Currently browsing posts about: Obesity

To many people, full-fat milk tastes better and is more satisfying, which is reason enough to prefer it.  But the “drink full-fat milk” advice in the new dietary guidelines doesn’t make much sense to me.  Most of the nutrients in milk are in the whey portion and vitamins A and D are added to low fat milk.  This makes low- and full-fat milk pretty much equally nutritious.   Also, full-fat milk is just as processed as skim milk; the dairy industry removes the fat and adds it back to the desired percentage.

But the dairy industry wants to sell more full-fat milk and sponsors research demonstrating its superiority.  This recent example replaced their typical dairy consumption with whole milk.  If they had the right kind of intestinal bacteria, they lost weight.

The study: Qin P, Berzina L, Geiker NRW, Sandby K, Krarup T, Kristiansen K, Magkos F. Associations Between Gut Microbiome Enterotypes and Body Weight Change During Whole Milk Consumption. Nutrients. 2026; 18(4):563. https://doi.org/10.3390/nu18040563

Background: Evidence is accumulating that gut bacterial communities modulate the outcome of dietary interventions.

Objective: To assess how gut microbial enterotypes correlate with obesity-related outcomes during one month of whole milk consumption.

Methods: This post hoc analysis used data from a previously published trial, which included a lead-in phase during which men with abdominal adiposity replaced habitual dairy product consumption with 400 g/day of whole milk for one month. We compared body weight, urinary metabolites, fecal metabolites, and gut microbiome composition and function based on shotgun metagenomic sequencing at the beginning and at the end of the lead-in phase between individuals with the two most prevalent enterotypes, the Bacteroides1 (B1) enterotype (n = 24) and the Ruminococcaceae (R) enterotype (n = 38).

Results: Individuals with the B1 enterotype, but not those with the R enterotype, exhibited decreases in body weight and the relative abundance of Streptococcus thermophilus. Multiple linear regression analysis identified enterotype as a strong predictor of body weight change (p = 0.0034). In addition, urinary taurine level change was positively associated with body weight change in B1 individuals, not in R individuals.

Conclusions: Our findings reveal an enterotype-specific response to an identical dietary modification, underscoring the value of integrating enterotype information into nutrition-intervention design and personalized nutrition strategies.

Funding: The FerMetS study and analyses were funded by research grants from Arla Food for Health and the Danish Milk Levy Fund. Dairy products were provided by Arla Foods amba.

Conflicts of Interest: NRWG has received grants from the Danish Agricultural and Food Council. FM has received grants from Arla Foods A/S. The funder had no role in the study design, data collection, data analysis, data interpretation, or the decision to publish the results. The remaining authors declare that they have no conflicts of interest.

Comment

I checked the Arla Foods website.  It says: “Arla Foods is the 4th largest dairy company in the world and a cooperative owned by more than 12,700 dairy farmers.”  The relationship between the microbiome and body weight is truly fascinating and this study suggests that some kinds of bacteria are better than others for maintaining a healthy weight.  The authors make the point of this study clear in their conclusion: “In summary, our findings suggest that individuals with the B1 enterotype may be more prone to weight loss in response to whole milk consumption…..”  They view whole milk as a diet aid.

Never mind the effects of anti-obesity drugs on the health and well-being of people taking them.  From the food industry’s standpoint, what counts is what they are doing to sales of food and drink.  Ouch.

Here is my most recent collection of items from industry newsletters.  These make it clear that GLP-1 drugs are a real threat to food industry profits.

• The snackdown: Are GLP-1s really killing snacks or is it just all hype?  Weight-loss drugs are billed as a $150bn threat to bakery and snacks, but so far the impact looks more hype than reality…. Read more
• Food industry scrambles to respond to GLP-1 craze:  The drugs have already been predicted to change the way we eat… Read more
• How food brands can stay ahead of GLP-1 craze:  Don’t underestimate the GLP-1 trend. It’s going to hit, hard… Read more
• Sweet speculation: GLP-1s could already be nibbling at confectionery sales.  As enthusiasm for the confectionary sector declines, could weight-loss drugs have a role to play?… Read more
• How is GLP-1 changing eating habits in Europe?  As GLP-1s begin to make themselves known on the continent, consumers’ habits are starting to change… Read more

As to what food companies are trying to do to respond:

• GLP-1 is changing taste: How can food makers reignite flavour?  When GLP-1 drugs make food taste dull, exciting taste buds will be the aim of the game… Read more
• What makes a GLP-1-friendly yogurt drink? Danone tells all: By formulating a dairy drink that specifically caters for weight loss medication users, Danone has set a new standard with Oikos Fusion… Read more
• 4 natural food ingredients that boost GLP-1:  It’s not only drugs that induce the satiety-causing hormone… Read more
• Food’s answer to Ozempic? New ingredients mimic GLP-1 without the pharma price tag.  Once everyone’s had enough of injections, side effects, and the vast expense of GLP-1 drugs, it could be natural alternatives’ time to shine… Read more
• GLP-1 users are undernourished: why F&B needs to fill the gapNutrient gaps in GLP-1 diets present a challenge and an opportunity for the food industry… Read more

Fascinating, no?  I’m paying close attention to all this.

I first read about this in a Forbes article: New Study: Front-Of-Pack Warning Labels Don’t Lower Obesity Rates.

As the FDA mulls interpretive food warning labels, a Georgetown University study shows these schemes have been powerless to halt obesity trends.  In an attempt to tackle stubbornly high adult obesity rates over 40% in the US, the FDA is advancing a proposed front-of-pack (FOP) label that highlights whether a food or beverage contains low, medium or high levels of sugar, saturated fats and sodium. But a new study from Georgetown University titled Can Front-of-Pack Product Labeling Fix the Obesity Crisis says that the FDA has not learned the lessons from other countries using such interpretive food warning labels: there is no hard evidence that they have been effective in improving consumer diets or in arresting rising obesity rates.

The author of this article is Hank Cardello, executive-in-residence at Georgetown McDonough’s Business for Impact.

If you click on the link to the study, you discover than Cardullo himself is its author.

Hank Cardello, executive-in-residence at Georgetown McDonough’s Business for Impact, has published a white paper titled,“Can Front-of-Pack Product Labeling Fix the Obesity Crisis?” This paper argues that front-of-pack (FOP) food labeling has not led to meaningful improvements in public health outcomes. It evaluates data from multiple countries to test the efficacy of other FOP labeling initiatives.

Both the article and his White Papert disclose the funder: the Consumer Brands Association, formerly known as the Grocery Manufacturers of America, which represents Big Food.

Comment

I can understand why the food industry does not like warning labels or any other front-of-pack label that might reduce product sales, which studies of Latin American warning labels show they do.  So this piece is predictable.

If you want people to lose weight, they have to eat less.  Eating less is very bad for business.

What good are front-of-pack labels?  At best they alert consumers to avoid high-calorie foods formulated to get us all to eat more of them.

But that’s just a start.  To lose weight, you also have to make sure the rest of your diet does not replace the calories you just saved.

Cardullo’s suggestion is smalled portions.  Good idea.

In the meantime, warning labels could help and I hope the FDA comes up with good ones.

________________

Published tomorrow!  Information is here.

The White House has announced the formation of a President’s Commission on Making America Healthy Again

It will be chaired by newly confirmed HHS Secretary Robert F. Kennedy Jr, and according to the The MAHA Commission Fact Sheet “is tasked with investigating and addressing the root causes of America’s escalating health crisis, with an initial focus on childhood chronic diseases.”

The Commission will include representatives of relevant agencies.  It is to:

• Produce a Make our Children Healthy Again Assessment within 100 days.
• Submit a Make our Children Healthy Again Strategy within 180 days.

Comment

Whew.  I can’t wait to see what this Commission comes up with.  But it sounds like nothing will be done, actually, for at least six months.

Oh.  Wait!  I’m having a deja vu.   Didn’t we already do this?

Isn’t this just what Michelle Obama’s Let’s Move initiative did in 2010?

• Recall: White House Task Force on Childhood Obesity Report to the President: Solving the Problem of Childhood Obesity Within a Generation.
• Also recall: Republicans pushed back so hard on this that hardly any of it could be accomplished.
• And: President Trump opposed her initiatives as late as 2017.

Don’t get me wrong.  I am totally for doing this and hope the Commission takes its mandate seriously.

Let’s Move got pushback for trying to take on the food industry.  If RFK, Jr’s Commission can do this, it will deserve much applause.

As always, stay tuned.

I am fortunate to be on the mailing list for Nicholas Fereday’s always-worth-reading Rabobank’s RaboResearch.  This one is especially worth sharing: Talking Points: Anti-obesity medications—Will the food industry be the biggest loser?

