It is estimated that around 11,000 people die about obesity-related diseases every day around the world. While the number of deaths worldwide for hunger or malnutrition-related illness is around 24,000 per day. Obesity is fought by reducing food spending while to fight hunger in the world it is necessary to increase food spending.
Both hunger and obesity are defined differently in different parts of the world. Hunger is generally defined as inadequate access to food, either because of famine or because of inability to grow or purchase needed food. Even the most wealthy nations have individuals and families that face hunger regularly, according to their definitions. Obesity is generally defined as being above the normal weight for one's age and height, but this too differs among countries. Hunger and obesity are not mutually exclusive, because obesity may be associated with high intake of fats and sugars, but not with a balanced diet that could also reflect hunger, due to lack of intake of essential nutrients. Hunger and obesity may or may not be related to amount one spends on food. They tend to be linked more to access of food.
Dear Jack, I fully agree with your answer. In fact, in many countries we find a graith number of obese people and many malnourished people. Perhaps many people are obese due to an unhealthy diet and too sedentary life. But I'm convinced that in many other countries obesity is due to excessive food even if it is of high quality. So, we spend a lot for to eat and also we have to pay a lot to cure obesity or the related illnesses. While in other parts of the world people are dying of hunger or diseases related to lack of food.
Dear Artur, I agree flatly with your answer, except for the fact that the earth can support 20 billion people. In fact, the current 7 billion we consume much more than the annual renewable resources available on earth. In practice, especially in the "rich" countries, we live in debt. In 2017, the Overshoot Day (that is, the day we in theory consumed all the annual renewable resources of the earth) was August 2, while in 2016 it was August 8 and 2015 on August 13. It is necessary to reverse this trend.
I agree with most of the answers above. It is not always possible to take 1 obese person and 1 hungry and make 2 normal. The problem of obesity may be genetic or low physical activity, and reduction of food intake (diet) does not always solve it. For malnutrition the major problem is lack of resources to buy basic food, so usually it is easier to solve it by money transfer.
It is very possible. The same environmental exposures can create a different health concern with each individual and yet the body can somehow survive with what little/excessive nutrition it receives. When attempting to go to a healthy state, the body has to undergo a different process which is where a lot of struggle occurs mentally, physically, and socially. A basic environmental and personal factor would be stress. Stress can cause us to over eat or under eat as well as change our metabolism and storage of fats. It can also increase/decrease hormones to unhealthy levels which can cause problems to the individual in the categories of health and well-being.
Dear Leonardo Cannizzaro,
FROM OBESITY IN THE WORLD DIES MORE PEOPLE, THAN FROM HUNGER.
This is stated in the report of the UN special rapporteur on the right to food Olivier de Schutter.
Overweight and obesity die 2.8 million people worldwide every year. Obesity and overweight affect more than 50% of the population of 19 of the 34 countries that are members of the Organization for Economic Cooperation and Development.
Dear Artur, not only do I agree, but I believe that with global warming, considering the amount of energy that comes to ground, this is a underestime. The problem is that plants and animals, which are the machines that produce our food, are too slow in producing this food. In fact, these "machines" to transform solar energy into food need time: a few days, a few months, a year, a few years. The "Machines" that turn solar energy into food even if numerically sufficient to produce the food that is needed are too slow. Therefore, it is necessary "convince" these "machines" to accelerate food production more and more, or we need to reduce consumption, tertium non datur.
I just saw the following news on this topic from https://lenta.ru/news/2017/10/10/obesity/
US will spend four trillion dollars to fight obesity
In the next eight years, the US will spend $ 4.2 trillion on fighting obesity. This is on Tuesday, October 10, writes The Guardian, citing the materials of the World Federation for the Fight against Obesity (World Obesity Federation, WOF). By 2025, the world will have 2.7 billion adults who are overweight, and 177 million adults with excessive obesity. If you do not take any measures, the countries of the world from 2025 yearly will spend up to $ 1.2 trillion on the treatment of diseases caused by excessive weight, experts say WOF. This problem is most acute in the United States. In 2014, the United States spent $ 325 billion on treatment for obesity. By 2025, this figure will increase to 555 billion annually, the WOF predicts. After 2025, China's spending on treating the effects of obesity will exceed $ 80 billion a year. The costs of Germany and Russia will be $ 50 and $ 40 billion, respectively. The top ten in terms of the number of people with excessive weight also includes France, Brazil, Britain, Canada, Italy and Mexico.
The WOF refers to the situation in the world with the obesity of the global epidemic. Excessive weight and smoking are the main killers in the modern world, they provoke the growth of cancer, heart disease and strokes. The World Day Against Obesity is celebrated on October 11th".
It is known that obesity is the major factor for chronic non communicable diseases like diabetes, hypertension, some form of cancer and the like. But some of the causes of non communicable diseases particularly in developing countries are not only linked to the behavioral risk factors but rather to the problems of malnutrition in the early life, “unfinished agenda of malnutrition”. The Barker hypothesis also proposes that exposure to inadequate maternal nutrition in utero and during the first years of life increases the risk of non communicable diseases in adulthood. Based on these it is hypothesized that malnutrition in early life increases the chance of obesity in adult hood.
In regard to the United States, if one looks at actual per capita consumption of foods for the last 8 decades, the primary changes have been in consumption of sugars (sweetners) and plant-based fats and oils. Red meat consumption has decreased. Dairy is about the same or a bit lower. Poultry has increased as well as fish. Obesity in the USA is primarily driven by increased intake of plant-based products from sugar cane, sugar beets, corn (maize), soybeans and canola.
It sounds strange, but obesity became a much more serious problem than malnutrition. The consequences of being overweight are already a matter of state. That is what a report of the United Nations will say today. There are 1.3 billion people in the world who are overweight, which translates into multiple diseases, resulting in 3 million deaths annually.
