Tomorrow, March 4, Is World Obesity Day

A couple of relevant things are going on at the present time. One is described by a contender for longest headline ever — “The 6th Annual Obesity Care Week (OCW) Takes Aim At Important Issues Impacting People With Obesity And Celebrates World Obesity Day.” We are already in the midst of Obesity Care Week, which started February 28. Its point is awareness cultivation, with the goal of…

[…] changing the way we care about obesity by creating a society that understands, respects and accepts the complexities of obesity and values science-based care.

Obesity Care Week wants to get people excited about widespread access to respectful, comprehensive, and appropriate care.

Worldwide, it is said that some 650 million people are affected by obesity. For a stunning example, the Pakistan Health Research Council has discovered that more than 50% of that country’s population is obese. That’s half the people! If projections are accurate, by 2030 — in another 10 years — that will include five million children in Pakistan alone.

One thing that really needs work is the idea that obesity is some kind of “lifestyle choice.” Okay, maybe for a very small segment of the obese population, it is. But five million Pakistani kids did not make that choice. It was somehow made for, and imposed upon, them. Among other issues, the problems everywhere include access to care, weight bias, and agreement on the best obesity treatment.

Currently in the U.S, the Treat and Reduce Obesity Act is before Congress, where it has 180 supporters.

The critical legislation will provide the Centers for Medicare & Medicaid Services (CMS) with authority to enhance the current Medicare benefit for intensive behavioral counseling by allowing additional types of qualified healthcare providers to offer these services. The Act also allows the agency to expand Medicare Part D coverage to include FDA-approved prescription drugs for chronic weight management.

The part about behavior counseling sounds great; the part about chronic weight management drugs, not so much. Realistically, in the face of threats to reduce or eliminate Medicare, and a frightening viral pandemic, the odds of success for the bill are not good.

Stories, resources, and more

WorldObesity.org, headquartered in London, invites and urges people to visit their website and obtain tools for preparedness to fight the good fight. They offer templates for social media applications, infographics, reports, and posters. The group collects and shares people’s individual stories, and directions to image banks of photos of obese people that are not stigmatizing, pejorative, or stereotypical, for journalists to use.

The project they suggest participating in this year is “Send Us Your O” for the World Obesity Federation Image Bank, and here is the call to action:

It’s a quick and easy thing you can do alone, or in a group. All of your photos will be compiled for use on our website and social media channels to demonstrate the global support that World Obesity Day has.

We would especially love to see you and your colleagues supporting World Obesity Day with any local landmarks in the background so that we can build a real global feel to the images we share.

Please email us your images at WOD@worldobesity.org.

Your responses and feedback are welcome!

Source: “More than 50 percent population in Pakistan is obese: study,” TheNews.com, 03/01/20
Source: “The 6th Annual Obesity Care Week (OCW) Takes Aim At Important Issues Impacting People With Obesity And Celebrates World Obesity Day,” IdahoStateJournal.com, 02/28/20
Image by Taro the Shiba Inu/(CC BY 2.0)

Putting Exercise on a Pedestal

When it comes to questions of consumption and health, Big Food and Big Beverage are staunch fans of the energy exchange equation. The perfect example is a piece of propaganda (now vanished from the Internet) originating with the International Sweeteners Association that touted “the importance of physical activity in weight management.”

Not an outright lie, but an effective coverup. It went on to say that “combining a well-balanced, reduced-calorie diet with increased levels of physical activity will offer the safest and most effective strategy for weight management.” Increased levels of physical activity means More Exercise, and anybody who doesn’t do More Exercise deserves whatever flabby physique they wind up with.

The answer is to be found not only in More Exercise, but in artificial sweeteners. “This in combination with physical activity also helps reduce the development of chronic disease and improving mental health.” Mental health! Under the onslaught of constant gaslighting from the industry, what level of mental health can the public be expected to maintain? But it gets worse, with this classic baloney:

Making small changes to your lifestyle, such as consuming foods and beverages sweetened by low or no calorie sweeteners, is a successful way of reducing calorie intake without feeling deprived.