It has been oer a year since the food industry finally woke up to the threats and opportunities of the new class of Anti-Obesity Medications (AOMs) such as Ozempic, Wegovy and Zepbound.  And gosh, what a lot has happened since then. Chiefly, both the demand and supply of these drugs have exceeded all expectations and the momentum driving the market suggests they are highly likely to become a permanent feature of the food landscape. Doubly so as scientists keep finding further benefits from taking them – the weight loss effects of these drugs might ultimately prove to be their least remarkable feature. But for now, the impact of these drugs on the food industry is real. The challenge for the food industry is to figure out how to respond to that and unlock some of the opportunities these drugs create. Here are three points to consider:

1.   The AOM market is much bigger and growing much faster than anticipated.

2.   There are good reasons to believe demand has strong momentum.

3.    Users of AOMs eat less and differently, providing a useful roadmap for food companies.

A reader, Maria Birman, alerted me to this new report in Lancet Diabetes & Endocrinology from the 56-member Commission on the Definition and Diagnosis of Clinical Obesity.  The commission recommended shifting the definition and diagnostic criteria for obesity away from the BMI and instead defining obesity in two categories based on health status.

• Clinical obesity: signs and symptoms of organ or other dysfunctions; a disease requiring effective health care treatment
• Pre-clinical obesity: high levels of body fat but no signs of dysfunction but higher risk for chronic disease, requiring support for risk reduction.

Maria writes:

I’m astonished by the full two-page “declaration of interests” (no conflict there, of course not!). Naturally Eli Lilly and Novo Nordisk are very much interested in obesity being considered a disease, and a treatable one at that. And doctors and scientists paid by these companies authored this paper which is posed to be very influential.

I took a look at the conflict-of-interest statement.  It is indeed astonishing as it goes on and on for nearly two pages in four columns.

Maria saved me from having to go through the analysis.  Here are her counts.

• Of the 56 authors, 47 declared conflicts of interest; only 9 did not.
• All 8 authors on the steering committee declare financial ties to drug companies.
• Novo Nordisk (Ozempic, Wegovy) is mentioned 60 times by 38 authors.
• Eli Lilly (Zepbound) is mentioned 39 times by 27 authors.
• Authors report financial ties to other pharmaceutical companies: AstraZeneca, Pfizer, Merck, Johnson & Johnson, Eurodrug Laboratories, Sanofi., and others.
• Authors report consulting fees, fees for educational purposes, research grants, speaker fees, co-authorship of manuscripts, medical writing assistance, and personal honoraria as a consultant and speaker, among others.
• Authors report financial ties to food companies such as Nestlé, which makes the Vital Pursuit line marketed to people on Ozempic.

Comment

No question, the BMI is an imperfect measure of the health risks of obesity, although it works pretty well as a first step.  Defining obesity as a disease may well help get treatment for people who need it.

I wish we had a health care system that could help people with obesity find out whether they have the clinical or pre-clinical form.  In the absence of  a functional health care system, we have drugs—effective and without deleterious side effects for some people, but for the great majority, highly expensive and hard to get.

This commission appears as an arm of the pharmaceutical industry.  Its findings require careful scrutiny.

I saw this on Twitter (X):

For the video, click here.

I’m for all three actions.  I’ve argued for years for getting rid of conflicts of interest and focusing resources on preventing chronic disease.

I can’t wait to find out how the new administration plans to accomplish these goals.   We all need to hold it accountable for delivering on these promises.

What started all this was this graph of obesity prevalence in the US from the Financial Times:

The most complete account of what happened next comes from Helena Bottemiller Evich in Food Fix (a must-read for anyone interested in following the food scene): “Have we passed peak obesity? New data sparks speculation.”

The Financial Times was the first to pick up on new data from the Centers for Disease Control and Prevention showing that the obesity rate for U.S. adults declined two percentage points between 2020 and 2023. The headline from across the pond was upbeat: “We may have passed peak obesity.” Soon, a couple of other news outlets followed, including Axios: “Americans are getting healthier by some key metrics.” The Washington Post editorial board jumped into the fray this week as well: “The obesity rate might have stopped growing. Here’s what could be working.”

The original data came from the CDC:

Plotted this way, the decline is not nearly so impressive (and severe obesity is increasing slightly).

As for the effect of the drugs, it’s much too early to say, says the epidemiologist Deirdre Tobias posting on Twitter (X).

The downtick occurred before the drugs were widely used.  Following her thread produces lots more data on that point.

We will have to wait a few more years to know how all this will play out.  I can’t wait!