If governments' food policies put the emphasis on malnutrition, it is time to start doing something about malnutrition. It is the message of the UN, which triggers the food industry and the inaction of governments. The system is a recipe for unhealthy lives, says the report, which talks about foods saturated with fats, salt and sugar. "States are neglecting their responsibility to guarantee the right to adequate food in the framework of international human rights law." The work also criticizes subsidies for corn and soybeans, which are the basis of these unhealthy foods, and calls for limits on the advertising market, which does the impossible to tempt people - especially the kids - to consume those bad products .
Not only the first world countries are obese, malnutrition grows everywhere, especially in the third world. The UN directly calls for legislation for certain health-related advertising, such as breast milk replacers, or juices and soft drinks for boys. And it goes further: it suggests taxing your consumption and using the resources to raise awareness about the consumption of fruits and vegetables.
Obesity and overweight are not only grounds for discrimination. In the long run they lead to what are known as noncommunicable diseases: diabetes, cardiovascular problems of all kinds, hypertension, complications of the bone system and metabolic disorders.
It is time to think not only of hunger but fundamentally better nutrition for all.
We emphasize individual responsibility, and it is a naive look to think that man can alone. Eating is an immediate pleasure, while eating well is a long-term benefit. You can not against the market, the marketing and the companies. Agribusiness, universities and governments must unite to regulate markets. They could tax certain foods and subsidize others, such as milks, fruits and vegetables.
Being overweight and obese is one of the problems of the moment. The most worrying thing is that the trend is growing, as in the whole world, "says Sebastián Laspiur, Director of Health Promotion and Control of Noncommunicable Diseases of the Ministry of Health. He speaks of the multiple causes of the epidemic: changes in lifestyle, new technologies, sedentary lifestyle, increased consumption of fast foods and low consumption of fruits and vegetables. It gives an account of the existing programs and the guides that are coming out: of healthy kiosks, of healthy work environments, of promotion and prescription of physical activity. Clearly, the subject exceeds the health portfolio.
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Low consumption of fruit and vegetables is critical plus the idea the fast cheap food is killing a generation way before their time.
Quality of the food—nutritionally as well as it’s form (processed vs unprocessed, microwaved vs convection, GMO vs organic), as well sedentary lifestyle, hydration, sleep, and life outlook has a great deal to do with obesity in the US. It is no longer just a matter of quantity of calories, but is immensely more complex and multifaceted. When we look at obese individuals who are sick and on multiple medications we see weight from angioedema, necrotic fluid trapped in interstitial areas, fatty liver sclerosis, fallen transverse colon, rampant parasites, and metallic disorders. Take out all the ill health aspects and at least half if their obesity problem is resolved.
Okay, let's look at data. Who are the healthiest people in the USA. It is a group that eats a high fat diet with a lot of red meat. And they consume a lot of dairy. And a lot of salt. BUT, they have high longevity and lower rates of heart disease. Their children are healthy and have few allergies. It is the Amish community that works many hours in the field and farm and consumes almost everything in a form PROCESSED on the farm (canning, salting, curing, etc). It is their vigorous lifestyle with work, work, work -- much of it outdoors that gives them their health. Look at the data.
There is accumulating information that the mineral and vitamin content of the world food system has been declining. The lack of original content could trigger over eating to compensate for the poor nutrient content. In ruminant animals they often are fed hay, when this hay is rained it loses nutrient and farmers feed more giving the fattened hay belly syndrome in the consuming animals. This is an example of over eating in an attempt to be satiated and satisfied. Another issue which is also disturbing is the gamut of toxic materials from the proliferation of agrichemicals increasingly utilized in the food system and accumulating in our bodies and the environment. These chemicals are generally fat soluble and will increase body fat where the toxicity is sequestered. There is a third factor which is the over refining of foods which end up taking the vitamins and materials out of the staff of life. A fourth factor is the artificial conditions for producing animals are depriving them from open air sunlight which can lead to depriving the animals and consuming public. There are potentially big issues with food system and our eating and exercise habits these poor choices will end up in sky rocketing health care. A real health system is needed.
In both developed and developing countries more education on diets and health is needed.
Jack is correct. Twice I’ve been asked to study the Amish population and was shocked to find all the conventional rules of diet did not apply to them UNLESS (and this is a big exceotion) they started adopting the typical American Diet of over processed, degerminated, genetically modified, synthetically fortified, microwaved diet. Then they went downhill in the proverbial hand basket. White, 24 chromosone, degerminated bread was their biggest downfall. The ones that stuck to their less adulterated more paleo style diet aged very slowly and maintained exceptional health.
All interested please find some data on obesity in North America USA
Leonardo:
You have already received some fine feedback from the various contributors to this forum, so let me try to address your excellent question from an evidence-based perspective, based on an internal review I recently completed for a regulatory authority [pending publication].
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MYTHS AND REALITY RE OBESITY AND HUNGER
It is true that we have robust evidence that under conditions of scarcity, the poor and the hungry react more impulsively towards food rewards [Claassen 2016]. This is known as obesogenic eating behavior. NOTE, however, that this want-driven behavior does NOT wholly account for an obesity-hunger connection, as both economic development and socioeconomic class play critical roles [Pampel 2012a] [Dinsa 2012].
Landmark data from several studies across 67 countries [Pampel 2012a] representing all the regions of the world examined how economic development, socioeconomic status (SES), and obesity were related. They found that:
(1) Across the board, obesity rose with a nation’s economic development
(2) But socioeconomic status (SES) modulated the dynamics so that in lower-income countries, people with higher socioeconomic status (SES) were MORE likely to be obese, however and conversely, in high-income countries, those with higher SES were LESS likely to be obese, this observation being known as the REVERSAL HYPOTHESIS.