Sure, deprived of nothing, except possibly our lives. Remember Gilda Radner, the sweetheart of Saturday Night Live‘s early days? The cancer she died from is suspected of being caused by the massive amounts of artificial sweeteners she consumed to stay slim for TV.

And she saw it coming. One of the most retrospectively grotesque performances in all of show business placed Gilda in the role of a pop star crooning a love song to saccharin. Part of her dialogue goes,

Statistics prove that most guys prefer skinny girls with cancer over healthy girls with bulging thighs.

The industry’s infatuation with exercise enables it to lay all the blame for obesity, and any other damage, firmly on the consumer. In effect, they are saying, “Don’t preach to us about what we put in the brightly-colored packages and bottles. It’s not our fault if you get fat, it’s your own fault for not doing enough exercise.”

Innocence is sullied

In the face of all this, any news that reaches the public about the benefits of physical activity, no matter how honest and accurate, is bound to look like part of the conspiracy. The year 2013 was replete with reassurances. The American Physiological Society notified the public that, for shedding pounds, aerobic exercise is much more effective than resistance exercise.

Inserm, France’s equivalent of our Department of Health and Human Services, reaffirmed the benefits of regular physical activity but added a remark that might seem to express an ambivalent or equivocal attitude toward Big Food and Big Beverage:

Such activity is limited, however, by our lifestyle in today’s industrial society. While varying degrees of physical inactivity may be partly explained by social causes, they are also rooted in biology.

Meanwhile, in America, the Early Childhood Longitudinal Study continued to gather information and, quite rightly, to advise exercise for kids. Strangely, it took until 2013 for the establishment to come up with “some of the first evidence of a causal effect between gym and childhood obesity.” Researchers also noted that physical education in grades Kindergarten through 5 was more effective for boys than for girls, in reducing and preventing obesity.

Your responses and feedback are welcome!

Source: “For those short on time, aerobic, not resistance, exercise is best bet for weight, fat loss,” EurekAlert.org, 01/02/13
Source: “Why Good Resolutions About Taking Up a Physical Activity Can Be Hard to Keep,” ScienceDaily.com, 01/04/13
Source: “More gym for kids means less chance of obesity, Cornell study says,” LATimes.com, 05/21/13
Source: “Gilda Radner Saccharin” youtube.com, current
Image by Saturday Night Live/YouTube

The Ins and Outs of Exercise

In tracing the history of attitudes about exercise, and proposals for fighting obesity, we see that there are two major schools of thought. One holds that exercise alone is the supreme way to control body weight, and this is based on the energy balance theory.

The premise is, if a person does enough physical activity to burn X number of calories per day, they can eat that number of calories and maintain a steady weight. The problem is, in real life working out doesn’t always work out. Weight loss that is supposed to occur, mysteriously does not. There is a lot of evidence for accepting that obesity is multifactorial, and that a strict energy balance equation often fails to yield the results that, theoretically, it should.

Another philosophy, and probably a much more realistic one, is that regular vigorous exercise is a good, in and of itself. The human body evolved to thrive on constant exertion. The organism just generally works better when we accept that it was designed to do hard work and stay in motion. Anything less is a disservice to it.

Reasons to exercise are hard to refute

Many fitness teachers have shared Neila Rey’s “50 Reasons to Exercise,” and every one of those reasons can rationally be shown to somehow prevent obesity. Number one is “Lifts the mood,” and who among us would not welcome a little mood elevation? When a person is in a brighter frame of mind, all things seem possible — even keeping a promise made to oneself about seriously clamping down on food consumption.

A huge and comprehensive benefit is that exercise has been shown to help prevent colds, hypertension, diabetes, some cancers, osteoporosis, dementia, depression, heart malfunction, and certain symptoms of aging, Without those problems to deal with a person’s likelihood of maintaining a healthy weight is much higher.

In the document “Canadian Sport for Life” important principles are spelled out:

An early active start enhances development of brain function, coordination, social skills, gross motor skills, emotions, leadership, and imagination. It also helps children build confidence, develop posture and balance, build strong bones and muscles, promote healthy weight, reduce stress, improve sleep, learn to move skillfully, and learn to enjoy being active.

