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Obesity is thought to be the primary cause of type 2 diabetes in people who are genetically predisposed to the disease. A proper diet and exercise are the foundations of fighting obesity with a greater amount of exercise yielding better results:
Here is a good general coverage of the topic: Our cities are killing us by Julie Robotham and Sherrill Nixon
Think of it as a vast experiment in human biology. Put millions of people in a limited space, then crank a few levers: increase the hours they work, and increase the distance they have to travel; tempt them with material goods but undermine their sense of security about the future; add stress; allow them almost unlimited access to food, but subtly direct their choice by making grease and sugar most accessible. See what happens.
The results are nearly in. Half a century of postwar growth - driven by escalating production, and flavoured by hard-core consumption and mass migration to cities - is yielding a consistent global pattern.
The population's physical health is starting to degrade. The body, overfed and under-exercised, stacks on weight; those extra kilograms turn on their owners, unlocking diabetes, kidney disease and cancers from a genome that evolved with little experience of carrying fat. Psychiatric illness increases as unbarred competition between individuals excludes and denigrates the more vulnerable.
Weight gain, says Dr Michael Booth, is a physical portrait of consumerism, an externalisation of our value system. "We do need to do something about 'I will give myself pleasure whenever and however I please and not think about the consequences,"' he says. "It's a problem that comes with greater and greater wealth. We see the world as the range of things available to us. Virtually anything is there for the taking. We've lost the notion that we should be denied anything."
Australia's various chronic health epidemics - obesity in particular - have been widely noted. Less frequently remarked is the degree to which they are just the logical conclusion of the lifestyle we have collectively adopted. Work, food, suburbs - the fundamentals of our lives - are no longer calibrated to be in harmony with the human body and soul, but have been relegated to afterthoughts in rampant economies as they lap one high water mark after another.
And for now at least, there seems little chance of a radical rethink. "The intensity in terms of policy we need won't happen until we all know a teenager with type-2 diabetes who has just taken 20 years off their life," says Booth, who is the director of the NSW Centre for Overweight and Obesity.
He is as aware as anyone how real that prospect is. The centre's study this year of more than 5000 children for the NSW Government found 20 per cent of year 10 students had raised insulin levels, putting them at increased risk of the chronic and incurable disease. Among the heaviest boys, that figure was 68 per cent.
It has been said frequently that this generation of children may die younger than their parents as a result of their weight gain. But the phenomenon of children having the physiology of unhealthy adults is so new that no one can really predict the consequences.
The fat boom is not reflected in official life-expectancy projections - slated to increase for at least another half century.
The Australian Bureau of Statistics considers a man who reaches 50 in 2051 will live to an average 87 years, and a woman to 89. Those are improvements of six and 4.5 years respectively on the present crop of 50-year-olds.
What seems guaranteed - because it is happening already - is that more people will live with debilitating illnesses that will reduce their capacity to work and leech the enjoyment from those extra years.
Booth thinks it will take two generations to fix the sabotaging of our health. Australia is now making serious progress with reducing smoking rates, he points out, but that has taken 20 years. "I think this is a much harder problem than smoking. Everyone's affected. Everyone sits, everyone eats."
Cities are hymns to hyper-consumption, and from this year, for the first time, more than half the world's population will live in one. But Australia is well ahead of that trend. Three-quarters of us live in cities, says the Australian Bureau of Statistics, and the urban population is gaining four times as many people annually as regional Australia. Sydney alone gains 30,000 residents a year.
The London of Charles Dickens, with its orphans and its garbage-sifters and debtors prisons, added citizens at a similar speed, trebling from 1 million to more than 3 million during the 1800s. More than a century later and in developed countries there is less explicit urban poverty, but by other measures the modern city may be at least as hostile to the striving human, and possibly more so.
"Cities are only there because they're supposed to be useful to people. When they start to have more negatives to people than positives you have to stop and think," says Pieta Laut, the executive director of the Public Health Association of Australia. "We can sustain human life in some of the cruddiest environments, and always have. We need to get beyond what we can survive in, but what's good for a community ... cities will not become untenable but they'll get nastier and nastier."
People will need more resources just to survive, and more people will be marginalised if they cannot run fast enough to keep up, says Laut, who was a town planner before finding its solutions too simplistic. "Life is complex and highly integrated. That's why I find public health so interesting."
In some remote Aboriginal communities infection-related deafness is so commonplace that people affected do not believe themselves sick.
Affluent city dwellers may have to drive two hours every day just to maintain their standard of living, but they do not consider that an imposition on their wellbeing.
It is the dark side of the celebrated adaptability of the human species. "There is a slow deterioration in human health - and people learn to accept that," Laut says.
She is not talking about the few people who are too fat to walk. She means the rest of us who buy a takeaway and collapse in front of the TV because life is too exhausting to contemplate doing otherwise.
"Our health system will do better by everyone losing two to five kilos," she says, than more dramatic weight loss among the heaviest.
Twenty-five years ago, long before it was either fashionable or profitable, David Crawford spotted the first signs of the weight-gain trend. Though it was then much less extreme, Crawford - now the associate head of Deakin University's School of Exercise Nutrition and Sciences - saw the association between weight and heart disease in statistics compiled by the National Heart Foundation, and took a punt on its importance. He has been delving into the connection ever since, and has watched the epidemic unfold.
"There's something basically wrong with our lifestyles," Crawford says. Diabetes and obesity are woven into the fabric of dysfunction, but so are, "depression, social isolation, people dying alone in an apartment".
He is frustrated with the standard political response to the latest dire new health statistic: "TV campaigns with jingles. That's lovely but most [researchers] would say on its own it's not going to make a difference."
He would prefer serious, focused study into the uncharted territory of how individuals navigate the plethora of options in their lives, and how these choices play into the balancing act of keeping them healthy.
