My answer would be that developed countries have become obesogenic by default. This could be attributed to many things including; advances in technology, changes in daily routines and the working environment, the availability of cheap, energy dense convenience foods and physical changes to our communities. We do have free will, however; people with more money, better education and higher social status have far great freedom to make choices relating to their health. In the end it does come down to energy intake and output; but we are not all in an equal position to control this. We can promote healthy lifestyles, educate people regarding the nutritional contents of foods or the benefits of exercise, we can increase their skills relating to shopping, cooking and planning, however; people are not free to make rational choices. If you live in a “bedsit” with no cooking facilities, you have no cookery skills, no transport and you have £30 a week to feed your family; chip butties, chicken nuggets and jam sandwiches are the only choice if you don’t want to go hungry. If you live in an area where it’s unsafe to go out after night, you are socially isolated and don’t have £25 a week spare to join a gym; a bit of “will power” isn’t going solve your physical activity issues. It is really important that we encourage people to take responsibility for their weight; I just worry about the parents who cannot afford to buy their kids 5aday or daren’t take them to the local park to play. Until we tackle these wider social issues it isn’t ethical to blame people for being overweight or obese.

Few cases of Obesity can be categorized as medical condition (Example: someone whose pituitary gland is curetted as a result of tumor) would require Hormorne Replacement Therapy which could result in serious weight gain. Most cases are however by choice-Unhealthy Lifestyles-Binge eating, heavy drinking and smoking, lack of exercises etc.

Well said Peter!

@Peter James. You right "Banning the advertisement of unhealthy food in the media is also a control measure..

Most of the advertising campaigns associate Cola with "freedom", happiness, success, Love... and so on. Fully misleading (directly, indirectly) advertising that passes without observation.

Obesity,if it was a medical condition,it can be treated. If it was a condition related to social habits, it can also be treated. Either way you need to be motivated. Either way their is no excuse.

More stringent measures should to taken by regulating bodies to monitor misleading Adverts. Also, awareness and enlightenment programs should be on top gear to inform individuals on the danger of unhealthy choices! It's like using one's hard earned money to buy DEATH!

I agree with the statements claiming the important role of the media and the misguided choices and lifestyles of many obese people, but I would like to put forward the importance of epigenetics here as well. It is known that the environmental information communicated to unborn children by the mother's diet has implications for the child throughout its life, and even for several generations further. A famous example is the Dutch famine of 1944, dietary deprivations for pregnant women resulted in a next generation of obese people, implying a successive epigenetic predisposition for excessive food intake, even for their grandchildren (next to predispositions for other health problems)!

The contrasts in diets across the globe exacerbate this effect, a mother in a food-limited environment passes on dietary information to the unborn child (preparing it for the environment in which it is to grow up) which is from then on 'genetically activated' and hence predisposed (there are suggestions this is expressed metabolically) to a life of increased consumption. If the child was to grow up and live as an adult in a similarly food-limited environment, no immediate problem... but once an adult, the child may experience food-richness by living in a different environment with ready access to large quantities of food (possibly combined with a less active and more unhealthy lifestyle perhaps), and well...

For instance, this problem is evidenced by high increases in diabetes in countries such as India, China where rapid industrialization is turning food-limited communities into food-rich communities.

I don't mean to underestimate the power of misguided advertising, media and individual choices, but it is not all down to choice, we are still to unravel the extent and importance of epigenetic factors.

Best wishes,

J

One can't get fat from air and water. Knowing when to stop, knowing the limits dictates the BMI. Education is the most important investment in personal life and our social condition.

Whatever the causal factor might be; be it genetic or otherwise, a good "Health Consciousness Routine" will to a great extent control the condition! For example, if one knew one is genetically inclined to be Obese, then unhealthy lifestyle choices would be a suicide mission.

I agree with the importance of education but for example, if the billions made by pumping cheap and addictive corn syrup into thousands of processed foods would be taxed for 'damaging effects on health' a lot of people could be helped, organic whole foods could become cheaper, and education could benefit from 'healthy' investment. Cheap unhealthy and processed food producers are to take a large part of the blame

Best wishes,

J

From some arguments above it is obvious that the majority feel it is up to the individual and if they have a genetic issue they should not eat foods that trigger. Nice for people to sit behind computers and judge others by limited social bias. We need to look at metabolic rate.

There is an important thing that causes obesity - antipsychotic medicines. E.g. clozapine. How to solve this iatrogenic problem ?

Sidharta Chatterjee - obesity does not come from air or water. Over consumption, too much food intake. too many calories as opposed to the consumed calories = fat deposit..

While speaking on Obese and obesity associated syndromes and disorders_ Its quite complicated and complex to clasiify.

I can say one day its like infectious disease to say Epidemic , and pandemics.

There are many causes , some are directly involving ,in a way like genetic factors, and life style, and habits. In another side its indirect like psychological patterns stress oriented tissue inflamations, and fat deposit , sick attitude,some times stress inducing hunger feel, and makes more consumption of food.

As interpreation of obese effect is like highway, many chances to poison the body, as awaring health concepts and mind oriented movements such as meditation and yoga can able to limit the obesity.

its time to give medals to Americans , and Australians for maintaining consistency of producing obese--- obese.

Today, I accidentally stumbled on a video of a heavy-weight news presenter (no pun intended) who has taken an email addressed to her by one of her viewers perhaps a bit too serious http://www.youtube.com/watch?v=rUOpqd0rQSo&feature=player_embedded .

