Gluttony and Sloth

Yves here. The title of this piece is likely to annoy readers, but the article makes an important point: that the widespread perception that the increase in obesity and overweight in the world is due to eating more appears to be wrong, at least in aggregate. It has much more to do with increasingly sedentary lifestyles. (And yes, preventable overweight is a public health issue which in turn increases health care costs which we all ultimately bear).

One indirect proof is the fact that in New York City, where the natives walk more than most places, you see fewer overweight people, even when you adjust for the fact that being trim has become a status marker, so middle and upper middle income people will expend time and money on weight control. I find that when I am out of town and using cars to get around, it is very difficult for me to get my regular level of overall exercise in, which includes running errands on foot (in theory I could easily compensate by doing intense and very time efficient interval sprints, but I have lax joints and alignment issues, so that is a fast track to injury for me. And do not discuss swimming. Showering before and after and hair washing and drying make it super time inefficient. Plus I hate swimming).

Contrast our modern lifestyle with that of people who were largely self-sufficient 150 years ago. The men would chop wood, haul heavy things around, often walk long distances (for errands, while hunting). Men and women would either pump water in a house if they were so lucky, or haul it from a well. Women would beat rugs by hand, churn butter by hand, scrub clothes on a washboard and wring them dry by hand. My parents told the story of my bantam rooster sized great grandmother (who nevertheless had everyone in the family terrorized). She was given a wringer washer in her old age but never trusted it, and continued to wring out clothes with her arthritic hands.

The article points to a decline in how active people have become since the early 1980s, and the degree of change surprises me. Far and away the biggest factor is the decline in the number of people in physically active jobs.

While that is no doubt a big overall driver, when I think of the men (back in those days it was men) that I’d encounter in corporate and professional jobs (peers and much more senior positions), they were vastly more trim on average then than now, both here and when I was in the UK (it is also noteworthy that when I was in the UK in the 1984, and going to gyms in London, even the people there, who were very committed to exercise, were markedly heaver than fitness enthusiasts in the US. The next time I had an extended stay in London, in 1997, it had reversed: the British gym rats were less hefty than the Americans I typically encountered. I don’t have time to check if the overall obesity levels conform to my limited data set). I wonder how much the decline in smoking contributed, since people who stop smoking often gain weight. Similarly, in the US, the widespread use of antidepressants, as in SSRIs which typically produce a 10-15 pound weight gain in patients, are no doubt another contributor.

I’d be curious as to what readers think might have contributed. One could be the decline in social activities generally, due to the fracturing of communities (more frequent moving, longer hours demanded by many employers, more two income couples, meaning spouses were spending what little time free they had on child care or relationship maintenance). For instance, my impression is that back then, far more people were able to do sports as a leisure activity (tennis, volleyball, pickup basketball, or softball games) than they do now. And for golf, was far more “physical” in the 1970s thank now. People would walk the course rather than ride in a cart, and often even haul their clubs (indeed, since I never understood golf, the point to me seemed to be more about walking in a nice, quiet, overly manicured setting with trees, with hitting a ball as an excuse for getting friends to join you. The cart thing seemed to me very destructive). The article contends change in sports are not a meaningful factor in the UK, but I wonder, since this is presumably self-repored, if the data is accurate (as in people exaggerate their activity level because they know it is good to exercise) or if the US is different than the UK. Similarly, the new style of insanely protective parenting means kids don’t walk too and from school. Put it another way: how many people have the time and self-discipline to exercise regularly and intensely enough to make up for our unnatural lifestyles?

Having said that, yes, American restaurant portion sizes are oversized relative to the rest of the world, and yes, too many people eat highly concentrated, highly processed carbohydrates (high fructose corn syrup! refined sugars and flour!) that produce blood sugar spikes and contribute to insulin insensitivity.

By Rachel Griffith, Research Director, IFS; Professor of Economics, University of Manchester and Melanie Lührmann,Senior Lecturer, Royal Holloway, University of London; Research Associate, IFS. Originally published at VoxEU

The rise in obesity has largely been attributed to an increase in calorie consumption. This column investigates this claim by examining the evolving consumption and lifestyles of English households between 1980 and 2013. While there has been an increase in calories from restaurants, fast food, soft drinks, and confectionery, there has been an overall decrease in total calories purchased. This decline in calories can be partially rationalised with weight gain by the decline in the strenuousness of work and daily life, and increasingly sedentary lifestyles.

The World Health Organisation (WHO) estimates that worldwide obesity has more than doubled since 1980, and that most of the world’s population now live in countries where obesity and being overweight are responsible for more deaths than being underweight (WHO 2015). Estimates by McKinsey Global Institute suggest that almost one third of the global population is overweight, and that obesity accounts for about 5% of deaths in the world (Dobbs et al 2014).

Watch Rachel Griffith discuss her research in the video below

The media, policymakers and the economic and medical research literature have largely emphasised an increase in food consumption as the main cause of rising obesity; highly cited papers making this argument include Cutler et al. (2003), Brunello et al. (2009), Swinburn and Hall (2012), and Swinburn et al. (2011). There are four pieces of evidence that seem to support this view:

  1. Food prices have fallen substantially over the past 30 years;
  2. Real food expenditure (the amount we spend on food, accounting for inflation) has increased;
  3. Expenditure on some types of calorie dense foods, such as fast food, eating out, ready meals, confectionery, and soft drinks has increased; and
  4. There has been a sizeable increase in calories available, according to aggregate data on food available for human consumption (the total amount of food produced, including imports and excluding exports, minus food used for animal feed, agriculture, industrial uses, and waste) (see Bleich et al. 2008 and FAO 2005).

While all four observations are true, the full picture is more complex. In a new study, we used data from the official UK government household survey over 30 years (from 1980 to 2013) on the food spending of a representative sample of households, along with nutritional information, to provide a more comprehensive overview of how the calorie content of the foods that households purchase has changed over time (Griffith et al. 2016).

Surprisingly, we find that total calories purchased have declined substantially over the last three decades. We distinguish two periods: 1980-2007, when food prices were falling; and after the Great Recession (2008-2013), when food prices increased worldwide and real incomes fell for many people. Table 1 shows the continuous decline in mean calorie levels regardless of food price changes. In the paper we show that this decline is not just occurring at the mean, but also across the distribution.

Table 1. Calories per adult per day, by food type

griffithtable1

 

Source: Table 4 in Griffith et al. (2016).

One important reason for this decline in calories, contemporaneous with a rise in real expenditure, is that households have shifted away from homemade food, and toward market-produced food (for example by shifting from food at home towards eating out), which is more expensive. The other reason is that there has been a decline in the purchase of some high calorie foods for consumption at home, such as red meat, full fat milk, butter, and jams, and this more than compensates for the increase in calories from foods and drinks outside the home.

The Calorie Puzzle

This leads to a puzzle: if people are buying fewer calories, and so presumably consuming fewer calories, how do we explain the rise in obesity? Weight gain arises from a caloric imbalance; that is, when more energy is consumed than expended. If there has been a decline in total calories purchased over the past 30 years, could an even greater decrease in levels of physical activity explain the rise in obesity?

Sloth at Work

We compile new data on the strenuousness of paid work in order to investigate that question. Data from the Labour Force Survey, a nationally representative survey of individual work patterns, shows that there have been significant changes to the nature of work. England has seen a marked shift over the last thirty years towards less strenuous and more sedentary occupations. This change is observable in many countries, but it has been particularly pronounced in England (Schettkat and Yocarini 2006, Bleich et al 2008), due largely to the substantial shift towards service sector jobs.

Table 2 summarises these changes. The fraction of men working in strenuous occupations has declined by 8% from 1981-2009, and those working in sedentary jobs has increased by over 11%. For females the decline in strenuous occupations is over 13%, with an increase in both moderately strenuous and sedentary jobs.

Table 2. Percentage of work force, by strenuousness of occupation

griffithtable2

Source: Table 7 in Griffith et al. (2016).

Change in the strenuousness of work and daily life has been studied by other researchers (and for other countries). Lakdawalla and Philipson (2009), Lakdawalla and Philipson (2007) and Lakdawalla et al. (2005) suggest that reductions in job-related exercise play an important role in increased weight, and that perhaps up to 60% of weight gain in the US is due to declining physical activity. Two other recent studies also suggest that declining activity levels in the US play an important role (Ladabaum et al 2014 and Sturm and An 2008). Finkelstein and Zuckerman (2008) relate the rise in obesity in the US to a combination of declining food costs, particularly of processed high-calorie foods, and an increase in the use of technology that makes the economy more productive but the population more sedentary. However, these studies that have emphasised the role of physical activity and technological change have received less attention – in the research community and in the media – than those that emphasise an increase in calories.

The change in work patterns has had a big impact, because work accounts for a large share of people’s time. In addition, labour supply behaviour has also changed, with different trends for males and females. Female labour force participation amongst 25-64 years olds has increased from 55% to 69% between 1980 and 2009, with particularly strong increases among younger women (aged 25-39). Hours of work (conditional on working) have remained constant around 26-27 hours per week on average, but have increased over time among women aged 45-49. During the same period, men have reduced their hours worked by 9.3%.

For men, both changes in the amount of time spent at work and increasingly sedentary occupations have led to reduced activity at work. Women, in contrast, have increased the amount of time they spend in market work, but the strenuousness of work has declined parallel to that of men.

In order to understand the implications this has for weight gain we need to know what sorts of activities females have substituted away from (were these activities more or less strenuous than work?) and what activities males are substituting towards. We also need to know what has happened to other activities of daily life.

Sloth at Home

Over time, working women have increased time in market work, and so have reduced the time they spend on other activities from 60% to 54%. They have also reduced the amount of time in strenuous domestic work by 4 percentage points (see Table 3). On average, house work is more strenuous than the kind of market work that women were doing in the labour market, so this led to an overall reduction in the strenuousness of life.

Men have reduced the time they spend at market work over the last 30 years. While they increased the time they spend doing housework by a small amount, they switched from strenuous housework activities like maintenance and DIY to less strenuous ones like child care and shopping.

Overall, changes in the nature and time spent on housework contribute towards a decline in the physical activity among both men and women. In addition there are other changes to the way people used their free time, for example, more time watching TV; and while females now spend more time doing sports and exercise, this accounts for a small amount of time use, and so has a negligible effect on overall strenuousness.

Table 3. Percentage of time spending doing activity

griffithtable3

 

Source: Table 6 in Griffith et al. (2016).

Rationalising Weight Gain

Overall, we see that declines in physical activity at market work and in other activities has largely counteracted the reduction in calories. As well as going some way toward explaining the rise in obesity, our research indicates that market work might also influence the types of foods we eat. Households that spend more time in market work buy more market-produced foods. They eat more often in restaurants and fast food outlets, and eat more takeaway. Market-produced foods are on the whole more expensive than home-produced foods, and this means that trends in expenditure do not necessarily mirror trends in calories.

What implications does this research have for policy? It does not mean that we should abandon policies that target food spending or calories, such as the recent introduction of a tax on sugary drinks in the UK (for a discussion, see Griffith et al 2016a). People are eating too much given their low (and declining) level of physical activity at work and at home. It does mean that physical activity and calories are linked in potentially complex ways, and it is important to better understand this and the implications it has on people’s behaviour in order to inform policy.

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170 comments

  1. MsExPat

    I think you hit it on the head with your observation about walking and NYC people being more trim. There are very few places to live in the US anymore where what I’d call “utility walking” is easier and more useful than driving around in a car. In walk-centric Hong Kong and New York, even on a slow day, I still end up walking 3-4 miles, usually toting packages of one sort or another. An active day pushes that number up to 6-7 miles, just doing my routine stuff (shopping, visiting friends, running other errands). Over time this adds up.

    In Asia, Malaysians are noticeably more chubby than Hong Kongers–Malaysia is very much a car culture country, helped along by state-supported petrol subsidy and lack of a good public transit system.

    However I also notice that the rise of junk food has had a startling impact on formerly slim places like Japan and Thailand (urban Bangkokers are getting fatter and fatter, and I saw evidence why when I recently went to a Tesco Lotus market, which was chockablock with the worst sort of convenience food crap).

    I wonder if there is a way to calculate the health costs, over time, of the US Interstate highway system?

    1. Clive

      Agreed; my fitness levels were transformed when I had to stop driving due to not-good-enough eyesight. I moved to where I could meet my basic needs (food shopping, buying clothes, getting cash, rail travel access and so on) by walking. Like you say, it’s not just the walking. If you’re buying, say, groceries, you’re possibly under some sort of time constraint, so you don’t amble along. And if I need heavy items, I have to just jolly well carry them. When I first started doing this, walking the 2/3rds of a mile to the store and then back with c. 4 to 6 kilos, around 2 kilo-ish in each hand nearly killed me. Now, I feel like I’m slacking if I don’t walk in total 2 or three miles, visit several stores or go to a large supermarket 2 miles away and come back with up to 10 kilos being carried.

      Going back to the wider points raised in the piece, http://www.hscic.gov.uk/catalogue/PUB13648/Obes-phys-acti-diet-eng-2014-rep.pdf contains some good data. The map on pg. 30 is especially interesting. Guess where the affluence is. And guess where you can manage without a car, if not necessarily easily, at least as a possibility. And guess where there’s a lot of choice in supermarkets, and of the supermarkets which there are, whether or not they sell boutique items (high value, high quality foodstuffs) or else there is a reasonably thriving set of independent grocery / produce stores. And of course the money to pay for what they sell.

      Section 4.6 bears repeating in full:

      Sedentary time

      Sedentary time is at least as important as moderate intensity physical activity as a disease risk factor. Sedentary behaviour is not merely the absence of physical activity; rather it is a class of behaviours that involve low levels of energy expenditure. Sedentary behaviours are associated with increased risk of obesity and cardiovascular disease independently of moderate to vigorous activity level

      As does this from section 4.7

      Men and women were found to have different barriers to doing more activity. Men were most likely to cite work commitments as a barrier to increasing their physical activity (45%), while lack of leisure time was the barrier most cited by women (37%).