"One of the areas I think we need to look much more closely at is those groups in the community who are disadvantaged. The gap between them and the rest of the community is widening all the time," he says.
"Just because healthy foods are readily available and well priced, is that enough to persuade people to eat them? You can't stop to fill your car without someone offering you a chocolate bar. There's all this informal eating that happens anywhere and everywhere nearly all the time."
On the other side of the energy-balance equation, Crawford says: "We are engineering exercise out of our lives, and opportunities to sit still are becoming even more common: ride-on lawn-mowers, kettles that switch themselves off. You can sit still and live huge chunks of your life."
Even beyond the home and garden, opportunities for incremental exercise are eroding, for some people at least. How suburbs are designed strongly influences how people travel around them, and that in turn is an important determinant of residents' health.
The mass production of cars early last century allowed suburbs to sprawl in areas not served by public transport. That was rapidly followed by the rise of the shopping mall, usually built on a busy, main road; who needed corner shops, when you could jump in your car and drive to retail heaven?
That assumption perpetuated itself. For decades, town planners creating new suburbs did not bother with local shops or public transport because they figured everybody had a car. Suburb design started to take on the look of a rabbit warren, full of dead-end streets and winding roads, because people no longer needed to walk. Only now are planners returning to the more grid-like pattern of older suburbs that makes it easier for people to leave the car behind.
Professor Anthony Capon, a visiting fellow with the Australian National University's National Centre for Epidemiology and Population Health, says Australia's suburb design is not quite as bad as that of the United States, but it goes close.
"The motor vehicle is positive in some respects," says the former medical officer with Sydney West Area Health Service. "I drive a motor vehicle, it can be quite liberating. But it's like penicillin. There's a place for it, it isn't a magic bullet. There's a need for a balance between the motor vehicle, walking, cycling and mass transit."
But for the people Professor Christina Lee studies - women - the developing science of the suburbs may continue to miss the point.
Even the terminology of the debate is a poor fit with the reality of women's lives, says Lee, the head of the School of Psychology at the University of Queensland and an architect of the long-running Australian Longitudinal Study on Women's Health.
Transport researchers talk about "journeys" and whether they are on foot, by train or by car. But time-use studies show women make more generalised forays into the outside world. A trip to work probably also involves ferrying children to sport or music, picking up dry-cleaning and dropping off a library book. That means for many women there is no realistic way to travel without a car - removing another opportunity for the small bouts of activity that add up to sufficient exercise.
In last year's update from the study, the average woman in her late 20s had gained five kilograms in seven years - despite the fact that two-thirds had not yet had children. It is a rate that far outstrips the average for adults.
Young women also had the highest depression rates. Money worries are having a real, measurable effect on women's health, says Lee, as casual work, shift work and a culture of working longer than standard hours to prepare for a conference or to get an order to a client have all taken the predictability out of the working week.
"The time pressure associated with money pressure means people are more likely to be working long hours," she says. "They're working unpaid overtime because they're frightened of losing their jobs, and paid overtime because they need the money."
The result is less time for all people - but women in particular with their extra family commitments - to use at their discretion. And that translates directly into poorer health.
"Particularly with exercise it's very easy to get out of a pattern and very hard to get back into it," she says. When unencumbered time evaporates, wellbeing goes with it. "It becomes kind of normal that you feel a bit tired and like you're going to come down with flu."
For Lee, the solution to Australia's chronic health crisis has to go well beyond public transport, well beyond a redesign of what we eat, when and how, and engage head-on with critical questions of social policy: child care, gender roles, disadvantage, industrial relations.
"An individual woman's decision that she's going to lead a healthy life can only take you so far," she says. "Individuals make choices, but only in a social context. Urban design, workplace relations ... the interaction between personal preferences and social structure has fallen through the cracks."
Sep 18, 2012 | medicalxpress.com
Circulation: Cardiovascular Quality and Outcomes , an American Heart Association journal.
The study in Brisbane, Australia, is the first in which researchers examined the association between daily average temperature and "years of life lost" due to CVD. Years of life lost measures premature death by estimating years of life lost according to average life expectancy .
The findings are important because of how the body responds to temperate extremes, the growing obesity trend and the earth's climate changes, said Cunrui Huang, M.Med., M.S.P.H., the study's lead researcher and a Ph.D. scholar at the School of Public Health and Institute of Health and Biomedical Innovation at Queensland University of Technology (QUT) in Brisbane, Australia.
Exposure to extreme temperatures can trigger changes in blood pressure, blood thickness, cholesterol and heart rate, according to previous research.
"With increasing rates of obesity and related conditions, including diabetes, more people will be vulnerable to extreme temperatures and that could increase the future disease burden of extreme temperatures," Huang said.
Mar 23, 2018 | www.newsmax.com
If you're still using the BMI -- body mass index -- to determine if you're dangerously overweight, you might as well be listening to music on an 8-track tape player or watching movies on an old VHS recorder.
That's because the latest research shows that once-vaunted BMI is as outmoded as those old audio-video technologies and that other methods are far better at obesity-related risks for heart attack or other health problems.
A new study, published last month in the Journal of the American Heart Association, found that one newer type of obesity measurement -- called a waist-to-hip ratio test -- is a far better way to calculate excessive body fat than the BMI.
To reach their conclusions, British researchers tracked 265,988 women and 213,622 men and found individuals -- particularly women -- with a bigger waist-to-hip ratio face greater risks of experiencing a heart attack than those who don't.
Lead researcher Sanne Peters, of the George Institute for Global Health and the University of Oxford in the U.K., explained that waist-to-hip ratio tests are a better measure of how and where fat tissue is distributed in the body than BMI.
"Waist‐to‐hip ratio was more strongly associated with the risk of [heart attack] than body mass index in both sexes, especially in women," reported Peters and his colleagues.