It highlights an important point, however, the fact that obesity is seen by many as an issue which can be buried in triviality, or alternatively, that pointing out to someone with public responsibilities that he or she is obese is a pure form of bullying or discrimination. I personally think the reaction by the presenter is out of proportion. She could have chosen to ignore it or at least refer to the fact that she is aware (or unaware) that obesity is an important issue in our society , aside the fact that it is not acceptable to call someone fat, obese, overweight, carrying too many kilos, unskinny (what is the politically correct term these days?). Whatever the case, it obviously touched a sensitive nerve, and maybe illustrated a lack of relativism.

On a personal note, I thought the email was well formulated and underlines some of the issues touched upon in the here discussion. Namely that obesity is a societal issue that should be addressed by highlighting the problem through the mainstream media channels, among many other avenues of course.

For all we know, the emailer may be aware of the pressure overweight is causing on the economics, health and ecology of our society and resources, but that doesn't matter, he is perceived as a bully of the worst kind. I guess it is an illustration that obesity is seen by some as an invalid stigma, a common, acceptable phenomenon without implications in the grander scheme of things, a personal trait no different from having a certain hair colour. Of course there should not be a lack of respect for the person, definitely not, but why can't we call a cow a cow (again, no pun intended, this is a common expression in Flemish, which means 'say things as they are') and mention the obesity problem in our society and discuss the underlying causes and consequences in public, whether they are inherent, choice, environment or an interaction between these three as mentioned above. Obviously, awareness still has a long way to go.

Best wishes,

Jeroen

I would have to say that it is a combination of the both because there are some individuals that have a medical condition that can cause obesity but on the other hand there are those who will feed their children in order to keep them quiet. Obesity is a rapidly growing public health problem in the United States. According to the National Health and Nutrition Examination Survey, the prevalence of obesity increased from 13.3% of the adult population in the early 1960s to 26.3% in 2007. Existing barriers is a direct reflection of the socioeconomic status which increases the incidence o becoming overweight or obese in certain social strata. Education, prevention, health care access, and support are the core elements of positive outcomes.

I think too the news-presenter took the e-mail too seriously, as Jeroen points out. In this kind of situations one should try to avoid exaggeration and too strong reactions. Moreover, the e-mail was a personal letter, right ?

What concerns public idols : what about Asterix and Obelix ? Not slim heroes ?

I think prevelance of obesity is great among youns nowdays because of junk food which contains monosodium glutamate (MSG). MSG is one of the experimental obesity. I found that MSG obesity in male rats was associated with increased platelet aggregation and decrease testosterone level.

This is a non-sense question because the answer has been already provided. We are all aware of a few cases in the literature of genetic conditions leading to obesity, e.g. leptin deficiency but usually these cases fail to document access to food and appetite disturbances. Actually, there was no obesity in Europe during and immediately after the II world war. Obesity in our days is simply an objective signal of our success as species in providing food every day, every time; this is a unique phenomenon limited to the last two generations of Homo sapiens. A related question should be how to limit obesity-associated diseases and costs without restricting the choice to be obese?

Other than junk food, main reason for obesity in current times is over stress and lack pf regular physical exercise.

I agree with you Peter Walsh. However one can't wait for a societal shift . For that individuals themselves have to change their attitudes. One can start with self management like doing at least 30 min vigorous exercise, and healthy diet.

My answer would be that developed countries have become obesogenic by default. This could be attributed to many things including; advances in technology, changes in daily routines and the working environment, the availability of cheap, energy dense convenience foods and physical changes to our communities. We do have free will, however; people with more money, better education and higher social status have far great freedom to make choices relating to their health. In the end it does come down to energy intake and output; but we are not all in an equal position to control this. We can promote healthy lifestyles, educate people regarding the nutritional contents of foods or the benefits of exercise, we can increase their skills relating to shopping, cooking and planning, however; people are not free to make rational choices. If you live in a “bedsit” with no cooking facilities, you have no cookery skills, no transport and you have £30 a week to feed your family; chip butties, chicken nuggets and jam sandwiches are the only choice if you don’t want to go hungry. If you live in an area where it’s unsafe to go out after night, you are socially isolated and don’t have £25 a week spare to join a gym; a bit of “will power” isn’t going solve your physical activity issues. It is really important that we encourage people to take responsibility for their weight; I just worry about the parents who cannot afford to buy their kids 5aday or daren’t take them to the local park to play. Until we tackle these wider social issues it isn’t ethical to blame people for being overweight or obese.

Unless under terrorism or warlike conditions, one can do all necessary activities for his living. Regarding gym, to do a physical exercise you don't need a gym at all. In fact my opinion is exercise in outdoors is a better option than indoor gyms. Jogging, running, climbing does not require gym. About food, I don't understand the need for chips and nuggettes. Cooking cereals, or plant-based foods is not costly nor difficult.

obesity by choice or by chance, There is no luck involved to be obese by chance, only those unfortunate persons loaded by hormones or steroids or some with abnormalities get obese, then the rest,

The present scenario is very much known. Ecological or economic impact. Obvious that the provider makes more money, cooking oil companies make more money and it you who make bigger bodies, carry them around, and difficult to fit in a standard chair, unable to walk steps and so on and so forth. Unfortunate that these only affect you after you are 35 or 40 years.

Children are becoming obese by chance because their mothers are overfeeding them and making them addicted to fast foods since they feel their career is more important than children

Hi Shashi. I do agree with you that the gym isn’t necessary for undertaking physical activity, I also agree that if you are determined to eat healthily or do enough physical activity; you’ll find a way.