      We’re literally being worked to death.

      1. fresno dan

        And I will note something with regard to myself.
        When I started a low carb diet and interval running (I have never had any wind) I found that my appetite diminished incredibly. At first I thought this was all due to the effect of carb reduction, but when I gave up my interval running for a period but was still low carb, my appetite increased considerably.
        Offhand it would seem more exercise would increase appetite, but I suspect a lot of satiety issues are influenced by balance.

        1. Clive

          Yes, I half noticed that too but it was subliminal until I just read your comment — I think you’re right. A couple of days mooching around the house (not something I do very often), I find myself snacking on junk at the back of the cupboard I’d not really been aware of such as biscuits in case someone calls in for tea or something like that.

          But having daily exercise means I don’t even think about it. Is it boredom maybe? That doesn’t sound quite right as I can’t sit there not doing anything for more than an hour or so before writing or grabbing a book.

          It must be a psychological phenomenon.

          1. optimader

            I find myself snacking on junk at the back of the cupboard I’d not really been aware of such as biscuits in case someone calls in for tea or something like that.

            I’ll float a pragmatic diet
            Make two lists.
            Food you like;
            Food you don’t like;
            Throw out the first list and only buy food you don’t like, then you’ll only eat when your really really hungry. I could probably fall into a vat of gelato or mango sorbet and eat my way out, consequently I just dont buy it

          2. robnume

            No, actually, you are both right. I remember reading some years ago, and I’m sorry that I cannot remember where it is that I read this: We have something which was described to be an “appestat,” referring to the “thermostat” which we know we have, physiologically, to control body heat, cold temps.The “appestat” controls your desire for food and I do remember that the article said that the appestat was stimulated to work expressly with physical exercise. Indeed, it went on to say that the appestat becomes virtually useless/broken if one were to stop exercising. Hence, your appetite increase when not active. I am doing low carb and relatively high fat – good fats – and 2 miles a day walking and am in good shape at 58. I have also experienced what you both did when I stopped being physical. I got real hungry, real quick.

          3. TheCatSaid

            Could it be that movement/exercise helps to regulate and balance–rather than thinking of it mostly increasing or decreasing in a specific direction? (and in many ways–biochemical, impact on satiety signals, etc.)

        2. savedbyirony

          Exercise changes hormone levels. In general, exercising leads to a suppression of hunger pangs but personal habits can change or negate the effect, such as snacking right after a workout or exercising while one is already hungry.

        3. JeffC

          I’ve noticed the same for years. For me regular exercise is the key to losing the carb cravings.

          I’ve long had an armchair theory to “explain” this. I figure we are evolved to be in mobile bands of hunter gatherers. As long as we are active, we keep up with the group and have regular access to the community’s food, so much so that we can afford to be slim: it’s more important to be lithe and agile and strong than to carry fat reserves. But inactivity is a signal that the group has had to leave us behind for some reason. In that situation food is available only intermittently and unreliably, and survival depends on packing on the pounds any time the opportunity arises. Hence we crave carbs.

          It’s truly half baked, but I like it anyway!

    2. Nelson Lowhim

      Saw the same thing myself. What’s funny is how expensive it is to choose the lifestyle where you can actually walk to things (NYC, SF,… Chicago?) instead of absolutely needing a car. Worse is how hard it is to change people’s minds about moving away from car culture because… muh freedoms

    3. Lord Koos

      It is very unfortunate to see American eating habits and lack of exercise take hold in Asia, which I have also witnessed first-hand. The Chinese are getting plumper too.

      1. Tony Wright

        Yes, I went to Vietnam in 2003; people were slim and smiled a lot. I went again in 2013 and people were noticeably heavier and smiled much less. More cars, less bicycles, and now US fast food chains.
        Kuala Lumpur would be the worst place I have been to get around on foot – except perhaps for Orlando,FL…..
        I’m looking forward to my next holiday hiking in Nepal; all that dhal and rice plus mountain hiking should help by a couple of belt notches.

        1. different clue

          Hmmm. Greater Orlandostan, Florida hmmm. . . I went there with a friend once to a big hotel out in the long-leaf pine woodlands for a hobby conference. I wanted to walk around when conference stuff was not happening and I asked the front desk about walking trails. They said there were no sidewalks ANYwhere and they gave me the map they gave wannabe-runners who asked that question. It showed people where the highways were and where they went and they said you could try crossing the superhighway if you wanted to risk your life to get to the other side of it.

          So I decided to walk around the hotel-side golf course until a maintainance man in a maintainance golf cart told me I wasn’t allowed to walk on the golf course and he gave me a cart-ride back to the hotel.

    4. visitor

      A couple of small observations:

      1) In Europe, till the late 1950s/early 1960s, a very large fraction of blue collar workers, and many white collar ones, went to work bicycling — and so did families when going on Sunday excursions. Cars were unaffordable for most people before the 2CV and VW Beetle.

      2) The same period saw the construction of entire “new cities” including lifts to access all storeys in apartment towers, while older buildings were repaired (after WWII) and retrofitted with lifts.

      From what I know from colleagues, bicycles were the individual mode of transport till the late 1980s in China. Since then, it is all cars and motorbikes and traffic jams.

      Perhaps a similar evolution is taking place in the rest of Asia, which would reproduce what took place in Western countries with a lag of several decades. I do not know whether the lift/no lift issue applies there, and to what extent this factor and giving up bicycling explain the increase in obesity rates.

      1. Tony Wright

        Ah elevators; reminds me of the most ignorant piece of graffiti I ever saw. Florence, Italy in 1999, when climbing up inside the duomo
        “Goddam Europeans, haven’t you heard of elevators?”
        I guess that explains the popularity of Trump…….

  2. Optimader

    And do not discuss swimming
    How about swimming? Get a cap

    http://m.imdb.com/title/tt0063663/quotes?ref_=m_tt_trv_qu
    The Swimmer
    Shirley Abbott: Would you mind telling me what the hell you’re doing here?
    Ned Merrill: I’m swimming home.
    Shirley Abbott: You’re what?
    Ned Merrill: Pool by pool, across the county.
    Shirley Abbott: Good Christ, Ned, will you ever grow up?

    1. Jay

      I can attest to this. I went on a low carb, high fat diet a few months ago and without increasing my exercise I’ve already lost 30 pounds. No cravings, because fat satiates your body. It’s called a ketogenic diet—look it up.
      And lest you claim that this is anecdotal, there’s PLENTY of evidence to back up the safety, effectiveness, and long term maintenance and prognosis for this diet/lifestyle.

      1. nick

        I’ll second as well. Plural of anecdote is (are?) data, right? Sugar is the worst.

        Weight loss after cutting carbs has been good (and I still drink), but the other benefits to mind and body are tremendous, e.g. clear head and less late day fatigue.

        And regardless of the root causes of obesity etc., exercise clearly has hugely beneficial health effects and should be championed.

        I find the rowing machine to be the best way to do intervals. Full body, easy on joints and the little computers allow for precise timing in setting up the sprint/rest lengths, and in tracking one’s work.

      2. Dave

        For your own sake, make it organic fat. The pesticide residues and industrial chemicals bioaccumulate, that is, work their way up the food chain into animal fat. Some of these pollutants in the environment are unavoidable. Most are avoidable if you eat high quality organic food.

        Best website about organic food and the organic food industry that I have found after decades of research:

        http://www.organicconsumers.org

      3. fresno dan

        Jay
        July 13, 2016 at 11:13 am

        I have found the same effect.
        It drives me nuts when studies are done, and the same amount of calories of fat, or protein, or carbs are given, and the conclusion is that a low carb diet doesn’t work.

        Are these scientists so obtuse that they have no conception that satiety will affect the amount of food one eats? Never having dieted in my life, when I actually decided that I should reduce my intake of food for health reasons, I can attest that it is EXTREMELY unpleasant being hungry, and not even really hungry, but just wanting something to snack on.

        I have found that low carb eliminates that desire for snacking and continually wanting to eat.

      4. Ian Lucas

        Yup. Exercise is good but the lack of it isn’t the main driver of weight gain. It’s the carbs.

        I cut the carbs and effortlessly lost all the weight I needed to in 3 months (10kg). Weight that had been unmoved by intense gym sessions several times a week for years, on top of brisk walking most days. I still walk and do some weight training at home, but no gym any more – don’t need it.

        Another n=1 to add to a very large pile.

    2. Vatch

      Be careful. A lot depends on the type of fat consumed, as well as the portions.

      https://en.wikipedia.org/wiki/Super_Size_Me

      Spurlock followed specific rules governing his eating habits:

      He must fully eat three McDonald’s meals per day: breakfast, lunch, and dinner.

      He must consume every item on the McDonald’s menu at least once over the course of the 30 days (he managed this in nine days).

      He must only ingest items that are offered on the McDonald’s menu, including bottled water. All outside consumption of food is prohibited.

      He must Super Size the meal when offered, but only when offered (i.e., he is not able to Super Size items himself; Spurlock was offered 9 times, 5 of which were in Texas).

      He will attempt to walk about as much as a typical United States citizen, based on a suggested figure of 5,000 standardized distance steps per day,[9] but he did not closely adhere to this, as he walked more while in New York than in Houston.

      . . . .

      Spurlock’s girlfriend, Alexandra Jamieson, attests to the fact that Spurlock lost much of his energy and sex drive during his experiment. It was not clear at the time whether or not Spurlock would be able to complete the full month of the high-fat, high-carbohydrate diet, and family and friends began to express concern.

      On Day 21, Spurlock has heart palpitations. His internist, Dr. Daryl Isaacs, advises him to stop what he is doing immediately to avoid any serious health problems. He compares Spurlock with the protagonist played by Nicolas Cage in the movie Leaving Las Vegas, who intentionally drinks himself to death in a matter of weeks. Despite this warning, Spurlock decides to continue the experiment.

      On March 2, Spurlock makes it to day 30 and achieves his goal. In thirty days, he has “Supersized” his meals nine times along the way (five of which were in Texas, four in New York City). His physicians are surprised at the degree of deterioration in Spurlock’s health. He notes that he has eaten as many McDonald’s meals as most nutritionists say the ordinary person should eat in 8 years (he ate 90 meals, which is close to the number of meals consumed once a month in an 8-year period).

      Had his sources of fat been olive oil, salmon, avocados, and walnuts, he would have been a lot healthier.

      1. ColdWarVet

        Had he bypassed the super-sized soft drinks and french fries he might have fared better as well. I watched that video. He was literally eating until he (quite graphivcally) puked. Hardly a representative sample. I’m no particular fan of McDonald’s, but Spurlock’s piece was slanted, to say the least.

      2. Pepe Aguglia

        lot depends on the type of fat consumed

        Exactly. For fat literacy, I recommend the book Perfect Health Diet by Jaminet and Jaminet

    3. Ike

      Sugars and processed foods are causations for poor gut health which triggers other diseases. Lack of exercise, along with the corresponding lack of sweat and mindfulness, definitely add to our obesity epidemic. Eating organic from my permaculture garden, shopping at local Farmer’s markets, and practicing Hot Yoga 4 times a week dropped my weight from 254 down to a sustainable 188 in about a years time. You have to watch the fats you consume. Some of us have the wrong blood markers which can spell doom. Before ACA, I was able to watch my blood chemistry re-correct itself. Now, it’s too expensive and the medical facilities have even STOPPED testing some of the markers completely!

    4. cocomaan

      The Food Pyramid, which was taught to me in elementary school and all the way through high school, might have been one of the biggest government healthcare disasters of all time. The entire base of the pyramid was grains.

      I recall watching a video about weight loss and nutrition that claimed, and I kid you not, that a study showed eating ten pieces of bread a day helped people lose weight.

  3. lezmaz

    Two reasons I live in New York: urban density and public transportation. Where else in this country can you get around without a car? That’s not a rhetorical question. I wish there were other options and think about it often. My husband and I go to England for walking trips. They call it “rambling.” This is different from American hiking, which is is about up and down, gear, sport, endurance. There’s another reason that walking doesn’t exist in the US: private property. Some of the paths we walked in England have existed since the middle ages, when peasants were allowed right of way to go to church. To this day, even the most paranoid landowner is obligated to allow passage where these trails exist. In the U.S., there’s hiking trails, but walking trails? Seems they’re often 1.3 mile wood-chipped loops one has to drive to, or asphalt riverside paths.

    To your point about golf carts… We were on a sheep-dotted commons near Cheltenham in the Cotswolds. It was raining lightly, of course, and quite windy. We climbed an unusually steep path to a plateau and discovered many elderly golfers pulling their golf bags around on two-wheeled carts. I was out of breath from the incline and the wind. Red-cheeked white-haired folks greeted us cheerfully. This was not a fancy course — in fact, I was a little afraid of getting beaned. Point is, I feel extremely lucky that I can walk out of my door and go about my life without a car. I have a sedentary job, don’t belong to a gym, but I am, and hope I can always be, a walker.

    1. jrs

      San Francisco? Definitely can be carless. Affordable not so much so. Places like Portland might be doable but still easier to have a car.

      1. Ike

        It is doable in Portland but takes either a lot of discipline and money management because costs are high relative to middle class wages, or you are well off and highly paid. Or course, it is easier if you have bought a new condo in the Pearl, West Side, or the South Waterfront but than THAT lifestyle is probably closer to SF and NYC and the established families of Portland helped financially support that lifestyle. Taking the yellow line up to North Portland offers more of a lifestyle that you find in Chicago but again ‘one’ has to have the good fortune of finding a good deal on a house or having upper class means. For the average Joe it is like most other places: longer commutes, congestion, suburban living, more processed foods, less time, and bills up the wahzoo. A car is, sadly, still a necessity. I know; I took transit for 8 years and the bus routes are slow and utterly inconvenient for suburban living.