The British study is only the latest research to question the value of BMI tests. University of California-Santa Barbara scientists also recently found that an elevated BMI isn't the best way to determine if you're overweight, obese, or unhealthy.
UCSB psychologist Jeffrey Hunger and colleagues said their work shows that you can be fit and still be considered overweight by BMI guidelines.
In fact, the UCSB research, published in the International Journal of Obesity, indicates nearly 35 million Americans labeled overweight or obese based on their BMI are, in fact, "perfectly healthy" -- as are 19.8 million others considered obese.
"In the overweight BMI category, 47 percent are perfectly healthy," said Hunger, a doctoral student in UCSB's Department of Psychological & Brain Sciences, arguing that BMI is a deeply flawed measure of health and should be abandoned.
"So to be using BMI as a health proxy -- particularly for everyone within that category -- is simply incorrect," he said. "Our study should be the final nail in the coffin for BMI."
The BMI -- calculated by dividing a person's weight in kilograms by the square of the person's height in meters -- was developed by Adolphe Quetelet, an 18th century Belgian mathematician. But the tool was originally designed to measure and compare societies, not individuals.
A growing number of researchers, including Hunger, have suggested measuring weight and height only isn't a good way to gauge obesity or a person's overall health.
For one thing, the index doesn't accurately measure body fat content or distribution on the body, or the proportion of muscle to fat -- all critical factors in determining obesity-related health risks. Nor does the BMI take into account gender and racial differences in body composition.
The BMI treats body weight the same, no matter what it's comprised of -- fat, muscle, bone, or other tissues. As a result, many people who are very muscular can be falsely labeled overweight or obese by the BMI, while those who fall within BMI's weight parameters may have high levels of body fat content.
Declaring a person obese based only on BMI, "is old-fashioned and not terribly useful," said Dr. Scott Kahan, director of the National Center for Weight and Wellness in Washington, D.C. He sees patients who are deemed overweight by the BMI, but are healthy and well.
"They're heavy," he noted. "BMI puts them in the obesity range. And yet on every level
their health is actually good. Cholesterol and blood pressure are excellent. Blood sugar is excellent. They don't seem to have any health effects associated with excess weight."
So what alternatives can be used in place of BMI to more accurately measure health and obesity? Here's are a few tests experts recommend that provide a broader picture of a person's health than BMI:
Waist-to-hip ratio. This test calculates how much excess weight you are carrying, which can indicate your susceptibility to high blood pressure, heart disease, and diabetes. To calculate your waist-to-hip ratio, use a tape measure to measure the size of your waist line and the widest part of your hips. Then divide the circumference of your waist by your hip measurement. Men with a waist–to-hip ratio above 0.90 and women over 0.85 are considered obese, according to the World Health Organization.
Waist measurements. Simply taking a tape measure to check your waist size can also provide a clue to whether you need to lose weight. Generally, a waist size over 35 inches in women and 40 inches in men indicates that weight loss is warranted, with the exception of only the most muscular individuals.
Body-fat content tests. Instruments such as DEXA (dual-energy X-ray absorptiometry) scanners -- becoming more widely available at health clubs and clinics -- provide a highly accurate measurement of body fat and lean mass distribution. They can also reveal important information about bone health.
In addition to these tests, health experts say measurements of other vital signs and health numbers are more reliable ways to gauge your overall health than the BMI. Among them:
- Blood tests to check for cholesterol levels, blood glucose, and hypertension.
- Measures of your heart rate and pulse.
- Screenings for hormone levels, heart function, and cardiovascular fitness.
UCSB Hunger argued that the idea of using a single measurement, such as the BMI, as a gauge overall health is outmoded and should be abandoned.
"We need to move away from trying to find a single metric on which to penalize or incentivize people and instead focus on finding effective ways to improve behaviors known to have positive outcomes over time," he said.
Aug 30, 2017 | www.msn.com
1. Lose fat. Researchers in Japan have found that fat oxidation occurs if exercisers work out before breakfast . There's only good to be said for fat oxidation, the process by which large lipid (i.e. fat) molecules break down, which, in addition to being the kind of weight loss most people want, may also reduce type 2 diabetes . One Belgian study found that eating a high-caloric diet had no effect on fasting exercisers but caused those who worked out after eating to gain weight (good news for those of us who like to have our cake and exercise too). Exercising before breakfast mimics the fasting state and can help kick start weight loss. If you have low blood sugar, eat a banana or a small energy bar 10-15 minutes before exercise.
Sep 05, 2016 | www.zerohedge.comSubmitted by Michael Snyder via The Economic Collapse blog,
The United States officially has an obesity crisis. According to a brand new report that was just released by the Trust for America's Health, at least one out of every five people meet the clinical definition for obesity in all 50 states. But of course in some states things are far worse than that. More than 35 percent of all adults are obese in four states, and the obesity rate is between 30 and 35 percent in 21 other states. And it is important to keep in mind that just needing to lose weight does not mean that you are obese. According to the CDC, you have got to have a body mass index of at least 30.0 to meet the clinical definition for obesity.
Each year, the American people spend 60 billion dollars on weight loss programs and products. That breaks down to about 188 dollars for every man, woman and child in the country. We are a nation that is absolutely obsessed with losing weight, and yet obesity levels are hovering near all-time record highs.
But some parts of the U.S. are definitely doing better than others. The following is an excerpt that comes directly from the new report
In 2015, Louisiana has the highest adult obesity rate at 36.2 percent and Colorado has the lowest at 20.2 percent. While rates remained steady for most states, they are still high across the board. The 13th annual report found that rates of obesity now exceed 35 percent in four states, are at or above 30 percent in 25 states and are above 20 percent in all states. In 1991, no state had a rate above 20 percent.
Did you catch that last part?
I put it in bold for a reason. To me, it is absolutely incredible that no state in the entire country had an obesity rate of more than 20 percent just 25 years ago.