I suppose my point would be that although we all have a choice; some of us have more choice than others, and how much choice you have often depends upon how “privileged” you are. As I mentioned in my previous post- some people simply cannot go out walking or running in their neighbourhoods; it’s not safe (or at least that is their perception). I live in a well lit, leafy suburb in the UK with attractive parks and woodland; busy with friendly dog walkers and families. I am happy to walk and run in my neighbourhood, even after dark. Three miles away is one of the most deprived areas in our county; I would not walk or run in this area because I would not feel safe. I have more choice, thus it is easier for me to make the decision to do physical activity. Incidentally; I also have a car to travel elsewhere to walk and run, a gym membership, an Ipod, a satellite running watch, several pairs of trainers and nice running gear. I have lots of friends who also enjoy exercising and have no children to care for. I also have a nutrition, behaviour change and public health background and am a great cook. I’m not showing off (honest!) I still struggle to keep my BMI under 25. If I have such great access to so many resources and still have limited success, what real freedom of choice does a 25 stone, low income, socially isolated single mum three miles down the road truly have? I cannot imagine how much sustained will-power is needed for her to make the changes sufficient to lose weight.

True Keran. I also stay in a safe city like Pune in India and enjoy social facilities like parks for walking or running. However other factors like genetic make up or hormonal imbalance may be responsible for resistance to reduce BMI. By the way I believe that your are a great cook !!..)

Thanks Shashi! Actually I do think cookery skills in themselves are essential if a person wants to make long term postitive changes to their own diet. An anecdotal example would be a colleague who joined a slimming club to lose weight and has learned basic cookery skills along the way. Those skills are now with her for life; even if the sliming club's influence wanes. I am a strong supporter of basic, healthy, frugal cookery being taught in secondary schools.

Obesity is a nutrition factor. Exercise has nothing to do with it.

Cut out carbs, especially fast-carbs (but all carbs is better - carbs are not an essential nutritional requirement).

Ian Clements .... how about some evidence to back up both of your unfounded statements!

Quite easy: Gary Taubes' book "Good Calories, Bad Calories" for a start.

Then as well as the mass of other research, my own over 10 years of measuring exercise amounts vs. body composition found virtually no correlation between exercise and fat except at the extremes - and then very little.

But heh, if you don't look, you won't find.

Right, exercise amounts and body composition do not correlate. However, "correlation" is a poor concept. Not to be confounded with the fact that lean individuals are more active than obese.

Gary Taube's book. Right. He's a medical journalist not a scientist. Never done any research on his own, just pulls together others research that fits his thesis while dismissing the rest (something he admitted in his own NYT editorials). For profit I might add; take what he says with a major grain of salt.

As far as your own research over the past 10 years, where is it? Point me to your publications, not your blog.

You state that your vast research measuring exercise amounts vs. body composition has found virtually no correlation between exercise and fat except at the extremes - and then very little. How does that argue for your point? Birth rate and stork breeding pairs are highly correlated too!

Back to your original point. Your statement that exercise has nothing to do with obesity ignores energy balance. EB is dynamic, not static. To say that obesity results from EI > EE, while true, can also be stated as the level of EE is not commensurate with the level of EI. Now, if you are trying to say that EI is MORE IMPORTANT than EE for weight loss, no arguments here. It's pretty obvious. One can do a 30 min moderate intensity bout of exercise and burn 300 kcals while ingesting the same amount in a matter of minutes. But to say that "exercise has nothing to do with obesity" is fundamentally wrong. And the literature supports the supposition that exercise is the more important factor for long-term weight maintenance.

As for your other statement, that "carbs are not an essential nutritional requirement". Let's see the evidence. The CNS derives fuel primarily from glucose. If not, the result is ketoacidosis. Not so good. When someone is in diabetic shock, you don't feed them a slab of meat do you? No, you give them glucose. Like to see how well elite marathon runners would do while carbo depleted.

Hi if one can go through this article it does give information.

http://www.plosone.org/.../info%3Adoi%2F10.1371%2Fjournal.pone.0000...

This article will add spice to the discussion

http://atvb.ahajournals.org/content/25/12/2451.full

Katharine Morrison

As for your other statement, that "carbs are not an essential nutritional requirement". Let's see the evidence. The CNS derives fuel primarily from glucose. If not, the result is ketoacidosis. Not so good. When someone is in diabetic shock, you don't feed them a slab of meat do you? No, you give them glucose. Like to see how well elite marathon runners would do while carbo depleted.

Glen, some of what you say makes sense to me, especially the concept that exercise is important for weight maintenance. I do have problems with your final paragraph.

Some populations eg Inuit traditionally have survived on mainly fat and protein with very little or no carbohydrate. There are essential fatty acids and essential amino acids but not essential carbohydrates. If pushed you could survive without any carbohydrate. Whether you want to or not is a matter now of choice.

The CNS does primarily run on glucose but you don't need to eat any carbohydrate to get this. Your liver can make it from ingested protein and stored protein via the gluconeogenesis pathway. The brain can also adapt to running on ketones. It will be doing this efficiently after a few weeks on a low carb diet.

There is no link whatsoever between dietary ketosis and ketoacidosis. Dietary ketosis is caused by a relative lack of carbohydrate in the diet. Ketoacidosis is caused by a relative lack of insulin in the circulation.