It appears therefore that in lower-income countries, higher socioeconomic status (SES) often leads to consuming high-calorie food and avoiding physically demanding activities, but in higher-income countries, individuals with higher socioeconomic status (SES) more typically respond with healthy eating and regular physical activity and exercise, and this was further confirmed in a study drawing from data from 17 nations [Pampel 2012b] where it was found that activities like reading, attendance at cultural events and films were associated just as much as exercise with a lower BMI, while people who participated in activities like significant watching TV, attendance at sporting events, and shopping, had higher BMI (this phenomenon sometimes referred to by the query: "Does Reading Keep You Thin?").
And if we look more specifically at the youth-to-early-adulthood transition, an intergenerational study [Scharoun-Lee 2011] found a nuanced picture, that men with a middle-class upbringing and lifestyle were almost as likely to be obese as those brought up in working-poor households who however were now working in lower-status jobs, while for women, the relationships varied by race: For white females, all socioeconomic status (SES) groups had a greater risk of obesity compared with the most advantaged, but in sharp contrast, among black women only those from working-poor households who now had lower-status jobs were at increased obesity risk compared with the most advantaged group.
These results show that risk of obesity affects different socioeconomic status (SES) groups differently, with additional variation by gender, by race, and by a country's economic development status [Newton 2017]., confirmed also in the large five-country WHO COSI (Childhood Obesity Surveillance Initiative) cross-sectional study [Lissner 2016]. And this teaches us that without subtle adjustments for socioeconomic status (SES), economic development, age, gender and race, all generalizations are necessarily suspect, and there is no single neat correlation between obesity and hunger, although the concept of eating in the absence of hunger (EAH) that I discuss in detail below has shown itslef to be the most productive and fertile avenue of investigation, with validated / cross-confirmed results as described.
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EATING IN THE ABSENCE OF HUNGER (EAH)
The form of disinhibited obesogenic eating behavior that is most relevant to the question of the connection between obesity and hunger is well-studied through hundreds of studies and clinical trial and is known as EATING IN THE ABSENCE OF HUNGER (EAH), which refers to the consumption of palatable foods in a sated state, that is in the absence of perceived physiological hunger [Kral 2007], and so constitutes a failure to self-regulate intake that then leads to overconsumption. It has been proposed that eating in the absence of hunger (EAH) promotes excess weight gain in youth, and has been widely - and correctly - construed as an indicator of disinhibited eating, making it one of the behavioral pathways implicated in the etiology of childhood obesity, predisposing youth to develop obesity. [Faith 2006] [Birch 2003].
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CONTRIBUTORS TO EATING IN THE ABSENCE OF HUNGER (EAH):
SOCIOCULTURAL PRESSURES, DIET, GENETICS
Across numerous studies, eating in the absence of hunger (EAH) has emerged as a robust endophenotype for child and adolescent obesity [Shomaker 2011] [Shomaker 2013]. In addition, sociocultural pressures linking to body image (like parental feeding restriction, family pressure towards thin body type, and in girls especially media pressure) may contribute to natural history of disinhibited eating behaviors during adolescence [Reina 2013]. It's also been argued that overweight boys are less susceptible than girls to social desirability effects, and that in girls, the desire not to be seen overeating itself might inhibit the expression of EAH [Moens 2007].
And we also know that greater increases in cortisol in response to psychosocial stress are related to dysregulated eating and higher body mass, especially in older children [Francis 2013], and that consumption of high-glycemic index (GI) carbohydrates may increase hunger and promote overeating relative to consumption of items with a lower glycemic index GI), suggesting strongly that consumption of whole grain and lower-GI cereals instead of highly refined cereals may be dietary change that may help prevent overeating [Roberts 2000].
In addition, eating in the absence of hunger (EAH) appears to be moderately heritable [Fisher 2007], with some provisional evidence that 16p11.2 deletion - where the 16p11.2 genotype is consistently associated with obesity - may influence certain specific obesity-associated disinhibited eating behaviors, namely:
(1) EAH due to external trigger and
(2) EAH due to boredom [Gill 2014].
EAH, on average, increases as children age, but children with overweight or obese parents consume more energy during the EAH paradigm, and consequently show the greatest increases in EAH over time compared to children without overweight parents [Francis 2007] [Faith 2006].
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EATING IN THE ABSENCE OF HUNGER (EAH): THE DYNAMICS
In a systematic review [Lansigan 2015] of 19 robust studies (six prospective, 12 cross-sectional, one behavioral-intervention), it was found that consistent evidence supported increased levels of EAH among overweight and obese versus normal weight children, both cross-sectionally and prospectively, with two studies supporting a genetic component to EAH [Birch 2003] [Faith 2006], as we noted above.
In two landmark studies [Hill 2008], it was found that the majority (over 90%) of children ate snacks when these snacks were offered, despite having just eaten a meal, strongly indicative of the power of sweet snacks to reinstate eating in the sated state, that is, EAH. And as the investigators observe, the amount of food consumed in the EAH task is significantly associated with adiposity, the thinnest subjects eating less than those who are normal weight, who in turn ate less than the overweight or obese.
LESSON: In boys, this demonstrates that EAH is a behavioural phenotype that is NOT specific to overweight or obese children, but instead shows a graded association with adiposity, and as I noted above, the weaker results in girls likely indicate the influence of social desirability constraining the expression of food cue responsiveness.
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EXTERNAL TRIGGERS VERSUS EMOTIONAL TRIGGERS
The subtype of eating in the absence of hunger (EAH) in response to EXTERNAL triggers (EAH-EXT) is thought to be more prevalent [Moens 2007], in contrast to another subtype of EAH, namely eating in the absence of hunger (EAH) in response to EMOTIONAL triggers (EAH-EMOT) which is thought to overlap more with disordered eating behaviors that begin to emerge during adolescence [Shomaker 2011], that is, EAH in response to negative emotions (EAH-NEG-EMOT) which is more closely aligned with adolescent disordered eating behaviors (e.g., loss of control or binge eating) that often involve eating to cope with negative affect [Tanofsky-Kraff 2007].