A New York Times piece by Gretchen Reynolds noted,

Multiple studies […] have found that without major changes to diet, exercise typically results in only modest weight loss at best (although it generally makes people much healthier). Quite a few exercisers lose no weight. Some gain.
[The] relationship between working out and losing weight remains complicated and tangled.

Reynolds mentions a 2012 study at the University of Copenhagen, in which young men who were sedentary and pudgy, but not obese, participated. They were divided into three groups, one being the control group, who did not change their habits at all.

Another group exercised vigorously for half an hour per day, and another worked out for one hour per day. On some days, motion sensors recorded their activity levels during the non-exercise portions of their days. This went on for about three months, and by the end…

[…] the men who had exercised the most, working out for 60 minutes a day, had managed to drop some flab, losing an average of five pounds each. Meanwhile, the volunteers who’d worked out for only 30 minutes a day did considerably better, shedding about seven pounds each.

Explanation was found in the participants’ food diaries. The group that exercised most, burning about 600 calories a day, were making up for it with increased meal sizes and snacks, “although the additional caloric intake wasn’t enough to explain the difference in their results.”

Since this part of the study depended on self-reporting, the researchers guessed that maybe the subjects forgot to jot down some of their food intake. The ones who put in more exercise time also tended to be inert during the non-exercise parts of their days — possibly tuckered out from too much activity.

The control group, predictably, lost no weight, and their body fat percentages were unaffected. But those who exercised for half an hour each day, the scientists noted, seemed to grow more “energized and inspired.”

Your responses and feedback are welcome!

Source: “50 Reasons to Exercise,” SmartAssFitness.com, undated
Source: “Maximizing the Sport Experience for our Children,” DocPlayer.net, undated
Source: “For Weight Loss, Less Exercise May Be More,” NYTimes.com, 09/19/12
Image by Ya, saya inBaliTimur/ShareAlike 2.0 Generic (CC) BY-S

Year of Exercise Inspiration

The year 2011 was full of interesting approaches to getting kids to move more. Tufts University student Christina Zagarino received a scholarship that financed the development of an idea inspired by her earlier experience of working at a circus camp created for tween-age kids.

Mentored by bona fide circus performers, the attendees spent up to eight hours a day vigorously practicing. Zagarino herself learned to juggle. Once a week, they put on a show. She later told journalist Sam Baltrusis,

I noticed that these kids were exercising and having a good time and I had the realization that the circus is very powerful. I started to think about how I could harness circus to promote physical engagement with children.

She created an interactive TV series featuring circus-based physical activities. Designed for the younger set, the three- to five-year-olds, “Big Top Circus” encourages them to watch TV and bounce around at the same time, in the safety of home.

This sort of diversion is especially needed by kids who live in urban congestion, or, for that matter, remote areas. Or suburbs. Or dangerous neighborhoods.

The five episodes never aired, but Zagarino learned from the experience enormously, to the point where, if she were to remake the series today, she would do some things differently. The point, after all — especially for a developmental psychologist — is not to push a product, but to internalize the principle that we all need to be learning, every step of the way.

Building playgrounds as safe play spaces

Also in 2011, a non-profit group (founded in 1996) whose mission is “saving play for America’s children,” built its 2,000th playground. With an estimated 14 million American children living in poverty, that’s a lot of kids who have no safe play spaces or opportunities to connect with their peers in healthy, fun environments. KaBOOM! also offers Adventure Courses, Multi-sport Courts, and mobile playgrounds that can be set up for short-term stays.

Aside from construction activity, the organization specializes in finding appropriate play spaces and in advocating, to municipal governments, the wisdom of instituting healthy play policies. Their literature says,

As of the end of 2018, KaBOOM! has directly built over 3,100 playgrounds. Combined with our other grants over our 20+ year history, KaBOOM! has built or improved over 17,000 playspaces.

Getting back to the prolific year of 2011, boxer Tim Witherspoon Jr., recuperating from shoulder surgery, looked around for something useful and compelling to do with his down time. The 2004 Golden Gloves Champion got himself certified as a personal trainer and made himself available at a boxing school to work with young people.