When someone is a type one diabetic having a hypo, you would indeed not give them a steak, but this is not indicative of glucose requirements in healthy people. Athletes and other exercisers can become ketoadapted over time. Perhaps performance at top levels could be better on regimes with more dietary carbohydrate but again this becomes a matter of choice.

I agree with Karen's explanation for the obesity problem. I am now 52. When I was at school there was only one plump girl in the class. She had a congenital heart condition and was forbidden to join in skipping etc. From her appearance as I remember it I also think she could have been on steroids. She died aged 8.

Food was a mix of a little meat, starch, vegetables and fat. My mother gave a family of 6 chicken on a Sunday and made soup with it and even sometimes had leftovers. Clearing your plate was a big issue. There was no alternative for fussy eaters. We never went to restaurants of any kind.

Day in day out we played outside from when breakfast was over till the street lights come on. There was children's TV for about 1.5 hours a day. The TV shut down in the afternoon.

Now, there is a lot more choice about what to eat, portions are much bigger and snacking is common from childhood onwards. Play is supervised and television is on 24 hours a day. Children and adults socialise on their electronic devices.

In 1989 I visited the USA and took photographs of fat people because I had never seen the like of it before. Now, Scotland is the fattest small nation in the world and I see enormous young people ambling down the street, eating paninis and drinking sport drinks. The UK has one of the longest working weeks in the European Union. Many people commute 3 or more hours a day.

There is a lot more opportunity to eat more, food is proportionately cheaper than before, we have become used to being indoors more, sitting on our backsides more, walking less, and exercising is something you make time in your busy schedule for, rather than being a part of your life.

Thanks for the discussion Katherine. I guess I was just reacting (maybe over-reacting) to a statement: "Cut out carbs, especially fast-carbs (but all carbs is better - carbs are not an essential nutritional requirement)". It seems unrealistic in modern society to cut out ALL carbs, but I do understand that there is no essential CHO requirement. And while the body can adapt based on the fuel you provide it, my understanding is that pathways such as gluconeogensis are not as "efficient" in terms of ATP yield (glycolysis generates cytoplasmic NADH while gluconeogenesis consumes mitochondrial NADH, so the "cost" of gluconeogenesis is six high-energy phosphate bonds, or four as it is argued as well). Is that true? This would have implications for endurance athletes, for example.

My mistake for mixing ketosis and ketoacidosis -- I did mean to keep those concepts seperate from each other.

I'm interested in learning more about keto-adaptation. Can you point me in the right direction? Similar to the point above, my understanding was that using ketones was not as "efficient" as using glucose. Does the CNS fully adapt to using ketones?

Thanks again!

Ian Clements, do you mean that if a person does not do any exercise and keeps on eating balanced diet, still he/she will not become obese? Not right? If you eat more energy and spend less, your energy balance is always positive and your excees energy will be stored in the body as fat. Your energy intake must balance your energy expenditure on a long term basis so that your average energy balance tends to be near zero. Then only you won't put on weight. We have lots of publications on studies for weight control. Some references below will be helpful for understanding the importance of physical activity in general and exercise in particular.

1. Agte V.V. and Chiplonkar S.A.,Thermic response of vegetarian meals and yoga exercise. Annals of Nutrition and Metabolism 1992. Vol 36, 141-147.

2. Khadilkar VV, Pandit DS, Khadilkar AV, Chiplonkar SA, Kinare AS. Diet and exercise intervention reduces cardiometabolic risk in overweight children with special reference to micronutrients. Inidan J Endocrinology & Metab, Jan-Feb 2012, Vol 16, 124-133.

Hi Glen,

You can find more about keto-adaptation in The Art and Science of Low Carbohydrate Living by Jeff Volek and John Phinney.

Some of the intricate science is beyond me particularly regarding metabolic efficiency. These two authors can tell you all about it however.

If it helps to understand how it works in practice, I was on a ketogenic diet for several weeks very recently (20-40g a day) and peeing out ketones as you do. I do a lot of mixed home exercising eg low impact aerobics, rowing, weight training, kettlebells, yoga, pilates sort of stuff. At no time did I feel lightheaded, unwell or not up to my usual mark. As the brain uses about 130g of carb a day I must have been producing glucose from gluconeogenesis and/or using ketones for brain activity. I upped my carbs to the usual 35-90g a day when I had recent shoulder op. I did this because I missed the fun of drinking wine and eating plain chocolate from time to time and I felt my stress bucket was full enough without continuing my ketosis experiment. Although Robert Atkins famously said that running on ketones gave you a mental lift that was better than sex, I can't say it made the slightest difference. The only thing I noticed was that my appetite was a bit blunted when I was in continuous ketosis. I was losing a pound a week of fat (my weight went down and so did my fat percentage and my weight lifting capacity did not change).

Jeff Volek has done a lot of keto-adaptation experiments on athletes, particularly cyclists, and he seems to think that provided they get enough time to adjust to the diet their performance does not deteriorate.

Anthony Colpo, the Austrialian blogger and author of The Fat Loss Bible, thinks that

although sedentary people and diabetics are generally better off on a low carb diet, active people and athletes perform better with higher carb diets. He prefers low glycaemic carbs to refined however.

I would say, having read both sides of the argument, that athletes in training can probably eat whatever they like and get away with it. Very few of my patients are in this league however.

It is obvious to me that one diet will not fit all and that the habits and preferences of the individuals concerned needs to be taken into consideration when designing a "healthy" diet for that person.

This is where the UK Eat Well Plate and US Food Pyramid are hopelessly out of tune. How the heck can some very sedentary dude eat 6-11 portions of starch a day as well as all the other stuff and get away with it?

