Tag Archives: obesity

When it comes to your health, don’t take the high road.

Posted on October 6, 2014 | 1 comment

When faced with challenging moral or ethical situations we are advised to do what is right, even if it is more difficult. “Taking the high road” is often synonymous with living a better life. When it comes to your health, though, taking the high road may lead you on a path to chronic disease, disability, and early death.

The high road I am referring to in this case has nothing to do with ethical decisions. It has to do with test results, specifically measurements your doctor makes of your weight and blood pressure as well as blood tests of cholesterol and glucose. This is the topic of my Health & Fitness column in the Aiken Standard this week.

These tests are indicators of your current health as well as risks to your health in the future. The results of these measures are used to classify you as having “normal” or “high” blood pressure, blood glucose, and blood cholesterol. For example, a fasting blood glucose between 70–100 mg/dl is normal but you are considered to have diabetes if your result is 126 mg/dl or higher.

Even if your blood glucose is above normal (100–125 mg/dl) but isn’t high enough for you to be classified as diabetic, it may still be too high. This condition is called prediabetes because without intervention most people in this category will eventually develop diabetes.

Considering that diabetes is a leading cause of heart attacks, blindness, and amputations, preventing your blood glucose from increasing should be a high priority.

The same is true for other measurements including blood pressure and body mass index (BMI), the most common assessment of obesity. Even if you aren’t considered obese or don’t have hypertension, the higher your BMI or blood pressure becomes puts you at increased risk of the condition getting worse over time or leading to other more serious health problems.

In fact, even within the normal range, a higher value is associated with increased health risks. Take blood cholesterol for example, where the risk of heart disease increases at total cholesterol levels above 150 mg/dl, well within the “normal” range of less than 200 mg/dl. At even higher levels, total cholesterol is associated with a much greater risk.

Clearly, having a high BMI, blood pressure, blood glucose, or cholesterol is concerning. But it is important not to be fooled into thinking that a value that is technically below the diagnostic criteria for “abnormal” is necessarily “normal.” For many, even slightly elevated levels of these variables now are likely to get worse over time.

The good news is that modest lifestyle changes including weight loss, regular moderate physical activity, and changes to what you eat can prevent conditions like prediabetes and prehypertension from getting worse. This can be achieved through losing as little as 10 pounds, walking or doing other activity for 30 minutes per day, and adding more fruits and vegetables to your diet.

To be sure, taking the “high road” with BMI, blood pressure, cholesterol, and glucose, even if your test results are within the normal range, can put you at increased health risk. For these conditions, you are far better off taking the low road and making the necessary lifestyle changes to stay there.

1 Comment

Posted in Health & Fitness

Tagged , , , , , , , ,

Loosening our belts. Expanding waistlines means expanding health problems.

Posted on September 22, 2014 | Leave a comment

In a report published this week, researchers showed that the waistlines of Americans are still expanding. This is bad news, since excess fat, especially around the waist, has serious implications for our health. Fortunately, there is much we can do to lose weight and improve our health.

This is the topic of my Health & Fitness column in the Aiken Standard this week.

The study, published in the Journal of the American Medical Association, looked at the percentage of adults who had a high waist circumference (over 35 inches for women and over 40 inches for men). Overall, the average American added over one inch to their waist circumference over the past decade. As of 2012, over half of U.S. adults (51%) meet the criteria for abdominal obesity, compared to 46% in 2000.

Since excess muscle tends to compress the abdomen, this really does reflect an increase in fat around the waist, not the benefits of a national sit-up campaign. And it is the location of the fat that makes this worrisome. Excess fat around the waist includes both subcutaneous fat beneath the skin (what you can pinch) as well as visceral fat stored deep in the abdomen.

Excess visceral fat is associated with an increased risk of high blood pressure, type 2 diabetes, and heart disease, among other chronic conditions. The only way to determine how much visceral fat a person has is through an imaging test like a CT scan. (In my lab we can estimate visceral fat by making a few abdominal measurements.) The important point is that the bigger your waist circumference, the more visceral fat you likely have.

