The Evolution of Obesity

UNIB 10009:
Food for a Healthy Planet 1
Dr. Anneline Padayachee
23 March 2016
 In this session
Obesity development
Prevalence
Internationally vs. Australia
Definition and outcomes
Causes
Solutions
 throughout most of
human history, chronic
malnutrition has been the
norm
- 1993 Nobel laureate Robert William Fogel

Fogel, R.W. The Escape from Hunger and Premature Death, 1700-2100. Cambridge University Press, Cambridge, UK; 2004
 Malnutrition
Malnutrition:
Malnutrition is a broad term commonly used as an
alternative to undernutrition (in)adequate
calories and protein for growth and maintenance or
they are unable to fully utilize the food they eat
due to illness.
but technically it also refers to overnutrition They
are also malnourished if they consume too many
calories (overnutrition).

Unicef Definition Report Card on Nutrition: Progress for Children, 2006

 Stone Age era (ca. 20 000)
Venus of Willendorf (Australia 1908): 17C description:
Female form fertility goddesses excessive fatness or
corpulence
The evolution of obesity
Agricultural revolution 1
Domesticated food supply = rise
of civilisations technological
Famine vs. thrifty gene advancement (widespread
malnutrition still prevalent)
19C
Agricultural revolution 1 18C Pathologic and
More consistent food supply pathophysiologic
complications defined
Increased accessibility: 19C Rise in technological
Quality, quantity and variety. advancements
Decreasing in malnutrition in Decline in manual work
developed world.
IOTF 2010
 The Obesity Epidemic

Rates increase with age up to age 64 and then Rates significantly higher among lower
decline SES groups
 Australian Diabetes, Obesity and Lifestyle
(AusDiab) study (2005):
Total direct cost for overweight and obesity:
$21 billion
- $6.5 billion for overweight
- $14.5 billion for obesity

NHMRC 2015 https://www.nhmrc.gov.au/health-topics/obesity-and-overweight

 ~50kg

Vital organs

Adipose tissue
(aka body fat)

Joints

Bones
 Cancer risk and obesity
Endometrium

Kidney

Colon

Gall bladder

Breast

Prostate

0 10 20 30
Percentage of cancers caused by obesity (%)

Bergstrom et al. (2001)

 So I want to lose weight?

Eat less.
Move more.
Less energy in.
More energy out.

Then why is the world* packing it

on?
(*>500 000 000 or billion); Taubes 2013
 Energy Input
Factors that influence energy input include:
Energy Density - how much energy does the food
contain
Portion Size - how much of a certain food you eat
Eating Frequency - how often you eat
Absorption of nutrients - how much of the energy
you eat is absorbed and utilised by the body
 Energy density
Macronutrients: include fat, protein, and
carbohydrate (CHO). These are required
in amounts of greater than 1 gram/day.
Too much fat or too much carbs?

Taubes 2013: HORMONE HYPOTHESIS INSULIN

Insulin hormone secreted to maintain blood glucose
levels
U.S. Department of Energy Leptin Mouse Model ORNL Laboratories 2014
When was the last time you felt
 BRAIN-washed (literally)
Kenny 2013, The Food Addiction, Scientific American:
Hedonic desire over-rules even fear and self-preservation
Rats eating chocolate would rather eat chocolate and get an electric shock
than stop

Normal eating Food Addiction

appetite stimulating hormones in desensitized to leptin
stomach alert hypothalamus increased signaling of endophorins
feeling of pleasure & stomach fullness (happy hormones dopamine)
is reached strong desire to continue eating
appetite SUPPRESSING hormones
(leptin and insulin) released
food less appealing
 Portion Size vs. Serving Size
Portion size (PS)
The amount of food/beverage intended to be
consumed in a single eating occasion (g/ml)
Serving size (SS)
The amount of food/beverage recommended to be
consumed in a single eating occasion (g/ml)
Used for dietary guidance purposes

Institute of Grocery Distribution, 2008

 Portion control
Bigger bowls = bigger
portions
Cornell University
Study:
69 preschoolers
8oz vs. 16 oz breakfast 3 years old,
cereal bowls 59kg

Requested 87% MORE

food to FILL the bowl
Ate 52% MORE food
 Then and Now
20 Years Ago Today
Coffee (with whole milk and sugar) Mocha Coffee (with steamed whole milk + mocha
syrup)

