Corporate Fitness and Active Aging

Whether we like it or not, we have an epidemic on our hands.  Whether you are overweight, obese or not, classifying obesity as a disease will affect you, if it hasn’t already.  Changes are in order.  Simply classifying obesity as a disease does not make the necessary changes automatically occur and I’ve already expressed my concern with the direction I think this could go. 

Fructose is processed in our bodies similarly to ethanol (alcohol).  Actually, chronic consumption of fructose shares 8 of the 12 side effects of chronic ethanol consumption. Fructose is like alcohol without the buzz.  How do you make alcohol?  Ferment sugar!   Due to the fact that fructose consumption has no immediate side effects, the government will not regulate it.  When the government won’t step in to make necessary changes, it becomes our responsibility. 

In 2007, Yale University published a meta-analysis of 88 cross-sectional and longitudinal studies looking at the effects of soda consumption.  They reported that consistent soda consumption correlates to an overall increase in average energy consumption (we eat more), increased body weight, decreased milk and calcium consumption, and decreased consumption of adequate nutrition.  This even included studies sponsored by major soft drink companies, which had consistently smaller correlations vs. the independent studies.  When the companies won’t admit fault and make changes, it becomes our responsibility. 

We must make the changes.  The supply won’t budge until the demand changes.

What are some things we can do?

1. Lead by example.  Our friends, family members, kids and our kids’ kids will learn and copy from what we eat and drink.  Adopt a lifestyle of healthy, whole foods and consistent exercise.
2. Get rid of sugar-sweetened beverages.  Fruit juice, Soda, Gatorade.  Wait, fruit juice?!  Isn’t that good for you?  Fruit juice is basically sugar and contains no fiber, unlike fresh fruit.  In 2008, a nurse’s study linked fruit juice consumption to type 2 diabetes.
3. Increase your fiber intake.  Eat FRESH fruits and veggies.  This helps lessen your insulin response, especially when eating carbohydrates.  A more controlled insulin response reduces your chances for fat storage and type 2 diabetes.
4. Wait 20 minutes before getting second helpings.  Leptin, a hormone responsible for telling our brains we are full, takes time to respond.
5. Buy your screen time with activity.  Minute for minute.  This is a hard one but will help to increase your activity levels.  Screen time includes: computer, TV, texting and video games.
6. Drink more water.  General recommendation is at least half your body weight in ounces each day.
7. Control your immediate food environment (food in home, at desk, etc.).  If the “bad” food isn’t in the house, we’re less likely to eat it.  When grocery shopping, keep two things in mind: stick to the grocery list and shop around the perimeter.  Only go to the middle aisles for specific items on your list.
8. Be aware of serving sizes, especially when we splurge.  The average size of the classic Coke has increased from 6.5oz in 1915, 12oz in 1960 to 20oz in 1992.  It’s ok to occasionally enjoy the good things in life but be very cautious not to overindulge.
9. Have blood work done on a regular basis.  Know your numbers!
10. Exercise!  Why is exercise important, especially in obesity?  I’ll give you a hint; it’s actually not the number of calories you burn.

• Improves skeletal muscle insulin sensitivity (decreases insulin)
• Reduces stress and resultant cortisol release (decreases appetite)
• Makes TCA cycle run faster and detoxifies fructose, improving hepatic insulin sensitivity (higher metabolism)

If you missed parts 1 and 2, go back and read Is Obesity Really a Disease and How did we get overweight?

How did we get this overweight, this quickly?  In part one of this series, we talked about what obesity is and if it's really a disease, you can read that here.  Obesity has been around since recorded history, but never to the degree we have experienced the past 30 years.  In nature, people and animals who store energy are more likely to survive famine, yet there is more food available now than ever.  Several experts feel we’ve encountered the “perfect storm.”  We’ve experienced a significant change in our environment with increased stress levels, while sleep, free time, and activity levels have decreased.  In our food, nutrient levels have decreased while use of chemicals and preservatives has majorly increased.  (Side note: Did you hear Twinkies are coming back with an increased shelf life of an additional 3 weeks?  They aren’t just refrigerating those things.)  Let’s look at a few of the causes of this increase in weight gain over the past 30 years.

Let’s eliminate pre-existing diseases which lead to weight gain from the start.  Pre-existing diseases have not seen much of a change over time and our diagnosis and treatments have improved drastically.  For that reason, it’s easy to eliminate this from the causes of our recent epidemic.  As a quick example, let’s look at hypothyroidism, an underactive thyroid gland, or type 1 diabetes, when your body does not produce insulin and breaks the ability to convert sugars, starches and other food into energy.  If  untreated, these two diseases can cause significant enough hormone imbalances to slow the metabolism and induce fat storage.

