For examples:
Here for kids in particular for example.
And here for the importance of behavioral changes for maintaining loss long term.
I think one should be able to write off things like gym memberships as tax deductions.
If car culture and urban planning were a significant factor I would think obesity rates should have exploded much earlier, in the '40s and '50s.
Workers have been increasingly sedentary since the industrial revolution, though back then people often walked several miles to work. But jobs where you just plop down and push paper all day predate the obesity epidemic by decades.
I don’t know how accepted the idea is as a causative factor vs. a correlation, but for years now I’ve been seeing articles like this making the case for the gut microbiome playing a key role.
Things that negatively affect it:
- Diet high in refined carbs.
- Born by c-section (America has a high rate of c-sections compared to other countries).
- Formula feeding instead of breast feeding (from a quick and dirty google, it seems like formula feeding actually peaked in the middle 20th century, and breast feeding became more popular in the 70s and beyond, except in poorer communities).
- Antibiotics.
I’ve heard Portion sizes have grown considerably over the years, especially when eating out. I guess i’d try to watch portions a bit, but the biggest issue is inactivity. I see parents everyday who are so proud their 2 year old can operate an ipad. Sure the kid appears to be baby Einstein but he or she starts the bad pattern of inactivity early on - encouraged by their parents. This generation is the first where parents will outlive their kids. I listened to the data on this and felt a great deal of sadness. Parks are empty on sunny days. Kids can’t walk home because what was normal 20 years ago is pushed as abuse?! Parents - Get your little ones active and engaged in outdoor activities and sports. Make them water babies or whatever you feel is healthy. The Einstein baby is cute - but is obesity and outliving your child worth it?
The root cause of obesity: food is extremely cheap, plentiful, and everywhere.
As long as food is extremely cheap, plentiful, and everywhere, the obesity epidemic can’t be solved.
Nah.
Food-like crap, created by the Food Industrial Complex, is extremely cheap, plentiful, and everywhere. Real food is not … if it was, and the food-like crap was not, there would very likely be no obesity epidemic.
The sad paradox is that in much of the world obesity and undernutrition are present at the same time. Plenty of cheap calories is not the same as adequate nutrition.
The microbiome connection is also very fascinating and correct that better antibiotic stewardship, both in the food supply chain and in medicine, especially by docs who take care of kids, is part of the long term solution. To that last bit a most recent article replicating what has been observed before, in particular antibiotic use during the first six months, or repetitively during infancy, is associated with increased body mass, presumptively by altering the evolution of the microbiome.
[QUOTE=DSeid;18328505
The microbiome connection is also very fascinating and correct that better antibiotic stewardship, both in the food supply chain and in medicine, especially by docs who take care of kids, is part of the long term solution. To that last bit a most recent [article]
(http://pediatrics.aappublications.org/content/135/4/617.abstract?sid=fc51597c-bb31-460e-9767-3ec29d97e74f) replicating what has been observed before, in particular antibiotic use during the first six months, or repetitively during infancy, is associated with increased body mass, presumptively by altering the evolution of the microbiome.
[/QUOTE]
Problem is, the role of the microbiome in obesity appears to have been overhyped.
“Much work has addressed the role that gut flora have in obesity, and several studies have found associations between the gut microbiome and weight gain8. To assess whether this association was cause or consequence, researchers collected gut-microbiome samples from human twins (one obese, one not) and introduced the microbiota to mice. Mice previously colonized with an ‘obese’ microbiome lost weight when supplied with a ‘lean microbiome’, but only if also fed a normal or low-fat diet. Diet alone had little effect. Although this elegantly controlled experiment suggests great potential for the microbiome and related therapies to affect health, it also shows the microbiome’s limits: the effect was dependent on other factors, in this case diet.”
And:
*"…several studies have claimed that the gut microbiome, the diverse array of bacteria that live in the stomach and intestines, may be to blame for obesity. But Katherine Pollard, PhD, a senior investigator at the Gladstone Institutes, says it is not that simple.
Pollard and her team reanalyzed several previous studies and revealed that there is no significant relationship between body mass index (BMI) and the types of microbes in one’s gut. In fact, her lab found that there was greater variability in gut bacteria between the different studies than between the lean and obese individuals within each study."*
Obesity is not the only situation where a potential link to gut flora may be exaggerated or false. The current fashion in woo communities is to attack favorite targets (like GMOs and vaccines) on the basis of theorized/fantasized damage to the microbiome.
It’s an interesting field of study that may yield useful information on improving health. But watch out for the premature and self-serving hype.
That’s certainly my go-to scapegoat. In the US HFCS seems to be in everything, including quite a lot of things that don’t require it. Salad dressing (as noted). Bread. Meat. There’s even HFCS in beer (which is already empty calories as it is).
Stop loading everything up with unnecessary sugars and you’ll make a dent in the obesity problem. Alas, HFCS is like Brawndo these days - the lucrative product of powerful agribusiness with major political connections - and it’s going nowhere.
(Also - stop building neighborhoods without sidewalks, America! It’s bad enough that most people don’t want to walk without you forcing those who do into the streets.)
While I agree that the hype gets ahead of the science, as it often does, and that the more we know the more questions we realize we need to ask (we are in fact dealing with many different sets of complex ecosystems interacting with various external inputs), your first cite contradicts your contention that the link “may be exaggerated or false.”
We could down a rabbit hole of studies here but the evidence is at this point overwhelming that there is an interplay between our microbiomes, our diets, and a wide variety of health outcomes including obesity. Simple the connections are not.
The animal studies have demonstrated that obese-prone and obese-resistant fecal microbiota (including human in origin) can transplanted with impacts that are then dependent on environmental circumstances. Interestingly a recent case report documented a previously life-long lean woman with C. diff infection who received as treatment a fecal transplant from a healthy but overweight donor with unintentional rapid weight gain as a result, corroborative with the animal data.