You may have heard of people’s body shapes described as “apple” or “pear.” Upper body obesity (apple), sometimes called android obesity because it is more common among men, is associated with a high waist circumference and visceral fat. Lower body, or gynoid, obesity (pear shape) tends to involve a narrower waist but more fat storage in the hips, thighs, and buttocks.

These body shapes become apparent when you measure both waist and hip circumferences. A high ratio between waist and hip measurements indicates more upper body fat; a low waist-to-hip ratio suggests lower body fat. That said, just measuring your waist circumference can give you the same information. A waist measurement greater than 40 inches for men and 35 inches for women indicates excess upper body—and visceral—fat.

There is no single explanation for why waist circumference has increased so much in the population. But it almost certainly has to do with a combination of individual factors including what foods we eat, how much we eat, and how active we are. The average American with an expanding waistline likely eats too much poor quality food and doesn’t get enough exercise.

These are exactly the same factors that, when reversed, can lead to fat loss. Indeed, research shows that even modest weight loss from a low-calorie diet and exercise can result in reduced body fat, including visceral fat. This is one reason why weight loss is effective for reducing high blood pressure and controlling blood glucose.

Even if you don’t lose weight, increasing your level of physical activity, particularly regular exercise, can offset some of the negative health effects of excess visceral fat. In addition to helping you lose weight, exercise can also help you maintain your waistline and prevent abdominal obesity.

The bottom line is that when your pants start to feel tight, they are trying to tell you something. Listen to them!

Leave a comment

Posted in Health & Fitness

Tagged , , , , , , , , , , ,

Fat still matters

Posted on September 15, 2014 | Leave a comment

Last week I wrote about some recent research suggesting that low-carbohydrate diets may be better for weight loss that low-fat diets. For many, this study reinforced the notion that traditional recommendations are wrong and that the key to good health is to eliminate carbohydrates from your diet. This couldn’t be further from the truth.

The recent study did show that people lost more weight and experienced beneficial changes in blood lipids when they followed a low-carbohydrate diet compared to those who ate a low-fat diet. However, this does not mean that low-fat diets aren’t effective for weight loss or that they are “unhealthy.”

In fact, low-fat diets have long been used effectively to promote weight loss, reduce heart disease risk, and lead to healthier eating in general. This is supported by the results of hundreds of research studies as well as the practical experience of health professionals and real people. Here are two reasons why fat still matters when it comes to health.

First, reduced-fat diets have been shown to improve blood cholesterol and lower the risk for heart disease. Eating a diet low in fat, especially saturated and trans fat, has been the foundation of nutrition recommendations for decades. The fact is that these diets are effective for weight loss, reducing cholesterol, and otherwise improving heart health.

One famous study demonstrated that following a low-fat diet contributed to a reduction in the severity of atherosclerosis, the narrowing of arteries that leads to many heart attacks. Literally hundreds of other studies have shown similar beneficial results.

This isn’t some magical effect of eating less fat, though. The health benefits are likely due to eating more vegetables, fruits, and whole grains as much as they are to reducing fat intake. The point is that adopting a low-fat diet can lead to better nutrition overall.

Second, reducing fat intake is a good way to reduce calories. This is true because fat contains nine calories per gram, more than twice that of carbohydrates and protein, so cutting fat is an effective way to cut calories. Limiting fat intake also reduces calories indirectly because many high fat foods are also high in sugar and calories (think of most desserts).

It is important to mention that simply reducing fat intake won’t always lead to weight loss; total calories must be lower, too. This is a mistake many make when they reduce fat intake, but increase the amount of calories from other sources, typically carbohydrates. Many low-fat foods are actually relatively high in calories due to added sugar or people tend to eat more of them (the SnackWell Effect).