Kessler, retired from the Food and Drug Administration has stressed just how much the food industries have tinkered about with food to make it as palatable and addictive as possible. it is also so relatively cheap to the consumer yet has a high profit margin for the manufacturer.

Robert Lustig, the paediatrician has campaigned about the ill effects of high fructose corn syrup. This mainly causes fatty liver, insulin resistance and central obesity, even in babies of around 6 months.

At a holiday about 3 years ago I noticed the usual very fat people in Las Vegas as we walked along. We then stayed in a lodge at Grand Canyon. Almost everyone must have driven there but I did not see a single obese person. I do think that income has a lot to do with the food choices you are able to make now.

Back to my childhood again. We were poor and so was everyone else. When I was five, I remember me and my friends stopping playing to watch a car drive up the street. We had seen them in the main street but never in our street. We got ice cream on Sunday's from Tony's ice cream van. One scoop each. We didn't have a fridge till I was 8. No one I knew had asthma. My mum made chips (french fries) by melting lard in the chip pan. If we had cake, my mum made it. Chicken was expensive and fish was cheap. Around the time I was 10 my mum started buying Vesta Chicken Curry which you reconstituted with water. This was the first processed food I recall.

I am now a very keen cook and baker (mainly low carb stuff made with almonds, whey protein power, coconut and soya and loads of butter). It costs me £5.50 around $8 to make one of my almond loaves and this is just the ingredients. It costs 39p around 55 c for six supermarket wheat sultana scones. No wonder home cooking and baking has declined.

The world today has changed dramatically in the last 50 years. So have our habits and waistlines. Unless we want to reverse the vision of the future presented in the film Wallee with us all fat, whizzing around in pods, we need to think intelligently about the changes that could be made to bring us back to normal sizes. In the UK the NHS is cracking up under the pressure of ill health. Much of this is related to obesity and diabetes.

To quote Rogers and Hammerstein from Oaklahoma, "The cowboy and the farmer should be friends". I think we need to, in order solve this problem.

Ian Clements,

Did your studies look at exercise type and body types?

What I want to know are Karen and I just kidding ourselves with all this exercise we are doing?

Katherine

No, my research was just for myself. But there's a mass of other work which came up with similar results.

Don't get me wrong: exercise is good for many things - for reducing inflammation, for example. Cancer patients survive longer if they exercise.

But exercise has almost no effect on fat%.

I initially believed it did, and only reluctantly was persuaded by the evidence on my own body. I jogged; did weights; walked a lot. It hasn't made any difference to my fat%. But food does.

"Exercise has almost no effect on fat %"--you're kidding me? I am trying to understand the various interpretations of this statement--are you referring to exercise (aerobic training) as a weight loss strategy via caloric expenditures? If that's what you mean you are absolutely correct. As an example, a 175 lb male will expend approximately 2600 Kcal running a marathon-barely 2/3 of a lb. Clearly, weight loss through calorie expenditure in the absence of compositional change, is a myth promulgated by those who benefit the most (gyms/health clubs etc) .However, strength training can and does lead to compositional changes (body fat levels) and has the effect of altering metabolism by increasing the amount of metabolic tissue in the body. Bottom line-if you convert fat weight/mass to lean body mass you create sustainable metabolic changes that lead directly to weight loss in the absence of any other intervention, The message becomes; if you want to lose weight through exercise--you strength train. We measure all of these parameters by the way with our own clients/patients i.e monthly body comp tests, metabolic tests, fat deposition measures and they really do change.

It is true that in many persons, exercise does not reduce the weight to a great extent. one reason is that their basal metabolic rate is low. so diet or exercise needs to be planned to increase the metabolic rate.

Obesity is a medical condition only ,not by chance.

Dear Ian,

"But exercise has almost no effect on fat%." by Ian Clements

Our research shows the opposite. I am not sure of your fat % measurement method but exercise not only consumes calories but also depending on the type it can increase the muscle mass. However, you also need to determine the mass. It is possible that fat% remained the same if measured accurately but if the mass dropped then you would see the drop is associated with fat mass. These changes can be small and if your method of mesurement is not very accurate you will begin to wonder if the exercise is even worth it. It is not the exercise it may be your method of measurement!

Dear Hormoz,

Whilst my measurement method may well not be accurate, I think it is consistent, especially when I use two different instruments, albeit from the same manufacturer.

Both show, over extended periods of time, with different exercise regimes (aerobic and resistance training - free weights), little or no correlations between fat and amounts of exercise.

There were changes of fat, but these did not correlate with exercise amounts. Which is odd, if exercise did indeed have any influence.

I did not come lightly to this conclusion - I was, initially, a believer that exercise did indeed cause fat changes. Reluctantly I have to reject this hypothesis - at least for me.

My reading of other research has now added weight to my work.

I believe that those who seem to find a relationship, such as body-builders, really have their changes caused by their nutrition changes rather than the exercises themselves.

But in the end, regardless of what other people find, I have found for myself that my fat is not altered significantly by any exercises I do. But it is changed substantially by my nutrition.

Dear Ian,

I am not sure what you are referring to as fat but if you mean total body fat then it is affected by exercise. Here is a link to calories per gram http://www.nutristrategy.com/nutrition/calories.htm. Fat has 9 calories per gram and carbohydrates have 4 calories per gram, protein has 4 calories per gram. If you eat excess of any of them body converts that to fat and stores it under skin (subcutaneous fat) and when the body needs energy you consume the stored fat. However, if you are referring to the type of fat i.e., what type of fatty acids (saturates, unsatuares, polyunsaturates, and trans) then I agree nutrition has a lot to do with that. Our technology can determine the total fat at the present time but in future we hope to do the type of fat each human body has.