    2. optimader

      Where else in this country can you get around without a car?
      lots of places actually.. I live in a Chicago suburb, I can walk to the train which connects to the City in ~25 minutes on an express and two international airports. I can at my discretion walk/cycle to a variety of stores/restaurants. My favorite irish pub is literally 10 minutes away by train…across from the station.

      I don’t think this is unusual.

      1. Clive

        Well, all I can say is that when I visited friends on an extended stay in Phoenix, the very idea of walking anywhere was met with quizzical looks. As in, “are you crazy?” And even if I’d not felt rather self conscious, it was a practical impossibility. Outside of the suburban subdivision (it was a “gated community”) there were simply no pavements (I think you guys call them “sidewalks”). I could find no viable way of getting from Scottsdale to the centre — or even the outskirts — of Phoenix itself. You were walking, if you’d tried, in a gutter or impassable strip of overgrown verge next to the highway.

        You were literally stranded without a car. Unless locals can advise of an option which I wasn’t aware of as a tourist.

        1. PQS

          Not to mention the fact that it’s always 100 degrees out in Phoenix….when I lived in Las Vegas I could always tell the tourists because they were trying to walk everywhere and melting in place. Pavement and asphalt increase the heat levels at least as experienced.

          The Southwest is getting hotter, as well. Not quite sure how they’ll get along when it’s 100 degrees 365 days a year.

          1. Clive

            Yes, it was a “mild” 85-ish degrees when I was there in Autumn (sorry, “Fall” (!)). I did get that it was a factor that in 100+ degrees of heat, walking anywhere is a trial. That said, I did survive Tokyo’s notorious hot and humid summers without having access to a car, the availability of public transport meant that you were still able to get your allocation of “every day” exercise.

            1. PQS

              I don’t know if there is any public transportation within the bounds of the entire state of Arizona…..Barry Goldwater was from Arizona and I would be most people there think public transportation is a commie import. (And I have family there.) Literally everyone drives all the time.

              1. Jim Haygood

                Not only is there light rail in Phoenix, but voters there approved Proposition 104 last year, to up the transit sales tax from 0.4% to 0.7% for 35 years.

                Late night train riders report seeing Barry’s ghost, furiously pounding the windows.

        2. optimader

          Arizona is a desert, as much as northern transplants would like to terraform it into something else with nonindigenous water..

          My recollection of Tucson was a family car tip there July -August as a youngster circa 1968ish or so in a 1965 Chrysler Newport with no air conditioning. At that time air conditioning was typically still at best a luxurious dealer retrofit kit.
          Mercifully a white car, but nonetheless touching any metal part during daytime and you’d literally get burned.

          Opening the windows was an interesting heat transfer conundrum. Keep the windows closed and evaporatively cool from sweat in what was essentially a rolling metal and glass equivalent of a concentration camp hotbox, only worse due to the glass greenhouse radiant heat gain…. or open the windows and convectively bake like a slab of beef jerky.

          I was volunteered to “dig” (pick axe) a tree stump out of my grandparents back yard. That’s when I learned about Caliche https://en.wikipedia.org/wiki/Caliche . I believe that was the hottest I have ever been.

          That said, there are the Sedona Mountains.

          1. PQS

            At least in Tucson it cools off at night most of the time! I, too, recall a 1970s car trip to Stovepipe Wells, CA in Death Valley in a friend’s parent’s Dodge Dart. No AC, Three on the Tree. I seem to recall we kept the windows down, hot air and all. We couldn’t wait to hit the pool and probably never left it once we arrived.

            But the desert is truly beautiful in its own way. Phoenix, not so much. Just a big hot bowl.

          2. Jim Haygood

            Arizona isn’t all desert. It contains the world’s largest contiguous ponderosa pine forest, at elevations ranging from 5,000 to 8,000 feet … with 20 inches or more of rain per year.

            Many people don’t know about Arizona’s mountain forests. I didn’t until visiting the area several years ago. I’m going, whoa, looks like Colorado. (Please don’t tell any Californians.)

            1. optimader

              Well, I’ll concede it isn’t all desert. I do think the Sedona mountains are beautiful, have an aged aunt and uncle up in them thar hills. you can go skiing in AZ . there is that..

              1. Jim Haygood

                Those red rocks around Sedona are beautiful (and feature dozens of hiking trails). Drive 30 miles north from Sedona toward Flagstaff (gaining 3,000 feet in elevation), and you are in thick pine and aspen forest.

                Flagstaff AZ gets 21 inches of rain a year, including 100 inches of snow — about as much snow as Buffalo, New York. It keeps it green. :-)

    3. Harry Shearer

      In the center of New Orleans, French Quarter, CBD, Warehouse District, much of what I need to do daily I can accomplish without the use of the car.

      1. lezmaz

        Chi-town, New Orleans.. Thanks. They’re going on my list. I’ve also wondered about Toronto, Montreal & Vancouver. Toronto seems foot friendly.

        Clive I had that experience in Phoenix too- walking .25 miles from my hotel on a nice sidewalk to a breakfast joint. Also in the Silverlake neighborhood in LA just a few months ago. People looked amazed when I asked directions to a place 15 min away on foot. I recall Bill Bryson writing about it too in A Walk in the Woods.

        This may be sacrelige, but I actually get my bagels sliced vertically in the bread machine where I buy them. I have a piece in the morning with my eggs. Lasts a week. I’m not bread-averse, having no allergies. I just think of it as cake.

      2. optimader

        Breakout your second line umbrella and sashay to the crawfish etoufee emporium …Maybe I am just projecting..

        btw, good job reanimating Clinton Something, a fertile field again it seems.

    4. a different chris

      Can you perchance recommend a good guide to English trails? Surprisingly I haven’t had much success on the internet, but then you go look for books and there are like 2 billion of them so how to know which one or two to buy?

      And anyway seems like they will need my money soon. :)

      1. Clive

        Sorry to butt in, but one of the best resources is the National Turst. They have thousands and thousands of miles of walks (trails? I’m really struggling with my American translations today!) and keep them, by and large, in excellent repair.

        http://www.nationaltrust.org.uk/lists/our-top-spring-walks
        and the rest of of their website gives you all you need to know. Wherever you are, there’s going robe something not too far away.

        1. lezmaz

          totally concur re: national trust.

          also, try http://www.ramblers.org.uk/

          an excellent resource is the long distance walker’s handbook (out of print but available)

          uk map by phil endecott

          most gloriously, ordinance survey maps.

          https://www.ordnancesurvey.co.uk/shop/maps.html?cat%5B0%5D=20&cat%5B1%5D=21

          they get pricey so we got an ordinance app of some kind.

          I admit we also stole itineraries from walking tour websites. once, we used an outfit to plan our “self-guided” route along the south downs way. coulda just as easily figured that one out ourselves.

        2. fajensen

          Absolutely. And. The National Trust have cottages everywhere that one can hire. Right on the coast of Cornwall, if one likes to try that kind of thing.

          Whatever you do: Stay away from the British school holidays if you are visiting Wales or Cornwall. The 12’th century roads are not up for the load and the pubs will be full! Just misery all over!!

    5. different clue

      Well, I get around in Ann Arbor without a car. But I don’t have a family to co-take care of or I would need a car for that. And I was able to get into a low income co-op. But there are very few of those, and those who can’t get into one may be forced into the social class Sowetos all around the social class Johannesberg I live in. And all those people will need a car to survive.

  4. Mrs Smith

    Interesting information. I think it’s great that scientific minds are working on the data as to why and how everyone has gotten heavier, but what I rarely see is an effort to work out how to improve life for those of us who have ended up overweight, or obese due to all these lifestyle changes that (oops!) we couldn’t really control for after all.

    Where are the studies about keeping overweight people healthier, despite the almost 100% certainty that they will never be a “normal” weight again (at least not in any long-term sense)? It is possible to be fitter and healthier without committing to losing significant amounts of weight, but no one is promoting the reasonable, sensible ways that the average overweight person might do this. Instead, we shame, stigmatize and marginalize them for being lazy, and accuse them of being a drag on society. Healthcare practitioners, if they address weight issues at all, still prescribe weight loss as the “cure” for every ill an overweight person might have. If only it were that simple.

    As someone who has struggled with weight issues my entire life (thanks to genetics, early and frequent exposure to antibiotics, and other potentially mitigating factors) I have managed to maintain a healthy body (and mind) with frequent, regular exercise. It’s not the only thing, but it is one of the most important things I’ve done to stay healthy. Actively promoting nutritious eating habits and regular, moderate exercise is a much better way to improve health outcomes than on-going calorie restriction or surgical interventions.

    I wrote about this recently: When Perfect Is the Enemy

  5. washunate

    The title of this piece is likely to annoy readers…

    Yves, I do appreciate your fairness and self-awareness on any issue imaginable.

    I will definitely count myself in the perturbed category. Thought it might be helpful to throw out three concrete reasons why. Food for thought, as it were :-)

    1) In general, gluttony and sloth imply internal personal sins rather than external system design. I think that mixes up the culpability. Sure, there is some personal responsibility (and I think we do a disservice to our fellow citizens on a wide range of issues in thinking too much in nanny state terms; no matter how bad you have it, you have some level of responsibility to take agency over your life). But come on, primarily, public policy choices impact how people live, not the other way around.

    2) Specific to public policy around food, there is the matter of the quality of the food, not just the amount. We know that low quality food causes gluttony and sloth, both directly (think addictive foods overloaded with sugars) and indirectly (through poor food leading to other health issues that impede the ability to be mobile). The notion that exercise is a solution to crap food is basically to side with agribusiness and fossil fuels over more efficient and environmentally friendly uses of our collective resources.

    3) Specific to sedentary lifestyles and stress and so forth, one of the major contributing causes of this is how work in the formal economy works, from the kind of work we do to the amount of it we do to how we commute. Jobs, as the formal economy is currently configured, pose a direct threat to public health.

    1. TheCatSaid

      Yes, washunate, this post is poorly framed and adds to disinformation.

      While I agree with your main points, you understate the extent of social engineering in various forms to which we are subjected. A few examples would be the concepts of “labor-saving devices” and the overt messages about what kinds of “work” are preferable and have higher status in society. Class has become intricately connected to our choices in how we perceive physical activity. Other examples include the ways that other harmful “improvements” to lifestyle are being sold on us (e.g., wifi is probably considered an inescapable TINA for many NC readers) and deeply embedded not only within our “advanced” culture but within our minds and what options and alternatives we do or don’t perceive.

      The food/calorie issue as presented in this post perpetuates disinformation. I don’t doubt Rachel Griffith’s good intentions as a researcher, or Yves’ good intentions regarding awareness of the importance of exercise. Griffith’s video hints at there being other factors involved, but this is not enough to excuse her perpetuation of fundamental misunderstanding of the relevance of measuring calories and relating that to exercise and to fat accumulation. Many researchers have added constructively to a more accurate understanding, here is just one. Why is this not more widely acknowledged? See the preceding paragraph.

      The topics discussed in this thread fail to recognize the high-level social engineering to which we are subjected, impacting virtually all our social structures (e.g., food production, eating choices, lifestyle, class consciousness, “medical care”, “education”, etc.). This social engineering has unfortunately been quite effective at degrading the human species’ physical, mental, emotional and genetic health. Alternatives involve taking on more awareness and responsibility to look beyond the choices that are most widespread. We do not have to limit ourselves to the dysfunctional choices we are commonly offered. It is up to us as individuals how much of our evolutionary potential we are willing to forego, in exchange for the “attractive” choices we are being offered.

      1. washunate

        Agreed. I’m essentially an optimistic doomsdayer, as it were, which is an odd fence to straddle on some topics…

        I agree we don’t have to be limited in our choices at an individual level. That agency is incredibly empowering and reassuring. And yet for us to acknowledge the systemic nature of the problem, social engineering as you describe it, means that if we care about people beyond us, we have to change that system. Making superhuman choices to buck the incentives, to step away, by definition doesn’t scale.

  6. Stormcrow

    Thank you for posting this article, which I think points to a very important social concern, not least regarding many children. The causes of obesity, as you note, are various and complex. A relatively neglected factor seems to be the everyday consumpiton of soft drinks. Here is an article with an amazing chart to accompany it.

    What Happens One Hour After Drinking a Can of Coke

    A trigger factor for many widespread diseases of the west such as obesity, heart disease and diabetes could be closely linked to the consumption of one particular substance found in many processed foods and drinks – fructose in the form of high fructose corn syrup.

    1. Sammy Maudlin

      I’ve suspected that HFCS is the culprit for some time, especially vis a vis soda consumption.

      When I was a child in the 70s, I remember getting Pepsi in the 16oz nonreturnable bottles. I couldn’t drink a whole one in one sitting. It was common, from my recollection, that people would generally drink some of a bottle, then use one of those stoppers they sold at the grocery store to save the rest for later. Remember, this was when it contained sugar.

      I recently spent time at a waterpark in Pigeon Forge, TN with my kids. I was shocked by the obesity of most of the children (well, really most of the people) there. Giant 32oz refillable cups of soda were de rigeur.

      I’ve tried drinking the “natural sugar” sodas recently and I’ve found that, like when I was a kid, I can’t finish a 12oz can. I really don’t want to; at some point the body says “enough.” But it seems like HFCS doesn’t trigger the same response. People can just drink it all day without being satiated. To me, this has to be a, if not the, contributing factor to the obesity epidemic in this country.