The effectiveness of low-fat diets for weight loss has been demonstrated in research studies (like this one) and countless weight loss programs. In one notable study, a diet low in fat even led to weight loss in people who weren’t trying to lose weight. And don’t forget that in the recent study about low-carbohydrate diets, the subjects that followed the low-fat diet also lost weight.

For some people, cutting carbohydrates as a way to lose weight is reasonable; for others, reducing fat intake makes sense. For most people, though, doing both to some extent is the best option, but going to extremes is unnecessary.

Eating less added sugar and avoiding foods with added fats (such as French fries) are good recommendations for almost everyone. That said, there is little evidence for the benefit of limiting carbohydrates in the form of whole grains, legumes, vegetables, and fruits or the fat in meat and dairy.

The bottom line is that the quality of food we eat is more important than the specific amounts of the nutrients it contains. Eating low-carbohydrate or low-fat diets can help steer you toward making healthier choices, but so can avoiding processed foods in favor of wholesome, nutrient-dense “real” food.

Leave a comment

Posted in Health & Fitness

Tagged , , , , , , , , , , , , , ,

Good sources of protein for your low-carb diet

Posted on September 10, 2014 | 1 comment

Thanks to a recent study and media coverage (including me), low-carbohydrate diets are a popular topic of discussion. For many people, cutting back on carbohydrates is a good way to reduce calories to promote weight loss.

Most low-carbohydrate diets also emphasize protein intake. But finding healthy protein sources is important for promoting weight loss and good health.

This recent discussion about the best protein for optimal weight loss  on the Train Your Body show on RadioMD should help.

1 Comment

Posted in Uncategorized

Tagged , , , , , , , , , , , ,

The diet wars continue

Posted on September 8, 2014 | 2 comments

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best, you are forgiven. First we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better. And back and forth it has gone for years.

During this time, the prevailing recommendations have suggested that a diet low in fat and high in carbohydrates was best. But more and more research has supported the notion that cutting carbohydrates, not fat, would lead to greater weight loss. Although this has been supported by some research, critics pointed out that eating more fat would raise blood cholesterol and other risks for heart disease.

According to a recent study, though, low-carbohydrate diets seem to have benefits for promoting weight loss and improving some indicators of heart health over low-fat diets. But you should hold off on shunning fruits and vegetables in favor of cheeseburgers! Here is a practical interpretation of the research and some common sense recommendations, taken from my Health & Fitness column in the Aiken Standard this week.

The study, published last week in the Annals of Internal Medicine, reported on 150 men and women who either restricted the amount of carbohydrates or fat they ate. After one year, the group that ate a low carbohydrate diet lost over 7 pounds more than the subjects on the low-fat diet. Additionally, the low-carbohydrate diet promoted greater improvements in blood lipids than the low-fat diet.

This is important for two reasons. First, this wasn’t a weight loss study; the researchers were simply following the subjects to see what would happen as they followed either diet. The fact that the low-carbohydrate group lost more weight suggests that it is relatively easier to cut calories following this type of diet.

This is consistent with other research showing that eating more carbohydrates, especially refined carbohydrates and sugar, can actually make people feel hungrier and eat more. Indeed, other studies have shown low-carbohydrate diets to be more effective for weight loss than low-fat diets (although a more recent study suggests there isn’t such a difference).

Second, the greater decrease in triglycerides and “bad” LDL cholesterol and increase in “good” HDL cholesterol in the low-carbohydrate group were different from what might be expected. Conventional wisdom holds that a low-fat diet should have a greater effect on blood lipids. Since weight loss can have a big effect on blood lipids, the improvement in the low-carbohydrate group may be due to losing more weight, not a direct effect of the diet.

It is important to note that the low-fat diet also led to weight loss in this and numerous other studies. The critical component of any weight loss diet is that it is relatively low in calories, regardless of what nutrients supply those calories. Really, almost any diet will lead to weight loss as long as it contains less energy than what is expended, but a low-carbohydrate diet may be more effective for weight loss than the traditional low-fat diet.

