Currently browsing posts about: Obesity

Kevin Hall at NIH has done a controlled diet study demonstrating that people who consume ultra-processed foods eat more calories—500 more a day (!)—and, therefore, gain weight.

Carlos Monteiro at the University of São Paulo and his colleagues explain how to identify ultra-processed foods.  

They also demonstrate that ultra-processed foods comprise nearly 60 percent of calorie intake.

No surprise.  Calories matter, as Mal Nesheim and I explained in our book Why Calories Count: From Science to Politics (and thanks Kevin for confirming what we wrote in that book).

The clear conclusions of this study have elicited a lot of attention.  Here’s my favorite from Francis Collins, the head of NIH and Kevin Hall’s boss, who also did a blog post:

Examples of media accounts (there were lots more)

• New York Times (this comes with pictures of the two different diets)
• Consumer Reports
• Mother Jones 
• Medical News Today
• NPR
• Center for Science in the Public Interest

The Lancet has been busy.  Last week, it published a blockbuster report on the need for worldwide dietary changes to improve human health and that of the environment.  I posted about this EAT-Forum report on Friday.

Now, The Lancet releases yet another report, this one taking a unified approach to dealing with the three most important nutrition issues facing the world: Malnutrition (undernutrition), obesity, and the effects of our food production and consumption system on the environment and climate change—for which this report coins a new term: The Global Syndemic.

This report breaks new ground in identifying the food industry as one of three main barriers to ending this “Syndemic.”  I’ve added the numbers for emphasis.

• Powerful opposition by [1] commercial vested interests, [2] lack of political leadership, and [3] insufficient societal demand for change are preventing action on The Global Syndemic, with rising rates of obesity and greenhouse gas emissions, and stagnating rates of undernutrition.
• New social movement for change and radical rethink of the relationship between policymakers, business, governance and civil society is urgently needed.
• The Commission calls for a global treaty to limit the political influence of Big Food (a proposed Framework Convention on Food Systems – modelled on global conventions on tobacco and climate change); redirection of US$5 trillion in government subsidies away from harmful products and towards sustainable alternatives; and advocacy from civil society to break decades of policy inertia.

Wow.  This is telling it like it is—at long last.  From the press release:

• A key recommendation from the Commission is the call to establish a new global treaty on food systems to limit the political influence of Big Food.
• The food industry’s obstructive power is further enhanced by governance arrangements that legitimise industry participation in public policy development, and the power that big corporations have to punish or reward governments by relocating investment and jobs.
• Regulatory approaches to product reformulation (eg. salt and sugar reduction), labelling and marketing to children are needed because industry-led, voluntary approaches have not been effective.

Yes!

The documents

• The Press Release
• The Policy Brief
• The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report – Boyd A Swinburn et al. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32822-8/fulltext
• Obesity needs to be put into a much wider context – Sabine Kleinert, Richard Horton, The Lancet https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33192-1/fulltext
• Rethinking systems to reverse the global syndemic – Rachel Nugent, RTI International https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33243-4/fulltext
• Transforming food systems for better health – José Graziano da Silva, Director-General, Food and Agriculture Organization of the United Nations https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)33249-5/fulltext

The press

▪ The Guardian
▪ The Times (London)
▪ Irish Farmers Journal

Additional press, posted January 30

Newswires (syndicated in international outlets):

• ‘Radical rethink’ needed to tackle obesity, hunger, climate: report – Agence France-Presse
• To fix climate change, fix the obesity and starvation epidemics, reports say – CNN
• Obesity, bad nutrition, climate change pose triple danger, commission says – Reuters
• Also covered by Xinhua, IANS.

UK:

• Public health experts call for global food treaty – Financial Times
• Take on food industry to beat malnutrition and obesity, says report – The Guardian
• Tackling obesity ‘needs treaty like climate change’ – The Times
• Also covered by BBC Radio 4, BBC 1 Breakfast, BBC News 24, The Economist (Espresso), The Guardian (Op-ed), The Telegraph, The Independent, Daily Mail.

US:

• Report: ‘Radical Rethink’ Needed to Tackle Obesity, Hunger, Climate – Voice of America
• Big Food Blamed for Ills Far Beyond Flab in Sweeping Report – Bloomberg
• Want to fix obesity and climate change at the same time? Make Big Food companies pay. – Vox
• Also covered by Thomas Reuters Foundation, Devdiscourse.

