Monday, August 04, 2008

Obesity is NOT about inactivity


I've been saying that forever - the math just isn't there.

Thankfully other people have been out there proving it.

People like Drs. Westerterp and Speakman who in May of this year published a fascinating paper in the International Journal of Obesity.

The paper looked at energy expenditure experiments conducted since the 80s. The experiments were gold-standard style as they used doubly labeled water to track results. Many health professionals, the media and the general public might assume that since obesity rates have risen dramatically since the 80s, energy expenditure (the scientific term for activity) must have declined in turn.

Imagine their surprise to read this paper which showed that not only has the developed world's average daily energy expenditure remained the same, it does not differ significantly from that of the third world (a conclusion also reached in that paper I blogged about that compared the energy expenditure of suburban Chicagoans to Nigerian subsistence farmers).

Given that there are ultimately only two components to energy balance (in and out), and given that "out" over the course of the past 30 years has remained the same, once again I'm going to say if we want to see any progress in the war on obesity it's going to have to come from shifting the focus to "in".

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7 comments:

  1. I agree completely. I've always found that it's much easier and faster for me to lose weight by dieting than by exercising. The exercise is undoubtedly good in many other ways, but it just doesn't produce serious weight loss for me. And that's important, because I really don't feel like doing much exercise when I have too much flab to carry around. Once I lose more weight through dieting, I'll be happy to step up the exercise intensity. Thanks for the post.

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  3. This article
    http://www.nature.com/oby/journal/v15/n8/abs/oby2007252a.html
    says that communities more suitable for active living have lower BMI. If this is so, it leads to the question why, and a natural hypothesis would be that those communities have greater engagement in physical activity than ones less suitable for active living.

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    This study
    http://www.nature.com/oby/journal/v15/n11/abs/oby2007304a.html
    says that both fat and skinny people have similar basal metabolic rates. So they burn a similar amounts of energy while at rest. This is consistent with the idea that obesity is likely a problem with "energy in", rather than energy out.

    --
    Is there any relationship between obesity and vitamin D deficiency or reduction? I found no info on the subject, except, of course, from vitamin pushers.

    --
    Is there a relationship between global warming and obesity? The world has warmed, through Europe and North America, about 1 degree since the period ending in 1950. Wouldn't this cause a slight lessening of basal metabolic rate, since less energy would be needed to maintain a now lesser temperature difference between the body and the environment? (Or do you think there would not be a real effect, because people have long lived in climate controlled environments, and worn insulating clothes.)

    Is there a relationship between BMR and latitude as well?

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  4. Hi CRF,

    There are studies and then there are studies.

    Studies with inferences and associations aren't particularly helpful in drawing conclusions but may be helpful in developing hypotheses that can then be tested.

    The issue with exercise being a minor player (a player for sure, but minor) is that it doesn't burn tremendous numbers of Calories.

    Regarding temperature variation, latitude etc, the world is growing larger much faster than it's growing warmer so any relationship therein I would imagine would be quite small.

    Vitamin D wise, I have not seen anything remarkable linking the replacement of low levels of vitamin D with any improvement in weight or reduction in gain.

    Regards,
    Yoni

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  5. Stefan8:10 PM

    Hi Doc,

    Here's a chart to go along with your article:

    http://graphics8.nytimes.com/images/2008/08/03/business/0803-sbn-webMETRICS.jpg

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  6. Anonymous2:29 PM

    I've always been of the opinion that there should be "Moderation in Everything". I'm trying to lose the weight and get healthier. So my approach is "eat less, eat better, move more". So far, I'm finding this approach works in changing my lifestyle. Trying to get me to go to a gym for 2 hours every day is not going to work, anymore than starving me on 800-1000 calories a day either. But doing a little of both seems to be much easier, and it's more likely I will continue it.

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  7. Actually your blog delivers the message that Time should have taken as their focus. However,istead of stating how a lack of exercise is not what is causing the obsiety epedemic, as your blog so nicly did, it twists the facts around and pretends that an excess of exercise is actually causing the obsiety epedemic. Although some of the indvidual pieces of information sound accurate, the writer misses the oppurtunity to warn people about the pitfalls of wieght loss and chooses to justify them instead.

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