You also mentioned that "There were changes of fat, but these did not correlate with exercise amounts." Do you mean there was a drop in the fat content but there was no correlation between the drop in fat content and the amount of exercise? If this statement is correct then it can be explained by the difference in the body type. For example, a long distance runner male or female when they start training there wijavascript:ll be a drop in the body fat content until they reach a plateu and maintain that fat content if they continue doing the long distanc running at the same rate. The same with body builders initially they will drop in body fat content until they reach a certain level and then they continue their exercise in order to maintain that body composition. However, in both cases if they stop exercise the body fat content will gradually increase. We have demonstrated that an anorexic person has significantly higher body fat content than a similar person with similar mass.

I hope that helps.

Hormoz

Choice

Dear Hormoz & Vera,

I can only reiterate what I've already written, but perhaps a bit more detail will help.

I have tracked my fat% vs. exercise for 38 years - over 3,300 records. The relationship is slightly positive (NOT negative), but with a R^2 of 0.0073. So (a) yes, my exercise did change my fat - but it increased it. (b) But the relationship is virtually random.

I have tracked my trunk fat (a reasonable proxy for visceral fat) over 5 years (over 1,800 records) and here the relationship is also positive and virtually random: 0.0078.

Now it may be that I am peculiar; that I did the 'wrong' exercise (which included aerobics of jogging and exercycling, and free weights); etc. But I don't think so.

For me, the conclusion is clear: exercise has no effect on body fat.

My body fat did change in that period, by 14% (10.7% - 24.7%), and this can be correlated with variation of nutrition much better.

I hope that gives more credence to my argument.

Ian

Prof Tim Noakes, from the Sports Science Institute in Cape Town, South Africa has made similar findings to the above ie. exercise ALONE cannot change weight. He has found that intake of carbohydrates has more of a detrimental impact than intake of fats. We have been brain-washed into thinking that "low fat" is healthy without considering the sugar content in foods. This is especially important for individuals whose metabolisms are "carbohydrate resistant".

My own personal experiment has reinforced this view. For 3 years I did 3 hours per week of speed walking and found that there was no positive impact on my weight (although there are other benefits such as being fitter and feeling the positive emotional effects from walking). After reading Tim Noakes's book "Challenging Beliefs", I cut out carbohydrates, especially wheat and sugar, from my diet and in 3 months I lost 7kg and am managing to stay at this ideal weight for me. The structure of the "Dukan Diet" has been a help too.

Thanks Susan; great ref on Noakes. There's a YouTube presentation that I've now watched, and it's great:

Challenging Beliefs: Tim Noakes at TEDxCapeTown

http://www.youtube.com/watch?v=4lzs5wpLkeA

Folks, An African proverb says "Not One Road lead to the Market!". I submit therefore that a combination of Will Power, Exercise and Diet will result in the "Eradication" of Obesity- Come to think of it, Looking Obese is not funny at all!

Grace, I agree with Will power and exercise. I should exclude the word diet due to associated reverberations; better not eat more than needed. This is a major point: to treat and/or prevent obesity is multifactorial..

Fast foods- burger, pizza, snacking(and other high fat/fried junk foods), soft drinks/packet juices with high sugar contents (instead of water) add unnecessary calories, plus 24/7 TV and video games instead of outdoor sports are just some of the basic reasons of obesity.

This behavior leads to isolation, social withdrawal and psychological problems, obesity is by itself one of the major reasons of social isolation, poor self esteem, poor self image and depression because of societal rejection. Often obese people have more problems making friends male and female alike.

Also poor physical shape plus obesity leads to early onset of diseases which has enormous economic, social and psychological costs.

Nutritional education, parental involvement in providing healthy food instead of convenient DIY fast foods plus organizing school menus according to a healthy diet plan can all lead to paradigm shift in eating habits of youngsters which they will carry all their life.

Whereas media cannot stop advertisements of such products due to commercial reasons, they can however allot more time on programs that educate kids and parents about eating right and making delicious recipes that kids would enjoy.

I wonder if anyone has considered reasons for weight regain after bariatric surgery. Evidence points to a significant regain after 24 months post-op.

Obesity : No matter how much you will eat, you can never fill the gap.

Obesity: In children I would say it is not by choice. Thery are gullible to suggestions and enticement from advertisment of fast food. They have easy access to the fast food if they are provided with plenty of cash to spend (pocket money). The overeating need to be balanced with good diet education and systematic exercise plan at school and at home..

Great commentary so far! My comment is based on a context of living in North America... Canada. Two points below.

One other factor could be the developments in food science and technology. What impact does the ability to break down whole foods and extract components for addition to mass-produced foods?

For example, my granddaughter is 5 months old and in looking for infant rice cereal to start solids, my daughter informed me of the long list of ingredients in commercial baby rice cereals. Including isolated, non-rice-related components like potato starch.

Similarly, as opposed to 30 years ago a simple food item like yohurt has been transformed. I am very careful about choosing the purest form (which is now becoming quite difficult) and even so, I notice that the "quite pure" yohurt in my fridge purchased on criteria of least ingredients includes rice starch and added sugar.

And, of course, the addition to many foods of transfatty acids, and other types of less desirable fats that are either cheaper or extend storage.