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THE PATHOLOGY OF EATING IN THE ABSENCE OF HUNGER (EAH)
There are plausible hypotheses as to the pathodynamics at work here: since adipose tissue is active and secretes several hormones related to energy maintenance, overweight or obese individuals may engage in greater levels of EAH driven by a hormonally-based, diminished satiety response [Klok 2007] [Henry 2008]; and EAH can also be seen as a behavioral trait where children don't completely compensate for excess calories consumed, thus progressing to weight gain [Kral 2012].
Further, there is a familial - independently of genetic - component related to childhood eating in the absence of hunger (EAH), as it's been observed that parents who use food as a way to help regulate their child’s emotions - PARENTAL FOOD REGULATION - may be unconsciously promoting EAH [Liang 2016], and in addition children of parents who themselves exhibit a disinhibited eating style (one marked by eating in response to external cues), have been found to be more likely to engage in EAH, so collectively these findings suggest that eating in the absence of hunger (EAH) may be a learned behavior in part, as witness also in that TV food advertisement exposure was associated with higher caloric consumption of recently advertised foods, the effect modified by a Fat Mass and Obesity Associated Gene (FTO), the rs9939609 single nucleotide polymorphism, increasing linearly with each additional FTO risk allele even after controlling for BMI [Gilbert-Diamond 2017] [Emond 2017] [Rutters 2010] [Faith 2006].
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REFERENCES
[Birch 2003] Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger. Am J Clin Nutr 2003; 78: 215–220.
[Claassen 2016] Claassen MA, Klein O, Corneille O. Poverty & obesity: how poverty and hunger influence food choices. European Health Psychologist 2016; 18(Supp.).
[Dinsa 2012] Dinsa GD, Goryakin Y, Fumagalli E, Suhrcke M. Obesity and socioeconomic status in developing countries: a systematic review. Obes Rev. 2012 Nov; 13(11):1067-79.
[Emond 2017] Emond JA, Tovar A, Li Z, Lansigan RK, Gilbert-Diamond D. FTO genotype and weight status among preadolescents: Assessing the mediating effects of obesogenic appetitive traits. Appetite. 2017 Oct 1;117:321-329.
[Faith 2006] Faith MS, Berkowitz RI, Stallings VA, Kerns J, Storey M, Stunkard AJ. Eating in the absence of hunger: a genetic marker for childhood obesity in prepubertal boys? Obesity 2006; 14: 131–138.
[Fisher 2007] Fisher JO, Cai G, Jaramillo SJ, Cole SA, Comuzzie AG, Butte NF. Heritability of hyperphagic eating behavior and appetite-related hormones among Hispanic children. Obesity 2007;15:1484-1495.
[Francis 2007] Francis LA, Ventura AK, Marini M, Birch LL. Parent overweight predicts daughters' increase in BMI and disinhibited overeating from 5 to 13 years. Obesity 2007;15:1544-1553.
[Francis 2013] Francis LA, Granger DA, Susman EJ. Adrenocortical regulation, eating in the absence of hunger and BMI in young children. Appetite. 2013 May; 64:32-8.
[Gilbert-Diamond 2017] Gilbert-Diamond D, Emond JA, Lansigan RK, et al. Television food advertisement exposure and FTO rs9939609 genotype in relation to excess consumption in children. International journal of obesity (2005). 2017;41(1):23-29.
[Gill 2014] Gill R, Chen Q, D'Angelo D, Chung WK. Eating in the absence of hunger but not loss of control behaviors are associated with 16p11.2 deletions. Obesity (Silver Spring). 2014 Dec;22(12):2625-31.
[Henry 2008] Henry BA, Clarke IJ. Adipose tissue hormones and the regulation of food intake. Journal of neuroendocrinology. 2008;20(6):842–9.]
[Hill 2008] Hill C, Llewellyn CH, Saxton J, et al. Adiposity and 'eating in the absence of hunger' in children. Int J Obes (Lond). 2008 Oct; 32(10):1499-505.
[Klok 2007] Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21–34.
[Kral 2007] Kral TV, Faith MS. Child eating patterns and weight regulation: a developmental behaviour genetics framework. Acta Paediatr Suppl 2007;96:29-34.
[Kral 2012] Kral TVE, Allison DB, Birch LL, Stallings VA, Moore RH, Faith MS. Caloric compensation and eating in the absence of hunger in 5- to 12-y-old weight-discordant siblings. Am J Clin Nutr. 2012;96(3):574–83.
[Lansigan 2015] Lansigan RK, Emond JA, Gilbert-Diamond D. Understanding eating in the absence of hunger among young children: a systematic review of existing studies. Appetite. 2015 Feb; 85:36-47.
[Liang 2016] Liang J, Matheson BE, Rhee KE, Peterson CB, Rydell S, Boutelle KN. Parental control and overconsumption of snack foods in overweight and obese children. Appetite. 2016 May 01; 100:181-8.
[Lissner 2016] Lissner L, Wijnhoven TM, Mehlig K, et al. Socioeconomic inequalities in childhood overweight: heterogeneity across five countries in the WHO European Childhood Obesity Surveillance Initiative (COSI-2008). Int J Obes (Lond). 2016 May; 40(5):796-802.
[Moens 2007] Moens E, Braet C. Predictors of disinhibited eating in children with and without overweight. Behav Res Ther 2007; 45: 1357–1368.