Reporter Adrian Fedkiw captured a quotation from Witherspoon:

Boxing is something that’s interesting. It’s not just running on a treadmill. It’s not just lifting a weight here, lifting a weight there. You’re learning a skill, and losing weight while you’re doing it. It’s a good workout.

Your responses and feedback are welcome!

Source: “‘Big Top Fitness’ Uses Circus Skills to Combat Childhood Obesity,” Patch.com, 05/13/11
Source: “Spotlight: Christina Zagarino,” Tufts.edu, 10/15/19
Source: “Building playgrounds for kids,” Kaboom.org, undated
Source: “Local Pro Boxer Fights Childhood Obesity One Punch At A Time,” Patch.com, 06/25/11
Image by Knight Foundation/(CC BY-SA 2.0)

The Ups and Downs of Exercise

Early in the decade, exergames, or interactive gaming systems, grew in popularity. A typical program was GoKids Boston, which met for two 90-minute sessions each week and used Dance Dance Revolution, LightSpace, Nintendo Wii, Cybex Trazer, Sportwall, and Xavix products. These programs were generally seen as positive, and a viable alternative to traditional fitness activities. But — and isn’t there always a but? — it was also recorded that “use of exergames by adolescents typically declines within a few weeks or months.”

At the same time, what amounted to an anti-exercise program emerged in some places. For instance, in Edgewater, Florida, a 48-family townhome community considered not only banning all outdoor play, but fining the residents $100 for each separate offense.

The common area had very little green space, and kids rode their bicycles and skateboards in the parking lot, so no more of that, and no games of tag, either. It’s hard not to see the grouchy residents’ side of things. There’s the noise, and nobody wants their car dinged up by a bike crashing into it.

Still, it makes a person wonder, couldn’t there be some kind of concession? Like, one morning a week, let’s all park on this one side of the lot, and allow the kids have their scooter rodeo or whatever? Would that be too much to ask? Maybe they worked it out. There does not seem to be any subsequent news.

Around the same time, Prince Edward County, Ontario, Canada, was working on becoming the first “come alive outside” community in North America. The object was “to teach young people the lost art of unstructured play at no cost to the municipality.” The prime movers were the Wentworth Landscaping Group, whose partial plans were described by journalist Nicole Kleinsteuber:

The landscaping group is working on developing a nature trail with fitness equipment near the soccer fields in Picton. The trail would start at Queen Elizabeth Public School, run across the street from PECI, along the top ridge of the Johnson Street soccer field and follow the track within the fairgrounds and the youth park.

Meanwhile, back in the lab

A meta study from researchers at the University of Missouri looked at “various animal models that simulate childhood obesity through inactivity.” This type of experiment uses a thing called the rodent wheel lock model, first allowing rats to have exercise, then shutting off the exercise wheels to see how the rodents’ organ systems are affected:

[S]tudies have shown that young, inactive rats have reduced insulin sensitivity, eat more and burn off fewer calories, and develop larger fat pads than animals who continue to exercise. Other studies show that fat cells multiply to a significantly greater extent in rats who aren’t allowed to run on their wheels…

Human studies have shown a similarity, in that inactive children strongly tend to remain inactive later in life, and that childhood inactivity “initiates the mechanisms that lead to the consequences of obesity seen in adults.”

Your responses and feedback are welcome!

Source: “Exergaming Provides Real Exercise for Kids,” MedPageToday.org, 03/07/11
Source: “Florida HOA says keep your kids inside,” ImperfectParent.com, 04/01/11
Source: “Come Alive Outside strategy teaches kids lost art of unstructured play,” CountyLive.ca, 06/17/11
Source: “To Understand Childhood Obesity, Researchers Look to Inactive, Fat Rats,” ScienceDaily.com, 07/24/12
Image by Troy Darr/Attribution 2.0 Generic (CC BY 2.0)

Evolving Attitudes and Exercise

Way back in Volume 1, Issue 2 of the journal Obesity Research, we find “Exercise and Obesity” by Dr. Claude Bouchard, Jean‐Pierre Depres, and Angelo Tremblay. It presents the evidence for “a role of regular exercise in the prevention and the treatment of obesity and of its metabolic complications.”

