Published in Impact Magazine, January 2002.
Obesity has reached epidemic proportions worldwide. Recent estimates, by the World Health Organization and by the Center for Disease Control in Atlanta, indicate that the incidence of obesity is doubling every five years. Current statistics show 71% (compared to 56% in 1984) of adults are overweight and in excess of 30% are obese. Dr. CL Birmingham of UBC wrote in the Canadian Medical Association Journal in Oct. of 1999 that the estimated cost of obesity in Canada is in excess of $1.8 billion or 2.4% of the total government health care expenditures.
It is doubtful that any other metabolic disorder has received more published attention in the scientific and popular literature. More people talk about this disorder than any other health problem. Those offering quick and easy solutions have made fortunes. It has been call the “World’s Oldest Metabolic Disorder” with recorded concerns unearthed from the Stone Age, Egyptian mummies and Greek Sculptures.
The risk of premature death and the morbidity statistics can be or are very depressing. Dr. Everett Koop, former Surgeon General of the United States, has said “... Obesity is the second leading cause of preventable pre-mature death in America”. Although there are metabolic reasons for obesity, it is essentially a “lifestyle” disease. Sustained caloric imbalance (too many calories consumed and not enough spent) with the consequent obesity is becoming a behavioral norm of the North American population.
One very sad footnote to the depressing statistics is that the trend has filtered down to children. The November 27 / 2000 issue of the Canadian Medical Association Journal shows the rate of obesity among Canadian boys aged 7 to 13 tripled between 1981 and 1996. Girls of the same age group have twice the prevalence of obesity over the same time period. Current estimates show 25 - 30% of Canadian children overweight and 12 – 14% are obese.
Another disturbing statistic from the Oct. 2001 issue of the American Journal of Obstetrics and Gynecology is that the average weight of pregnant women at their first pre-natal visit has increased from 144 to 172 pounds during the 1980 to 1999 time frame. The obesity figures (defined as those in excess of 200 pounds) for this group have risen from 7% to 24%. Obese women were at significantly increased risk for cesarean deliveries, gestational diabetes and large birth weight babies.
A second related epidemic appears in conjunction with obesity and that is Type 2 Diabetes, The Journal of the American Medical Association reported in Sept of 2001, that the “twin epidemics” continue to threaten the health of Americans. With a 61% increase in the incidence of obesity and a 44% increase in the incidence of Type 2 Diabetes (another preventable lifestyle disease) between 1991 and 2000, there is just cause for concern and incentive for individuals to take action.
Risk of increased incidence of hypertension, coronary heart disease, stroke, cancer, gall bladder disease, pulmonary abnormalities, arthritis, other inflammatory diseases and Type 2 Diabetes among the obese are well documented. The prevalence of these major health risks and the likelihood of premature death increase disproportionately with increasing weight. Although the prevalence of these ailments shows strong correlations they cannot necessarily imply causation. (Obesity does not necessarily cause hypertension nor type 2 diabetes – they just occur together and another factor like chronically elevated insulin may well be the cause of all three ailments.) Chronically elevated insulin is due to excess consumption of easy to digest (high glycemic index) carbohydrates and the under-consumption of good protein and fat in conjunction with carbohydrates (further explanation of this is another column).
Enough gloom and doom, it has been said that “knowledge is power” and you now have some of that knowledge. One has to wonder when the power of our collective knowledge is going to take effect. It is my position that with our current knowledge of nutrition, the solutions for the prevention and rehabilitation of obesity are relatively simple for the vast majority of the population. Knowledge, experience and published research have clearly demonstrated that wise nutrient rich food selection including adequate protein, good fats, low glycemic carbohydrates and responsible supplementation combined with some responsible exercise creates an anti-obesity “lifestyle” solution.
The food selection issue seems to be the most controversial in spite of the overwhelming evidence that chronically elevated insulin seems to be one of the most significant causes a long list of metabolic upsets leading to most of the risk factors associated with obesity. When insulin is elevated, we store fat and cannot metabolize fat for energy. To metabolize fat, blood insulin levels must be reduced in favor of higher levels of the fat mobilizing hormone glucagon.
Lee Coyne, Ph.D. is a nutritional consultant, lecturer and author of several weight loss books, including Fat Won't Make You Fat. Dr. Coyne is also the creator of the "Lean Seekers Nutritional Coaching Program" that trains individuals on a "Better Balanced Diet" as a way of eating for better health and weight management. He may be reached at 1-800-668-4042 or by e-mail firstname.lastname@example.org
Copyright Lee Coyne, Ph.D., reprinted with permission.
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