How is that possible?
How could obesity explode to such a dramatic level in just a couple of decades?
Well, a lot of it has to do with what we eat and drink, and I will have some comments about that below. But first, let's take a look at some more statistics from this new report. It turns out that there seems to be a significant link between obesity and poverty
9 of the 11 states with the highest obesity rates are in the South and 22 of the 25 states with the highest rates of obesity are in the South and Midwest. 10 of the 12 states with the highest rates of diabetes are in the South. American Indian/Alaska Natives have an adult obesity rate of 42.3 percent. Adult obesity rates are at or above 40 percent for Blacks in 14 states. Adult obesity rates are at or above 30 percent in: 40 states and Washington, D.C. for Blacks; 29 states for Latinos; and 16 states for Whites.
The report also noted that it has been estimated that our obesity epidemic costs the United States somewhere between 147 billion dollars and 210 billion dollars every single year.
That is an enormous amount of money, and if we were all a bit healthier it would benefit our society tremendously.
Sadly, as a society we have fallen into some very bad habits. For example, the new report also found that the number of high school students that play video games for at least 3 hours per day "has increased more than 88 percent since 2003 (from 22.1 to 41.7 percent)".
When I was in high school, almost all of the kids couldn't wait to get outside and play after school. But these days most playgrounds are parks are eerily silent most of the time, and even if kids wanted to go use them the truth is that many of them aren't very safe.
In the old days, parents could let their kids go outside and play freely without having to worry about it. But in 2016, many of our communities are infested by addicts , gangs, sex predators, etc.
But that is a topic for another article. Last year, Gallup also did a survey on obesity , and what they found lines up with this new report very well...
-The national rate of obesity has risen to an all-time high of 27.7 percent. That is up from 27.1 percent in 2013, and it is much higher than the 25.5 percent number that we were sitting at in 2008.
-At 19.0 percent, Hawaii has the lowest rate of obesity in the entire country.
-At 35.2 percent, Mississippi has the highest rate of obesity in the entire country.
-The rest of the top 10 includes West Virginia, Louisiana, Arkansas, Oklahoma, Alabama, Kentucky, Indiana, Iowa and Missouri.
And remember, being obese is different from being overweight.
According to CNN, an astounding 70 percent of all Americans are overweight at this point.
Let that number sink in for a moment. 70 percent. So how did this happen?
Well, our addiction to sugar plays a major role in this. If you were just to make one change to your diet, you could immediately start living a much healthier lifestyle. What I am talking about is soda.
Many people that have cut all soda out of their diets have immediately started losing weight, and they often report feeling much better too. Other people have actually decided to completely cut all sugar out of their diets, and needless to say the health benefits have been nothing short of astounding.
If you know me, you know that I like sugar, but I try to keep it at a very reasonable level. But that is difficult, because sugar is in just about everything. And if it isn't sugar, it is some other type of sweetener such as high fructose corn syrup.
There are others that know much more about these things than I do, but I just wanted to share with you a couple common sense things I have learned over the years that can immediately help you if you are interested in a healthier lifestyle.
Of course cancer loves sugar too, and so it is no wonder why we have a cancer epidemic in this country. If you can believe it, Americans spend 100 billion dollars a year on cancer drugs alone.
We are literally digging our own graves with our forks, knives and spoons. What we eat and what we drink are the biggest reasons why we have an obesity epidemic in this nation, and if we will just take a few common sense steps we could start turning around this crisis tomorrowPT DownWithYogaPants Sep 5, 2016 12:45 PMSon of Loki looseal Sep 5, 2016 12:38 PM
When you're worried about where your next meal is coming from, you do tend to try to conserve energy (sleep) and pack on the calories so you're ready to endure the famine, so yes it is no co-incidence that many welfare people are obese and tired or, if you prefer, fat and "lazy".
These days I tend to believe the Gabriel Method (Book - look it up) : We all know that the answer is diet and exercise, so why don't we do it? Gabriel Method basically says to get counselling and I believe he is probably right.
I say people are fat because they have "brain damage". This "brain damage" can be cured / repaired without brain surgery. A lot of the time it could be "cured" by some good, hard work (if available) but first people need to admit what they're up against.
We all know that physically, the answer is "diet and exercise", so why don't we do it? Ever met an unemployed fat person who INSISTS they don't have time to exercise? You can call them out on their faulty logic - you got 24 hours per day where the average worker is battling to have 16, but they simply do not hear you. You may as well just say they are fat because they have brain damage - it will save you from hours of tedious and pointless bullshit arguments.
What about the people who do try to diet / exercise but "forget" after a day or two?
Then there are those who exercise but keep getting bizarre injuries that prevent further exercise.
Or the procrastinators who have all the good intentions in the world but simply don't do anything.
May as well just say they have "brain damage".
"The Gabriel Method" makes an interesting assertion about our flight / flight response. If you're under extreme stress and you do NOT fight back or run away but instead just stand there and take it, your body will decide to defend itself my making itself bigger. So if the boss yells at you and you just stand there and take it, then after he wanders off you should run up and down the stairs or run around the block so your body decides it needs to be lighter, not heavier, to endure this "threat".