The Abstract says,

The evidence suggests that regular exercise can be an important factor in the development of sustained negative energy balance conditions provided the volume of activity is high. This implies a program of low to moderate intensity exercise performed on an almost daily basis for at least one hour per session. To induce significant weight and fat losses and to treat overweight and obese patients, compliance to the program for several years becomes a necessity.

“Energy balance” of course refers to the idea that calories ingested and calories expended in exercise are the sole and only factors in obesity. The researchers regrettably reported that the long-term benefit of exercise seems to be negligible, with a tendency to disappear as soon as physical effort ceases to be made. But obese people should do it anyway, because even if they don’t lose an ounce in weight, the improved insulin sensitivity makes it all worthwhile.

Ten years ago, the Safe Routes to School program had reportedly doubled the number of kids who walked or rode bikes, to and from school. Less than 10% of all schools provided daily physical education, and even then, the definition is open to interpretation.

The Robert Wood Johnson Foundation recommended that every child should have 20 minutes per day of vigorous activity (involving sweat and hard breathing.) Reportedly, the Foundation heavily influenced the Obama administration’s policies around health care and fitness.

Another angle

In 2011, Vanderbilt University’s Energy Balance Laboratory studied a dozen marijuana users who had no intention or desire to quit. They ran on treadmills for 10 sessions of 30 minutes each, over a two-week period. The experiment sought to determine whether regular exercise would reduce their frequency of use, and it did.

This was the first study to demonstrate such an effect, and reportedly the subjects’ cannabis use was reduced by more that 50%. The report’s co-author, Peter Martin, M.D., said,

This is 10 sessions but it actually went down after the first five. The maximum reduction was already there within the first week.

This could mean many things, including that the body assimilates THC molecules more efficiently in active people than in sluggish layabouts. In recent years, many elite athletes in different fields have spoken openly about their cannabis use for both training and recovery. Rock-climbers, weight-lifters, skiers, enthusiasts of jiu-jitsu and other martial arts; and to an even greater extent, people who engage in low-impact activities like yoga and hiking. They are said to become aware of their bodies in new ways that lead to a striving for healthful change.

Attitude adjustment

In those days, like many other fitness mentors, Health and Wellness Coach Ellen G. Goldman always emphasized to her clients that physical exertion needs to be regular and consistent. Her recommendation was 150 minutes per week, including cardiovascular, flexibility, and strength components. And, if they were exercising chiefly to lose weight, they would probably suffer disappointment.

The reason to do it is for overall health and well-being, because exercise cultivates not only physical strength and endurance, but a better mental outlook and improved self-esteem. Those qualities, in turn, encourage people to look more closely at their eating habits, and enable them to make helpful changes. Sometimes, they even lose weight! This attitude of plugging away at it, while not expecting miracles, is very helpful and has become widespread.

Your responses and feedback are welcome!

Source: “Exercise and Obesity,” Wiley.com, March 1993
Source: “F as in Fat: How Obesity threatens America’s Future, 2010,” RWJF.org, June 2010
Source: “Vanderbilt study shows exercise can curb marijuana use and cravings,” Vanderbilt.edu, 03/04/11
Source: “Can You Be Overweight and Healthy?,” SparkPeople.com, 09/20/11
Image by Fit Approach/Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)

Be Your Own Research Primate

The title is not a piece of advice, but it is descriptive of the philosophy of thousands of scientific innovators through the ages who have tried out theories, substances, and interventions on themselves. Sometimes the experiment is totally unwitting. Many important discoveries have been made through following up on accidents, by scientists who were open to exploring the implications of an unintended exposure or incident. When Albert Hofmann accidentally dosed himself with LSD, he didn’t just write it off as a bad day.

Often these scientists are on the trail of something else, and have an awareness of what experimentation does to their bodies, but don’t care. Like Marie and Pierre Curie, they know that potentially fatal damage has been done, yet they persist.

Often, the gathering of data is long-term and intensely deliberate. Santorio Santorio, an early adopter of self-experimentation — the early 1600s, in fact — was a pioneer of obesity studies. A doctor and professor who pondered the mysteries of intake and output, Santorio designed a weighing chair that apparently was quite accurate. Tim Jewell wrote:

He took detailed notes of how much he ate and how much weight he lost each day, eventually concluding that he lost half a pound each day between mealtime and toilet time.

