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Evolution of the Obesity Epidemic

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Title: Evolution of the Obesity Epidemic


1
Evolution of the Obesity Epidemic
  • Information from Time Magazine, National
    Geographic Magazine, and other sources

2
Exercise and Body Composition
  • Two major factors that lead to obesity
  • Over-nutrition consuming too much
  • Under-expenditure expending too little energy

3
Over-nourishment
  • Increased caloric consumption
  • Increased portion sizes
  • Eating as entertainment

4
Exercise and Body Composition
  • Decreased daily energy expenditure
  • Transportation
  • Manual Labor
  • Entertainment

5
Role of Genetics
  • About 2/3rds of tendency for obesity is genetic
  • Factors include
  • Low RMR 15
  • High RQ (low fat oxidation) 5
  • Low spontaneous physical activity (fidgeting) 10
  • Other???
  • (Ravuzzin, ACSM, 2008)

6
Ancient History
  • Humans started by living in a world of scarcity.
  • To survive they developed the habit of eating
    everything that tasted good whenever they could
    find it.

7
Ancient History
  • That's the way it was during 99.9 of human
    evolution.
  • For most of the 7 million years of human
    existence, life has been "nasty, brutish, and
    short"
  • Thomas Hobbes

8
Ancient History
  • Life expectancy was under 30 years - mainly due
    to accidents, infection, childbirth, and
    predation.

9
Ancient History
  • Early diet consisted of fruits, shoots, nuts,
    tubers, and vegetation - all low in calories -
    took constant work and eating whatever we found
    just to stay alive.
  • Fruits were highly desirable so we learned to
    seek fructose and glucose.

10
Evolution
  • It was some 2.5 million years ago that our
    ancestors developed a taste for meat.
  • As a result, the human brain became markedly
    bigger and more complex at the same time.
  • We also increased in physical size.

11
Evolution
  • Because it's packed with nutrients and calories,
    meat gave early humans a respite from constant
    feeding.
  • Our ancestors ate a diet composed of lean meats,
    vegetables, and fruits and worked out almost
    nonstop.

12
Agriculture
  • 150,000 to 100,000 years ago.
  • Provided steady source of food.
  • No longer hunter/gatherers.
  • Farming became major source of food.

13
Agriculture
  • Nutritionally the shift away from wild meat,
    fruits and vegetables to a diet of mostly
    cultivated grains robbed humans of many of the
    essential amino acids.
  • Still physical exertion was common.

14
Progress?
15
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16
Environment
  • Our bodies evolved in an environment where food
    was scare and movement was required
  • We now find ourselves in an environment where
    food is abundant and movement is optional
    recent development

17
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18
Then and Now
  • In 1700, the average Briton consumed 7.5 pounds
    of sugar per year.
  • In the US, we currently consume 150 pounds of
    sweetener per year.

19
Overconsumption
  • We each ate 1775 pounds of food in 2000, up from
    1497 in 1970.
  • Although it appears we are eating more
    vegetables, almost 1/3 of these vegetables were
    iceberg lettuce, French fries, and potato chips.

20
Now
  • Rapid change in environment last 50 years
    compared to previous 50,000 years.
  • Removal of physical activity combined with
    abundance of food.

21
Now
Daily imbalance is on average small an extra can
of soda per day (150 kcal) can add 15.6 pounds
per year
22
Factors Related to Obesity
  • Food producers and the "Fast Food industry - if
    theyre successful, we all eat more

23
Childhood Obesity
  • The growth of the fast food industry and
    increasing portion sizes make it easy for
    children to overeat

24
Supersize Me
25
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26
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27
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28
Childhood Obesity
  • A large fast food meal (double cheeseburger,
    French fries, soft drink, desert) could contain
    2200 kcal, which would require a full marathon
    to burn off
  • Ebbeling CB, Pawlak DB, Ludwig DS. Childhood
    obesity public health crisis, common sense cure.
    Lancet 2002360473-82.

29
Childhood Obesity
  • On days that children and youth eat fast food
    they consume an extra 126 kcals/day (Plt0.0001)
  • Bowman S, Gortmaker SL, Ebbeling CB, Pereira MA,
    Ludwig DS. Effects of fast food consumption on
    energy intake and diet quality among children in
    a national household survey. Pediatrics, in
    press.

30
Twenty Worst Foods in America
31
Childhood Obesity
  • Sugar-sweetened beverages contribute to childhood
    obesity incidence

32
Childhood Obesity
  • For each additional serving of sugar sweetened
    beverage consumed, both BMI (0.243 kg/m2
    P0.03), and incidence of obesity (odds ratio
    1.60 P0.02) increased.
  • Ludwig DS, Peterson KE, Gortmaker SL. Lancet
    2001, 357505-8

33
Childhood Obesity
  • Television and video/film production and
    distribution industry - if theyre successful we
    all watch more

34
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35
Now
  • Advertisers constantly telling us to "eat this
    now".
  • Obesity increases as industrialization increases.

36
A Widening Problem
  • In a historical first, there are now as many
    overnourished people as undernourished around the
    world.

37
Why are we fatter?
  • Here's the recipe for obesity on such a global
    scale
  • Take technologycars, washing machines,
    elevatorsthat reduces physical exertion.
  • Increase calorie consumption, courtesy of
    increasing prosperity.  

38
A Widening Problem
  • Add television, computers and video games.
  • Stir in the intensive marketing of candy and fast
    food, and you have the makings of an epidemic.