45 calories/8 ounces 350 calories

16 ounces

If you walk 1 hour and 20

minutes, you will burn ~ 305 cal.
Calorie Difference: 305 calories (~70kg person)

210 calories 500 calories

1.5 ounces 4 ounces

Calorie Difference: 290 calories If you vacuum for 1 hour and 30

minutes you will burn
US Dept of Health & Human Services 2013 available at approximately 290 calories.
https://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/eat-right/portion-distortion.htm (~70kg person)
 Grazing vs. 3 meals
Grazing maintain blood glucose levels
Low GI foods, higher protein foods

3 main meals French Diet

Eat til 60% full
Experience

Individual

Grazing habitual eating

hungry or bored?
A.Padayachee 2015. Use with Permission
 Societal solution Public Health

Government
policy

Food Industry
Food Supply
and access
Individuals

20% tax:
6% decrease
12% decrease in
low SES
up to 17%
decrease the first
1% drop in obesity, but it makes a lot of difference because
12 months
obesity is so prevalent across the country~200 000 cases
(2014-2015)
prevented
Dr Mike Rayner (Public Health, Oxford University)
 Google images
Body fat model: https://www.enasco.com/c/healtheducation/Nutrition/Body+Fat+%26+Muscle+Replicas/?ref=breadcrumb
Butter: http://bonfirehealth.com/eating-good-fat-makes-you-healthy-in-case-you-forgot/
Sedentary overweight child http://catalog.flatworldknowledge.com/bookhub/reader/3728?e=zimmerman_1.0-ch13_s03
Obesity http://health.alot.com/conditions/obesity-symptoms--2131
McDonalds KFC photo http://www.smh.com.au/news/health/society-promotes-obesity/2007/10/19/1192301001588.html
Obesity causes: http://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/
Thrifty gene caveman: https://www.sciencenews.org/article/ancient-famine-fighting-genes-cant-explain-obesity
The Venus of Willendorf. Limestone figure from the Late Paleolithic Period, c. 25,000 BC (Naturhistorisches Museum, Vienna, Austria. Reproduced with permission.)
Photo credit: Erich Lessing, Art Resource, NY.
Domesticated Ancient Egyptians File:Maler der Grabkammer des Menna 012.jpg , circa 1422-1411 BCE, Public Domain.
A chicken in every pot: https://www.emaze.com/@AILCFLQF/Politics-of-the-20s
Henry Fords car http://www.theguardian.com/artanddesign/picture/2013/jul/31/henry-ford-car-photography
Australian Obesity infographic: http://www.smh.com.au/national/health/australians-are-fat-and-unfit-but-at-least-we-are-drinking-and-smoking-less-20151207-
glhycn.html
MRI body scans: Professor Jimmy Bell from Imperial College, London, orthopaedic surgeon Mike Hayton and consultant radiologist Waqar Bhatti, both of Alexandra
Hospital, Cheadle, Manchester. http://www.dailymail.co.uk/health/article-1269074/Crushed-lungs-strained-joints-swollen-heart--extraordinary-scans-reveal-fat-
does-you.html
Keep Calm: http://www.keepcalm-o-matic.co.uk/p/keep-calm-if-you-can-t-beat-em-join-em/
Lu Hao obese toddler: http://www.dailymail.co.uk/news/article-1368790/Lu-Hao-Chinese-toddler-3-weighs-staggering-132lbs-hes-growing.html
Bambi: http://www.thesun.co.uk/sol/homepage/features/3828916/Weird-animals-disowned-by-pals.html
Eat something: http://www.popsugar.com/fitness/Do-You-Have-Eat-Something-Sweet-After-Dinner-1970303
Insulin and glucose metabolism: http://www.popsugar.com/fitness/Do-You-Have-Eat-Something-Sweet-After-Dinner-1970303
Hungry man: http://www.diet-blog.com/07/yes_exercise_does_make_you_hungry.php
Hungry Patrick: http://giphy.com/search/hungry
Hungry Homer: http://theodysseyonline.com/dayton/home-break-expectations-reality/186147
MRI obese man: http://www.mirror.co.uk/news/technology-science/shocking-mri-scan-picture-64-stone-3753113
Tess Holliday quote: http://www.buzzfeed.com/ashapiro009/tess-holliday-plus-size-model#.nbZDbyAe4
Mexico bans softdrinks: http://www.theguardian.com/news/2015/nov/03/obese-soda-sugar-tax-mexico