you're starving and have very little time, a Whopper will do--you know that. You know that if you are starving after your late night bar shift, you'll eat a damn Big Mac--don't lie to yourself.

So stop trying to feed me this useless science that says we need a ban on fast food. Maybe instead they can do fast food profiling like they do with antihistamine sales in pharmacies now (you know they do that, right?). Anyone entering Mickey D's will need to give up his or her ID card and have their fatty-grub usage tallied. More than two visits per month and you'll only be allowed the McSalad. Sound good? Yeah, not to me either. I guess we'll just have to kiss the neighborhood KFC goodbye.

The Real Thing

Spent the day in downtown L.A. fulfilling my civic duty. Jury duty called and I was promptly selected--aargh!

While having lunch in the local food court, I couldn't help but notice a very interesting observation: about 90% of the people in my view were drinking soda. I am certain that I saw a couple hundred people, so that's a heck of a lot of soft drinks. I counted a few water bottles, but mostly I saw people drinking out of waxy soda cups, the kind you typically find at fast food restaurants. True, it might have been water, but since I know the national soda consumption numbers, which are astronomical, I'm sure these people were drinking what most Americans choose--good ol' fashioned candy pop.

I couldn't help but think about the weight loss industry too; about how it's booming, and about how promising its future looks. How many people in this country are trying to lose weight right now? How many of you reading this are?

Well I've got a real buzzkill for you: You are never going to lose weight if you don't give up your sodas. I know, I know--eff you, Campos!--because people feel strongly about their soft drinks. Never have I received so much resistance when suggesting a habit kick than when suggesting people stop drinking soft drinks--not from smokers, not from heavy drinkers, not from heavy sushi eaters. Nope, soda drinkers beat them all. They come up with all kinds of reasons why everything but soda is bad for them. Soda is not that big of a deal. Yeah, right.

I used to drink soda, I get it. You can pound these things all day long. Some people nail six or more in 24 hours! That's pure, unadulterated liquid sugar. No nutrients, no vitamins--pure calories, pure sludge. I'm telling you, you can watch every other thing you eat. You can work out seven days a week. You can get liposuction and a stomach staple. But if you keep drinking sugar, you'll never lose weight. I've been there, done that. Believe me soda is the first thing you must kick if you're ever going to drop pounds. Next is booze, but that's another story (don't worry, I'll get to it one day).

Here is the scary thing: Most people I observed at the food court seemed to be employees of the legal court. I know because I followed a bunch of attorneys down there; figured they'd know the best place to grub. They did. But no way I could eat that way every day. However, as I clearly saw, many people in downtown L.A. do. I didn't see many other places to eat in the area. Funny, but my pompous L.A. arse always assumes that we know better in this town, but clearly we don't. I can't even imagine what it's like in other less health-conscious cities like Houston, Oklahoma City or Vegas.

So here's the skinny: If you wish to lose weight, drop the sodas, man; it's the only way. But if you love your sodas so much that you can't kick the habit, then don't be so hard on yourself--enjoy your coke and your smile, and just be content with the extra 20 pounds.

A Welcomed--If Not Temporary--Victory

Yay! A judges ruling last week has allowed New York's fast food restaurants to ignore posting calorie and fat counts on their menus. Basically, a pre-existing federal law takes restaurants that voluntarily provide this information off the hook. As long as they provide nutritional information somewhere--on tray papers or Web sites, for instance--they cannot be restricted in how they comply with city law.

Thank goodness. As I've said in earlier posts (here, and here), nothing is dumber than the government stepping in where individual discretion is warranted. Do we really need the government to tell us what's junk and what's real food? Please. All that would do is hurt businesses that provide a product the public wants--junk food. And it takes the responsibility away from the individual. We'll never see an increase in national health until people become responsible for theirs, plain and simple.

Interestingly, this is being proved by yet another recent study. Researchers have found that people consistently underestimate the calorie content of foods served at restaurants they consider healthier, like Subway, for example. In the study, researchers asked people who had just finished eating at Subway or McDonalds to estimate how many calories they had just consumed. On average, Subway diners underestimated their calorie intake by 151 calories--that is, they mistakenly believed they were eating less calories by eating a 12-inch turkey sandwich than by eating a Big Mac, although both have exactly the same amount of calories. What this then led to was the Subway diners ordering more sodas and cookies than the McDonalds diners, giving them actually more calories overall. This meant that, on average, Subway diners wound up consuming 1,011 calories, compared to 648 calories for the people eating McDonalds. Whoa. Get it? People make assumptions about food, and these assumptions lead to poor food decisions.

But wait, if calorie and fat content is posted won't it lead to people making better decisions? Not necessarily, because only fast food restaurants would be required to post such information (more on this concept here). So, in my opinion, people will go to the local Whole Foods and pig out because they assume it's healthier. Should Whole Foods then post calorie content? How about Spago? I've got a better idea: How about understanding two basic principles instead:

1. Fast food is junk that should only be eaten periodically
2. How much one eats is as important as what one eats

Got it? Eating too many carrots, falafel, or soy veggie burgers is just as detrimental to the health as an occasional Big Mac. True, carrots have a greater vitamin and nutrient content, but people aren't using this as their criteria yet.

I just don't see calorie reporting at fast food restaurants as being the answer, and worse, I think it will lead people down the wrong road. Just understand the basics about food, and practice prudent principles. Don't know what they are? Get yourself a copy of The Six Keys to Optimal Health--it's all in there--and you'll be sure to make the right decisions.