[Newton 2017] Newton S, Braithwaite D, Akinyemiju TF. Socio-economic status over the life course and obesity: Systematic review and meta-analysis. PLoS One. 2017; 12(5):e0177151.
[Pampel 2012a] Pampel FC, Denney JT, Krueger PM. Obesity, SES, and economic development: a test of the reversal hypothesis. Soc Sci Med. 2012 Apr; 74(7):1073-81.
[Pampel 2012b] Pampel FC. Does reading keep you thin? Leisure activities, cultural tastes, and body weight in comparative perspective. Sociol Health Illn. 2012 Mar; 34(3):396-411.
[Reina 2013] Reina SA, Shomaker LB, Mooreville M, et al. Sociocultural pressures and adolescent eating in the absence of hunger. Body Image 2013; 10(2):.182-190.
[Roberts 2000] Roberts SB. High-glycemic Index Foods, Hunger, and Obesity: Is There a Connection? Nutrition Reviews 2000; 58:163–169.
[Rutters 2010] Rutters F, Lemmens SG, Born JM, et al. Genetic associations with acute stress-related changes in eating in the absence of hunger. Patient Educ Couns. 2010 Jun; 79(3):367-71.
[Scharoun-Lee 2011] Scharoun-Lee M, Gordon-Larsen P, Adair LS, Popkin BM, Kaufman JS, Suchindran CM. Intergenerational profiles of socioeconomic (dis)advantage and obesity during the transition to adulthood. Demography. 2011 May; 48(2):625-51.
[Shomaker 2011] Shomaker LB, Tanofsky-Kraff M, Yanovski JA. Disinhibted eating and body weight in youth. In: Preedy VR, Watson RR, Watson CR, eds. Handbook of Behavior, Food, and Nutrition. New York: Springer; 2011.
[Shomaker 2013] Shomaker LB, Tanofsky-Kraff M, Mooreville M, et al. Links of adolescent- and parent-reported eating in the absence of hunger with observed eating in the absence of hunger. Obesity (Silver Spring). 2013 Jun;21(6):1243-50.
[Tanofsky-Kraff 2007] Tanofsky-Kraff M, Goossens L, Eddy KT, et al. A multisite investigation of binge eating behaviors in children and adolescents. J Consult Clin Psychol 2007; 75:901-913.
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Constantine Kaniklidis
Director, Medical Research, No Surrender Breast Cancer Foundation (NSBCF)
Oncology Reviewer, Current Oncology [journal]
Society for Integrative Oncology (SIO)
European Association for Cancer Research (EACR)
Hi Leonardo,
I can give you a quick answer: the methylation patterns of the DNA may vary with the diet and that obesity (or not) may not have a genetic basis. There is a well-known and studied study of pregnant Dutch women before and after the II World War.....The study showed that poorly pregnant women (badly fed) had a different degree of DNA methylation and produced progeny obese and with cardiovascular disease. I'm talking about epigenetic effect...... I suggest to read this italian book : l'ultimo mistero dell'editarietà - the english version : the ultimate mystery of inheritance.
Cioa
Hi,
Somewhat paradoxically obesity is moderately heritable. It seems that genetics plays a role in defining the risk of obesity given exposure to an environment containing excessive food availability. The drive to accumulate calories was built into our genetic makeup for good reason - it enhanced survival.
Overlaying this genetic risk, there is increasing evidence of intergenerational nongenetic transmission of increased risk from obese parents to F1 and F2 offspring. This may be by direct exposure to a maternal obesogenic environment during fetal growth (F1) or via germ cells (F2) carried in female offspring during gestation. These types of transmission are thought to be due to induced epigenetic changes that are mitotically transmitted i.e. changes in DNA methylation and histone protein modifications. This model explains the increasing incidence of obesity rates over only a few decades i.e. the accelerating cycle of obesity incidence. The evidence for true transgenerational transmission (meiotic transmission) is weak in my opinion.
Obese individuals lose weight given strict diet and exercise programs however the sustainability of this loss at the 5 year mark is very poor. There is evidence also emerging that this low rate of sustained weight loss is due to the retention of a hormonal program characteristic of obesity even when obese individuals have lost weight. This metabolic programming may also be mediated by epigenetic modifications. My thoughts are that community dietary interventions to curb obesity in the population may be more effective when targeted at children and especially young women. This is not to say that paternal influences are negligible, just they have not been fully researched yet.
It does not seem strange that obesity or thinness are also influenced by hereditary factors. As, while not being an expert, I think that just as there are children born more or less high, there are also children born more or less lean. Then, probably the diet and the more or less sedentary life does the rest. But, the problem is that most obese people are obese because they eat too much. Therefore, they spends many money for nutrition, for a controlled diet and for obesity-related illness cures. Most of these expenses are rightly borne by the community. On the other hand, many people in the world are dying of hunger or illness linked to malnutrition due to lack of food. Therefore, it is necessary to educate people to feed themselves in such a way as to avoid obesity and use the funds thus spared to limit or completely eliminate the malnutrition due to lack of food.
The fact that two things happen at the same time does not mean that they are interconnected. With hunger and obesity such interconnection could be explained, but I would be careful. I agree that hunger as well as obesity in many cases are the result of poverty. Food prices decide of how much food one can purchase (and consume) and also about the quality (in form of balanced food with carbs, protein, fibre, micro-nutrients, etc). Quality food, however, does not need to be costly, unaffordable......
Still I do not have the impression that the poorest sections of societies overlap much in the prevalence of hunger and obesity. The latter group is often better off, able to avoid undernutrition, but experiencing malnutrition.
Here in the Pacific Islands, where malnutrition in form of obesity is a huge problem undernutrition rarely plays a role, indicating that the people are not in poverty to an extent that they cannot buy enough calories. Obesity is also surely a more complex issue than of socio-economic nature. It is about food culture and changes to it, about fast food and the decline in the importance of quality food that is available at affordable prices........