Fit people can give unfit people good advice about diet and exercise but then, in order to preserve their own sanity, they need to walk away. The fat guy knows what he needs to do. All the "excuses" he gives are bullshit. He just has "brain damage" and the only cure for the "brain damage" is counselling ( or sometimes a career change, or travel ).
https://i.imgur.com/j1tF70S.pngWomen these days, even the young girls I see in my classes are pretty fat by ANY standard. It's a very sore subject to bring up with them but most will tell you before you even ask, "It's a hormone problem" as they munch down on a Quarter Pounder and Fries, supersized, and warsh it down with a double whipped cream Mochachinno with a double shot of hazlenut syrup.looseal -> Son of Loki Sep 5, 2016 1:19 PMThey are correct, it is a hormone problem; the hormone is insulin. And you are correct in up question to ask, are you hungry again within 2 hours of eating or does it take 5 hours between meals or snacks before you want anything else? If 2 hours or less then it's definitely insulin resistance.AustriAnnie -> looseal Sep 5, 2016 2:16 PM+1El Vaquero -> LetThemEatRand Sep 5, 2016 12:27 PM
They are correct that hormone problems lead to obesity. Every function in your body is regulated by hormones so hormones affect everything. And any imbalance anywhere in diet, lifestyle affects hormones. Food is medicine. Anything that disrupts your liver/gut function disrupts hormones. Poor activity levels affects hormones, staying up late on your electronic device and missing out on sleep affects hormones. Stress/anxiety affects hormones.
Women today start downing 3 servings of coffee before noon, without eating breakfast, then eat processed snacks all afternoon/evening because they are starving from lack of proper nutrition. Coffee was not meant to replace sleep, food, or the energy-boosting effects of exercise. Yet you see girls at the age of 10 or 11 walking out of Starbucks with 18-ounce suger-laden double-shot mochas instead of breakfast. Higher insulin levels, higher cortisol levels, and no food, great for the metabolism. Add a few more years of facebook instead of exercise, being a student where you eat top ramen, pizza, and beer, topped with alcohol, and there you go.
Then they are afraid of eating meat (no protein) or healthy fats. "like, oh my god! do you know how many grams of fat are in that avocado?! Here, have another Wheat Thin!")It's probably a lot of things. We're more sedentary than we were back in the '80s. I used to ride my bike all over the place when I was a kid. The food is processed even more, and there is a lot of evidence that what is grown today is less nutritious than it was back in the '50s.
I haven't had it tested, but it is a safe bet that the corn that I grow has a higher protein content than any off of a megafarm. I doubt that you can point at any one thing and yell "EUREKA!"
19 September 2010 | The Observer
Got a few pounds to lose? Cancel the gym membership. An increasing body of research reveals that exercise does next to nothing for you when it comes to losing weight. A result for couch potatoes, yes, but also one that could have serious implications for the government's long-term health strategy
My mum used to complain that she couldn't lose weight. A size 18 and a couple of stone heavier than ideal, she tried in vain for years to shed the extra. Every week she headed to the gym, where she pounded the treadmill like a paratrooper, often three times a week. Most days she took the dog for a brisk, hour-long walk. She didn't eat unhealthily the rest of the family ate exactly the same meals, and did a fraction of the exercise she did. She ought to have been the slimmest of the bunch: that she remained overweight was a frustration to her, and a mystery to all of us.
From StairMasters to kettlebells, Rosemary Conley to Natalie Cassidy, we understand and expect that getting in shape is going to require serious effort on our part and the reverse is true, too, that we expect exercise to pay back the hours of boring, sweaty graft with a leaner, lighter body. Since the days of the Green Goddess, we've known that the healthiest way to lose weight is through exercise. It's science, isn't it?
Well, science has some bad news for you. More and more research in both the UK and the US is emerging to show that exercise has a negligible impact on weight loss. That tri-weekly commitment to aerobics class? Almost worthless, as far as fitting into your bikini is concerned. The Mayo Clinic, a not-for-profit medical research establishment in the US, reports that, in general, studies "have demonstrated no or modest weight loss with exercise alone" and that "an exercise regimen is unlikely to result in short-term weight loss beyond what is achieved with dietary change."
It sounds faintly heretical, if not downright facetious. And it's a scientific discovery that most health professionals are, naturally, keen to downplay. After all, exercise is still good for us. It's just that, in defiance of decades of New Year resolutions, it's unlikely to make us slim.
Most of us have a grasp of the rudiments of weight gain and loss: you put energy (calories) into your body through food, you expend them through movement, and any that don't get burned off are stored in your body as fat. Unfortunately, the maths isn't in our favour. "In theory, of course, it's possible that you can burn more calories than you eat," says Dr Susan Jebb, head of nutrition and health research at the Medical Research Council, and one of the government's go-to academics for advice on nutrition. "But you have to do an awful lot more exercise than most people realise. To burn off an extra 500 calories is typically an extra two hours of cycling. And that's about two doughnuts."
From a practical perspective, then, exercise is never going to be an effective way of slimming, unless you have the training schedule and the willpower of an Olympic athlete. "It's simple maths," says Professor Paul Gately, of the Carnegie Weight Management institution in Leeds. "If you want to lose a pound of body fat, then that requires you to run from Leeds to Nottingham, but if you want to do it through diet, you just have to skip a meal for seven days." Both Jebb and Gately are keen to stress that there is plenty of evidence that exercise can add value to a diet: "It certainly does maximise the amount you lose as fat rather than tissue," Jebb points out. But Gately sums it up: "Most people, offered the choice, are going to go for the diet, because it's easier to achieve."
There's another, more insidious, problem with pinning all your hopes for a holiday bod on exercise. In what has become a defining experiment at the University of Louisiana, led by Dr Timothy Church, hundreds of overweight women were put on exercise regimes for a six-month period. Some worked out for 72 minutes each week, some for 136 minutes, and some for 194. A fourth group kept to their normal daily routine with no additional exercise.
Against all the laws of natural justice, at the end of the study, there was no significant difference in weight loss between those who had exercised some of them for several days a week and those who hadn't. (Church doesn't record whether he told the women who he'd had training for three and half hours a week, or whether he was wearing protective clothing when he did.) Some of the women even gained weight.
Church identified the problem and called it "compensation": those who exercised cancelled out the calories they had burned by eating more, generally as a form of self-reward. The post-workout pastry to celebrate a job well done or even a few pieces of fruit to satisfy their stimulated appetites undid their good work. In some cases, they were less physically active in their daily life as well.