39
A Widening Problem
  • In countries where the food supply has been
    unstable, people are getting fat despite far less
    abundance than in the United States.

40
A Widening Problem
  • The implication?
  • Newly industrialized nations in Asia, Africa, the
    Caribbean, and Latin America may develop even
    higher rates of obesity-related health problems
    than in the U.S.

41
A Widening Problem
gt24 20-24 15-19 10-14 0-9 No data
42
A Widening Problem
  • North AmericaStates with the highest obesity
    ratesMississippi and Alabamaare in the South.
    The more affluent and outdoorsy western states of
    Colorado and Utah have the lowest rates. South
    AmericaAs Latin America becomes more developed,
    supermarkets stocked with processed foods have
    become the norm, rising from 20 percent of food
    retail during the 1980s to 60 percent in 2000. 

43
A Widening Problem
  • EuropeCandy, fast food, and sweetened cereals
    account for more than half the food ads in ten
    European Union nations. In the U.K. snack food
    consumption rose nearly 25 percent in five
    years. AfricaIn some parts of Africa obesity
    afflicts more children than malnutrition. In
    Tunisia the urban population is shifting from
    traditional healthy whole grain breads to white
    bread. 

44
A Widening Problem
  • AsiaIn Shanghai, roads once filled with
    pedestrians and cyclists are now congested with
    cars. KFC opened a drive-through restaurant in
    Beijing in 2002, with more to come. OceaniaPaci
    fic Islanders have always valued hefty physiques.
    Now their shift away from local foods to a
    high-fat, Western diet has made them among the
    world's fattest people

45
Now
  • The Puget Sound ferries in Washington have
    increased the width of their seats from 18 to 20
    inches to allow squeeze-in room for bigger
    bottoms.

46
Now
  • In Colorado, an ambulance company has retrofitted
    its vehicles with a winch and a plus-size
    compartment to handle patients weighing up to
    half a ton (1000 lbs).

47
Now
  • An Indiana manufacturer of caskets now offers a
    double-oversize model - 38 inches wide, compared
    with a standard 24 inches.

48
Discrimination
  • In one study at Michigan State University,
    undergraduates said they would be more inclined
    to marry an embezzler or cocaine user than an
    obese person.

49
Discrimination
50
The Stigma of Childhood ObesityCan be
devastating
  • An obese childs quality of life is similar to
    the life of a child diagnosed with cancer, which
    has been determined as the lowest quality of life
    score.1

51
The Stigma of Childhood Obesitycan be
devastating
  • Adolescents who are teased about their weight are
    2 to 3 times more likely to have suicidal
    ideation and attempts compared to adolescents who
    are not teased about their weight. 2

52
The Stigma of Childhood ObesityCan be
devastating
  • Obese children and adolescents are 4 times more
    likely to experience impaired school function
    when compared with healthy children and
    adolescents. 1
  • Obese children and adolescents have been found to
    miss an average of 4.2 days of school during the
    month. 1

53
It starts early
  • Low self esteem is not a characteristic in inner
    city obese African American children or obese
    preschool children. 3
  • Levels of self esteem of preschool children do
    not differ between non obese and obese children,
    but upon entering school this feelings change
    substantially. 3

54
Negatively affects school aged children and
adolescents
  • 4-11 year old children describe obese peers has
    ugly, selfish, lazy stupid, dishonest,
    socially isolated and subjects of teasing
    compared to their average weight peers who were
    described as clever, healthy, attractive,
    kind, happy, socially popular and a
    desirable playmate. 4
  • Overweight adolescents are more likely to be
    isolated and peripheral to social networks then
    their normal weight peers. 5

55
Negatively affects school aged children and
adolescents
  • Social marginalization is more pronounced in
    white non Hispanic adolescent girls. 5
  • 90 of 9-11 year old overweight children believe
    that teasing and harassment from their peers
    would end if they could lose weight and 69 felt
    that if they were thinner they would have more
    friends. 6

56
It is also seen in homes, schools and clinical
settings
  • 30.0 of adolescent girls and 24.7 of adolescent
    boys report being teased about their weight by
    their peers. 2
  • 28.7 of adolescent girls and 16.1 of adolescent
    boys report being teased about their weight by
    someone in their families. 2
  • 14.6 of adolescent girls and 9.6 of adolescent
    boys report being teased about their weight by
    both their peers and family members.2

57
It is also seen in homes, schools and clinical
settings
  • Parents communicate to their children negative
    stereotypes about obese children. 7
  • Parents of overweight children are criticized and
    feel that they are guilty and to blame for their
    childs obesity. 6
  • On implicit and explicit measures, health
    professionals labeled obese people as lazy,
    stupid or worthless. 8

58
Perception vs Reality
  • Who do we think we are or strive to be?
  • vs
  • Who we actually are?

59
Mr and Ms America?
60
Mr. And Ms. America
61
Conan the Governor
62
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63
Jack Nicholson
64
Jack Nicholson
65
Denise Richards
66
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67
  • What this leads to is body disatisfaction

68
Eating Disorders
69
Progress?
  • By contrast, among people who still live in
    conditions most like those of our distant Stone
    Age ancestors - Maku or Yanomami of Brazil -
    there is virtually no obesity at all.

70
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71
Tsunami of Health Care
72
Tsunami of Health Care
  • Cardiovascular Disease
  • Diabetes Mellitus
  • Glucose Intolerance
  • Overweight and Obesity
  • Sedentary Lifestyle
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