The bottom line is that the best diet is one that emphasizes eating wholesome foods, not on cutting carbohydrates or fat. That said, limiting carbohydrates in the form of refined grains and added sugar is an excellent way to reduce calorie intake and improve the overall nutritional value of what you eat. And shifting toward more monounsaturated fats (think olive oil and nuts) rather than worrying about the total amount of fat you eat is also a good idea.

2 Comments

Posted in Health & Fitness

Tagged , , , , , , , , , , , , , , , , , ,

Mindfulness matters for health.

Posted on September 2, 2014 | Leave a comment

According to a TIME magazine cover article from earlier this year, we are in the midst of a “mindful revolution.” Beyond being a trendy topic, mindfulness is important for making meaningful and lasting health behavior changes. This is the topic of my Health & Fitness column in the Aiken Standard this week. 

Mindfulness can be described as an awareness of thoughts, feelings, bodily sensations, and the surrounding environment. This is most commonly explored through mindful meditation, a practice that is credited with improving physical and mental health. Beyond meditation, being mindful can help to improve attention and focus in nearly every aspect of life.

 

Thinking about your actions and the effect they have on your health and the health of others can be good for you and those around you. It turns out that we engage in many health behaviors that are driven more by habit than conscious decision-making. This includes what, when, and how much we eat as well as how active we are, two of the most important determinants of health.

 

When was the last time you thought about what you were eating? Not just which restaurant to go to or what time to eat, but really thought about what and how much you ate? Chances are, at least some of the time you eat when you aren’t hungry or keep eating even when you are full. You probably also eat foods you know you shouldn’t or don’t intend to, sometimes without even realizing it.

 

This concept was explored in depth by Brian Wansink in the 2006 book, Mindless Eating. Based on his research, this book helped to explain the hidden reasons behind what, why, and how much we eat, often without being aware of it. This includes marketing tricks as well as environmental factors, many of which operate outside of our consciousness, that drive our food choices and prompt us to eat. 

 

This is where mindfulness comes in. By making an effort to be cognizant about your own thoughts and sensations as well as the environment you are in, you can prevent overeating and poor food choices.

 

Furthermore, we should be aware of how our food choices influence others around us. Research shows that children of parents who eat more fruits and vegetables tend to eat more of these foods than kids without such influence. Mindful eating includes accounting for how our actions and choices can influence the decisions of other family members and friends.

 

 

The same is true for how active or sedentary we are. Being active is a choice, sometimes a difficult one, that is influenced by other people and the environment. Most people spend the majority of the day sitting at work and at home, often without thinking about it. This sedentary lifestyle has been linked to an increased risk of obesity and heart disease, so it is relevant.

 

 

Sure, it feels good to sit on the couch to watch television. Think about it: is that really the best way to spend your time? At work, taking short breaks to get up from your desk and move can make you feel more alert and energized. Isn’t that worth it?

 

 

Similar to eating, our activity choices can influence the actions of those around us. A suggestion to walk to lunch can increase your own activity and that of your friends. Planning to go for a walk or bike ride with your family after dinner is a great way to share the benefits of activity.

 

 

When it comes to health, mindfulness matters. Being mindful about what you eat and make a choice to be more active allows you to have a positive effect on your health and the health of those around you.

 

 

Leave a comment

Posted in Health & Fitness

Tagged , , , , , , , , , , ,

To make your diet healthier, add exercise.

Posted on August 25, 2014 | 2 comments

The American diet is frequently blamed for the poor health of Americans and, increasingly, other countries. The quest for the healthiest way to eat can literally take people around the world to find the right foods eat.

Unfortunately, diets and supplements that include these “super foods” are rarely the answer to good health on their own. It turns out that the key getting the optimal health benefits from your diet isn’t the food itself—it’s exercise!

This is the topic of my Health & Fitness column in the Aiken Standard this week. It’s not to say that what you eat isn’t important (it is!). The point is that healthy eating will only get you part of the way to the goal of good health.

For decades scientists have tried to isolate the types of foods or individual nutrients that lead to good health by studying what healthy and unhealthy people eat around the world. In some studies eating more of a certain nutrient or food, like saturated fat or red meat, was associated with a higher risk of heart disease and people who ate more fish had better heart health.

This is how we arrived at the common guidelines that encourage us to eat more fish and less red meat. The assumption was that the saturated fat in red meat was the cause of more heart attacks in Americans while the beneficial oils in fish protected the Japanese from heart disease.

But these studies, or at least the interpretation of these studies, didn’t take into account the fact that the populations that had the higher heart attack risk were also less active than their healthier counterparts. Perhaps it was the physical activity that made the difference in health.

A good example of this is the popular Mediterranean diet, which is often touted as the healthiest diet in the world. It’s true that people in the Mediterranean region historically tended to have a lower risk of heart disease. This was thought to be due to their diet which emphasizes healthy fats from olive oil along with vegetables, whole grains, seafood instead of red meat, and red wine in moderation.

Unfortunately, eating more olive oil or drinking more red wine, both recommendations based on the Mediterranean diet, won’t necessarily make you any healthier. This is because health benefits are due to a complex interaction of what we eat and other lifestyle factors, including activity. And people in the Mediterranean region move a lot more than we do, a key to realizing the benefits of the local diet.

Another example is the Ornish diet, a low-fat, semi-vegetarian diet that has been credited with improving blood lipids and even reversing the process that clogs arteries in heart disease. This is part of the reason for the recommendation to avoid foods high in saturated fat and cholesterol and eat more vegetables. It’s true that this diet has been shown to improve heart health, but the subjects in the studies also exercised regularly. Achieving the full benefits of this diet requires exercise, too.

Even the typical American diet won’t necessarily be unhealthy when combined with enough exercise. The Olympic swimmer Michael Phelps famously revealed what he ate on a typically day. The amount and type of foods he consumed were not what you would expect from someone so fit and healthy! Without the hours of training he engaged in each day that diet would almost certainly have resulted in obesity and poor health.

So, as you work toward improving your diet, don’t forget about the importance of daily exercise or other activity in maximizing the health benefits. And when people ask your secret, you can tell them that the real key to a healthy diet is exercise.

2 Comments

Posted in Health & Fitness

Tagged , , , , , , , , , , , , , , , , , , , ,

Time to make your new school year resolutions

Posted on August 18, 2014 | Leave a comment

Today is the first day of school for my kids and the first official day back for me and my colleagues at USC Aiken. So, it seems like a perfect time to make and plan for New School Year resolutions. It’s also a good time to assess your progress on your New Year’s resolutions and restart (or finally get started) on your goals. This is the topic of my Health & Fitness column in the Aiken Standard this week.

It’s hard to believe, but summer is winding down and the start of a new school year is upon us. As teachers, students, and parents know, this is the real beginning of the new year. For those of us involved in education, the first day of school is a perfect time to make new goals for the upcoming year, whether they are related to school or not.

This is a lot like making New Year’s resolutions on January first. Hopefully, you are still on track with your resolution. Sadly, research suggests that only 8% of people actually achieve their goal (more data here).

There are a host of reasons for this. Some of the most common resolutions—quitting smoking, losing weight, and getting in shape—are also some of the most difficult behaviors to change because they require making significant lifestyle modifications. To make things worse, many people set unrealistic goals or try to take on too much at once.

Many people who fail to keep their New Year’s resolutions this year will recycle them next year and try again. In fact, most people who manage to successfully quit smoking or lose weight have tried many times in the past. Sometimes experience, even a bad experience, is the best way to learn what does and doesn’t work.

But there is no need to wait until 2015 to restart your stalled New Year’s resolution or finally get around to doing what you planned months ago. Setting a date to begin a behavior change is an important step in the process so, why not make a New School Year resolution and try again now?

Here is some advice to help make this second chance to start or restart your New Year’s resolutions successful.

Be realistic. Many people fail to keep their resolutions simply because they don’t set realistic goals or aren’t realistic about what it will take to meet those goals. For example, running a marathon is an ambitious goal for almost everyone, especially someone who doesn’t exercise at all. A resolution to work up to jogging five days per week, with a goal of completing a 5k run is more realistic and achievable.

Focus on learning. Making most health behavior changes involves learning as much as doing. Something as simple as eating a healthier meals requires learning about the nutrients that make some foods healthier than others, learning to read food labels to select healthy foods, and learning how to cook and prepare healthy meals. If your resolution is to learn about healthy meals you will be able to achieve that goal and be well on your way to eating a healthier diet.

Manage your time. Most health improvement projects require taking time to learn about, implement, and maintain those healthy behaviors. If you resolve to manage your time to include exercise or meal preparation in your daily schedule you will be much more likely to meet your goals. Trying to add these new activities as “extras” to your already busy day will inevitably lead to them getting squeezed out.

Plan ahead. Most people already know that changing health behaviors can be challenging, even under the best circumstances. It’s no wonder that holidays, travel, and other life events can complicate or even derail an otherwise successful diet or exercise program. Make it your resolution to think about what you can do before, during, and after these (and other) disruptions occur to keep yourself on track.

Hopefully these steps will help you keep your resolutions, achieve your goals, and make this a happy, healthy year. As a bonus, you can take January 1 off!

Leave a comment

Posted in Health & Fitness

Tagged , , , , , , , , , , , , , , ,

Don’t go into (health) debt!

Posted on August 12, 2014 | Leave a comment

We are all aware of the hazards of being in debt. Too many individuals and families have gotten themselves in a poor financial situation by spending too much and not saving enough. For most, this debt has developed over several years and will have an impact lasting years into the future.

Unfortunately, this is not the only debt we face. Many of us are also in a health debt crisis. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Poor eating habits and increasingly sedentary lifestyles have led to an obesity epidemic. This is important since the three leading causes of death among adults (heart disease, stroke, and cancer) are directly linked to poor diet, inactivity, and obesity.

Obesity, diabetes, heart disease, and cancer are among the conditions that make up our health debt. Even if we have not been diagnosed with these or other health conditions, our lifestyle has put us on that path.

Whether our doctors have told us or not, many of us are in poor health. And our overall health and potential complications get worse each year, so the longer we are overweight and inactive, the worse our health is likely to be in the future. That is our health debt crisis.

Another example of a health debt is smoking, the cause of nearly 90% of lung cancer cases. Lung cancer doesn’t develop after the first cigarette; it takes years of smoking to cause cancer. One estimate suggests that there is a 20 year time lag between smoking and lung cancer diagnosis.

During this time smoking is causing damage to the lungs that leads to cancer, but it is usually undetectable. The cancer process is underway long before it causes symptoms, and since smokers are unaware of it, they continue to smoke. Quitting smoking begins to erase this debt but former smokers suffer poor health even after they quit. In some cases, the debt can’t be completely paid back.

Aside from poor health and reduced quality of life, health debt carries a financial cost. The medical costs attributed to obesity alone are estimated to be $147 billion per year, and a typical obese patient spends over $1,000 more per year on their own medical care than someone at a healthy body weight. The financial burden is both collective and individual, meaning we all pay for it.

Just as financial debt is due to an difference between the money we save and what we spend, much of our health debt is due to an imbalance between the energy (calories) we save and spend.

We have been spending too little energy through activity and saving too much of the energy we eat in the form of fat. Each day we consume more calories than we burn, we store that extra energy as fat. Even a small difference each day adds up over time.

Putting it in these terms, the pathway out of health debt is clear—spend more energy by being more active and cutting back on the calories we eat. Like a financial debt, even though the solution is easy to identify, putting it into place requires making some difficult choices.

But it doesn’t have to be a painful process. Even small changes in activity and diet can lead to weight loss and improved health over time. Make it a priority to be active every day and try to spend less time sitting. Pass on second servings at meals and skip desert once in a while.

Remember, the health debt wasn’t created overnight. It was the result of small changes over time, some of which we may not have noticed. Fixing it will take time, too.

Leave a comment

Posted in Health & Fitness

Tagged , , , , , , , , , , , , , ,

Calories Still Count!

Posted on June 30, 2014 | 1 comment
The debate about whether diet and exercise are the cause of or good treatments for obesity has been going for some time. A familiar point of argument is the role of total calories vs. the source of those calories.A new model of how obesity illustrates how calories in, calories out may not be the initial step in the cascade of physiological and behavioral factors that lead to significant fat gain. But this doesn’t change the fact modifying eating and activity behaviors are a key step in the development of obesity—and the key to weight loss.This is the topic of my Health & Fitness column in the Aiken Standard this week.

Eat less, exercise more. Calories in, calories out.

These phrases are probably familiar to you if you have tried to lose weight. This is because these concepts make up the traditional explanation for why people gain weight and the most common method of losing weight.

More and more research suggests that gaining and losing weight might involve more that the simple math of counting calories. It may be that the source of the calories matters as much as the total amount that you eat.

However, this doesn’t mean that you can ignore the calories you eat and expend through exercise and other activity. While it may be true that the quality of the food we eat is important, calories still count.

A recent article in the Journal of the American Medical Association proposes an alternative to the classic model of how weight gain occurs. Traditionally, an imbalance between calories in and calories out causes obesity. According to this model, eating too much and not being active enough results in increased fat storage.

The new model suggests that diet quality, especially the type and amount of carbohydrates, combined with genetics and lifestyle factors including getting enough sleep and excessive stress leads to fat accumulation. The excess fat alters levels of hormones and other factors that stimulate hunger and inhibit energy expenditure, including physical activity.

In the new model, increasing fat mass comes first and excessive food intake and inadequate activity follows. The end result is the same, though: a small increase in body fat turns into obesity.

This seems to suggest that carbohydrate intake, especially from refined grains and sugars, is the main culprit. This is good news for people who follow and promote low-carb diets! It also gives the impression that exercise isn’t as important as previously believed.

But a closer look at the new model shows that obesity—storage of excessive body fat—really is the result of too many calories in and too few calories out. The difference is that the eating and activity behaviors is driven by other factors.

The fact of the matter is that diet quality, genetics, and factors such as stress and sleep do play a role weight gain. Changes in hormones, sugars, and fats in the blood are real and powerful physiological signals that certainly contribute to obesity.

But so do changes in how much we eat and how active we are. It would be wrong to disregard these behavioral factors and the important role they play not only in body weight regulation, but in health in general.

Furthermore, the traditional calories in, calories out model of weight gain leads to a sensible treatment for obesity: Eat less, exercise more. Even though these simple recommendations can be challenging to implement, certainly in the long term, people who follow this advice do lose weight.

Even in the new model, calories in must be greater than calories out to lead to the significant fat gain that characterizes obesity. Additionally, the focus on the food quality is also consistent with this idea. People who get more of their calories from refined grains and sugars tend to consume more total calories.

As of now, the only treatments we have for obesity focus on changing energy intake and energy expenditure. This almost always involves altering eating and activity behaviors and frequently includes other lifestyle changes including stress management and getting enough sleep.

Given this new model of obesity, the best way to lose or maintain weight is not new at all: Eat less, move more, chill out!

1 Comment

Posted in Health & Fitness

Tagged , , , , , , , , , , , , ,