  7. PlutoniumKun

    My understanding is that many scientists think that obesity is less to do with calories, than the particular type of calories. 100 calories of cheese may well metabolise differently than 100 calories of sugar in a fizzy drink. Even the pattern of eating may have an impact – it seems, for example, that people who occasionally fast are significantly slimmer than others, even if total calorie intake is the same. So I suspect some scientists would take issue with the underlying assumptions of this study *disclaimer, I’m not a scientist*.

    There is no question I think but a major contributor is a reduction in physical activity, even if it may not be the primary cause (just as an example, I do a high tempo 45 minutes weights class which my trainer calculated uses up just 300 calories, maybe two biscuits worth). But its difficult to underestimate the impact of constant low activity rates – people who go from bed to car to office desk back to car and sofa. The difference with a non-car owning city dweller such as myself must be very significant.

    A huge problem is the way we’ve built our cities. A shocking number of people live in places where its simply not practical to walk to the local shop or school or to your work. Many suburbs lack attractive places for an evening stroll. They are built entirely around cars – or in the case of some Asian cities – for scooters, taxis and trains (try, for example, walking a significant distance across Bangkok or Taipei or many Chinese cities, its remarkably difficult). New York (at least, the traditional boroughs) was developed before the car dominated. So people walk – several times a day. That alone must make a huge difference.

  8. zazen

    There’s a lot of fascinating research out recently about the gut microbiome, with associations (correlations–not necessarily causation) between the gut microbiome and rheumatoid arthritis, chronic fatigue, Crohn’s disease, obesity, and who knows what else. Could increased exposure to antibiotics, particularly in childhood (or increased c-sections and/or changes in breastfeeding), play any role in obesity in the absence of increased caloric intake?

    1. readerOfTeaLeaves

      It’s my understanding that the Human Genome Project actually led to the research on the micro biome, and on microbiota (the ‘bugs’, or bacteria, in your gut). Super interesting stuff, and a very hot area of research at present.

      C-section babies are now prescribed bioflora, which is given in an eyedropper daily, as they lack the ‘covering’ of ‘bugs’ that an infant gets while passing through the birth canal. These babies are healthier if they are breastfed, and the longer during the first year of life, the better.

      And yes, lots of growing evidence that antibiotics, by killing microbiota throughout the gut, is related to obesity later in life.
      Have some kefir, or pickles, or kimchi, or kombucha, or yoghurt, each day.

      Researchers are wondering about the role of the many varieties of gut bacteria in breaking down and metabolizing foods. If there are no gut bugs, the body can’t properly break down and metabolize foods. If there are gut bugs, they need lots of fiber (broccoli, beans, cabbage, etc) to break down and feed on if they are to flourish. By flourishing, they protect the lining of the intestines and its mucus ‘protection layer’, which is starting to seem quite important for immune function.

  9. JimTan

    Lets not forget about liquid calories. People naturally consume larger daily volumes of liquids than food, and soft drinks (coke, fruit juices, flavored tea) have huge quantities of sugar per unit volume. The use of corn syrup sweeteners has made them very cheap, and branding has made them ubiquitous in modern society.

    1. dk

      Hear, hear..

      Might be worth mentioning beer, too. Beer is high in carbos, and the presence of alcohol can interfere with carbohydrate digestion. Alcohol also reduces rates for fat “burning” (metabolization). The way people metabolize beer may vary with other diet factors, as well as genetic heritage, not to mention liver health, etc.

      Just speaking for myself, if I drink any beer, it goes straight to stomach fat within 4 hours. Even a half of a glass is noticeable. The only other food I’ve found so far that does this (to me) is avocado. I monitor my metabolism more than most people (and regulate it through diet and activity), so I notice things that might be too subtle for the inattentive.

  10. upthecrik

    My “gut” tells me it is linked to childhood activity levels. So much of our “being” is laid down in the earliest years of our lives. I haven’t researched the issue, but I think a baseline is set for metabolism early on in our lives. Further, our base muscle, ligament and joint structures are established early as well. To top it all off, we learn the habit of exercise when children. This is only anecdotal evidence, but I’m 45 years old and very fit. My two older sisters are both obese. Same genetics. What’s different? I was an extremely active child, involved in multiple athletic pursuits that have carried over into my adult life. My sisters were not.

    Today, I think we are seeing the results of the “Atari effect.” For a couple decades now, many, many children just don’t establish a healthy foundation that will support them into advanced adulthood.

    1. Yves Smith Post author

      Hate to tell you, but I was a borderline obese child and was so poorly coordinated and have such lax joints that my orthopedist (I was seeing orthopedists as soon as I could walk) insisted I be excused from the state phys ed requirement. Despite that, I’m now a very strong gym rat with a low BMI. My brother who was pudgy in his childhood got skinny as an adult, and the brother that was skinny in his childhood now weighs 350 lbs. So needless to say, I beg to differ with your generalization.

      1. upthecrik

        I’m definitely not saying the generalization can’t be overcome. It obviously can. What I am saying is that I’d imagine if you took a big enough sample of kids, measured their activity levels and longitudinally studied them into adulthood, a positive correlation would be found between highly active children, and healthier adult outcomes. Of course there would be outliers, which it sounds like you are.

      2. upthecrik

        And for my own curiosity on the subject in general Yves, were there any particular factors that you can point to that motivated the shift from “borderline obese child” to “gym rat”? Good for you regardless!

    2. Clive

      I was an extremely active child (the walk to school — England in the 1970’s meant one car per family usually even if you were fairly well off — was 2 miles each way and that was just the minimum I did, I did track and field too). But I nevertheless acquiesced to a somewhat sedentary lifestyle in my 30’s. External factors forced a revision in my 40’s. So I for one don’t fit this theory.

  11. oho

    Second the cortisol-iinduced stress, add non-traditional work schedules, upsized portion creep…using sugar/fat as a soothing tonic, especially since we drink and smoke less.

    Lots of contributing factors, fat by 1000 cuts.

    As for Yves, Nassim Taleb would suggest weightlifting….even with the joints

    1. Yves Smith Post author

      I have been weight lifting for nearly 30 years. And unlike most women, heavy weights. Most women are afraid they’ll get too muscular, which is not a risk for 99.9% of women (the female bodybuilders that freak them out are on steroids).

      1. Anon

        Weight lifting for women is changing. I use a college fitness center to do my weight training and the college women’s teams (volleyball, basketball, track, even the Cheer Team) are all doing supervised heavy weights. Particularly the Dead Lift which develops major leg muscles and coordinated control of other core and upper body muscle groups.

        To see a sleek, but powerful woman, search for a photo of Carli Lloyd standing next to Lionel Messi accepting their Best Player in the World award. (The power in her trapezius makes Messi look small.)

  12. Mikes Aurelius

    If I missed this in the article, my apologies – but, should we not also consider the content of the foods we eat? A calorie is a calories, indeed, but the chemical nature of food and the questionable nature of processed and “nutritionally enhanced” products makes this a concern. Also, the poor of our nation must budget in higher costs for “quality” foods, something they must forego if other costs are rising to mess with any budget. Here I must echo “washunate” with the same caveats.

  13. Gareth

    Ten years ago I made an involuntary switch from working a sedentary office job to working in a warehouse, on my feet eight hours a day and lost thirty pounds in one year with no change in diet except for an increase in beer consumption. Unfortunately I developed a terrible case of plantar fascitis from walking on concrete, so you win some and lose some.

    1. Synoia

      Stretch your calf muscles. Contraction of the Calf muscles and Achilles tendon exacerbate plantar fascitis.

  14. PJ

    We are all awash in chemicals (e.g. endocrine disruptors in the plastic in water bottles) that have been implicated in the etiology of obesity, there are a lot of good studies out there that provide supporting evidence for this.

    1. Medbh

      This gets my vote. I’ve read about some studies that found comparable weight increases in lab and wild animals too occurring over the same period of time.

      Weight is central to health and survival, and involves such a sensitive (unconscious) balancing of exercise, food, and appetite. I don’t think it’s enough to blame our changed physical environment. When I don’t exercise, I get fidgety and want to get moving. When I’ve eaten enough food, I want to stop. I don’t need to think about or work at it, my body does it by itself. I think this process is being thrown off by the chemical stew we swim in.

      Another insight I had regarding this issue was when I took the drug Zyprexa. I’ve never had any problems with my weight and have always been very physically active. I gained 30 pounds in a few months after starting this drug, and my appetite was constantly ravenous. I would eat until I felt sick and my stomach was taunt. I stopped the drug, the crazy appetite went away, and I slowly had to exercise the weight off over the course of months (and it’s now much easier for me to gain weight too, although that could just be an aging thing).

      That experience made me much more humble and compassionate for people with weight issues. If I felt that kind of hunger and food obsession all the time, I would weigh 300 pounds too. It was such a night and day change for me. One key issue is that hunger became part of the background noise of life. I was always thinking about it and fighting it. It would be like telling someone to ignore the water around you when you’re constantly thirsty. That drug completely threw off my appetite/weight system, and I suspect something similar has happened with environmental chemicals for vulnerable folks.

      People often blame soda, and I agree it’s terrible. But a nuance to that is to ask why people find it attractive to consume 30 ounces of soda or a supersized french fry. My “normal” appetite would find that meal repulsive. But when my system was off, I would crave that type of food.

      Finally, I think it’s important to remember that people will do a lot to avoid stigmatization or disgust by others. Given the severe health, economic, and social consequences of obesity, there is likely some very strong primitive systems influencing people’s actions (like with alcoholism, or other types of addictions). It’s not “just” about diet, exercise, or how our communities are structured.

      1. TheCatSaid

        Medbh, elsewhere on this thread, Idaho spud has a link to a video I found really good. Among other things, it mentions how certain ingredients in soft drinks (high fructose corn syrup) is metabolized differently in the body, with one of the results being that no satiety signals are produced. Depending on the drink (e.g. caffeinated) there can be water loss and thus thirst is increased–a negative cycle.

  15. petal

    I made the move from Boston to the woods of NH 6 years ago. Since then I put on a lot of weight, and I think it’s due to all of the walking and running I did while living in Cambridge. Walk to the T, walk from the T to work, and back again, plus walk to shopping, and jogging or coaching after work because I had time. Since I started going to the gym every day a few months ago, it’s now coming off. My diet hasn’t changed all that much. The stress level went up after the move, which my old trainer thinks also contributed to difficulty losing the weight a few years ago even though I was doing crossfit 3x a week and doing more than the other participants. During summers when I was younger I worked on a farm. Stayed trim no matter how much I ate. I think for me it’s mostly down to activity level.

    1. petal

      And when I do visit Boston for a day trip, the difference in obesity level is immediately striking. It shocks me every day when I go to work-the level of severe and morbid obesity is off the hook up here in this rural area. You think you’ve seen it all and then you see someone heavier. It just keeps going up.

    2. craazyman

      You don’t get chased around by wild animals in the woods? That would work you out.

      There’s moose up there. And probably bears. I’ve noticed deers run away.

      maybe you should go chase some deer. I bet you couldn’t catch one if you tried. I can’t. I’ll admit.

      1. petal

        Hey craazyman! You are right, can’t catch the deer. However, the bears have been up next to my deck so if the dogs don’t bark and scare them off I might be able to get one! Will let you know how that goes unless I end up in the news as a Darwin Award winner(“Woman dies in foot race with black bear”). Cheers!

        1. philnc

          Oh. Wait. Chasing bears? Think I’ll stick to the greenways here in town where the only danger you might face is the occasional vicious land rabbit.

          On the sedentary nature of a lot of modern work: maybe it’s time for employers to amp up opportunities for regular exercise and (at least for those expected to put in 50+ hours a week) look at carving out time for it during the regular workday. Alert, healthy workers tend to be a lot more productive than fatigued, unhealthy ones.

  16. tommy strange

    good article, good comments, and like what yves said too.
    All things I’ve been mulling over for 20 years living in san francisco, and visiting many euro walkable cities over the years. Yes obesity rates, and diabetes rates going up in spain and Italy, but jeez walk around their cities, and then compare that to the people you see at an airport hub in the USA.
    yikes!
    BTW, san francisco is still affordable for 1/3 of the population in the old rent controlled buildings. Yes, we are getting cleared out, but don’t forget about us workers here and still fighting!! I am digging in hard against an ellis act now over the entire house (room for 15 people as all victorians use to have)…not just cuz my life and love is here, but because I don’t and won’t live in any over sloth USA city. NYC is out of reach now of course. I would get fat, depressed, and die years ahead of my time. I drink tons of beer, eat a lot of cheese, and at 50 I am better shape than 70% of the 20 something tech kids. Cuz I walk, and walk, and play in a band, and do warehouse work. Never had to count calories in my life. Never been to a gym (I hate gyms and pool also).

  17. Richard Jackson

    In many or most US suburban or rural areas, destinations are much too far apart to walk practically. Also, to do so is not safe. Roadways are designed exclusively for cars and trucks. Walkers and bikers are subject to heavy doses of dust, noise, and pollution, which are very unpleasant and may negate much of the health benefits of exercise. Speeding, frustrated, and angry drivers view walkers and bikers as mere obstructions, and often refuse to yield or slow down. Even courteous drivers often don’t see pedestrians, as they may be watching out for other vehicles, sun-blinded, talking or texting on their phones, fatigued or impaired by prescribed or non-prescribed drugs or alcohol. If there is a designated bike lane, it is typically used or blocked by automobiles and trucks. There is not even a shoulder or sidewalk on most roads.

    Although roads are absolute deathtraps for pedestrians and bicyclists, city and county governments appear not to care. Maybe it’s because most voters and politicians are also drivers. Recreational walking and bike paths are sometimes available, but they usually have no practical destinations, such as school or workplaces, and access to them is typically required by car. I think the problem is not so much indolence as it is complete, externally imposed automobile dependence. In most locations, public transportation is almost nonexistent, and the only alternative is to stay home. Driving is a virtual requirement to participate fully in our society and culture, at least outside a few metro areas. So for now, I continue to drive.