In developed countries, it is difficult to separate nature and nurture in the development of obesity. In studies with food insecure families, the parents will often often use their limited resources to buy the most calories for their children. Sadly, that will be high carbohydrate foods, with little protein, fruits, or vegetables because those yield the most calories per $. In our food pantry surveys, some parents were not aware of balanced diets (listing high protein foods, for example). Others were aware, but couldn't afford those foods and prefer to send their kids to bed full, rather than hungry. So, in this environment, if the parents are obese, the children likely are as well. Both genetics and environment.
Funny how most of the contributors do not focus on fitness. A unmuscled body burns less calories and the under nourished with over comsume calories. Fitness and exercise can be used to both burn more calories and down regulate appetite. Much of our issues in obesity is also related to how seductive the food advertisement is.
Quality of food has a great deal to do with both fitness and weight measures. Food, like we have in the US, where the gemination has been removed (wheat, corn, etc.) the glycemic index is higher than it is for common sugar. Add the GMO high frcutose as the predominant sugar in our food supply, and we find our extremely cheap food, consumed in huge quantities by most of the population, and especially the "poorer" ones, is where the obesity is greatest. Fitness often reflects education level more than economics...much of what is assumed about poverty is a distortion of the definition of what poverty means. In the US, literacy and education are the markers that separate those who are considered "poor and obese" and those who are slightly more affluent, but much more educated, and fit. Calories come cheap here, but self discipline and nutritional knowledge are in short supply.
Absolutely there are interconnected. How? I will answer in a philosophical way; I think the more number of obese people increases, the more hunger increases. Most important reason to obesity is excessive consumption of foods which causes the majority of money paying for producing and selling the food stuff, 20% of this money may be saved for foods for hungery communities. This can be easily achieved; extra taxes for junk food (that are somehow responsible for obesity) will be taken and directly be transfered to the requiring countries.
Despite some brilliant answers above (see Constantine's contribution on obesity, and Max's contribution on refined food), it seems to me that the majority are missing the point of the question. If there is any link between hunger and obesity, we have to look beyond the science of metabolism and beyond the science of social behaviour because they are defined by local conditions combined with genetics, while any possible link must be at a global scale. Thus, the real question is if at a global scale a link can be identified between hunger and obesity? If there is any, I would propose to look at the global divide between the rich and the poor and between the few in power and the many without any powers. We may conclude that famine is often caused by conflicts and/or climate changes, and obesity is often caused by social status (see Constantine). Hunger and malnutrition in developed countries are also caused by social status. The social status that may either cause hunger or obesity is generally not a choice made by the direct involved, and likewise are the conflicts and climate changes causing famine not any choice by the direct involved. But there is a global responsibility by the few in power who have the means to moderate such massive anomalies, and as far as I can see, there is no political or financial incentive to intervene. On the contrary, I fear that commercial interests dictate the global social divide, the local conflicts and to a certain extent also the climate changes. The hunger and obesity are mere symptoms to this much larger problem. There is the link.
Great comments and a very interesting discussion.
The obesity epidemic in the western world has arisen relatively recently - in the last 30-40 years and is now rapidly spreading to many other populations. Thus, if there is a causal direct link between obesity and starvation/poverty from the highly impersonal world-wide perspective then the prediction would be that the incidence and severity of starvation and poverty should have increased over the same time frame.
However, FAO figures, possibly contrary to the popular view, (http://www.fao.org/news/story/en/item/288229/icode/) show a world wide decline to only (!!) 800 million chronically undernourished people as of 2015, 216 m fewer than in 1990-1992. This may be due to more efficient food production and distribution. Therefore the conclusion, based on holistic world population trends does not support a direct cause-effect relationship between obesity in one population and chronic malnourishment presumably in another population. This conclusion does not comment on trends within a subpopulation, which could be showing fractional population increases in the extremes of both obesity and chronic malnourishment at the same time.
To All:
Once again, I will play my customary role of Contrarian, and maintain that:
(1) the obesity-hunger connection is growing stronger, not weaker;
(2) world hunger and malnutrition are not any longer decreasing, or even slowing down in aggregate growth rates;
(3) world hunger and malnutrition will continue to rise for the foreseeable future, as they now are, as will environmental insecurity, consequent to the Climate-Conflict Axis that I discuss below.
I pose these stipulations - with evidentiary support - as a challenge that we all, as scientists, must awake to, and address aggressively and proactively, otherwise our coming generations will inherit a grim future, as I suggest briefly here.
THE PERSISTENCE - AND UPSWING - OF THE HUNGER-OBESITY CONNECTION
It is well documented and now indisputable that hunger and obesity can in fact, and do, co-exist - the hunger-obesity paradox as this is known.
We see the hunger/obesity association even in more developed LMICs, such as India and Brazil, where the prevalence of overweight/obesity is even increasing in urban slums despite persistent poverty [Misra 2001] [Peterson 2013], and in Hungary [Vagi 2016], among other countries (and also in Canada where a significant association was found nationally between hunger and overweight in children).
This is true also in United States: there are high rates of excess body weight (overweight and obese) among low-income African-American adults (at 89.2%) and children (at 49.9%) in Baltimore City for subjects who exhibited food insecurity concurrent with hunger) [Vedovato 2016], taking the expert consensus definitions that food insecurity is a household-level economic and social condition of limited or uncertain access to adequate food, whereas hunger is an individual-level physiological condition caused by a lack of food; as well as among shelter-based homeless women in Minnesota [Richards 2010], among the homeless in Boston [Koh 2012], among dozens of other geographical areas. From these and other studies, we know that under conditions of scarcity, the poor and the hungry react more impulsively towards food rewards [Claassen 2016].