Rest of world:

• Vested interests, misplaced economic incentive major drivers: Lancet report – Indian Express
• Obesity, malnutrition 2 sides of climate change – Hindustan Times
• Eat right to save the planet – Deccan Chronicle
• Also covered by El Pais, O Globo, The Wire, Sydney Morning Herald, The Age, Japan Times, New Zealand Herald, The Australian, El Confidential, Algemeen Dagblad, Nouvel Observateur.

United Nations agencies have just released their annual report on world food insecurity.

Its main unhappy conclusion:

Food insecurity has increased since 2014:

So has worldwide obesity:

What is to be done?

Alas, that’s not what this report is about.

If you want an overview of the current status of nutrition problems in the world, what is being done about them, and what needs to be done about them, this report is required reading (to get to the download button for the entire report, scroll to the end of the page).

The report is chock full of useful facts, figures, case studies, and recommendations.  A massive undertaking, it

was produced by the Independent Expert Group of the Global Nutrition Report, supported by the Global Nutrition Report Stakeholder Group and the Secretariat at Development Initiatives. The writing was led by the co-chairs Jessica Fanzo and Corinna Hawkes, supported by group members and supplemented by additional analysts and contributors.

For a quick overview, go right to the slide deck and then to the graphics in the executive summary.

The report deals both with problems of malnutrition (undernutrition) and obesity (overnutrition), especially in children.

It also deals with adult obesity:

It identifies measurable nutrition indicators that can be used to track progress:

It recommends actions to reduce the prevalence of malnutrition and obesity.

What stands in the way of implementing these steps?  Political will, alas.

These reports have come out annually since 2014.  Let’s hope this one gets the attention it deserves.

My email inbox was flooded last week with The Obesity Society’s call for more research on the value of taxes on sugar-sweetened beverages.

“Although taxing SSBs might generate revenue that can be used to promote other healthy food items, the net outcome may not necessarily decrease overweight and obesity rates in the United States or worldwide,” said Steven B. Heymsfield, MD, FTOS, President-Elect of The Obesity Society (TOS) and professor and director of the Body Composition-Metabolism Laboratory at the Pennington Biomedical Research Center at Louisiana State University in Baton Rouge.

Why would a professional society that represents people who ostensibly care about obesity science, treatment, and prevention issue a statement aimed at casting doubt on a demonstrably effective public health measure?  (Soda companies know the taxes are effective; that’s why they fight them so hard).

The Obesity Society (TOS), alas, often appears far more favorable to the interests of food and beverage companies than those of public health.  Could funding of the society and its members have anything to do with this?

Here is the TOS position on corporate funding:

TOS recognizes the value in providing any donor that wishes to support our mission to find solutions to the obesity epidemic the opportunity to provide financial support.

The current TOS policy expressly eliminates all forms of evaluation or judgment of the funding source (other than the stipulation that funding is reasonably assumed not to be derived from activities deemed ‘illegal’).

TOS chooses instead to focus its ethical mission on transparency in disclosing the sources of funding, clear stipulations outlining our commitment to the ethical use of funds, and a commitment to non-influence of the funding sources over the scientific aspects of funded projects and TOS as a whole.

Translation: We will take money from any company, regardless of the effects of its products on public health.

The TOS rationale is that disclosure takes care of the problem and that funding won’t influence the science.  Unfortunately for this view, research demonstrates that disclosure does not eliminate the influence of funding, and the influence of funding is considerable—though often unrecognized, as is apparent in this case.

TOS has a disclosure policy, and discloses its officers’ conflicts of interest.  These are considerable.

• The TOS president’s university, Louisiana State, has received more funding from Coca-Cola than any other in recent years.  Researchers there have been funded generously by Coca-Cola.
• An elected president of TOS had to resign over charges that he had been paid by the restaurant industry to file an affidavit opposing New York City’s calorie-labeling proposal.

In 2013, Dr. Yoni Freedhoff resigned his TOS membership over the society’s sponsorship policies.  In his comment on the current TOS statement, Freedhoff points out that “sugar-sweetened beverage taxes decrease sugar-sweetened beverage consumption and increase healthier beverage consumption while providing the greatest potential health benefits to low income consumers.”