Next, when the first law of thermodynamics is applied to the world of health and fitness, “The change in internal energy of a body is equal to the heat supplied to the body minus work done by the body”, it can be roughly translated as “calories in vs. calories out.”  This is a point many argue on.  If this were the only factor to consider, weight loss would literally be as simple as a math problem.  If it was true, it would mean everyone who is overweight or obese is just lazy and eats too much.  Eat less, exercise more!  But then why, according to the Institute of Medicine, is there an increase in obese children under two years old?  They don’t diet and exercise.  Are you going to call them lazy?  Unfortunately, the issue is not as simple as “Eat less, exercise more!” and goes way beyond personal responsibility for any age.  Thinking the answer is simply “calories in vs. calories out” is wrong and ignorant.  Personal responsibility is only a part of the equation for many people; nonetheless, assessing dietary trends is critical to solving the issue.  As well, average caloric consumption is up and average activity levels have decreased with the advancement of technology.

In February of 1977, the U.S. government released a directive urging Americans to “Reduce overall fat consumption from approximately 40 to 30 percent of energy intake” in an attempt to lower the occurrence of heart disease, our #1 cause of death in the U.S.  According to the CDC, since roughly that same time mean caloric intake has increased, mean percentage of calories from carbohydrate has increased, and mean percentage of calories from total fat and saturated fat has decreased.  In addition, we’ve experienced not just an increase in carbohydrate over that time but more specifically an increase in sugar.  In 1975 our average sugar consumption per capita was roughly 25lbs/yr; we hit over 100lbs/yr per capita in 2000 and it is now estimated to be over 150lbs/yr per capita.  This coincides eerily with our obesity epidemic.  So we’ve succeeded in adopting our hallowed low fat diets but we’ve only gotten fatter and heart disease is still our #1 killer.

In my opinion, this change in our diets has caused a wide-spread toxicity and hormone imbalance in our bodies; our epidemic.  Americans (and now much of the world) are sick and it’s not because we’re lazy.  Of our total sugar consumption, much of it is estimated to come from High Fructose Corn Syrup (HFCS).  HFCS is a man-made sweetener introduced to the U.S. in … you guessed it… 1975.  Use of HFCS has increased at about double the speed of standard sucrose (table sugar) since its introduction.  You’ll find more foods at the grocery (roughly 60-80% of products) packed with sweeteners and chemicals than those without.  Now we can’t simply correlate the introduction and steady incline of HFCS or other chemicals to our obesity epidemic, but it’s certainly a culprit and part of the equation at least, causing a huge debate all by itself.

What are your thoughts?  Comment below and look for my 3rd post in the 3-part Obesity Blog Series on the cure for obesity.

Officially, one-third of the U.S. is now ill. The American Medical Association has voted and officially upgraded obesity from a “condition” to a “disease.”

While I have no doubt this decision will affect everyone due to the change in how insurance companies view and care for obesity, I find myself wondering whether obesity truly should be considered a disease. Some will argue it fits the definition of a disease. People die of obesity as they would cancer, while others feel people actually die of the diseases from the metabolic dysfunction, which in turn causes obesity. It’s a very complex issue that has already created quite the debate, and surely there is more to come.

The Implications of Classifying Obesity as a Disease

One thing is for sure: By classifying obesity as a disease that is costing insurance companies and Americans more money, there will be increased pressure on associated industries to work together to find a “cure.” As an example, obesity needs to be measured differently on a universal scale. The current standard is Body Mass Index (BMI) and because of this simplistic means of measuring one’s height versus weight, the Council on Science and Public Health actually recommended against classifying obesity as a disease. It is not uncommon for someone with a BMI above the recommended level to be healthy and free from metabolic dysfunction. On the other hand, it is equally normal to have someone who is within the recommended BMI range with an unhealthy amount of body fat and suffering from the same metabolic dysfunction. The first person would be overtreated, while the latter would go untreated.

My Opinion on Obesity Diagnosis and Treatment

Do I feel obesity is a disease? No, it is my professional opinion that obesity is a symptom or marker of metabolic dysfunction; however, I am optimistic now that it has gained the title of disease because it does shed new light on the issue. My fear is that classifying obesity as a disease will bring obesity too far into the medical world. Insurance is likely to cover expensive drugs and surgeries rather than support lifestyle changes. Knowing there is no single way to “cure” everyone of obesity, I feel strongly this would not be the right direction to go. As we seek an effective means of treatment for obesity, I support its classification as a disease under a few conditions:

• If a more inclusive method for identification and diagnosis is implemented. BMI alone is not sufficient or even accurate in some cases.
• If each case is handled separately. With different causes of obesity and metabolic dysfunction, there will be multiple successful methods.
• Lifestyle changes should play a role in all cases to some degree, and including these changes should be a priority.
• More resources need to be applied to further research and education of causes, treatments, and prevention of obesity and metabolic dysfunction.

What do you think? Comment below and watch for part two in this three-part obesity series, on the causes of obesity.