    The only things which I imagine can change this will be lack of available or affordable fuel, or lack of funds to maintain the roads in drive-able condition. Something like that must happen eventually. Until then, I won’t walk enough, and my bicycles will wait in the basement, for me, or my children or grandchildren.

  18. TastySharkSnack

    Adding to the sedentary lifestyle point, the late 70s and 80s saw the earliest home video game consoles marketed to the masses, although I’m not sure if time spent playing video games would count as part of the “watching tv” leisure category.

    Now that 2 year olds are playing with smartphones and tablets, I wonder if future generations will be even more conditioned to just sit still and interact with the world through a screen.

  19. Synoia

    Caused of Obesity:

    Causes: Suburban life, the Car culture (lack of public transport), air conditioning in summer, soft drinks instead of water.

    I live in Santa Ana, CA. I have not had a car in 8 years, I use a Bike.

    I too noticed the lack of fat people in NYC, and compared that to the immense obesity I notice when visiting Springfield, MO. NYC is a walking town, Springfield a car town.

    London is a walking city, as are all the cities in Europe. When they were built walking was the only option.

    1. Synoia

      I’d add commuting and TV to that list, They both destroy time, and one is always sitting. The more expensive the city centers become, the more the migration to the suburbs, and the suburban lifestyle is based around cars.

      Acquire a spouse, have kids, live the suburban dream, stress of commuting, financial stress of the kids, lack of community, bad climate (too hot, too cold, most of the US), become more house bound, sit around and watch TV, and there you have it.

  20. Dave

    What contributed to weight gain? I can almost guarantee that you Dear Author and readers, are not standing on a treadmill while you read this.

    I do know a delightfully productive lunatic woman who stands on a moving treadmill, working on her laptop, on a specially built desk, wearing earbuds connected to her phone while switching between the sound output of the laptop and the the phone while surrounded by bottles of pills, supplements, with an espresso machine within reach. Everyone else sits and sits and sits.

    Where we live, Pilates are now passe and people are going onto other trendy exercise thingies. The aerobics princesses of the 1980s have produced daughters who do yoga now. Yoga has gone from the habit of a tiny number of really with it bohemians in the 1960s to people at Walmart who are buying yogamats today.

    I shop at organic markets and frequent places like that. Yoga pants are in vogue. Girls and women from middle school age to their forties wearing these might as well be naked from the waist down. What this has led to is a wave of butt sculpting, where every ripple and muscle is visible through ever more sheer material that is approaching semi-translucent. Is it rude to stare? I think that women are doing this in competition with each other.

    The only question is whether it will be socially acceptable to have a belly and some extra weight on you. The plus size and definitely obese models are getting more and more attention per the media exposure. The funny thing is that most of the guys I know end up being attracted to women with a belly and extra weight because it’s a sign that they are not uptight.

    Prediction: Women will sometimes be actually naked in public from the waist down in a few years. Then a wave of Neo-Victorianism is going to occur and everything will be covered up.

    One out of 10 guys here in the San Francisco Bay Area have beer bellies. You see tragically fat guys working in the trades like plumbing and in some fast food places, but in general, men are not that concerned about their appearance or their health.

    Have a great old book at home from the 1960s.
    “The Businessman’s Steak and Scotch Diet Book.”

  21. Harry Shearer

    At some point in young adulthood, I realized two things: 1, I’d get very cranky if I didn’t have a substantial meal within two hours of waking up; 2, I therefore didn’t have an appetite for lunch, and if I did eat lunch, I wasn’t hungry at dinnertime.
    And I love dinner.
    So I fell into the habit of two meals a day, with fruit and veg snacks–bananas, apples, plums, carrots–in between. Much later, I read research indicating that substantially reduced caloric intake–on the order of 20%–led to increased longevity in rats.
    As Yves likes to say, the plural of anecdote is not data, but still…

    1. optimader

      read research indicating that substantially reduced caloric intake–on the order of 20%–led to increased longevity in rats.

      Good for Dick Cheney, how about you?

  22. Chibboleth

    This does not match my personal experience of the last ~5 years. I’ll explain.

    I’ve been living in Indianapolis (public transit is useless in most areas, driving a lot isn’t optional) since 2010, and have been fat since I was a teenager. In 2012 I decided to actually do something about it, and that “something” is I started counting calories with a phone app. This actually worked, and resulted in me dropping about 120 pounds over the next year or so.

    Here’s the thing: I didn’t start deliberately getting more exercise until after I dropped the first 45 pounds. I work downtown, so in 2010 I was taking a lot more steps daily than before, to no effect. And since I was actually tracking everything I have data to back this up: when I started exercising it helped, but not to the degree that the dietary adjustments did. At least in my case, diet has been much more important to weight loss than exercise.

    In 2014 I moved to another role at work, which involved me moving to a building in a different part of downtown which is much farther from all the good places to eat lunch. So I’m actually walking significantly farther than I used to every day, and keeping a similar evening exercise routine as before, but (I guess) due to stress and distraction I fell back into my old food habits and have gained back about 60 pounds since the move. Working on reversing that now and I’m doing so by going back to strict calorie counting.

    When I started taking data on my diet (at someone’s suggestion I didn’t make any adjustments for the first week or so, I just logged my normal food intake to see what it was), it was shocking. Simply put I was eating many more calories in a typical day than I’d realized. I think this is true of most fat americans – they’re fat because year after year they eat an amount of food that would be reasonable if it was better, less calorie dense food. This is I think also why fatness is now a class marker; the way our food economy is set up, the lower classes eat really a hell of a lot of cheese, bread, and greasy meat and not so much actually nutritious food.

    I got down to a good calorie intake mainly by cutting out sweets (including soda) and avoiding dairy FYI. In case it’s of interest I only had to swear off two things entirely, and they are pizza and ice cream.

  23. local to oakland

    The computerisation of work cuts down on a lot of physical movement. Filing records used to be a physical task. Likewise, some non disabled people prefer elevators and electronic doors.

    Re food, Michael Pollan made a very good point about hidden calories in restaurant sauces and processed food. If you cook for yourself then you know or can easily find out how much you are eating. High calory processed ingrediants used to enhance flavor or texture are often not satiating.

  24. IdahoSpud

    It’s not gluttony and sloth. A moral lens is a perfectly valid way to view financial crimes, but I don’t think it is a useful way to frame at a public health problem like obesity (or STDs).

    Yves, you of all people should be able to connect the $ on big agri and big pharma, and unnecessary suffering of the proles. I’m slightly surprised about your blind spot on this particular subject.

    That said, exercise is good for you, and you should of course do it regularly.

    I *highly* recommend taking the time to watch the video below (all of it) and see if you still believe that it’s just gluttony and sloth.

    https://www.youtube.com/watch?v=dBnniua6-oM

  25. Tertium Squid

    spouses were spending what little time free they had on child care or relationship maintenance

    I think it is the opposite, that people having fewer kids = less exercise. This is anecdotal, but I have three small children and child care is physically exhausting. I have a step-counter, and just puttering around the house with the kids and cleaning and taking care of stuff I walk quite a bit further than friends and family with fewer or no children.

    And you never sit down – if you do you get swamped by little bodies with sharp knees and elbows.

    1. Tertium Squid

      Also sleep is a big factor, not mentioned that I can see. It’s very hard to do unnecessary activities (nobody makes you go to the gym) when you aren’t sleeping enough.

    2. Medbh

      I can confirm this. I have four kids, and recently quit my job to stay home. I bought a fitbit to record physical activity. I have no problem getting 12K steps from doing housework, gardening, and taking the kids to the library or whatever. It’s an amazing activity difference between when I’m on mom duty versus solo.

  26. craazyman

    I don’t know what this author is trying to prove.

    Sloth is a virtue and it’s nothing at all like gluttony. Gluttonous people devour things with animal-like energy and incredible determination.

    Sloth is laying around doing nothing. Working in an office in a chair isn’t sloth. That can be hard work.

    Sloth is going home and laying around on your belly watching Youtube eating pizza with a glass of red wine & crumbs falling on the floor and then not vacuuming them up.

    YOu don’t have to be fat for sloth. You can be thin and lazy, or, like me, incredibly buff, good looking, smart, creative, thoughtful, articulate, sensitive and all-around cool, and lazy. That’s just a hint — hahaha.

    Fuk. Sloth is Good! Sloth is when you have your best and most amazing insights about the universe. Then you think “Laying around is pretty good, isn’t it. It may be that sloths are the geniuses of the animal kingdom. It makes you wonder, thats for sure.”

    1. optimader

      Sloth is Good!
      TM that and start printing on tee shirts…
      mmmm. but have someone else do the printing.
      Sloth.. market it right,
      well… have someone else market it for you, and it might become a popular children’s name.

      Has a nice old testament feel to it.

      1. craazyman

        I gained 700 pounds when I started watching Youtube music videos from the 1970s, but lost all of it in just weeks after I started watching short fitness clips of 5 or 10 minutes each.

        Now I watch 3 a week — just 20 minutes total — and I can lay around in a dream state of slothlike-unconsciousness for days without gaining weight.

  27. Northeaster

    Being fit is a lifestyle.

    Seeing fat kids, sans medical conditions (and being poor & uneducated), I put the parents of such right up there with folks who throw cigarette butts out their car window.

  28. Epistrophy

    What about the demise of the local ‘Mom and Pop’ businesses to be replaced by mega-global corporations? Would this not affect lifestyle, the quality of food, the length of commutes, the development and integration of communities and sedentary working conditions quite considerably?

  29. NOLA veteran

    When I lived in New York, I noticed that the food delivery bike messengers and the construction workers were still fat *despite* all of the physical exercise. You’ll see lots of overweight runners and cyclists if you try to avoid your own confirmation bias.

    Anyone who’s lost a significant amount of weight knows that you can’t jumping jack your way out of a spare tire.

    It’s diet. But it’s not just calories.

    The fundamental flaw in the article is

    ” Weight gain arises from a caloric imbalance”

    The science is not settled. Your body is not a bomb calorimeter despite what we learned in health class.

    The body is not merely an engine. But rather a biochemical system that reacts differently to different stimuli. You see this in the glycemic index and the insulinogenic index.

    And once you start looking at the hormones, then you have entirely different pathways to understanding fat gain and loss.

    The carb insulin hypothesis that is promoted by Gary Taubes has come under criticism after an unfavorable recent study, but there is too much real world evidence that suggests that the caloric model is too simple.

  30. annie

    woman friend moved from nyc to small town in midwest. over 2-3 years she put on 50-75 pounds. not merely car culture but there’s ‘contagion’ in that one’s perception of ‘skinniness/fatness’ morphs.
    when everyone around you is obese, you feel thin, you feel ‘why not eat a donut?’ you gain 20 pounds, you’re still skinny in that world. ‘why not eat fries?’ etc etc.

  31. vlade

    I just saw a study http://www.bbc.co.uk/news/magazine-36763102 that suggests otherwise – i.e. the portion sizes (=calory intake) is what matter most, at least short time.
    That chimes with my experience. I walk a lot (including stairs), and few years back I was also exercising a lot in general. Yet my fat levels were pretty much the same – but the distribution tended to change. As a result of walking, I now have very muscular, fat free legs, but the fat just moved upwards :), and the overall fat/body ration stayed more or less the same.

    Last year I changed my diet (including having a bit more regular meals) – and dropped pretty much all the exercising I was doing at the same time (except for walking), and my body fat dropped a lot. So did my overall fitness to be honest. This year I went back to more irregular and weird-and-wonderful diet, and took on weight rapidly, despite being less sedentary than last year.

    But then, my metabolism is a really weird one (for example, lifting weights, I can much more easily do 20 repetition than 5 repetitions, stop and another 5, and no, I’m not cheating and using momentum).

    So I’d say it’s a combination.

  32. Sluggeaux

    Sitting is the New Smoking.

    BTW, agree one hundred percent with @Synoia about regular calf-stretching as the cure for plantar fasciitis. It worked for me. It’s not pounding, it’s tightening of the plantar fascia along with the Gastrocnemius in the calves that causes foot pain. Now, off on a hike!

  33. Adam Eran

    A good beginning to the discussion. The revision in farm subsidies to produce more high-fructose corn syrup and fast food is certainly to blame. The crappification accelerated with Nixon’s revised “get big or get out” farm policy that also favored commodity crops and feedlot beef (far less healthy than grass-fed). As Wendell Berry says, feedlots, or CAFOs, “neatly divide a solution [animals fertilizing soil] into two problems.” Michael Pollan’s Omnivore’s Dilemma and John McDougall’s writing is worth a look. Take a look at McDougall’s miracle cure testimonials for the effects of a vegan diet, too. Moving stuff.

    Human livestock consumption has quintupled since the 1950s…enough that a (flawed) UN report suggests it exceeds human transportation as a contributor to global warming since the methane from livestock is 23 times more powerful than CO2 as a greenhouse gas.

    But a lot of the problem of inactivity stems from the built environment. The distinctly un-sexy term “land use planning” is the topic of James Kunstler’s rants (e.g., Home from Nowhere), and Andres Duany’s writing (with Elizabeth Plater-Zyberk and Jeff Speck: Suburban Nation: The Rise of Sprawl and the Decline of the American Dream). Duany has many Youtube lectures well worth watching too.

    What builds walking out of our daily lives? Sprawl. Single-use neighborhoods (all residences, all commerce, all offices, etc.) are connected by auto-only streets. You cannot walk anywhere useful. This has several effects: 1. All driving age adults must own a car. This is the most regressive of taxes. 2. Any viable transit effectively dies. How can people walk to the stops? 3. Youth and the fastest-growing age cohort (85+) are socially disenfranchised. Mom must drive, or we must send Grandma to the warehouse with a bus and collective meals. 4. The public realm–including pedestrian-friendly street space, parks and public buildings–consistently suffers. Parks are no longer important public spaces, they’re leftover floodplain. Public buildings used to be something in which a community could take pride; now, they’re often tilt-up warehouses with large parking lots.