Unable to account for how his “output” was less than his intake, he initially chalked this up to “insensible perspiration,” meaning we breathe and sweat out some of what our body digests as invisible substances.

In short, Santorio discovered metabolism, and medicine has been the better for it.

The visible man

Another example of this strange type of entrepreneur is Larry Smarr, who started as an astrophysicist and then became a computer scientist, one of the influential creators of the Internet. He moved from Illinois, “the epicenter of the obesity epidemic,” to health-worshipping Southern California and decided to shape up. About 12 years later, he was interviewed for The Atlantic by Mark Bowden, who reported,

Three or four popular books on weight loss left him mostly confused, but they did convey a central truth: losing weight was only 20 percent about exercise. The other 80 percent was about what he put in his mouth.

The entire fascinating journey is not ours to tell, and definitely worth reading in the original.

Among other things, Smarr became his own lab animal and began to carefully chart every calorie consumed and expended. The journalist noted,

When Larry works out, an armband records skin temperature, heat flux, galvanic skin response, and acceleration in three dimensions. When he sleeps, a headband monitors the patterns of his sleep every 30 seconds.

“Big deal, he has a fitness gadget. Doesn’t everyone?” Well, no, not at the time of the interview. Today, such advanced monitors are easily available to the consumer, but back then, the tools to indulge in this obsession were quite exotic, and not accessible to the average DIY enthusiast.

Suspecting that a lot of important activity goes on below the belt, Smarr outsourced the analysis of the biochemical content of his output, and routinely sent stool samples to a lab. Poop is a vast library of information that puts the Library of Congress to shame. As Smarr explained it,

There are about 100 billion bacteria per gram. Each bacterium has DNA whose length is typically one to 10 megabases — call it 1 million bytes of information. This means human stool has a data capacity of 100,000 terabytes of information stored per gram. That’s many orders of magnitude more information density than, say, in a chip in your smartphone or your personal computer.

Somewhere along the way, Smarr found that his indicators for systemic inflammation were rising — which led to an early discovery of Crohn’s disease before any symptoms manifested, and this led to a profound interest in the role of Clostridia in immune system malfunction. But overall, the interviewer reported, Smarr’s focus is on something much bigger — “for the first time in history, a scientific basis for medicine.”

Your responses and feedback are welcome!

Source: “For better or worse, these researchers changed science,” HealthLine.com, undated
Source: “The Measured Man,” TheAtlantic.com, August 2012
Images by J E Theriot and Henry Shi/Attribution 2.0 Generic (CC BY 2.0)

The Ever-Changing Reputation of Exercise

Dr. Pretlow says,

Obesity is neither a poor nutrition nor lack of exercise problem. It appears to result from eating for reasons other than hunger, for simple pleasure, and as a coping mechanism for relief from sadness, stress, anxiety, and boredom.

The food industry promotes physical activity as a solution for obesity.

Now, why is that, exactly? For starters, the psychologists who make a career of selling their souls to corporate interests are very aware that most people are caught up in the delusion of dichotomy. We don’t have time to think about a lot of complicated matters. To simplify things, we narrow it down to either/or. In the either/or mindset, obesity is the result of either not doing enough physical exertion, or eating the wrong stuff.

When people consider the question of “What is the wrong stuff?” the visions that spring to mind are of chicken nuggets, quart-sized soft drink cups, potato chips, sugary breakfast cereal, and so on. In other words, all the substances that the people who work in the processed foods business are tasked with selling to the public.

Since there are, ostensibly, only two options — either stop eating their junk, or get more exercise, the solution is obvious. They exhort us to exercise more. If we don’t do enough pushups to equalize the doughnuts, it’s our own fault — but also, gloriously, our problem to solve.

Big Food and Big Soda have locked in on what they hope is a winning strategy: Convince the public that every ounce of obesity is caused by the customers themselves, who do not have enough sense to exercise for hours every day. The corporations are heavily invested in propagating the belief that we deserve every fat roll, because we are lazy slobs who simply refuse to work off the calories that we consume in their irreproachable, unimpeachable products.

