The Childhood Obesity Perfect Storm, Part 2

Another Storm Over Cayuga

We’re taking a closer look at the elements of the childhood obesity perfect storm, as Dr. Pretlow terms the combination of circumstances that all came together in just the wrong way. The first element is the use of high technology to develop and manufacture not only food, but pseudo-food, ersatz food, fake food, and food-like substances.

Again, for a quick overview of the perfect storm concept, please see Dr. Pretlow’s presentation, “Why Are Children Overweight?” (Slides 42-48 in particular).

Thanks to the ancient Romans, we have a handy suffix that will fit on the end of almost any word, and that is “-genic.” It has to do with causality, and when something is described as obesogenic that means it makes you fat. According to the Centers for Disease Control and Prevention (CDC), the word applies to our entire culture:

American society has become ‘obesogenic,’ characterized by environments that promote increased food intake, nonhealthful foods, and physical inactivity.

What makes our society and, increasingly, so many other societies, particularly obesogenic? There are many little answers and no Big Answer. As Dr. David Katz says,

To hold back the flood waters, no single sandbag will do.

Technology is one of the problems, not just the technology that does such a splendid job of producing edible substances that are irresistible, yet useless. There’s the technology of all our wonderful electronic gizmos that keep us chained to our glowing screens when we play games, banter with our friends, or even do actual work.

Then, there is transportation technology, i.e. the cars that most of us do all our traveling in. Exercise burns calories; sitting in a car doesn’t burn calories. It’s that simple. Or is it? Even the value of exercise is not universally agreed upon, as, for instance, the Early Bird Study seems to indicate.

This subject is discussed in “A glimmer of hope for childhood obesity prevention!” whose author, Yoni Freedhof, describes himself as “an obesity medicine doc and certifiably cynical realist.” He founded the Bariatric Medical Institute in Ottawa, Ontario, described as “a multi-disciplinary, ethical, evidence-based nutrition and weight management centre.” The field traditionally embraces pharmacotherapy, but, Freedhof says,

Nowadays I’m more likely to stop drugs than start them, and love going to work in the morning.

He’s talking about a National Institute of Diabetes and Digestive and Kidney Diseases study that placed 4,600 teenagers under the microscope over a three-year period. The goal was to find out how much good it did to teach kids about nutrition, and how to set goals, and so on. Exercise was part of the program also, in order to “increase baseline physical activity and to teach the energy components therein.”

Freedhof’s opinion, expressed in another article, is that exercise:

[…] is the second most important determinant of health (nutrition being the first). To me it seems the story on exercise is very clear — it’s absolutely crucial for health, in extreme quantities it’s helpful for maintaining weight, and it’s really, really lousy as an exclusive modality for weight loss.

Any experiment worth doing will include both a group of subjects who are treated in some way, and a control group of subjects who are left alone to just do what comes naturally. The expectation is that the subjects who are being treated will change in some way, and the control subjects will pretty much stay the same.

Freedhoff calls the results of this study “odd.” The kids from the intervention schools, the ones who were being taught and exercised, showed less of a propensity to become overweight or obese. And so did the kids who weren’t doing anything different, except for being monitored and measured.

This might be an example of what psychologists call the “observer-expectancy effect.” It happens in physics, too — “the greater the amount of ‘watching,’ the greater the observer’s influence on what actually takes place.”

Your responses and feedback are welcome!

Source: “Overweight and Obesity,” CDC.gov
Source: “A glimmer of hope for childhood obesity prevention!,” Weighty Matters, 06/29/10
Source: “Weight ain’t about exercise,” Weighty Matters, 03/10/10
Image by [Adam_Baker], used under its Creative Commons license.

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