    Remember: Even a daily 10-minute walk produces a significant reduction in late-life health problems.

    The alienation, separation, divide-and-conquer tactics of the economic elites are literally cast in concrete in our neighborhoods. Sprawl often lets you know what your neighbors’ incomes are.

    America didn’t always build this way. The most valuable neighborhoods are often older ones built as pedestrian-friendly, mixed-use (stores among the residences, or residences above the stores), mixed-income (apartments among the mansions). Duany and many other New Urbanists are attempting to revise this pattern of building. Of necessity, engagement with public policy and an enriched public realm are likely to follow.

    Incidentally, the public realm includes the environment. Environmental degradation follows societies who are divided and conquered.

    The “experts” who have sold us the shoddy goods that sprawl embodies are often subsidized by their favored constituency. The education in the pseudoscience of “traffic engineering” is heavily subsidized by auto manufacturers.

    Planning itself is similarly flawed. Jane Jacobs (The Life and Death of the Great American City) says something like this about civic “Planning”: “The pseudoscience of planning is positively neurotic in its willingness to embrace what manifestly does not work, and reject what does…. It is in the stage of advanced superstition roughly like nineteenth century medicine which bled patients in a vain attempt to cure them.”

    …and Jane would know given her encounters with planning in NYC.

  34. Donna Knipp

    Usually love your commentary but you’re off the mark on this one. Read “Missing Microbes” by Martin Blaser, a highly regarded infectious disease guy.

    Americans in particular have a problem with their gut flora — the little critters that evolved over millions of years to regulate our metabolism & immune system, and influence every other important biological function.

    Indigenous people (who are almost never overweight) have 2 or 3 times more diverse gut flora than Americans or other Westerners.

    This ecosphere of microbes in our gut is the cutting edge of medical research. Many folks believe this area will yield far more useful medical knowledge than sequencing the human genome (gulp!)

    Why is our gut flora so diminished? Two reasons — extreme overuse of antibiotics, and processed foods.

    How does a diminished gut flora make people fat? They don’t fully understand the mechanism, but they have clear, independent, verified studies to show that repeated antibiotic exposure correlates strongly with obesity.

    The thinking is that many of us no longer have the correct mix of gut flora to properly regulate our metabolism, and in people who’ve had too many antibiotics, it leads to overweight and obesity.

    This explains why obesity has climbed in every part of the world where antibiotics are now used. (even in areas where a western-style diet has not been adopted).

    Google for antibiotics and obesity. You’ll see all kinds of reporting — from mainstream media to heavy duty clinical trials.

    But stop putting the blame on people’s behavior! It satisfies some universal urge to harshly judge people, but it doesn’t reflect what’s really going on out there.

    And read Blaser’s book. It’s clearly written and very eye-opening.

    1. Yves Smith Post author

      I am old enough to have seen diet fads with some new gee whiz theory of why people are fat and what that means in terms of what to do.

      I was fat and both my fat period and my weight loss had nada to go with gut flora. I was fat at one year old. I did not have antibiotics and neither did my mother. My brothers with similar diets and similar genetics were not fat. One got fat as an adult (obsee!) and the reason was huge changes in his activity level and quitting smoking. No antibiotic use.

      I can give similar stories from friends and family members.

      The point is it may be relevant in some cases, but your claims are vastly overstated. And like most diet fads, if you look at the underlying studies, they are crap. Poor sample sizes, poor study design, etc.

      And BTW Aborginal Australians, including ones who live in the outback, are regularly overweight. Native Hawaiians have a propensity to overweight, but they see it as culturally desirable. In general, island dwellers are very prone to obesity precisely because they are even more regularly exposed to near starvation than other populations. Nothing to do with gut flora

      http://foreignpolicy.com/2011/02/09/why-do-the-worlds-fattest-people-live-on-islands/

  35. Jim A

    To what extant have computers made even office work more sedentary? Sitting in one place sending emails rather than walking around meeting people, and filing physical paper uses less energy.

    Even a little bit of exercise helps.I certainly found that when I stopped from walking to and from the train station less than a mile away, i became more tired. That small amount of exercise everyday made a difference.

    1. Readoutsider

      I agree! I took 10 years out of the workforce to raise children and when I returned could not believe how much more sedentary office life had become. Now you stare at your computer hardly moving for hours at a time. In the old days I would run up and down stairs to deliver trade tickets and memos, go to actual in person meetings rather than conference calls, and just had a lot more reasons to walk around the office.

  36. Larry

    I find the estimates of net calories purchased to be woefully inaccurate. And gross levels of caloric intake across whole populations simply don’t matter. Individual choices do. Calories and activity absolutely effect weight gain. While most in NY seem slim, I’d venture that if you navigated to poorer sections of NYC you would not find the same case. In those poor neighborhoods there would likely be more cheap bad food options than healthy options to go alongside the cheap bad options. I see this in Boston plenty when I’m around. Go to the Seaport district which is all high tech now and you see people lining up 45 minutes to by a salad. Head to downtown crossing with more state and working class people and you’ll find plenty of heavier people buying fast food. Even if we could accurately measure calories purchased across the whole of the population, the individual choices still matter and consumption of purchased calories won’t be even.

  37. WG

    The data I’ve seen here in the US contradicts this author’s initial premise, that calorie consumption has gone down since 1980. Griffiths’ approach is novel, because typically food availability data is used to assess caloric intake. US data is cited both here and here saying the opposite of what Griffiths claims. My second citation relies on USDA data which says that calories went from 2076 to 2534/day between 1970 and 2010 – almost the exact inverse of what Griffiths says.

    Griffiths acknowledges that “there has been a sizable increase in calories available” yet asserts anyway that calorie consumption has declined, based on household food spending. She makes no attempt to explain this gap – that many more calories are increasingly being lost or wasted – and it will take some time and some expertise to address her novel approach, and its adequacy (or inadequacy). It’s beyond the scope of a blog comment, at least at this time.

    (Incidentally, my citations are from a US registered dietitian and a US MD/author specializing in obesity treatment. The author of the Vox article is an economics professor.)

    It should be borne in mind generally that “calories in, calories out” is a marketing slogan and not nutritional advice. Specifically it’s designed to rationalize eating/drinking junk (ie non-nutritive) calories. Griffiths seems to have bought into this creaky theory way too readily. Considering the novelty of her primary theory – calories have gone down – I’m surprised to see this paper cited without question here. I would expect there may be responses from people who have researched this themselves, and I’ll be interested to read those before I can treat Griffiths’ novel approach as reliable. For now, considering it’s the opposite of what I have read elsewhere, I can’t (though I’m open to hearing why her method is more reliable).

    As far as the theory of city-dwelling and exercise goes, I was obese most of my adult life. I moved to NYC in 2010 and yes, began walking everywhere, all the time. My weight changed by not one pound. Not a bit. Walking everywhere, carrying your parcels by hand, sweating on subway platforms – they’re not good for weight loss, it turns out. Even doing it for two years. After that, I moved back to the burbs in 2012 and again, my weight changed not at all. My own experience is confirmed by another Vox article that says, no, exercise won’t help you lose weight (and in fact, seems to SLOW DOWN weight loss), here. This article relies on 60 studies that support this conclusion, a big contrast to Griffiths’ approach of citing only her own novel research approach.

    What did work for me? Finally discovering that sugar and processed carbs don’t work so well in my body. I cut out foods with added sugar and cut back carbs to 1 serving/meal, and cut out snacking; 30 lbs fell off in 3 months with no hunger. From there I went lower carb and went on to lose a total of 70 lbs, again without hunger. I’m maintaining that, easily, with no real effort, for over a year now. For many of us, carbs – especially concentrated and highly-digestible carbs like sugar and highly processed foods – just don’t work so well. It’s easy to eat and live this, but one does have to overcome the culturally mandated fear and loathing of dietary fat. Yes, dietary fat must go up, and be sure to make them good quality fats from naturally occurring sources (meat, dairy, fish, avocados, nuts) and not from seed oils. Then watch your HDL soar, your triglycerides and your weight plummet – all while people tell you over and over how “dangerous” that fat is, LOL.

    1. Yves Smith Post author

      1. You appear to be new here. Our written policies state that we expect readers to read a post before commenting. You did not do that. The study is based on UK data, not US data. Your opening comments are off base.

      2. No one knows how much Americans consume. The USDA data works back from total calories produced per capita and assumes loss factors due to waste, cooking, etc. So for all we know, the USDA is fitting its “more calories” story to the observed reality of “people are much fatter on average.” The UK saw a similar explosion in obesity and overweight (it was second only to the US), and it appears from their data that sedentary lifestyles played a bigger role than was commonly realized.

      3. By sheer happenstance, due to having a number of orthopedic issues that even supposed “sports” doctors could not address, I now have good contacts in the elite sports mafia. This includes doctors who read all the cutting edge research about diet, medications, hormonal response, dietary supplements, the various theories about toxins, absorption, etc. They know what are good studies and bad studies. Most “studies” are garbage from people pushing products or treatments.

      People dealing with high end athletes do not fool around. They need to use what will work. There is too much money at stake to mess around. That is why I wound up with them. They have successfully rehabbed me after spending the better part of 20 years with every other supposed expert (medical and alternative) who was convinced he could fix me up until he failed. And then they would make it my fault even though I am very compliant as far as treatments are concerned.

      Exercise will get weight off, period. One of the specialists in my network is the one Hollywood sends actors to when they need to lose weight quickly for movies or TV shows. It will take most trainers 3-4 months to get them trim. He can get them in shape (big reduction in body fat) but they have to do exactly what he says for 33 days.

      Virtually all of these studies on exercise do not understand hormonal responses to exercise. And the objective is to lower body fat. Some people wind up becoming a lot smaller, but they have lost only some weight because they added muscle mass. Having more muscle mass is extremely beneficial from an anti-aging and longevity perspective. Strength is the single best predictor of biological age as opposed to physical age, and the second is muscle mass. A higher muscle mass also elevates the amount of calories you can consume daily at the same weight (it takes virtually no food intake to maintain fat, while it does take calories to maintain muscle).

      If you are already significantly overweight, yes, walking will not be intense enough to make a difference. It serves more to keep people from gaining weight than playing a useful role in weight reduction. My middle brother went from being thin to being obese as a result of going from a job where he walked 7 hours a day to a desk job, plus quitting smoking.

      I never said routine errand walking would make anyone thin (although some readers said it worked for them). What will take off weight is exercise designed in a specific way to increse your lactic acid levels which in turn raises your growth hormone levels, which means increases your metabolism. Routine cardio is not good for that at all, and almost without exception, that is what the various “exercise” studies look at. You need either to do weight training (very specific protocol high intensity with adequate rest periods. Most people skimp on the rest period in the workout with means they don’t work hard enough in the work periods to generate enough lactic acid) and/or interval sprints (again, specific protocol, where you work to your absolute maximum for short periods with long rests in between).

      If you really were obese, you probably would have needed to lose some weight through diet alone and then build up a basic level of strength to exercise this way. You run the risk of joint injury otherwise. But because that was the correct and successful path for you (and congratulation, it is not easy), does not mean that is the best approach for other people. I can tell you that for me, exercise was and remains essential. I eat an extremely good diet (no intake of refined foods starting in college, I was stringent about diet early on), eat very little (<1200 calories a day save for 2 "cheat" days a week to keep my metabolism from resetting even lower, and even then I eat 1700-2000 calories) and I exercise daily, including serious weight training 3-4X a week. Even with my stringent diet, I must exercise to remain trim.

  38. Code Name D

    The myth of “affordable” whole foods.

    I remember reading an account of a social worker who was determined to help a single mother fight her obesity problem. Despite having sent her booklets and recipes, she continued to feed herself and her four kids processed foods. So she decides to show her how easy it is in person.

    Problem #1 popped up almost immediately, working two jobs and a long commute, not to mention regular school events made scheduling a home visit a real chore. But this was only the beginning of the problem.

    Once in the home, she discovered the mother didn’t have a working stove and only had a small ten watt microwave, a hot plate, and small toaster oven. Undaunted, she proceeded to prep the meal, only to learn that the electrical system in the house was so old that trying to use more than one appliance at the same time blew the fuse. Things were further complicated when the social worker realized that the mother only had a few small pots and no utensils.

    And while the mother really wanted to learn how to cook, her four children kept pulling her attention away from the kitchen. When the mother was able to pay attention, it was clear that she didn’t know the first thing about cooking. Her own mother worked most of her life until she died in a car accident, never having the opportunity to pass on her skills, assuming she even knew them. It became clear to the social worker that it would take weeks to properly train the mom with the basics, proper cooking hygiene and food safety being the most important.

    In the end, the social worker was able to prepare a meal, but finishing far later than intended, cutting into al already anemic sleep schedule. But her effort had been a complete failure, and not for a lack of effort on her, or even the mother’s part.

    And other problems also became apparent. She was only paid once a week, with her benefits coming in once a month (and usually late). Whole foods spoil quickly and have to be used within days. So how is one to store a weeks’ worth of food that can only be acquired, at best once a week?

    And this particular editorial never touched on food deserts or something called “captive market” that exists within school systems or work places. It’s not uncommon for school lunch programs to be the only meals some kids receive, so if the school lunches serve sugary and fatty foods, what other options are there? And just getting to a grocery store can be a challenge, often requiring passing over dozens of fast food establishments that offer up enticing air conditioned playgrounds and novelty toys.

    While whole foods may be cheaper at the store, once you add in the needed cooking utensils, working stove, and gas or electricity, cost start to add up. And then there are huge time costs, storage concerns, and basic knowledge on how to cook with a minimum degree of competence and safety.