His findings are backed up by a paper on childhood obesity published in 2008 by Boston academics Steven Gortmaker and Kendrin Sonneville. In an 18-month study investigating what they call "the energy gap" the daily imbalance between energy intake and expenditure - the pair showed that when the children in their experiment exercised, they ended up eating more than the calories they had just burned, sometimes 10 or 20 times as many. "Although physical activity is thought of as an energy-deficit activity," they wrote, "our estimates do not support this hypothesis."
In the 1950s, the celebrated French-American nutritionist Jean Mayer was the first to introduce a link between exercise and weight reduction. Until then, the notion that physical activity might help you lose weight was actually rather unfashionable in the scientific community in the 1930s, a leading specialist had persuasively argued that it was more effective to keep patients on bed rest.
Over the course of his career, Mayer's pioneering studies on rats, babies and schoolgirls demonstrated that the less active someone was, the more likely they were to be fat. Mayer himself, the son of two eminent physiologists, and a Second World War hero to boot, became one of the world's leading figures in nutrition and most influential voices in the sphere of public health. As an advisor to the White House and to the World Health Organisation, he drew correlations between exercise and fitness that triggered a revolution in thinking on the subject in the 60s and 70s. "Getting fit" became synonymous not just with healthier living, but with a leaner, meaner body, and the ground was laid for a burgeoning gym industry.
Each successive postwar generation was enjoying an increasingly sedentary lifestyle, and those lifestyles have been accompanied by an apparently inexorable increase in obesity. Three in five UK adults are now officially overweight. And type II diabetes, which used to be a disease that affected you at the end of your life, is now the fastest-rising chronic disorder in paediatric clinics.
But have we confused cause and effect? Terry Wilkin, professor of endocrinology and metabolism at the Peninsula Medical School in Plymouth, argues that we have. The title of his latest research is: "Fatness leads to inactivity, but inactivity does not lead to fatness". Wilkin is nearing the end of an 11-year study on obesity in children, which has been monitoring the health, weight and activity levels of 300 subjects since the age of five. When his team compared the more naturally active children with the less active ones, they were surprised to discover absolutely no difference in their body fat or body mass.
That's not to say that exercise is not making the children healthy in other ways, says Wilkin, just that it's having no palpable effect on their overall size and shape. "And that's a fundamental issue," he adds, "because governments, including ours, use body mass as an outcome measure." In other words, obesity figures are not going to improve through government-sponsored programmes that focus primarily on exercise while ignoring the behemoth of a food industry that is free to push high-calorie junk to kids (and, for that matter, adults).
For one thing, Wilkin believes he has discovered another form of "compensation", similar to Timothy Church's discovery that we reward ourselves with food when we exercise. Looking at the question of whether it was possible to change a child's physical activity, Wilkin's team put accelerometers on children at schools with very different PE schedules: one which offered 1.7 hours a week, and another that offered nine hours.
"The children did 64% more PE at the second school. But when they got home they did the reverse. Those who had had the activity during the day flopped and those who hadn't perked up, and if you added the in-school and out-of-school together you got the same. From which we concluded that physical activity is controlled by the brain, not by the environment if you're given a big opportunity to exercise at one time of day you'll compensate at another."
Wilkin argues that the environmental factors we tend to obsess about in the fight against obesity playing fields, PE time in school, extracurricular activities, parental encouragement are actually less of a factor in determining what exercise we do than our own bodies. "An evolutionary biologist would say physical activity is the only voluntary means you have of varying or regulating your energy expenditure. In other words, what physical activity you do is not going to be left to the city council to decide. It's going to be controlled, fundamentally, from within."
His thesis has caused controversy among his peers there have been cavils that his study sample is inconclusively small and not all obesity experts appreciate the message. "We haven't had the sensitivity in the studies to really determine the longitudinal determinants of obesity in children yet," says Dr Ken Fox, professor of exercise and health science at Bristol University and advisor to the government's obesity strategy. "It's far too early to start discounting things as important as physical activity. Those who are saying it has no impact are neglecting a huge amount of the literature. I am suspicious of anyone who polarises obesity as one thing over another when there is strong agreement that it has multiple causes."
"Terry's point is right," says Paul Gately, "but it's not right in the context of public health promotion. In people who have lost weight and kept weight off, physical activity is almost always involved. And those people who just do diet are more likely to fail, as are those who just do exercise. You need a combination of the two, because we're talking about human beings, not machines. We know that dietary behaviour is quite a negative behaviour we're having to deny ourselves something. There aren't any diets out there that people enjoy. But people do enjoy being physically active."
"What we want to avoid is people thinking they can control their weight simply by dieting," adds Jebb, who points out that this is the very scenario that encourages anorexia in teenage girls. "Just restricting your diet is not going to be the healthiest way to live." Traditional dieting clubs like Weightwatchers and Slimming World promote exercise as a key part of a weight-loss strategy: scientific studies show that exercise is an important factor in maintaining weight loss and, Jebb adds, some studies suggest it can help in preventing weight gain.
But it is still much harder to exercise when you're already overweight, and "high energy density" foods are quick to get us there overeating by just 100 calories a day can lead to a weight increase of 10lb over a year. "Education must come first," says Wilkin. "Eating habits have to change to a much lower calorie intake, much lower body weight, and we would be fitter as a result because we would be able to do more physical activity." He would like to see higher levels of tax on calorie-dense food, similar to those levied on tobacco, which have proved effective in the campaign against smoking.
Does the coalition government which will launch a White Paper on the subject this autumn agree? Anne Milton, minister for public health, is not keen to commit to any particular strategy before its publication. "There's not a magic bullet here," she says. "Despite the best efforts of government actually the public's health hasn't improved hugely.Change4Life [the government's current healthy-living initiative] is doing a good job. But we think there's still lots more we can do with it."