It's also important to appreciate that the issues surrounding the hunger-obesity paradox are more complex than the naive suggestion of better food choices like increasing fruit and vegetable intake, which ignores other factors of individual access to better quality foods (availability and access to supermarkets, to transportation, various governmental and private assistance programs, and unsafe environments offering scarce opportunity for physical activity [Drewnowski 2004], and at a macro level, global and regional factors like climate change and political conflict, which I have called elsewhere in my writings the Climate-Conflict Axis).
THE CLIMATE-CONFLICT AXIS
AND
THE UNDERMINING OF FOOD SECURITY INITIATIVES / GOALS
It is in large part the confounding factor of the Climate-Conflict Axis that was not weighted in the now manifestly naive projections of the Millennium Development Target in the UN SOFI ("State of Food Insecurity") report under the joint auspices FAO (Food and Agriculture Organization), IFAD (International Fund for Agricultural Development), and WFP (World Food Programme cited by contributor Ross Tellam above, so that after a decade-long decline, World hunger and malnutrition spiked last year (2016), by 38 million (from 777 million in 2015), to reach 815 million) consequent to the dual scourges of environmental insecurity, like climate change / global warming, coupled with refractory civil conflicts that show little sign of abating, entailing that 11% of the world’s population went hungry every day, a dramatic setback for the United Nations’ Millennium Development goal of eliminating global hunger by 2030 where easy math suggests that that upswing imperils the target as unrealistic, as projections in civil and climate disruption paint a grim picture of the future [The State of Food Security 2017].
This is a picture made even more sobering when we drill down on the data to see that no less than 60% of the 815 million food insecure and malnourished are face massive survival challenges in countries afflicted by violent conflicts that - as always - affect children the most, with intra-regional (within one nation) conflicts having increased 125% since 2010, as we see in the savage conflicts within Yemen with 60% of Yemenites living with daily abject hunger (as of March 2017, 20% increase over June 2016, 47% increase over June 2015, and the wholesale breakdown of the health care system and its infrastructure, coupled with outbreak of cholera and other epidemics), as well as South Sudan (42% food insecure), Nigeria, Somalia, Syria, the Democratic Republic of the Congo, Burundi, Lebanon, East Africa (Ethiopia, Kenya and Uganda), and Columbia, with populations decimated by civil strifes, and where food insecurity has been "weaponized" in the subjugation and cleansing of target subgroups, and simultaneously facing disruptions of climate change such as droughts, floods, landslides, cyclone activity and other climate-related traumas, impacted further by political crises and the continued severe economic drops in nations reliant on commodity exports, leaving these and other nations with crippled health care, agricultural production, food systems and supporting social institutions.
Add to this Climate-Conflict toxicity, the corrupt profit-driven motives of giant commercial entities, as documented in the New York Times Special Report on "How Big Business Got Brazil Hooked on Junk Food" [NYTimes 2017], and as the detailed expose shows, with Nestlé, Coca-Cola, Pepsi-Co, and General Mills ruthlessly peddling caloric junk to at-risk Brazilian populations (and of course elsewhere). This toxic brew, even with the shrewdest economic metrics set into "optimistic" mode, removes the 2030 Millennium Development Target of End of Global Hunger as a plausible goal - world hunger now appears to be inexorably on the rise for our foreseeable futures, synchronized and cross-fed by the triple threats of obesity, diabetes, and metabolic syndrome (themselves dispositively linked to elevated risk of multiple malignancies) [themes discussed with considerable depth and insight above by Jan Voskuil, Max Stanley Chartrand, and the many other fine contributors here].
I invite my many perceptive and insightful colleagues here to take up the challenge I raise and pool our collective experience, expertise and moral commitment to help provide a Working Consensus on the most effective means to address these critical problems, at any level of stakeholders, for the sake of our planet continued viability for future generations.
REFERENCES
[Claassen 2016] Claassen MA, Klein O, Corneille O. Poverty & obesity: how poverty and hunger influence food choices. Europ Health Psychologist 2016 (18 supp.).
[Drewnowski 2004] Drewnowski, A., Darmon, N., & Briend, A. Replacing Fats and Sweets with Vegetables and Fruits- A Question of Cost. Am J Public Health 2004; 94(9):1555-1559.
[Koh 2012] Koh KA, Hoy JS, O'Connell JJ, Montgomery P. The hunger-obesity paradox: obesity in the homeless. J Urban Health. 2012 Dec; 89(6):952-64.
[Misra 2001] Misra A, Pandey RM, Devi JR, Sharma R, Vikram NK, Khanna N. High prevalence of diabetes, obesity and dyslipidemia in urban slum population in northern India. Int . Obe. Relat Metab Disord 2001; 25(11):1722–29.
[NYTimes 2017] Andrew Jacobs, Matt Richtel. NY Times. September 16, 2017. At: https://www.nytimes.com/interactive/2017/09/16/health/brazil-obesity-nestle.html?_r=0
[Peterson 2013] Peterson K, de Sousa Ribeiro G, Galvão dos Reis M, et al. Household food insecurity and obesity risk in an urban slum in Brazil. FASEB J 2013; 27:243.6.
[Richards 2010] Richards R, Smith C. Investigation of the Hunger–Obesity Paradigm Among Shelter-Based Homeless Women Living in Minnesota. J Hunger Environ Nutr 2010; 5(3).
[The State of Food Security 2017] The State of Food Security and Nutrition in the World. Food and Agriculture Organization. United Nations. 2017. At: http://www.fao.org/3/a-I7695e.pdf
[Vagi 2016] Vagi ZS, Nagy-Borsy E, Nagy B, Skerlecz P, Kiss I, Rakosy ZS. The hunger-obesity paradox associated with homelessness in Hungary: Zsuzsa Rakosy. Europ J Public Health 2016 November; 26(Issue suppl_1, 1).