    Add these things together, and is it any wonder most Americans are not eating well. Heck, a growing number of Americans face growing challenges of simply eating at all.

    Again, these are examples of your typical neo-liberal solutions which add up to little more than free booklets and stern lectures, then blaming the victim when they fail to accomplish what was never feasible to begin with. Here is an example where “education programs” are more panacea than solution.

    1. Dave

      My bullshit detector is pinning to the max.
      That’s not a nutrition problem, nor a kitchen infrastructure problem, it’s a problem keeping her legs together. Harsh judgement? Yup. How much would a working used stove or a repair part cost? Why didn’t the landlord take care of it as was his responsibility in every state. Or, did she own her own home? Unlikely.

      Pots and pans are cheap at garage sales and the Salvation Army. Dry beans and rice last forever and are very cheap per meal. Protein can be picked up in fast food outlets and sprinkled into beans and rice as a condiment.

      Pandering to poverty and making excuse after excuse for people’s choices and behavior is Neo-Facism, in that the state institutionalizes poverty with the help of social workers like the one mentioned and the welfare programs that provide junk food and calories without quality to poor people.

      1. Yves Smith Post author

        You can go to hell. I had a neighbor in one of my first buildings in NYC who had a not real kitchen (no stove, only a half fridge) and it was legal. You are clearly privileged if you don’t understand that slumlords exist and that people rent apartments from them (and BTW this was not even remotely in a “slum” building, it was a tiny rent controlled studio in a building that had been cooped long ago). It was only in the last few years, under Bloomberg, ironically, that the city set up 311 and gave priority to calls from people in the winter where the landlords weren’t sending up enough heat, as in the tenants were at risk of freezing.

        And how is this woman supposed to get her landlord to provide a working stove? Sue him? Are you nuts? Even in tenant friendly NYC tenant court, you need to go with a lawyer to have any chance of winning. And that takes time DURING THE WORK DAY which poor people do not have.

        Re the wiring, I have wiring that is not up to code in a building on Park Avenue. I live in the oldest elevator doorman building in NYC. The wiring is “grandfathered”. I can’t run an air conditioner in my bedroom and a hair drier in the bathroom at the same time without blowing a fuse. And I can’t use a wireless router because the power is not “conditioned” well enough (too spiky) so the router turns off and on and gets fried. Similarly, light bulbs guaranteed to last 2 years last three months.

        And how is this woman who has NO time, as the article makes clear, supposed to find the time go buy used equipment, haul it back to her apartment (she can’t lift it, are you now assuming a man, the way economists assume a can opener on a desert island, and a pickup truck) and not get ripped off, get it installed (particularly if her building uses gas, she can’t even legally install a gas stove as a tenant)?

        On previous posts, you’ve pretending you know something about poverty when you have no clue. Stop insulting the intelligence of our readers, and even worse, denigrating how poor people struggle to get by, and peddle your fabricatoins about your background elsewhere.

        1. Dave

          Okay, I’ve never been East of the Mississippi and am unfamiliar with eastern law and buildings. It sounds like New York City is falling apart even though you live in a nicer “better” building. Landlords seem to have no responsibility from what you are saying.

          I grew up eating the neighbors throw-aways, leftovers brought home from bars, 1/2 of one parent, in a violent neighborhood, never had dental work done until I was 21 and I have a good idea about poverty, perhaps from a regional perspective.

  39. Tinky

    There’s no doubt that a sedentary lifestyle is often a contributing factor to obesity, nor that regular walking is helpful in preventing it. Processed foods are also a huge contributor. But I’m surprised that there is no mention of metabolism in the post, as there is mounting evidence that it is not only a very big factor, but one that can be altered in a simple manner: fasting.

    I highly recommend reading the article by Canadian doctor Jason Fung linked below. (Well, I tried linking, but do not see it in the post…)

    Here is an excerpt that reveals the interesting crux of his research conclusion:

    In standard caloric reduction strategies, the body reduces its caloric expenditure to adjust to the reduced caloric intake. Stores of energy locked away as body fat are not available. If your reduce your calories from 2000 to 1200 per day, then your body is forced to reduce calorie expenditure to 1200 per day since it cannot get any from the stored food (fat). Where’s the extra energy going to come from?

    However, by lowering insulin drastically during fasting or alternate daily fasting, the body does not shut down. Instead, it switches fuel sources. No food in coming in. Insulin falls. Your body has a choice. It can reduce calorie expenditure to zero, also known technically as ‘dropping dead’. Or, it can force open the reserves and power itself from fat.TEE

    Lowering insulin makes it much easier to open up these stores of fat. That it’s normal job. When you eat, insulin goes up, fat goes into storage. When you don’t eat (fast), insulin goes down and fat comes out of storage. Dr. David Ludwig showed a similar result when comparing diets. In his study, he compared the total energy expenditure after weight loss with three different types of diets – low fat (standard advice), low glycemic index and very low carbohydrate.

    The low fat diet does nothing to reduce insulin levels. So fat stores are blocked from being used for energy. Basal metabolism drops almost 400 calories per day. But on the other extreme, very low carbohydrate diets would be the diet that lowers insulin the most. This allows access to the basement fat ‘freezer’. Now our body has the energy it needs to start revving up its metabolism.

    1. JustAnObserver

      Interesting conclusion to be had here. Since full-bore, water only, fasting is difficult for most of us to achieve why not try a no-carb day (or 2) variant ? Tricky bit would be to avoid all the hidden carbs (high fructose corn syrup in everything :-(( ).

      1. jrs

        well fasting is probably easier than monitoring food intake, I’ve certainly found it such. But whether or not one loses much weight really depends on creating a serious calorie deficit. In a world of massive food excess it’s good health and weight maintenance at least.

        1. Tinky

          You’ve missed the point. Fasting alters metabolism, which in turn can make a big difference irrespective of caloric intake (within reason).

    2. Medbh

      I’ve done temporary fasting on and off my whole life. It wasn’t something I did intentionally, but I wouldn’t have anything in the house that looked good to eat, or I got busy and would miss a meal or two. I still don’t like to eat breakfast, and will often not eat until noon or so. I used to feel guilty about it, but I guess it’s a good reminder to listen to your body.

      What I found with fasting is that I would get a hunger spike, but then my body would be like “ok, I guess we’re not having food now,” and get over it. It wasn’t that big of a deal, and it seemed like something my body expected to deal with occasionally.

      I’m very much a believer that the obesity is being driven by an internal process. Perhaps the problem gets kicked off by some environmental trigger (like antibiotics, chemicals, or a sustained period of overeating or specific diet that changes the gut flora), but the root cause is something internal. When things are working right, you want to get exercise, and you eat when you’re hungry and then you stop. It seems like we’re focusing on the wrong issue when we say that people shouldn’t drink soda or eat junk food, or they need to exercise more. A better question would be why they crave that food in the first place, and why their body doesn’t want to move.

  40. Anon

    Lots of interesting comments on this topic.

    While exercise, early and late, in life is helpful and diet is extremely important, and genetics makes every BODY different; it is the ubiquitous SUGAR in processed food that is the impetus for the society-wide expansion in girth in most folks. (Katie Couric’s documentary “Fed up” is an entre’ into this phenomenon.)

    While staying active improves body metabolism, and eating non-processed foods makes for a better gut environment, SUGAR contained in today’s food has more calories than most folks can “walk off” in a day (or two). And it induces a subliminal craving that processed food manufactures exploit. (Fruit juice might seem refreshing, but without the fiber content attendant with eating fresh fruit, it is nothing less than a sugar jolt.)

    In my younger days I was so fit that I did not float in a pool. Now I do. So I’ve learned the proper way to swim (low-impact activity) so that maybe one day I will NOT be able to float, again. But only if I can find a way to remove most SUGAR from my diet.

    1. Adam Eran

      Yours is a point made by Dr. Robert Lustig (see his Youtube appearances entitled Sugar: The Bitter Truth, for example here.) … I’ll agree that sugar is not good at all.

      But that’s not the whole story. The promoters of no sugar, or low-carb, or high-fat / protein-rich diets also appear in this brief video….where you’ll see the plant-based, whole foods diet produces lean people… The paleo- low-fat, voodoo is promoted by fatties, including Lustig.

      Better to trust the experts whose system actually works for them!

      So…capitalize SUGAR all you want. It’s bad, but it’s not the whole story.

      1. Anon

        A full reading of my comment surely doesn’t imply that SUGAR is the whole story. It’s substantial removal from one’s diet is essential to reducing food/caloric intake.

        As I noted , every Body is different. But trying to exercise one’s way to slimness is very difficult with too much sugar in the bloodstream. I’m well aware of the various dieting fads, but removing substantial amounts of sugar from one’s diet is not a fad; it is essential for most folks to maintain a healthy body (trim?) though their life span.

  41. JustAnObserver

    Interesting site I read from time to time debunking the various official health/nutrition guidelines which she considers to be so heavily corrupted by pressure from the “fake food” and pharma industries as to be worse than useless. In fact from her perspective and the meta-analytical studies she and others have done she’s come to the strong conclusion that these guidelines are to a large degree the actual *cause* of the obesity epidemic.

    http://www.zoeharcombe.com

    Caveat: She does promote a diet on the site so there’s some talking her (several) book(s) going on. Still there’s a lot of useful info there and there isn’t too much book pushing on the main & blog sites.

    To give a flavor of her level of polemic. In a take down of a study that purports to show how eating more whole grains reduces your risk of dying of heart disease:

    “To prove me wrong, the authors of these studies need to give 3oz of whole grains daily to the smoking, drinking, obese, sedentary, aimless, fourth generation unemployed, living-on-benefits, deprived populations in the Welsh valleys and change nothing else. Do you think that will “slash their risk of dying from heart disease by 25%”?!”

  42. clarky90

    I recently set up a standing desk in my lounge. It It is just an old cupboard which is as high as my bellybutton. ($40 at the Op Shop) I put my laptop on top of it. I am standing as I type this! I also have my remotes for the smart TV, as well as my hot drink on my standing desk.

    Now for the really surprising part (to me). Initially, I thought I would stand a bit (15 minutes or so) and then go straight back to the chair with the laptop. It took about a month, but now I stand almost all of the time. It feels like being at the helm of a ship to me.= Actively engaged with the media. If I have music on, I can dance/move along with it.

    Please, please watch this amazing interview with biomechanist Katy Bowman

    https://www.youtube.com/watch?v=Zy7iL33g-tM

    Here is a link to her book.
    https://www.amazon.com/Move-Your-DNA-Restore-Movement/dp/0989653943

    This interview inspired me to set up a standing desk at home. At 66 years old, it is profoundly transforming my health and fitness. Some of us old dogs can still learn a new trick! Also, it is very easy, enjoyable and intuitive. Sitting is unnatural, and our body remembers this if given a chance.

    Thanks Yves for the wonderful article and discussion.

  43. ewmayer

    I sometimes think that the most-hated four-word phrase in the English language must be “eat less, and exercise”. Sedentism and tech-related postural/orthopedic problems are of course rampant where I live (Sillycon valley) – all those tech geeks hunched over their laptops and devices 7 days a week, as are their smartphone-addicted kids. How about going outside, playing kick-the-can, riding your bikes around, throwing or kicking a ball, climbing a tree? Nope – these kids are helicoptered to and from everywhere, overscheduled year-round, and in the summers get sent to “code camp” so they can learn from early age to become dutiful little cubicle monkeys, all that propaganda about “innovatively disruptive sharing economy thought leaders” notwithstanding. Sickening.

  44. Adam Eran

    I’m distressed to see so many people sucked in by the diet hokum. Low carb, more meat, more fat…etc.

    “But it works! Look, I got ketosis and lost 30 lbs!” — yes, and you could lose weight by undergoing chemotherapy too. Ketosis means you’re sick…not something sustainable.

    And sure enough, virtually all that reduced-calorie dieting lost weight eventually comes back. One nutritionist I heard speak said that reduced calorie, low-carb diets generally mean that for every seven pounds lost only two are fat. The rest is lean body weight. Anorexics are typically very fat (40% body fat isn’t unusual, while 15 – 22% is normal healthy), but the fat is marbled in the muscle tissue, so they’re weak, not plump.

    Lean body weight is what burns the fat, and diets reduce those faster than they reduce fat. Diets don’t work. They’re cons.

    And con men / women promote them. Check out the contrast between those promoting whole foods, plant-based diets (which actually work) and those promoting some magic nutrient … (here)… like fat, or meat, or “just avoid sugar.”

    Probably one of the most believable authorities in this area is Columbia biochemist Colin Campbell. You may remember him as the discoverer of a mold-generated carcinogen, aflatoxin. As he was dying of stomach cancer, Cho En-Lai commissioned “The China Study” — the largest-ever study of the connection between diet and health, which Campbell helped run.

    Note that Campbell grew up on a dairy farm, and certainly ate plenty of meat and milk as he grew up. After his research, he now tours the country promoting a vegan diet.

    As difficult as it is to persuade people about political prejudice, I don’t think it holds a candle to the stubborn willfulness of those stuck on diet hokum. Believe me, I’ve tried. No amount of facts are persuasive. I was lucky enough to get sick on a conventional American diet, then got well switching to vegan eating. (How often do you read “I was lucky enough to get sick…”?…;-)

    But don’t take my word for it. Read or watch the incredible testimonials of others.

  45. Wade Riddick

    Yves is partially correct, but there are five other factors besides exercise driving modern diseases like obesity, diabetes, cancer, autism, multiple sclerosis and arthritis.

    In short, the same way industrial pollution is destroying our climate and creating global warming, corporate fraud is destroying our gut ecology. Just as you can’t grow crops without bees, butterflies and soil organisms, you can’t digest your food and regulate your immunity without the proper mixture of worms, fungus, bacteria and viruses in your gut.