Historical ups and downs

About 10 years ago, the EarlyBird Diabetes Study upset the applecart by suggesting that everyone got it backwards, all those years. Actually, a sedentary lifestyle is not the cause of obesity — on the contrary, obesity causes the sedentary lifestyle. Journalist Tiffany O’Callaghan related how the researchers saw things:

The study authors posit that a combination of embarrassment and discomfort may deter children from getting exercise, and suggest the findings point to a need to shift more attention to nutrition — and put less emphasis on exercise — when it comes to battling childhood obesity.

A couple of years later, 20 authors collaborated on figuring out what really works for public health, policy, or clinical recommendations. Their study, published by the New England Journal of Medicine, indicated that exercise, as currently practiced, does not much matter.

Ranging widely, through areas of knowledge, they studied both myths and “facts that are well supported by evidence.” One of the myths they identified was that physical education classes in schools are effective. But rather…

Physical education, as typically provided, has not been shown to reduce or prevent obesity. Two meta-analyses showed that even specialized school-based programs that promoted physical activity were ineffective in reducing BMI or the incidence or prevalence of obesity.

The authors concede that while some combination of frequency, intensity, and duration of exercise might produce a synergy that can prevent or reduce obesity, we are certainly not there yet.

Your responses and feedback are welcome!

Source: “Which comes first, inactivity or childhood obesity?,” TIME.com, 07/07/10
Source: “Myths, Presumptions, and Facts about Obesity,” NEJM.org, 01/31/13
Image by K. W. Barrett/Attribution 2.0 Generic (CC BY 2.0)

Everything You Know About Milk Is Still Wrong

Here, we pick up from the previous post discussing the virtues of whole milk versus low-fat or skim. House Bill HR832, “To amend the Richard B. Russell National School Lunch Act to allow schools that participate in the school lunch program under such Act to serve whole milk,” was introduced over a year ago but has not even passed committee yet.

Whole-milk proponent Arden Tewksbury writes, “Our dairy farmers have been messed up long enough with this low-fat problem.” However… while the dairy farmers may be ours, so are our children. How good is the evidence for restoring whole milk to schools? Also, when it comes to deciding priorities, the reputation of Secretary of Agriculture Sonny Perdue is not unblemished.

Plenty of online comments address the matter. One says the National Academy of Pediatrics is partly funded by the National Milk Board, which seems in this context to be neither here nor there. A nurse practitioner says she’s never seen a fat child who got that way from full-fat dairy products. Blame should fall on juice and soda. Fat makes a person feel full for longer, so they eat more moderately and snack less.

Several citizens mention that pig farmers give pigs skimmed milk to fatten them — because it leaves them hungry, so they eat more, and become more desirable for the market. Some say the issue might be not fat or sugar, but hormones.

Enter the conspiracy

Others point back to the gigantic hoax perpetrated by the sugar industry six decades ago, blaming fat for every form of obesity when really the onus should fall on sugar.

Some mention a recent study determining that low fat milk has 2.5 times less vitamin D. But since Vitamin D is water soluble, that can be solved by adding Vitamin D powder to low-fat milk. (Readers will recall the previous post, which cited research pointing, confusingly, to the fat-solubility of that nutrient.)

A commentator called Jeff says,

Another possibility is that parents who give their children whole milk are also more likely to give them “whole” other foods like grains and fruits and vegetables… Whole grains and veggies have more fiber which in turn slows the absorption of sugars, which in turn lowers insulin levels which also reducing craving for more food.

Then, there is a very fresh report from Brigham Young University that concerns not obesity but another vital issue: aging, which is characterized by short telomeres, the structures on the ends of chromosomes. Long telomeres are the kind we want to have.

Larry Tucker, Ph.D., studied data on 5,834 adults and found that…

People who drink low-fat milk experience several years less biological aging. Drinking 1% rather than 2% milk accounts for 4.5 years of less aging in adults than those who drink high-fat (2% and whole) milk.

