Title: The problem of obesity in perspective: Dealing with the modern food world
1The problem of obesity in perspective Dealing
with the modern food world
- Paul Rozin
- Buenos Aires
- September, 2014
2Definition
- BMI weight (kg)/height (m) 2
- Obesity BMI gt 30
- Overweight BMI gt25, lt30
3Patagonia 69,853 kg 40 m BMI 43.7
4Obesity in perspective
- The risk overweight and obesity
5Flegal et al., 2005Main Outcome Measures Number
of excess deaths in 2000 associated with given
BMI levels
6The obesity epidemic
- 1.4 pounds gained/year in USA over last 20 years
7- http//www.surgeongeneral.gov/news/testimony/obesi
ty07162003.htm - Statement of Richard H. Carmona, M.D., M.P.H.,
F.A.C.S.Surgeon GeneralU.S. Public Health
ServiceWednesday, July 16, 2003 - Nearly two out of every three Americans are
overweight or obese. - One out of every eight deaths in America is
caused by an illness directly related to
overweight and obesity. - But the fact is that we have an epidemic of
childhood obesity.
8Epidemic versus Slow crawl
9Food industry
Media
Medical research
Govern- ment
Public
10Obesity and Malnutrition
11World obesity 2010
- http//www.who.int/mediacentre/factsheets/fs311/en
/ - In the world, over 200 million men and nearly 300
million women are obese
12World Obesity (CIA, 2008)Obesity BMIgt30 as
of all adults
- https//www.cia.gov/library/publications/the-world
-factbook/rankorder/2228rank.html - 1. American Samoa 74.6
- 18. USA 33.0
- 23. Mexico 32.1
- 29. Argentina 29.7
- 102. Brazil 18.8
- 108. France 18.2
- 157. Japan 5.0
- 184. India 1.9
13Obesity in USA over time
14Obesity in USA 2009-2012
15Kwashiorkor protein deficiency
Marasmus energy deficiency
16World Malnutrition
- http//www.wfp.org/hunger/stats
- Hunger kills more people every year than AIDS,
malaria and tuberculosis combined - 842,000,000 dont get enough to eat in world
- Poor nutrition causes nearly half (45) of
deaths in children under five - 3.1 million
children each year.
17- The Paleolithic human in the modern, developed
world - Old heuristics, e.g., the image equals the
object
18(No Transcript)
19Late 20th Century developed world
- Epidemiological revolution longer life and death
from degenerative diseases shift to long-term
consequences - food surplus
- extraordinary range of food choices
- development of super-foods (e.g. chocolate)
- no work needed to attain choices
- Old heuristics not applicable bias to eating
- massive amounts of risk information
- no training in dealing with risks/benefits or
nutrition
20Feature Heaven Hell
Love Italians
Banks Swiss
Universities British
Food French
21Feature Heaven Hell
Love Italians Swiss
Banks Swiss
Universities British
Food French
22Feature Heaven Hell
Love Italians Swiss
Banks Swiss Italians
Universities British
Food French
23Feature Heaven Hell
Love Italians Swiss
Banks Swiss Italians
Universities British French
Food French
24Feature Heaven Hell
Love Italians Swiss
Banks Swiss Italians
Universities British French
Food French British
25The developed world
- Western Europe vs India
- 60 of all people live in Asia
- 50 of total expenditures on food in developing
world
26Rating scale
- 1. strongly disagree
- 2. disagree
- 3. neither agree nor disagree
- 4. agree
- 5. strongly agree
27Eating is a religious experience My diet must
adhere to strict moral/religious principles
Mean Agreement
28The combination of health and beauty norms
29Concerned about being overweight
- responding often or almost always
- 57 females, 21 males
- US college students from 6 universities across
the country
Rozin, Bauer Catanese, 2003
30I am embarrassed to buy a chocolate bar in the
store
- American college students from six campuses
across the USA - Females 13.5
- Males 4
31Cultural solutions
- France
- With Claude Fischler
32ObesityFrance vs USA
- BMI gt 30
- France 16
- USA 32
- 2008 http//www.who.int/gho/countries
33Life expectancy at birth(data from 2008-2010
www.who.int/gho/countries)
rank country years rank country years
1 Japan 83 10 Norway 81
4.5 Australia 82 10 Sweden 81
4.5 Israel 82 14 Austria 80
4.5 Italy 82 14 Belgium 80
4.5 Singapore 82 14 Finland 80
4.5 Spain 82 14 Germany 80
4.5 Switzerland 82 14 Greece 80
10 Canada 81 14 Korea 80
10 France 81 14 U.K. 80
10 Netherlands 81 19.5 U.S.A. 79
34Age-standardized annual mortality from CHD and
related risk factors (males 35-64)WHO/MONICA
Renaud de Logeril, 1992
Location Mortality / 100,000 Serum chol- esterol (mg/dl)
Toulouse, France 78 230
Lille, France 105 252
Stanford, USA 182 209
35Percent of subjects preferring a week at a luxury
(vs. gourmet) hotel at same price
Females Males
Paris, France 13 8
USA 83 70
36Percent of subjects selecting unhealthy for
choiceWhat do you think of when you think of
HEAVY CREAM? whipped or unhealthy
Females Males
France 28 23
USA 68 48
37Percent of subjects agreeing that they eat a
healthy diet
Females Males
France 76 72
USA 28 38
38Attitudes regarding food and meat among American,
French, Argentinean and Brazilian college
students
- Marle S. Alvarenga
- Paul Rozin
- Matthew B. Ruby
- Guillermina Rutszein
- Eve Richter
- Teri Kirby
39If there was an inexpensive pill to safely
satisfy nutritional needs and hunger without
having to eat, I would take it
gt very true of me
Argentina 15.8
Brazil 11.3
France 5.9
USA 14.3
40Enjoying food is one of the most important
pleasures in my life
gt very true of me
Argentina 52.8
Brazil 56.1
France 66.2
USA 53.1
41In general, I am more concerned with the caloric
content of food than the taste
gt very true of me
Argentina 5.3
Brazil 4.4
France 2.5
USA 34.6
42Eating alone does not bother me
gt very true of me
Argentina 54.8
Brazil 51.5
France 41.7
USA 51.8
43(No Transcript)
44Argentina P I
C Brazil P I
C France P I
C USA
P I C
Ccurrent I ideal Ppeer ideal
45Argentina PI C
?? Brazil ICP France
CPI USA
ICP
Ccurrent I ideal Ppeer ideal
46Beef consumption by country (2007 or 2008)
kg/capita/year
- France 13.3
- USA 28.5
- Brazil 37.6
- Argentina 71.8
47Liking for beef (-100 to 100)
Mean Liking
48Free Assoc to BEEF most common words
Argentina Brazil France USA
FEMALE FEMALE FEMALE FEMALE
Asado 36 saborosa 66 viande 130 Cow 52
Rojo 31 churrasco 59 steak 23 Meat 24
sabroso 29 sangue 43 rouge 22 Hamburger 22
Comida 19 Gordura succulente 18 vache 20 Disgusting 19
Jugoso 17 Animal 13 Red 18
MALE MALE MALE MALE
Asado 17 churrasco 39 viande 68 Cow 27
Sabroso, delcicioso, rico, 10 saborosa 31 Steak 26 Steak 18
Vaca, sabrosos, grosso sangue 25 vache 17 Meat 15
Jugoso. milanesa 3 Proteina 17 sang 8 Hamburger, red 7
Boi/vaca 15 rouge 5
49Sample free associations to beef USA (with
valence)
Word 1- Word 2 Word 3 Sum Valence Ambiv- alence
Cow (0) Burger (1) Baseball (1) 2 No
Fat (-1) Unhealthy (-1)_ Cholesterol (-1) -3 No
Fat (-1) Protein (1) Meat (1) 1 Yes
50Valence of 3 beef free associations (-3 to 3)
Valence
51The food environment
- With Claude Fischler, Kim Kabnick and Erin Pete
52About 2001
53Restaurant portion size
54Supermarket food portions
55(No Transcript)
56Supermarket non-food portions
57(No Transcript)
58Mean own portion size (chicken) (1 to 8 half
card decks)
Mean Portion size
59(No Transcript)
60Mean own portion size (coca cola) (8 levels)
Mean Portion size
61(No Transcript)
62Mean own portion size (ice cream) (scoop size
10-110)
Mean Portion size
63Obesity Changing the person
- Dieting
- Nutrition information and education Education
about science, risks, benefits - Changing preferences and intake
- Failure of obesity treatments and dieting
- Only bariatric surgery
- Think about height
64Changing the food environment
- Accessibility
- Small accumulated value
- 1-3 standard coca cola cans a week
-
65(No Transcript)
66Salad bar
- Reaching over to the middle (about 5 reduction
in calories) - Spoon versus tongs (about 5 reduction in
calories)
67Portion size
- Amnesia study Availability
68Environment Changes
- Glass size
- Plate size Brian Wansink
- Very large serving amounts (Wansink soda)
69In a student cafeteria, when students are served
a 50 larger portion of macaroni and cheese
(right) they eat more, and dont compensate by
eating less of the rest of the meal
Diliberti, Rolls et al., 2004
70Cultural norms Unit bias(Geier and Rozin, 2006)
- Free access in lobby to bowl of MMs, with either
teaspoon or tablespoon - Amount taken with tablespoon is 70 greater
- Similar effects with large or small tootsie rolls
or pretzels
71Cumulating increments
- James Hill, David Levitsky,Barbara Rolls, Marion
Nestle, Paul Rozin et al. - Some evidence that portion change effects may
endure, and are not fully compensated for over at
least 2 weeks (Rolls, Levitsky)
72Lays stacked potato chips
Segmentation and consumption interrupts About 50
reduction
Geier, Wansink and Rozin
7335 calories/wedge
74Government versus Industry initiation
- Let the free market do it (organic, fat free,
calorie free) - Smaller portion sizes
75Energy Expenditure
- Suburban Life
- Malls
- The car culture
- Small but continuing increments
- Role for government e.g., better and cheaper
public transportation
76(No Transcript)
77(No Transcript)
78(No Transcript)
79Learning from the French
80Some French-American differences
- Portion size
- Eating time
- Eating sociality/ conversation (conviviality)
- Freshness and taste (vs shelf life) priority in
foods - Degree of snacking and snacking opportunities
- Differences in actual foods consumed (e.g., wine)
- Differences in variety of food consumed
(Drewnowski et al.) - Walk/bicycle vs car orientation
81We can learn from the French in this domain (not
all domains)
- Focus on the environment to try to reduce food
intake and waist lines - Dont reduce the pleasure of eating
- Make small changes that encourage more exercise
and less eating - Let the effects of those small changes
accumulate, and..
82Vetri Foundation Charter School Lunch Feb, 2013
831.50
Vetri Foundation Charter School Lunch Feb 2013
84Yes, eating can be bad for health
85But NOT EATING is much worse for health