    These following acts of medical malpractice drive inflammation and insulin resistance in modern societies:

    1) Deworming of the gut. It’s never been proven safe in any clinical trial. It is the original sin of modern medicine that makes multiple sclerosis, Crohn’s disease, inflammatory bowel disease, ulcerative colitis and food allergies possible. The worms maintain a proper balance of microorganisms and prevent infection, among many other things.

    2) Broad-spectrum antibiotics kill healthy flora (which is, per se, medical malpractice). You need those healthy flora, for instance to digest dietary fiber and produce incretins. Loss of incretins leads to amyloid accumulation in the brain, insulin resistance, inflammation – all sorts of nasty chronic problems.

    3) Fiber-free processed foods are deficient in the vital nutrients your gut biome needs to function. (Se #2)

    4) Loss of omega-3 fatty acids in the diet and substitution of omega-6’s and transfats because of their industrial suitability (i.e., no self-respecting microorganism wants to eat them when you leave them lying around on a shelf – which should have been a good indication we should have stayed away from them too).

    5) Loss of sunlight. Yes, it causes skin cancer but people in the sun can expect to live longer anyway. Vitamin D3 is antiviral, inhibits autoimmunity and regulates insulin sensitivity too. Blue light cues also control pineal gland hormone synthesis (e.g., melatonin), which prevents everything from cancer to depression.

    Take the antiviral, antidiabetic, antifungal, antibacterial, angiogenic multiversatile compound cathelicidin. It is synthesized from dietary fiber (via butyrate and HDAC inhibition in the gut andby a FOXO1/fasting pathway everywhere else), Vitamin D3 (sunlight), bacterial byproducts in the gut and exercise. That’s four out of the six. Since worms make their own version of cathelicidin, that’s 5/6.

    Deplete cathelicidin and your risk of influenza goes up. Same for CMV and numerous other viruses. And just to make the trifecta, or sixfecta, an antiviral DHA-derivative named NPD1 rounds out the fatty acid angle.

    In short, industrial food and medicine has undermined our innate defenses against infection, destroyed our self-tolerance and our ability to regulate our metabolism. It’s not just the fault of fatties for overeating. Many of these pathways also alter the hunger response.

    But it’s all about the gut ecology. Just yesterday we found out that gastric bypass alleviates diabetes in mice by altering gut flora first and foremost. Only when balance is restored to these bacterial populations does the insulin sensitivity and inflammation improve – both main drivers of obesity.

    http://www.sciencedaily.com/releases/2016/07/160711092303.htm

    The FDA regulates poop now as a drug – except there are a few problems. Patients with C. diff infections can be cured with this drug, but the FDA won’t allow “off-label” prescriptions for other G.I. infections like E. coli or conditions caused by disturbed flora like Crohn’s or M.S. Some of these conditions have been cured with these fecal transplants but you’re talking about diseases where a single drug can hit the $50-$100K mark every year.

    They’re clearly freaked out purely over the threat to corporate drug profits. Do you also hear the FDA restricting antibiotics like this (or any of the other five drivers I mentioned)? It’s a basic confiscation of public goods problem to force us to take overpriced private substitutes provided by rent-seekers. The FDA allows incretins on the market for $3000+/yr. Dietary fiber does the same thing for about $100, but the FDA won’t let any companies tell this to diabetics in ads. It’s like requiring people to run a clinical trial to prove that Vitamin A cures Vitamin A deficiency.

    Oh, yeah. There’s another problem with the FDA classification of poop as a drug. When millions of women deliver their children through the birth canal, they also poop on them – which is how nature designed mothers to transfer G.I. flora to their children. According to FDA regulations, shouldn’t these women be arrested for giving their babies illegal and unapproved drugs?

    Other recent research insights:

    http://arstechnica.com/science/2016/06/in-rodents-fed-high-fat-diets-gut-microbes-boost-hunger-trigger-obesity/

    http://www.sciencedaily.com/releases/2016/04/160429095038.htm

    http://www.sciencedaily.com/releases/2016/04/160414145513.htm

    1. Anonymous123

      You are absolutely correct on this. I’m currently working with a microbiome expert and a bioinformatician on a microbiome therapeutics company in the autoimmune space, and there are several companies out there who are trying to tackle this. I think in the next 5-10 years we’ll see some really impressive science come out for modulating microbiomes to cure disease based on the root cause, particularly autoimmune disease and some cancers. No more of these immunosuppressants with horrible side effects that patients currently suffer with. Stay tuned…

  46. pretzelattack

    naked capitalism come for the poltical analysis, stay for the lifestyle tips. i’ve started walking backwards after i finish my usual walking/jogging.

    1. Tinky

      I walk backwards (part of the way) up hills almost every day, and while it’s certainly not the only variable, I am 59, run and climb as I did when I was in my 30s, and suffer no joint pain whatsoever.

      1. pretzelattack

        i’ve just started recently. i can’t run as well as i did in my 30’s (60+), but i’m exploring the new limits.

        1. Tinky

          Well done! The important points are that it is never too late to make positive, and meaningful changes.

          1. craazyman

            isn’t walking backwards uphill the same, mathematically, as walking forward downhill?

            it sounds like your lazy but trying to pretend it’s exercise.

            1. Tinky

              No, it isn’t the same. Try both and you’ll discover a remarkable world beyond mathematics.

  47. Dean

    Massive ag subsidies towards corn soy and wheat make these crops cheap. These crops are refined into easily digestible carbohydrates/sugars which find their way into many of the foods we eat: bread, cereals, soft drinks (HFCS), flour, chips.

    Insulin levels rise due to the sugar spike, forcing these refined sugars (carbs) into the fat tissue.

    Refined carbs are not the same as carbs found in fruits or vegetables. Fruits and veggies have fiber and vitamins which make them more nutritious and slower to digest, thus mitigating the insulin spike.

    Gary Taubes’ book Why We Get Fat lays out a compelling hypothesis.

  48. Midwesterner

    As an immigrant, I have noticed that many people in the U.S. regard hunger as a problem – a problem to be solved by eating something, and preferably immediately. Whereas my experience has been that a willingness to put up with mild hunger pangs for a few hours each day makes it easier to lose weight. (Provided I do not compensate later by overeating.)

  49. Anonymous123

    I believe/know a lot of the increasing obesity is due to the changes in gut microbiomes, directly related to antibiotic use and preservatives in food (and perhaps environmental estrogens from plastics, etc also play a role). You can read the scientific literature, which clearly shows how gnobiotic (germ free) mice will gain weight if given a fecal transplant from an obese mouse whose guy bacteria metabolize more food (extract more calories from it). And conversely it will lose weight if given a fecal transplant from a slim mouse whose bacteria poorly metabolize food (extract fewer calories from a given amount). You also see a corresponding rise in autoimmune disease in recent decades because of the degree to which we’ve created aberrations in the microbiome and are losing diversity in species of gut bacteria.

    That said, I don’t doubt that sedentary behaviors also play a large role. This is just a biologic component that is also making a notable impact.

  50. Moneta

    I believe the lack of exercise throughout the day is an important factor but I also believe the price of food relative to our disposable income as the “quality” of it has an impact.

    For example, professionals in finance typically have much better quality lunches than those in IT. The portions tend to be much better also.

    We eat out much more than we used to a few decades ago, and unless you are going to a higher end restaurant (and even then), the food is toxic… I have trouble eating past 8pm in a restaurant nowadays because I will be digesting until 3am while I can eat a lot at home but do not suffer from this. At home, we better control the salt, breading, fat, processing, etc.

    When I go to the US, I am always amazed by how big the portions are. But I have to say that these have been growing everywhere. I think that food going from 25% of the basket in the 60s to 10% today has probably contributed to this.

    A couple of months ago, I went to a new restaurant and when they asked how I enjoyed my meal I proposed that they cut the portions. She laughed and said her clients would squeal if they tried that… the issue is that if they cut the portions, they would need to cut the prices and then they would not cover all their other costs. Only the very upper end restaurants will use scarcity and higher prices as a strategy. It makes more sense for a restaurateur to increase the portion by a few cents and price the meal higher by a couple of dollars.

    For me, the fact that restaurants have to use a strategy that does not match human requirements is proof that our pricing mechanisms are off in our economy. If going to the restaurant was a one off event, I would not come to this conclusion but the fact that we are going to these multiple times a day or per week convinces me that food is too cheap relative to other goods and services in our daily life. And the big culprits are those ingredients used as fillers or for processing which are getting subsidized.

  51. GlobalMisanthrope

    Wow. The high number and personal nature of the comments suggests to me that the issue is our issues.

    Research is just getting going on it, but I’m betting that the some combination of the ubiquity of endocrine system disrupting chemicals in our environment; digestive system biome death due to antibiotics, pesticides and herbicides; and the ubiquity of agents in most food—from colorings to flavor enhancers to stabilizers to preservatives—that we did not evolve to recognize as food is going to be found to play a huge role.

    I am a semi-retired chef working as a restaurant consultant. Nobody is sedentary in kitchens, but I can tell you that over 25 years kitchen workers are also heavier on average than they used to be.

    On another note, it pains me to see so much emphasis placed on individual behaviors and that those are so commonly cast as choices. Obesity as just another failing of character one needs to bootstrap oneself out of is just another expression of the punitive neoliberal meritocratic paradigm.

  52. Stephen Liss

    I wish I could photo comment with a picture of my Grandpa, who made it to 90 before he died. He was a farmer. Cleared his own homestead, 480 acres, with oxen, because he could not afford dynamite.

  53. Donna Knipp

    I’m glad to see more people tuning in on gut flora.

    And Yves, you’re right of course that there are other factors besides the bacteria in your gut that can make you fat. Genetics (which you seem to be pointing to in your remark about having been a fat baby), and also the simple arithmetic of taking in too many calories and / or burning too few calories.

    HOWEVER, obesity is an epidemic. It’s everywhere, even in places where people are not consuming more calories or eating radically different diets, or don’t have genetic predispositions. The propensity to obesity is affecting wide swaths of the Earth’s population like never before, in Asia, South America, Australia, the developed world….

    And the rise in obesity correlates strongly with decreasing gut flora, around the world.

    I urge you to not dismiss this idea out of hand, but take a few minutes and read up on it from more knowledgeable folks.

    The book I mentioned before is great (“Missing Microbes”), but here is a very straightforward story in Time magazine, a very mainstream source, on the undeniable causative correlation between antibiotics (ie less diverse gut flora) and the rise of obesity:

    http://time.com/4082242/antibiotics-obesity/

    We are destroying our gut flora — a miracle of evolution, aggregated over the 200,000 years that homo sapiens have existed and before that, over the millions of years in which our forebears evolved. That community of bacteria — our human microbiome — protects us in myriad ways, only a few of which we understand. And we are destroying it willy-nilly, without any idea of what the long-term consequences may be. For ourselves or the planet.

    But we DO know already that obesity and its related diseases are surging, while gut flora is rapidly going extinct.

  54. nothing but the truth

    the most important cause of obesity is the new synthetic emulsifiers introduced in the early 90s (thats when the obesity took off). These induce reaction from the gut bacteria, causing inflammation and obesity.

    also the encroachment be internet, reduction in park spaces, stressed in general kind of lifestyle meant that kids were no longer allowed to be kids….

  55. different clue

    The thing that’s wrong with the title of this article is using the word “sloth”. “Sloth” means freely chosen laziness and maximum inactivity in the teeth of a world which makes ACtivity the easier default choice. Modern Industrial/ Post Industrial inactivity is more often inflicted by sedentary-type jobs and walking-prevention cities and suburbs and etc. So we need a one-syllable work for FORCED sedentation. One as punchy as “sloth”.

  56. Questor

    GMO’d grains of all types are physically proven to be addictive, in the same way opioids are addictive, causing extreme hunger and cravings that are worse than those from ordinary sugars from cane and fruits, and with a higher glycemic index. Exorphins from grains feel like a runner’s high, so sloth becomes very attractive.

    The blood-brain barrier that separates the bloodstream from the brain… this barrier is there for a reason: The brain is highly sensitive to the wide variety of substances that gain entry to the blood, some of which can provoke undesirable effects should they cross into your amygdala, hippocampus, cerebral cortex, or other brain structure. Once having gained entry into the brain, wheat polypeptides bind to the brain’s morphine receptor, the very same receptor to which opiate drugs bind.

    In some cases, where the super-sized gliadin has become a poison, you have every part of the digestive process messed up…from eating to digesting to eliminating, without providing nutrients to the body to make the required hormones to run our bodies.

    So you have a devil’s brew of corporate controlled politicians pushing ‘whole-grains’ in large quantities to everyone. GMO’d changes in what those ‘healthy grains’ used to be like in the 1950’s to increase yield, and profits while addicting the populace are not remedial, as the poor and ignorant will gladly reach for a tasty loaf of bread that fits within their government subsidy, since only the high yield grains can feed the amount of people on the planet.

    Celiacs and Diabetics (of which I am both) have no choice but to dump all grains to get our health back…but you will not have the greater populace doing so any time soon. Your first step into any ordinary market will remind you that you need to pick up those grain products…properly sweetened with the corn syrup that compounds the digestive imbalance…because the excellant marketing in the grocery stores makes sure they are the first products you see…and crave.

    Gluttony and sloth via grains are now designed into our food supply…and it won’t stop…ever.

    1. different clue

      I remember reading somewhere that traditional wheat itself has contained some exorphins for thousands of years and thereby made itself a favored grain in the brains of many. I wonder if other grains and beans might be free of such exorphins. I also wonder if sprouting wheat and eating the sprouted wheat seeds might bio-degrade the exorphins.

  57. Wade Riddick

    Gliadin also hits the antiviral pattern receptor CXCR3, which happens to overactivate in a number of inflammatory disorders [PMID 18485912].

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