In terms of inaccessibility of good quality food for lower-income citizens, I believe there are options but education starting at school-level is required. My mother was an orphan and lived in a religious-order- run orphanage during the Spanish Civil War. They had a healthy legume stew every day for their main meal when food was scarce at war time - granted, the nuns had their own orchards and other types of food crops plus butchered their own animals. However, I can quickly cook a lentil, chick pea or white bean stew using limited, but natural whole food ingredients and experience a feeling of satiation for a longer time due to the complex carbohydrates.

Lastly, I am a proponent of urban gardens...at schools, at community centres, parks, front sections of high-density buildings...anywhere possible...for all to establish a stronger connection to simple but healthy food.

To get fat: eat more energetic food than you need.

To slim: eat less energetic food than you need.

To be stable: you can be stable in overweight, slim, or normal.

To be ok, to be not ok, with our weight.

To be not ok: you are not happy with you. Psychological problems, relationship problems, insecurity.

To be ok: you are normal without psychological problems, normally more self- assured, many friends.

Obesity is worse than over weight. In the normal levels of biochemical analysis.

You can be ok in health. All levels well. Normally if you make good exercise, walk, etc. (But if you are not happy with you, you must slim).

Is the same the ideal weigh and the healthy weigh?

The ideal weigh have a component social. When we look how are we looked for others normally it´s more insecurity.

What do you prefer, obesity or anorexia? (Anorexia is worse).

It´s nice to be nice, but not is the only goal of people.

(I must take a slimming diet right now!! je)

Obesity is such a complex issue. But I believe there are a couple of things to be highlighted:

- Education. From an early age we need to teach our kids what is good for them, using both modelling, theory and practice. Cooking their own lunch at school once a week or month will, I think, do more good than years of theory unrelated to their reality.

- Choice: We always have a choice! Even for people with no kitchen, there is a choice to heat up a can of soup (on a little gas burner for example) instead of eating chicken nuggets, putting canned tuna on the sandwiches instead of jam, etc. We do have a choice to learn to exercise and play in small spaces indoors, if we feel too scared to go outside.

- Responsibility: We all need to take responsibility for ourselves, our health, our children's health and their future. If we feel like it's someone else responsibility, then we are starting to slip.

- Support: There is a need for numerous, easily accessible avenues to receive support, in terms of mental health, information, coaching etc.

Just recalled a presentation I heard from a German nutritionist working at a preschool daycare focusing on educating the small preschoolers to have a healthy relationship to good food. She created a separate eating area for the children similar to a restaurant dining area, the children helped set the tables at lunch time, and ate sitting down in social environment focused on eating a meal at a table just like adults. I believe they also helped with some of the preparation of the food where they could...we are talking preschoolers!

The menu consisted totally of healthy vegetables such as swiss chard, a good quality fat such as extra virgin olive oil, etc.

I asked her if it was more expensive to maintain this type of approach - she said "no, because I have meticulously calculated the volumes required". If I recall correctly the perishable food ingredients were brought in just-in-time as well.

Apparently there is a long waiting list of parents interested in sending their small children to this preschool.

@ Mohamad Arif ·, so we are coming back to square one: PARENTS and parenting. What and how parents fail exactly as far as the child obesity is concerned?

Thanks,

Adrian TW

@A T Williams. Thanks for your comment. Personally, after watching children of close relatives and families and talking to their parents, I think parents should get help from professional before obesity sets in. Children need to have their interphase with the computer regulated. Many children are "hooked" on computer games. Spend more time on Games requiring physical efforts and get them rewarded for their achievemnets even in simple noncompetetive exercise.. Parents (myself included) need to watch what we put on the dining table - less of the unrequired elements. On a higher plane there can be an advocacy to get food and drink industry to cut down sugar in soft drinks and not to include sweet drinks in food package deal at fast food outlets.

@ Mohamad Arif, you are absolutely right.

Children, teenagers, young adults and adults as well: Computers (games, Facebook, messenger), cell phones (text, talk) are technologies, structures that have an side effects other structures such as FAT STRUCTURE on our bodies.

For the young adults, adults, to add to the above, cars ( less walking ) and working without having regular ( in time) balanced meals (nutritious).

regards,

Adrian TW

Children cannot go out home alone now. Walk less, play sitting. Eat more energetic food, less fruit, less vegetables. Easy food for parents and their.

We must procure plays with all the body and with friends. Sport, relation with other, because now is less. To be alone it´s not good too.

To mix carbohydrates with lipids is negative for metabolism. (It´s the worst food). With bad lipids worst. (More natural food, less elaborated it´s necessary).

Hi Ana, can you refer me to any research studies on the negative consequences of mixing carbohydrates with lipids?

Thanks, Dolores Smith

Obesity is caused by one or more factors interacting together

1. Depression is a very important cause. Serotonin release is helped by food intake (as is nicotine in case of smoking). Many depressed people found eating as a way to feel better through this mechanism. It is only when they succeed to cut their food , that they feel more depressed

2. Cultural aspect. Eating habits are highly influenced by education and habits of the society and family. These habits are transmitted by family and parents to children. It is hard for these habits to be modified in children unless parents and society change their behavior of eating. Here the role of the different institutions as school and clubs might influence these habits by motivation

3. Overlooked medical illnesses as peptic ulcer disease or endocrinal derangement might facilitate increased food intake in excess of the actual requirements for the daily energy expenditure

4. Drugs as antipsychotics and steroids increase the hunger and excessive eating

5. Limited exercise delays and decrease gluconeogenesis, an important step in providing glucose for energy production between the meals

All these factors should be put in consideration to manage a case of obesity; sociocultural, medical, psychological, psychiatric and motivational

Dolores,

I´m talking about aliments rich in carbohydrates and grass like sweets (pastries) than must be the less contribution in our feeding. (High glycemic index).

