Thursday, May 24, 2012

"The Weight of the Nation"

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HBO's four-part special, The Weight of the Nation, aired last week and it's now available on their website to watch for free, in its entirety. Part one shows the dangerous long-term effects of the standard American diet; part two focuses on the steps individuals can take to improve their health; part three focuses on childhood obesity, with a spotlight on school lunches; and part four shows how we can take collective action to reverse poor health trends in our communities.

My main problem with the series is that it makes a lot of statements that indicate a causal relationship between obesity and various health problems. It says that obesity causes diabetes and heart disease, etc. It doesn't. Obesity is just one of the more visible symptoms of a body that can't regulate its blood glucose effectively. The inability to regulate blood sugar causes obesity, diabetes, heart disease, etc. Saying that obesity causes diabetes is like saying your sore throat caused your runny nose. Just because one happens before the other doesn't mean it caused it. But obesity is a good indicator that you need to change your habits in order to head off health problems.

In general it's disappointing that we're talking about an obesity crisis rather than a diabetes crisis or heart disease crisis. It's sadly and typically American that we're fixating on physical appearance and assuming that being too heavy is the evil behind all our health problems. It's not. Out of diabetes, heart disease and other problems, obesity is just the one that offends us the most.

Another problem is that the show uses that old myth about calories in equaling calories out. This so-called weight loss formula has gotten us nowhere in thirty years of counting calories and gym memberships. If you want to be scientific, the formula would be physical mass = energy in - energy out + energy stored. And what causes our bodies to store extra energy in excessive amounts? Poor blood glucose regulation, not physical activity or lack thereof. Exercise is critical to health, but not to weight loss, although people tend to improve their eating when they exercise regularly. Part two of the series emphasizes calorie counting when the focus should be on high-starch and high-sugar foods, plus sugary beverages. Cutting those out would get us much farther than parsing out low-carb pasta and fat-free cookies. The old eat-less-move-more advice has gotten us nowhere in 30 years and I'm disappointed that the creators of this series don't seem to know that.

Now the good advice that the series gives. Two big messages are: 1) cutting out sweetened beverages (including fresh squeezed juice) is a great first step, and 2) even a small amount of weight loss makes a big difference for your heart and liver. I take this to mean that even a small change in your lifestyle will have a significant impact on your health. The program suggests going for a 10% reduction in weight, which sounds okay to me because in order to lose 10% and keep it off, you have to make a permanent change for the better in how you live.

According to the program, ideal cardiovascular health is defined as -
  • Optimal levels of total cholesterol
  • Normal blood pressure
  • Lean body mass index
  • No smoking
  • No diabetes
  • Healthy diet
  • Regular exercise
- but this is the reality: less than 1% of Americans fit all seven of these criteria.

One more striking assertion that the program makes is that if you live a typical American life and just go with the flow, you will be overweight, which is to say, you will have blood sugar regulation problems. This underscores what I've suspected: no matter how much you exercise or how good your natural metabolism is, you will eventually have blood glucose problems (and probably become diabetic or overweight) unless you actively avoid the typical American way of eating. Since this requires vigilance and resistance, every hour of every day, no wonder most of us are having health problems. It's not anyone's individual fault that they're diabetic or have heart disease due to diet, but it is our collective responsibility to change things.

It really is a problem that's entrenched in our beliefs about food, our cultural habits, the power of the food industry and our relentless American drive to make money, including by feeding unhealthy substances to our kids. It's a four part series that should make us feel ashamed, not because of our size, but because we've sold out the health of our children in order to support American agribusiness that churns out wheat, corn and soy products in toxic amounts. Since those businesses aren't going to stop willingly, we have to make changes ourselves. Start by watching it.

[5/26 - "Obesity not always tied to higher heart risk" More evidence that obesity isn't the cause of our health problems, but a symptom of the true problem. And another viewpoint on how the HBO series misses out on the true problem. ]


Mick said...

All the points here are good and very true but not quite the full story.
I'm a great believer that the biggest single problem is exercise or lack of.
Lifestyle in western countries as changed so much from a physical point and going to the gym few hours a week will not address the problem.
Previous generations worked out almost perminantly without even thinking about it.
Look at the number of labour saving devices around the home from the TV remote to automatic washing machine.
Most jobs were labour intensive with lifting, climbing, pulling, as just part of it, now we have machines to do it, most jobs are desk based.
As kids we went out to play (until dark)and didn't sit in our bedrooms playing on our x boxes or computors, we didn't have a phone we went around to see our friends.
Count the cars down your street, back in the day we went to work or school on our feet or bikes.

Saying all that here i am sat with my laptop on my knee, better get up and do something.

Regina Rodríguez-Martin said...

Mick - right, you can't snack while plowing the field or doing laundry by hand, but we eat endlessly while watching TV or surfing the Net or working at our desks. Physical activity also keeps you from focusing on food. We've replaced all the traditional activities of daily living with eating.

whcf99 said...

Thanks for the post and the comments. I have watched the series and one point I really found to be helpful: if you want to lose weight, eat less and if you want to maintain the weight loss, move more. I have tried to exercise to lose weight and it just doesn't seem to work very well. I can sabotage my exercise efforts with a few snacks. Thanks again.