Any drastic measures to curb the excesses of junk food marketing seem unlikely both Milton and Secretary of State for Health Andrew Lansley stress the importance of working "with" industry and much of her language is concerned with "individual choice". When it comes to losing weight, it seems there's only one real choice stop eating so much food.
Running on empty: fat is a feminine issueThe good news The latest scientific findings from the US suggest that an intense workout in the gym is actually less effective than gentle exercise in terms of weight loss. Barry Braun, associate professor of kinesiology at the University of Massachusetts, says that the evidence emerging from his research team shows that moderate exercise such as "low-intensity ambulation" (ie walking) may help to burn calories "without triggering a caloric compensation effect" ie without making you reach for a snack the moment you're done. In one experiment, Braun showed that simply standing up instead of sitting used up hundreds more calories a day without increasing appetite hormones in your blood.
The bad news Perhaps offering one reason for a multi-billion-pound weight-loss industry aimed almost exclusively at women, research has confirmed that it is more difficult for women to shed the pounds than men, because women's bodies are simply more efficient at storing fat. In one of Braun's experiments, in which overweight men and women were monitored while walking on treadmills, the women's blood levels of insulin decreased while appetite hormones increased; the men's, meanwhile, displayed no such change. "Across the evidence base, it seems that it's tougher for women to lose weight than men," affirms Ken Fox, professor of exercise and health sciences at Bristol University.
This means limiting calorie intake, especially from added sugars, solid fats, and alcoholic beverages-sources of calories that are very poor sources of essential nutrients.
Top 10 Triggers for Over-eating
" Overeaters Anonymous - Welcome to Overeaters Anonymous
Tips For Changing Eating Habits to Healthy
Change Your Eating Habits to Lose Weight
6 Steps to Changing Bad Eating Habits1. Take Baby Steps. Making small changes in your diet and lifestyle can improve your health as well as trim your waistline. Some suggestions from the experts:
- Start each day with a nutritious breakfast.
- Get 8 hours of sleep each night, as fatigue can lead to overeating.
- Eat your meals seated at a table, without distractions.
- Eat more meals with your partner or family.
- Teach yourself to eat when you're really hungry and stop when you're comfortably full.
- Reduce your portion sizes by 20%, or give up second helpings.
- Try lower-fat dairy products.
- Make sandwiches with whole-grain bread and spread them with mustard instead of mayo.
- Switch to cafe au lait, using strong coffee and hot skim milk instead of cream.
- Eat a nutritious meal or snack every few hours.
- Use nonstick pans and cooking spray instead of oil to reduce the fat in recipes.
- Try different cooking methods, such as grilling, roasting, baking, or poaching.
- Drink more water and fewer sugary drinks.
- Eat smaller portions of calorie-dense foods (like casseroles and pizza) and larger portions of water-rich foods (like broth-based soups, salads, and veggies).
- Flavor your foods with herbs, vinegars, mustards, or lemon instead of fatty sauces.
- Limit alcohol to 1-2 drinks per day.
6 Steps to Fix Bad Eating Habits continued...
2. Become More Mindful. One of the first steps toward conquering bad eating habits is paying more attention to what you're eating and drinking. "Read food labels, become familiar with lists of ingredients, and start to take notice of everything you put into your mouth," says Gans. Once you become more aware of what you're eating, you'll start to realize how you need to improve your diet. Some people benefit by keeping food diaries.
3. Make a Plan; Be Specific. How are you going to start eating more fruit, having breakfast every day, or getting to the gym more often? Spell out your options. For example: Plan to take a piece of fruit to work every day for snacks, stock up on cereal and fruit for quick breakfasts, and go to the gym on the way to work three times a week. "To say 'I am going to work out more,' won't help you," says Gans. "What will help is thinking about when and how you can fit it into your lifestyle."
4. Tackle a New Mini-Goal Each Week. These mini-steps will eventually add up to major change. For example, if your goal is to eat more vegetables, tell yourself you'll try one new veggie each week until you find some you really enjoy. Or look for easy ways to add one more serving of vegetables to your diet each week until you reach your goal. Try topping your lunch sandwich with slices of cucumbers; adding shredded carrots to the muffins you have for breakfast; or topping your dinnertime pizza with sun-dried tomatoes and mushrooms.
5. Be Realistic. Don't expect too much from yourself too soon. It takes about a month for any new action to become habit. Slow and steady wins the race -- along with a dose of vigilance.
6. Practice Stress Management. "Focus on dealing with stress through exercise, relaxation, meditation, or whatever works for you, so you don't fall back into those bad habits during periods of stress or use food to help you cope with the situation," advises Foreyt.
Robyn Beck/Agence France-Presse
Two-thirds of Americans are overweight or obese. For most, research shows, neither diets nor moderate exercise brings significant long-term weight loss.
Weight control is not simply a matter of willpower. Genes help determine the body's "set point," which is defended by the brain.
Dieting alone is rarely successful, and relapse rates are high.
Moderate exercise, too, rarely results in substantive long-term weight loss, which requires intensive exercise.
Americans have been getting fatter for years, and with the increase in waistlines has come a surplus of conventional wisdom. If we could just return to traditional diets, if we just walk for 20 minutes a day, exercise gurus and government officials maintain, America's excess pounds would slowly but surely melt away.
Scientists are less sanguine. Many of the so-called facts about obesity, they say, amount to speculation or oversimplification of the medical evidence. Diet and exercise do matter, they now know, but these environmental influences alone do not determine an individual's weight. Body composition also is dictated by DNA and monitored by the brain. Bypassing these physical systems is not just a matter of willpower.
More than 66 percent of Americans are overweight or obese, according to the federal Centers for Disease Control and Prevention, in Atlanta. Although the number of obese women in the United States appears to be holding steady at 33 percent, for most Americans the risk is growing. The nation's poor diet has long been the scapegoat. There have been proposals to put warning labels on sodas like those on cigarettes. There are calls to ban junk foods from schools. New York and other cities now require restaurants to disclose calorie information on their menus.