Carbohydrates are very different in glycemic index. Aliments with fiber make it less, starch is more slow to degrade than disaccharide, (saccharose (G-F) is different than maltose (G-G)), the more quickly like saccharose make more insulin peaks.

We look that aliments like pastries mast be less in the food pyramid recommended.

http://www.gobiernodecanarias.org/educacion/4/Medusa/GCMWEB/Code/Recursos/DetalleRecurso.aspx?IdNodo=683&IdRecurso=6260&Preview=Si

Grass need lipase for its metabolism. (bile: pancreatic lipase).

Lipase is activated for AMPc, activated by adenylate cyclase.

Adenylate cyclase is activated by adrenalin, noradrenaline and GLUCAGON.

When you have sugar you need INSULIN to take Energy and the excess of glucose by insulin path sign make glycogen.

When you haven´t sugar, you need GLUCAGON to make Energy by glycogen.

Glucagon and Insulin are contrary effects.

Adenylate cyclase- AMPc- Lipase: relation, Earl Sutherland (50 decade). I studied this in Biochemist book, "Lubert Stryer" 1975, 1981, 1988, 1995, editions.

Another work (Spanish) http://www.nutrinfo.com/pagina/info/monografia_sindrome_metabolico_ninos_obesos.pdf

Your question is very good. It´s difficult to found works about lipid and sugar mix in high quantity in human to look if the metabolism be worst. Metabolic syndrome we can found now in children. We must use the food test to look this consequences.

A relevant paper to the subject has recently been published in Environmental health.

Associations of health, physical activity and weight status with motorised travel and transport carbon dioxide emissions: a cross-sectional, observational study

Anna Goodman, Christian Brand, David Ogilvie

Environmental Health 2012, 11:52 (3 August 2012)

http://www.ehjournal.net/content/11/1/52/abstract

As we becomming seniors in any workplace lifestyle is bit sedentary.If you are in scientific /research again one has to devote quality time to write papers or some publication work and sit hours togather for reading and infront of computerseven after the regullar working hours .This itself causes stress ,no time to exercise and tend to overeat without being able to burning those calories

Multi tasking is increasing so intake of quality diet is diminishing in all the age groups in a family . people are not botheredm may be medical help is easily possible. so concept of retaining health naturally by controlling or adopting few strategies fading away . Increasing obesity is not by choice but by lifestyle /professional hazards.

is a situation by choice for sure.... would recommend reading all the books from dr.F Batmangheldij a medical dr who spent 22 years researching the causes and cures for many diseases....

Kamimura et al. Molecular hydrogen improves obesity and diabetes by inducing

hepatic FGF21 and stimulating energy metabolism in db/db mice. Obesity 19(7):13961403

(2011).

Perhaps the causes for over eating may be as many as the number of obese people in the world. If it were a choise no one would choose to be fat in our society. Some people are fat and eat less than some very skinny ones. We have to understand that hunger is selective. People know their body wants to eat, salty, warm, cold food and the quantity. If one wants the control I would highly recommend processional assistance. If a member of the family or a friend won the battle against obesity it is not a good idea to repeat the treatment for others. This a too complex process  with roots in several áreas as in psychology, endocrinolog, social issues, family etc. Blaming the obese for the priblem alone is not correct. If your experience says differently I recommend you to make friendship with one obese person. Do not count with your o not. Try to understand his life. Do not trust his self blaming o not. Some times they have a low self steem and they may be listining at all times they should close their mounths and start exercising to get thin.

IMHO, Ignorance is the sole cause of obesity.

1. Ignorance about 'Who I am"

2. Ignorance about 'my place in the world'

3. Ignorance about 'why to eat, what to eat, when to eat & how to eat'

4. Ignorance about the sense of taste and wisely using it to choose instead of overeating

Close to nature societies have an innate awareness while industrialized societies cut off from nature are ignorant about the above. Thus the obesity epidemic among the overly industrialized and the technology abundant.

Including the genetically predisposed, an individual is solely responsible for his/her obesity. Such conditions need awareness guidance about actions and their effects, so that they are made aware that they themselves are solely responsible for their obesity instead of blaming 'external' factors for the condition. This is very vital in curing the condition.

http://time.com/3595856/obesity-overweight-exercise/

You Exercise Less When You Think Life Isn’t Fair.

The emphasis is on the 'think'.

Regards

Not a medical condition by chance nor by choice .... Nothing happens by chance...Just a matter of looking the wrong way ..  Excess fat is simply our solution to an underlying problem " too much toxic waste build up " and body is protecting itself for further damage from these toxins ... Why do we always hear " fat around the waste is the most dangerous " it is loaded with toxins ....  Nobody here that is smart enough to ask the question " where do these toxins come from" ?????

See there is gene environment interactions, however problem is due to obesogenic environmental conditions.

Obesity is not by chance or choice. It is more of a psychosomatic problem. It may be the result of lack of awareness about nutrition and right eating habits, sedentary lifestyle, and mental stress. However once you cross the weight limit,  it is almost impossible to return to normal weight except surgically. It is like prediabetic condition, one has to control it before it becomes an irreversible state.