So, whole milk equals short telomeres — but, surprisingly, no milk also equals short telomeres. In this one respect at least, the sweet spot is right there in the middle, with low-fat milk. Professor Tucker says,

Milk is probably the most controversial food in our country. If someone asked me to put together a presentation on the value of drinking milk, I could put together a 1-hour presentation that would knock your socks off. You’d think, “Whoa, everybody should be drinking more milk.” If someone said do the opposite, I could also do that.

A person with the handle “AGoldstein” has perhaps the best take of all:

I don’t see why this information is worth sharing or even publishing until the authors get beyond the purely speculative stage in which they present their data. There are simply too many uncontrolled variables to act on information like this.

Your responses and feedback are welcome!

Source: “Childhood obesity has gotten worse since whole milk was taken out of schools,” PennLive.com, 02/13/20
Source: “Drinking 1% rather than 2% milk accounts for 4.5 years of less aging in adults,” ScienceDaily.com, 01/15/20
Image by fdecomite/Attribution 2.0 Generic (CC BY 2.0)

Everything You Know About Milk is Wrong… Unless It Isn’t

A few years ago, Dr. Jonathon L. Maguire, of the University of Toronto, studied the data on 2,745 healthy children between the ages of one and six years. As the fat content of their milk went up, so did their Vitamin D levels, while their BMIs went down. Two things stood out: the implication that Vitamin D is better absorbed with fat, and the notion that “drinking low-fat milk may leave a child hungrier for more calorie-dense food.”

Fast-forward to last month, when the American Journal of Clinical Nutrition published a paper that analyzed 14 studies encompassing 20,897 children, up to 18 years old. The same pediatrician, Dr. Maguire, in the capacity of senior author, looked deeper.

The meta-study concluded that higher intake of cow-milk fat corresponded with a lower occurrence of childhood obesity. This went against the existence of international guidelines recommending reduced-fat milk, and the fact that the American Academy of Pediatrics was still recommending that all children by age two should be on skim or low-fat milk.

The study found, the more whole milk, the less obesity — and there is even a number: “39 percent reduced risk for overweight or obesity.” Journalist Nicholas Baker wrote,

The authors speculate that are several possible mechanisms. It may be that children who drink whole milk consume fewer calories from other food. Some studies suggest that milk fat has properties that make people feel full. Reverse causality could also be at play: It’s possible that skinny children have parents who offer them whole milk to fatten them up.

Dr. Maguire noted that none of these observational studies really said a lot about cause and effect. To the announcement that reduced-fat milk is more associated with obesity than whole milk, reactions varied.

In Modern Farmer, Dan Nosowitz suggested that by bringing back whole milk the government wanted to help the dairy industry, and also that its proponents desired to “strike a blow at what’s seen as unfair nannying.” He granted the possibility of “plausible explanations” on either side of the milk question.

This accession to multifactorialism included human motivations:

Many parents give whole milk to underweight kids to get them to gain weight; that would throw off the studies, because those kids wouldn’t qualify as obese, but it would certainly have no relation to their milk consumption. Or maybe parents of overweight kids give their kids reduced-fat milk to lose weight. Same problem.

Just a few days ago, writer Arden Tewksbury opined that the large majority of Americans strongly favors putting whole milk back in to school lunch programs. He said:

[…] the best information that has ever been alluded to was made by U.S. Secretary of Agriculture Sonny Perdue at a U.S. Senate Ag Hearing when the secretary said twice, that obesity has gotten worse since we took whole milk out of our schools.

This writer is mad at U.S. Secretary of Agriculture Tom Vilsack, who allegedly has the ultimate authority, and could restore whole milk to schools by decree. But Secretary Vilsack is on the low-fat or fat-free side of the debate.

(To be continued…)

Your responses and feedback are welcome!

Source: “Regular Milk May Beat Low Fat for Kids,” NYTimes.com, 11/22/16
Source: “Whole Milk May Be Better When It Comes to Children’s Weight,” NYTimes.com, 01/07/20
Source: “Study Finds Reduced Fat Milk More Associated With Obesity Than Whole Milk,” ModernFarmer.com, 01/10/20
Source: “Childhood obesity has gotten worse since whole milk was taken out of schools,” PennLive.com, 02/13/20
Image by breic/Attribution 2.0 Generic (CC BY 2.0)

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources