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Our entire nation needs to become “metabolically fit”

Barbara Abrams, professor of public health | November 4, 2009

Although there is an enormous body of epidemiological studies that link obesity with poor health, a 2009 review by Wildman* concluded that a third of obese people have normal levels of metabolic markers that would suggest no increased risk of heart disease.  This field of study is in its infancy, and we don’t know why, but genetics may play an important role.  It is also likely that physical activity, healthy eating, good self-esteem and stress management in concert with managing metabolic risk factors and holding weight stable improves fitness for obese individuals.

Once established, obesity is intractable.  Americans spend billions of dollars each year losing weight, only to regain it. Therefore, we must recognize that preventing weight gain is essential, especially for children, adolescents and young adults.  For many who carry the burden of the obesity epidemic, healthy foods are too costly and neighborhood environments are not safe and welcoming places to walk or play.

Our entire nation needs to become “metabolically fit”. This requires major changes in food systems, schools and health care; and at the level of the social and the “built environment”.   If we want to improve the health of all Americans—young and old, obese and lean– we must find ways to address the underlying causes of the obesity epidemic at the policy level.

*Wildman RP. Healthy obesity. In Current Opinion in Clinical Nutrition and metabolic care. 2009 12:438-443.

Comments to “Our entire nation needs to become “metabolically fit”

  1. Advocates on both sides attempt to draw equivalence between adiposity and smoking. How otherwise intelligent people do this is beyond me, for the simple reason that any claim of second-hand adiposity is a far different matter than the obvious and immediate mechanisms of second-hand smoke. An individual with respiratory impairments can be incapacitated and put in lethal danger in literally seconds by a smoker. Except in the possible case of a fetus in a mother’s womb, one can’t really raise someone else’s health risks with one’s own food.

  2. Interesting post. I feel that eating locally, eating fresh food, eating simply goes a long way to stopping obesity from establishing itself in people in general. We used to migrate thousands of years ago. Now we sit on the couch and play video games. The sedentary nature of our modern lifestyle contributes significantly to the problem.

  3. There is certainly also a subset of the smoking set that exercises and has “markers” for good health and will not end up with lung cancer. Should we also try and understand “healthy” smokers?

  4. I think Barbara hits the target with “preventing weight gain is essential, especially for children, adolescents and young adults.”

  5. I believe it’s very important for someone newly diagnosed with type II diabetes to change to a diet that is diabetic friendly. That becomes a lot easier if the new diet is one filled with great tasting food.

    Ken

  6. Interesting post. I feel that eating locally, eating fresh food, eating simply goes a long way to stopping obesity from establishing itself in people in general.

  7. As a type 1 diabetic, I take my diet very seriously. I think that, just as changing the ‘built environment’ will benefit people, a change in attitude is key to stopping the obesity epidemic. Since I’m managing insulin dependent diabetes, it’s now natural for me to really know what I’m eating, otherwise I could inject too much or too little and have a bad day as a consequence.

    I’m not suggesting that everyone should get type 1 to tackle obesity (!), but rather that people should be encouraged to learn more about the food they eat, and listen to their bodies to know when to stop! I don’t really believe in special diets (whether you’re diabetic or ‘normal’) to lose weight, but I think that a more active lifestyle and a moderately reduced calorific intake can do wonders.

    As for the link between being ‘even slightly overweight’ and diabetes (type 1 or 2), it’s more complicated than “you’re fat so you will become diabetic”. Insulin resistance (type 2 diabetes) will probably make you put on weight. So often it’s not that people have eaten too much so they get type 2, but rather that becoming fat is a symptom of the disease. With type 1 diabetes there’s no link to weight (as far as I know), but it can be quite easy to get fat as you become used to injecting insulin.

  8. I am agreed with the point made by you. A person should make permanent changes in dietary habits in order to remain away for weight problems like –

    1. Reducing caloric intake by 300-500 Kcal

    2. Consumeless and fat and fatty food like butter, meat products and fried food.

    3. Going out for walking, jogging to burn fat from the body.

    4. Be sparing with salt and sugar, and food that contains large quantities of added sugar or salt.

  9. I think Barbara hits the target with ‘preventing weight gain is essential, especially for children, adolescents and young adults’.

    The children and youth are our future and we need to start educating them in a way that they understand the real impacts of being metabolically unfit and obese.

    The challenge we face is the growing market for take away, sweets and soda. While everything can be good in moderation these markets target our young and as a result our obesity numbers are growing every year.

  10. Yes some very good points you made. I also would like to bring up the notion of the food industry and fast food as well. For the last few decades the obesity level has been rising more and more. Here is a link to a picture that shows the rise of obesity for the last few decades. Obesity increase

    Some may say it is because people are less active and I believe that could be true. However, I believe it is more directly tied with the food industry and fast food. I bet if you matched the rise of obesity with the rise of the fast food industry you would see a direct correlation between the two.

    The fast food industry has given rise to a whole new way of producing our foods, even the food we buy at the grocery store. It is more of a factory than a farm. These animals are given growth hormones to make them grow faster, they are feed diets that they would not eat in the wild and are given antibiotics.

    To me these seems like it could easily relate with the rise of obesity. The food system has been so flipped that buying veggies cost more than buying a hamburger from a fast food place. I think if we address that problem it will help the problem with obesity in the US.

  11. Interesting post. I feel that eating locally, eating fresh food, eating simply goes a long way to stopping obesity from establishing itself in people in general. We used to migrate thousands of years ago. Now we sit on the couch and play video games. The sedentary nature of our modern lifestyle contributes significantly to the problem.

  12. There is certainly also a subset of the smoking set that exercises and has “markers” for good health and will not end up with lung cancer. Should we also try and understand “healthy” smokers?

    While I understand the academic benefit of studying the genetics behind this so-called paradox, I feel it is very dangerous to bandy about terms like “metabolically fit” or “fit and fat.” There is SO much evidence linking even moderate overweightness with diabetes and other horrible diseases. Let’s not start a movement to make the populace feel that it is acceptable.

    • Advocates on both sides attempt to draw equivalence between adiposity and smoking. How otherwise intelligent people do this is beyond me, for the simple reason that any claim of second-hand adiposity is a far different matter than the obvious and immediate mechanisms of second-hand smoke. An individual with respiratory impairments can be incapacitated and put in lethal danger in literally seconds by a smoker. Except in the possible case of a fetus in a mother’s womb, one can’t really raise someone else’s health risks with one’s own food.

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