But the notion that Americans ever ate well is suspect. In 1966, when Americans were still comparatively thin, more than two billion hamburgers already had been sold in McDonald's restaurants, noted Dr. Barry Glassner, a sociology professor at the University of Southern California. The recent rise in obesity may have more to do with our increasingly sedentary lifestyles than with the quality of our diets.
"The meals we romanticize in the past somehow leave out the reality of what people were eating," he said. "The average meal had whole milk and ended with pie.... The typical meal had plenty of fat and calories."
"Nostalgia is going to get us nowhere," he added.
Neither will wishful misconceptions about the efficacy of exercise. First, the federal government told Americans to exercise for half an hour a day. Then, dietary guidelines issued in 2005 changed the advice, recommending 60 to 90 minutes of moderate exercise a day. There was an uproar; many said the goal was unrealistic for Americans. But for many scientists, the more pertinent question was whether such an exercise program would really help people lose weight.
The leisurely after-dinner walk may be pleasant, and it may be better than another night parked in front of the television. But modest exercise of this sort may not do much to reduce weight, evidence suggests.
"People don't know that a 20-minute walk burns about 100 calories," said Dr. Madelyn Fernstrom, director of the weight-management center at the University of Pittsburgh Medical Center. "People always overestimate the calories consumed in exercise, and underestimate the calories in food they are eating."
Tweaking the balance is far more difficult than most people imagine, said Dr. Jeffrey Friedman, an obesity researcher at Rockefeller University. The math ought to work this way: There are 3,500 calories in a pound. If you subtract 100 calories per day by walking for 20 minutes, you ought to lose a pound every 35 days. Right?
Wrong. First, it's difficult for an individual to hold calorie intake to a precise amount from day to day. Meals at home and in restaurants vary in size and composition; the nutrition labels on purchased foods - the best guide to calorie content - are at best rough estimates. Calorie counting is therefore an imprecise art.
Second, scientists recently have come to understand that the brain exerts astonishing control over body composition and how much individuals eat. "There are physiological mechanisms that keep us from losing weight," said Dr. Matthew W. Gilman, the director of the obesity prevention program at Harvard Medical School/Pilgrim Health Care.
Scientists now believe that each individual has a genetically determined weight range spanning perhaps 30 pounds. Those who force their weight below nature's preassigned levels become hungrier and eat more; several studies also show that their metabolisms slow in a variety of ways as the body tries to conserve energy and regain weight. People trying to exceed their weight range face the opposite situation: eating becomes unappealing, and their metabolisms shift into high gear.
The body's determination to maintain its composition is why a person can skip a meal, or even fast for short periods, without losing weight. It's also why burning an extra 100 calories a day will not alter the verdict on the bathroom scales. Struggling against the brain's innate calorie counters, even strong-willed dieters make up for calories lost on one day with a few extra bites on the next. And they never realize it. "The system operates with 99.6 percent precision," Dr. Friedman said.
The temptations of our environment - the sedentary living, the ready supply of rich food - may not be entirely to blame for rising obesity rates. In fact, new research suggests that the environment that most strongly influences body composition may be the very first one anybody experiences: the womb.
According to several animal studies, conditions during pregnancy, including the mother's diet, may determine how fat the offspring are as adults. Human studies have shown that women who eat little in pregnancy, surprisingly, more often have children who grow into fat adults. More than a dozen studies have found that children are more likely to be fat if their mothers smoke during pregnancy.
The research is just beginning, true, but already it has upended some hoary myths about dieting. The body establishes its optimal weight early on, perhaps even before birth, and defends it vigorously through adulthood. As a result, weight control is difficult for most of us. And obesity, the terrible new epidemic of the developed world, is almost impossible to cure.
Between 20 to 50 percent of your daily caloric needs are determined by physical activity. The remainder are burned through basic body functions such as breathing, circulating blood and keeping cells functioning.
"It's easier to get up the will-power to turn down a 900 calorie double-burger with cheese and sauce and opt for a 400 calorie chicken sandwich or salad when you know your entire daily needs are about 1600 calories," says Joan Carter, a CNRC registered dietitian and instructor of pediatrics at Baylor College of Medicine in Houston.
- Decrease prevalence of obesity.
- Increase physical activity.
- Improve dietary behaviors related to population burden of obesity and chronic diseases.
- Increase the number, reach, and quality of policies and standards set in place to support healthful eating and physical activity in various settings.
- Increase access and use of environments to support healthful eating and physical activity in various settings.
- Increase the number, reach and quality of social and behavioral approaches that complement policy and environmental strategies to promote healthful eating and physical activity.
The state program will develop strategies to leverage resources and coordinate statewide efforts with multiple partners to address all of the following DNPAO principal target areas:
- Increase physical activity.
- Increase the consumption of fruits and vegetables.
- Decrease the consumption of sugar sweetened beverages.
- Increase breastfeeding initiation, duration and exclusivity.
- Reduce the consumption of high energy dense foods.
- Decrease television viewing.
For these behavior targets, as well as health outcomes of obesity and other chronic diseases, the program emphasizes reducing health disparities including but not limited to those related to race/ethnicity, socioeconomic status, geography, sex, age, and disability.
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Cholesterol The top five foods to lower your numbers - MayoClinic.com
Walnuts, almonds and more
Studies have shown that walnuts can significantly reduce blood cholesterol. Rich in polyunsaturated fatty acids, walnuts also help keep blood vessels healthy and elastic. Almonds and some other nuts appear to have a similar effect.
According to the Food and Drug Administration, eating about a handful (1.5 ounces, or 42.5 grams) a day of most nuts, such as almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachio nuts and walnuts, may reduce your risk of heart disease.
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