TOS members who care about creating a healthier food environment should consider joining Dr. Freedhoff.  lf not, they should insist that TOS leadership take vigorous pro-public health stances on matters affecting their patients’ health.

Additional comments, October 31, 2018

Yesterday I received a message from Liz Szabo, a reporter for Kaiser Health News, who is writing a piece on TOS’s relationships with food companies.  She questioned Steve Heymsfield, the group’s current president, who responded at length with a message that included this paragraph:

Marion Nestle, on the other hand, is professor “emeritus” and our understanding is that she no longer reports directly to a dean at New York University. That created a hurdle for us when trying to manage Dr. Nestle’se false and misleading blog related to this matter on her website. Even after learning her comments were misleading from Dr. Popkin, and unlike Popkin who has a high ethical standard, she failed to take down that post.

This surprised me, because nobody from TOS or anywhere else had written me to correct the post, Dr. Popkin’s corrections were to something he—not I—had written, and my ongoing relationship with NYU is readily evident from the information posted under About on this site.

I pointed this out to Dr. Heymsfield, who replied with annotations to my post.  Most of these deal with opinion and interpretation rather than fact.  The one thing I got “completely false” is my interpretation that TOS lacks standards for deciding which donors are acceptable.  Dr. Heymsfield says it does.  I am happy to hear that and stand corrected on that point.

Since September, the New York Times has been investigating how the food industry markets its products in the developing world, and how this marketing is encouraging a rising prevalence of obesity and its health consequences. The series is called Planet Fat.   This is the complete set to date, in reverse chronological order.

If you haven’t read them, this week is a good time to catch up.  Enjoy!

One Man’s Stand Against Junk Food as Diabetes Climbs Across India

India is “sitting on a volcano” of diabetes. A father’s effort to ban junk food sales in and near schools aims to change what children eat.

By GEETA ANAND

Dec. 26, 2017

 

Dec. 23, 2017

 

Dec. 11, 2017

 

Nov. 13, 2017

 

Oct. 2, 2017

 

Oct. 2, 2017

 

Sept. 16, 2017

 

Sept. 17, 2017

 

HLPE [High Level Panel of Experts on Food Security and Nutrition]. Nutrition and food systems. A report by the High Level Panel of Experts on Food Security and Nutrition of the Committee on World Food Security, Rome, 2017.

This report takes a food systems approach to recommendations for reducing the double burden of malnutrition—obesity in the presence of widespread hunger and its consequences.

This report aims to analyse how food systems influence diets and nutrition. It offers three significant additions to previous frameworks. First, it emphasizes the role of diets as a core link between food systems and their health and nutrition outcomes. Second, it highlights the central role of the food environment in facilitating healthy and sustainable consumer food choices. Third, it takes into account the impacts of agriculture and food systems on sustainability in its three dimensions (economic, social and environmental). 2. A food system gathers all the elements (environment, people, inputs, processes, infrastructures, institutions, etc.) and activities that relate to the production, processing, distribution, preparation and consumption of food, and the outputs of these activities, including socio-economic and environmental outcomes. This report pays specific attention to nutrition and health outcomes of food systems. It identifies three constituent elements of food systems, as entry and exit points for nutrition: food supply chains; food environments; and consumer behaviour.

Where are we in obesity prevalence?  The Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health (TFAH), are keeping score for us.   Their report gives figures state by state.  Since I live in New York, I’m highlighting its figures.

ADULT OBESITY PREVALENCE

This looks like good news.  The increase is slowing down and maybe trends are leveling off at long last.

 

CHILDREN’S PREVALENCE OF OVERWEIGHT AND OBESITY

 

This also looks hopeful.  The prevalence is level or declining in most states.

But, as Richard Besser of the Robert Wood Johnson Foundation and John Auerbach of Trust For America’s Health explain in an editorial in The Hill,

One of the best ways to bring down those adult obesity rates in every state is to prevent children from becoming overweight or obese in the first place…Unfortunately, there are signs that we are moving in the wrong direction—and not just on school meals…These kinds of threats put at grave risk the progress our nation has achieved. To accelerate progress in addressing obesity, we urge policymakers to support proven programs like school meals and SNAP that put kids on a healthier track for their entire lives, and maintain full funding for agencies like the Centers for Disease Control and Prevention that are responsible for protecting the health of kids and adults nationwide.