[Vedovato 2016] Vedovato GM, Surkan PJ, Jones-Smith J, et al. Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: associations with food-related perceptions. Public Health Nutr 2016 Jun; 19(8):1405-16.
Constantine Kaniklidis
Director, Medical Research, No Surrender Breast Cancer Foundation (NSBCF)
Oncology Reviewer, Current Oncology [journal]
Society for Integrative Oncology (SIO)
European Association for Cancer Research (EACR)
Dear Constantine,
Many thanks for your ever so thorough and well-founded analyses. Rather than trying to find solutions, I propose to firstly identify the direct culprits. It looks like they are all here for the picking: Commercial enterprises who exploit both developing and developed countries alike (mining industries -including oil, gas and hardwood-, financial industries and weapon industries), corruption (power-hungered dictators and cronies who help supporting the above mentioned industries), brainwashing practises (guilty by all religious power centres, again to keep the status quo of war and poverty), and last but not least the charade of modern parliamentary democracy (each member of parliament being restricted by disciplinary measures and intimidation). West blaming East of lack of democracy and vice versa. It is all one big theatre and we all are to blame by our naivety. It does not help that multimedia are primarily owned by just a few commercial stakeholders so to prevent the public finding out too much details (again no real difference between East and West).
Perhaps I have overlooked a few things, but we should not have the illusion to be able to change the world as long as the centres of power (listed above) remain unchallenged and remain untouchable.
Then, I have not even mentioned the nagging issue of overcrowding. Without worldwide birth control measures, any future attempt to reorganize the centres of world power will remain futile when humans keep multiplying and keep devastating the biosphere, thus limiting nutrition sources.
The climate-conflict axis is here to stay and with that the hunger-obesity paradox until the entire world order has drastically changed.
It seems like nothing occurs in a vacuum. Let us look on how addictive industries create addictive products and then using product manipulation and advertizements to supercharge the addictive nature of the products. Tobacco is accentuated for its nicotine and then additives such as ammonia and flavorings are part of the addictive cocktail. Free samples are given as well as products of interest to young people. We lace our food with corn syrup sugar fat and salt as part of deliberate strategy to hook the consumer and keep them there. The food addiction is biggest part of cheap food economy. Unfortunately we cannot afford the high cost of cheap foods. This is not occurring by happenstance but rather part of the plan.
Perhaps a more salient question that could affect real change to mankind’s plight is “is there a link between freedom and hunger and obesity?“. While some free people may opt to use that freedom to waste away their prosperity with gluttonous and learned helplessness, the majority will use that freedom to live a better life and share their resources with their less fortunate fellow beings.
When the giving is done by force of government neither sender or receiver fully benefit or make as wise of decisions. Givers (under duress of force) strive to dodge giving where possible and receivers (under current concepts of politician guided welfare) tend toward learned helplessness and self neglect. Hence, when freedom, individual responsibility and noble principles coincide we find a healthier, wiser, and more empowered population regardless of their economic status.
Interesting topic. Its a global issue and time to focus. Following for more updates.
Some workers suggest that obesity is a malnourishment which is related to consuming nutrient deficient food which does not satiate the consumer. In farmers who feed hay which was rained on they feed more in a vain attempt to give adequate nutrition a condition called hay belly in horses and cattle.
Our modern foods in Europe and North America are not as rich in nutrients as previously and this may be part of the obesity issue.
Likewise in poor areas the foods which are price available are not necessarily complete either.
The ability to identify complete nutrition in rich and poor economies may be a key to fighting malnutrition. Quality of our food maybe the neglected consideration in our global malnutrition while experts are almost solely focusing on quantity not quality.
Yes Indeed and also the style of life. For example we eating a lot of high calories foods to a level of saturation. Accordingly, it cross the level of our skin boundaries, as a result the skin looses its power of hold and the body expels. It is similar as no trimming of a tree with a result of very clumsy bushy shaggy look and structure. Overfilling with NO Exercise/Trimming gives rise to obesity, is one of the severe aspect/reason. Also feeding himself/themselves a lot and keeping the surrounding world hungry/depraved cause obesity.
Yes the connect a lot. The aftermath of hunger can result in obesity because of improper dieting.
Since resources in this world are limited, excess usage in one area can result in deficiencies in another area.
According to some untested hypothesis hunger particularly at an early age is interconnected with obesity among a group of populations.
Absolutely true that obesity can be fought by reducing food intake whereas hunger requires increased food intake. Yes obesity and hunger have something in common that is ‘food’ and both are controlled by brain. We know that humans eat for a variety of reasons. Obese individuals will eat even if they are not hungry
In my opinion obesity requires determination and change in life style not only reduction in food intake to controll whereas hunger needs controlled food intake
Food intake is an important consideration.
In addition is the issues will food quality.
Nutrient poor foods is problematic for hunger and obesity.
The joke goes that I like lo calorie food because I eat twice as much.
When food are complete and they can fill and satisfy the issues of eating empty calories is allayed.
Food processors make the products addictive by adding cheap fats, salt, colors, and sugar.
The modern foods are processed to loss fiber something very important for digestion and health.
We need to jettison the idea of producing massive amounts of cheap food to looking a cost effective nutrient rich foods which will promote rather than deteriorate our health.
Often this hunger is due to what I call pseudohypoglycemia. i.e., after overconsumption of refined carbohydrate the blood sugar rises. The insulin response causes a rapid but normal drop. This drop is falsely sensed as hypoglycemia along with acute hunger for another consumption of a refined carbohydrate and even "the shakes" which is self "treated" by eating a flour or sugary food. Note, it is the dropping serum glucose...which never goes below normal...pseudohypoglycemia. Nevertheless this behavior results in the associated overconsumption of calories resulting in obesity etc.,etc., etc.