Smearing the actual science because it is misunderstood and misrepresented by those who believe in woo is very odd. Careful Jack. You are using a computer keyboard and the internet and those who believe in also use those things.
Bolding mine. I would think this is one area where mice studies would be of little use. Surely we don’t expect mice to have the same gut flora as people, do we? Have there been any human trials on this?
Noted that my choice of words was poor here when discussing fecal transplants … 
Well no, it cites a specific example to support the overall contention that we need to dial back the hype on The Microbiome Conquers All. I suggest reading the article before jumping on the “overwhelming evidence” train.
And solitary case reports, while interesting, are grounds for further research and do not justify an “overwhelming” tag.
No, the reason I brought that up is to highlight the importance of evidence-based medicine getting this right, and not falling into the mistakes made by the woo crowd. The general public should be able to perceive a difference in how we conduct science.*
*google “epigenetics” for another example.
So can someone please explain how having “bad” bacteria in your gut will make you gain weight? That is counter-intuitive to say the least. Gut bacteria can help you absorb nutrients from food that you wouldn’t be able to absorb on your own. “Good” gut bacteria do that. So what do the “bad” ones do? Even bacteria can’t create calories out of nothing, you still have to eat them in the first place.
BTW, any info on the relationship between all of this and appendectomy? I’ve read that perhaps the function of the appendix is to store gut bacteria for a rainy day, i.e., to repopulate if they’re flushed out after diarrhea or some such.
Not quite sure I have heard even the over-simplifying media hypesters claiming that the Microbiome conquers all. Albeit again the hype, oversimplification, and over-reach is there, as it almost always is when the media discusses science and in particular medical science.
My favorite and closest to “Microbiome uber alles” was the idiot (described as a scientist - go figure) who self-administered a fecal transplant from a Hazda tribesman, as if the complex ecosystem selected for a particular genetic make-up in a particular place with a particular diet could just be dropped into a completely alien environment (from the body make up, immune system, genetic markers, to the feedstock for the gut as even eating so-called “paleo”).
I appreciate in particular the NYT’s take on the subject, including what that idiot did -
That last paragraph brings back to the op. No simple panacea. We need to tweak our diets, lifestyles and environments to impact population wide health outcomes. Personally I see obesity not as the problem but as a marker of the problem.
Yes it is counter-intuitive but what seems to happen is that certain bacterial ecosystems digest fiber and such into compounds that feedback on receptors elsewhere that decrease appetite. Here’s one example article.
I suspect that the story will get much more complicated though.
It’s funny how so many people who want to “solve the obesity crisis” are stuck in 1960s thinking about how we need to shove carb after carb down the gullets of kids. EAT MORE OATMEAL! NO PROTEIN EVER!
I’ve taught high school in the US and in Europe. The difference in the obesity rate among kids in the States and in Europe is astounding. A very small percentage of kids in Europe are obese compared to the US. However, junk food is not banned. There are plenty of US fast food chains in Europe, and they are always busy.
The school offered a balanced lunch of an entre, starch, veggies, salad, dessert and juice, milk or water to drink. But there was a little market a couple of blocks away, and the older kids bought junk food there: they were allowed to leave the school at lunch time–11th and 12th graders.
There were three main differences I noticed that probably result in far, far less obesity among European kids.
One is the lack of fat acceptance. Fat acceptance had led to a huge trend in obesity in the US. Outside the US, if you ask people what is one of the things that identifies Americans, they will say one of them is that Americans are fat.
Another thing is exercise. Europeans, including kids, move a lot more. They walk instead of getting in a car to go a few blocks away. The kids do a lot of sports, not just playing team sports. They bicycle, skate, ride horses, play tennis, etc., as a normal thing–most kids are just a whole lot more active.
Also, kids still tend to eat dinner with their family, like we did back in the 50s. And mom or dad cook instead of ordering out.
There is just a different attitude in general to maintaining a healthy body. So I think, banning things or having extra classes on nutrition, etc., are not really the way to go. It’s a cultural problem. We need to move more. We need to not accept being fat and obese. We need to have parents who cook healthy food and have dinner daily with their kids.
HFCS may be more of a villain than you think. Some study show that HFCS has a extremely low satiety index (much lower than sugar)- that is to say you dont “feel full” even after consuming a lot of it. Thus larger portions. We all remember Mom saying “dont drink that soda before your dinner, it’ll spoil your appetite”. Well, with sugar she was correct. Sadly, not so with HFCS.
This may explain todays 32oz soda as opposed to my 8 or 12oz soda when I was younger- when soda just had sugar.
Cite?
Well, there’s lot of thoughts here. First, with a good gut biome, you tend not to be constipated. Many obese people are constipated.
This is why some docs suggest a large spoon of that orange fiber stuff in a tall glass of water half hour before dinner. Most Americans need more fiber, and that stuff will make you feel full, thus you eat less. Hardly a magic bullet, but I have heard tales of people losing ten # just doing that. Pretty damn safe too, for most.
Next- which nutrients do the good biotics pass on as apposed to thru, and vice versa for the “bad”?
I agree with** Jackmannii** that it’s possibly overhyped and more research is needed, but many Americans have gone thru several course of antibiotics, thus their gut bacteria are out of whack (My Doc sez to replace your probiotcs after any course of antibiotics). Eating some of that yogurt or taking some probiotic supplements is cheap insurance.
It’s hard to get people to eat right, but replacing that Mc Muffin with some yogurt , and drinking a glass of orange fiber stuff is pretty easy, and will likely help- but i doubt if it’s a miracle cure or anything.