The skinny on fat

The more we seem to know about fat, the more task forces we create, the more studies that are released, the more entrenched fat becomes in the social fabric, the fatter we become. Why is that?

Anne Kingston

National Post (Canada)

link to article

We all know being overweight is more than a cosmetic issue; it vastly increases the risk of having a heart attack, becoming diabetic or even getting cancer. So why are so many of us so fat? More than half of all Canadians are overweight, as are an estimated 37% of children. In The Fat Files, a six-part series beginning today, the National Post will look at the secret life of fat and why it is so difficult to lose weight.

- - -

This week has brought us yet more breaking news from the rapidly expanding fat infrastructure, none of it cheering. On Thursday, the New England Journal of Medicine announced the discovery of a naturally occurring, appetite-suppressing peptide, dubbed YY3-36, that can reduce the intake of calories by as much as 30%. It will be years, however, before the research will benefit those who are overweight. And even when the remedy comes to market, it is unlikely to be "a magic bullet," claimed the medical journal.

In another announcement that seems the set-up for a joke were it not fact, McDonald's was named "the official restaurant sponsor" of Get Lean Houston, a civic fitness program created after Men's Fitness magazine named the city the nation's fattest three years in a row. McDonald's has 253 outlets in the city, or one per 7,718 citizens. In addition to its usual high-fat, high-sodium, high-fructose fare, the chain will be offering "low-fat" menu selections of salads, chicken sandwiches and a veggie burger. It will also distribute pedometers to inspire customers to walk more. Don Thompson, president of McDonald's West, disavowed any relationship between fat and Big Macs, blaming the nation's obesity problem on lack of exercise. That said, he claimed it is up to "the McDonalds of the world to take on a leadership role."

On the processed food front, H.J. Heinz Co. announced it is revamping its frozen food line because the North American craze for the high-fat, low-carb Atkins diet has put a crimp in sales of its high-starch potato products and frozen meals. On the plus side, said a company spokesman -- clearly referring to the company's ledger, not American health prospects -- the diet has boosted sales of pork rinds, pepperoni sticks and beef jerky.

Shall we review? The search for the "magic bullet" to fight fat continues. McDonald's has become the latest anti-obesity advocate. We can look forward to more fat in processed food. Just another week in the ongoing battle against obesity.

So why are we so shocked and outraged by the deluge of statistics that reveal both adult and child populations are supersizing? Just look around. Fat is being institutionalized -- medical-ized, corporate-ized, criminalized, academic-ized, socialized. The corollary is this: The more we seem to know about fat, the more task forces we create, the more studies that are released, the more entrenched fat becomes in the social fabric, the fatter we become. In fact, the only theory that has not been put forth from the highly complex fat front is one that suggests our ever-increasing "knowledge" about fat and its causes might be a contributing factor to our failure to do anything about it.

As a theory, it is not as silly as it first appears. Research into fat is increasingly focusing on causes and solutions unconnected to personal behaviour.

Scientific wisdom long ago moved away from the belief that becoming fat was the result of consuming more calories than you burn. No longer do scientists see everyone as a blank metabolic slate, each of us equally capable of banking or sloughing off fat. The zealous search for a "skinny gene" or a "thin pill" has turned the field into what one researcher has described as a "gold rush." The latest research on the subject, to be reported in these pages next week by Brad Evenson, is looking at fat as a '"separate organ." Evenson also reports on a new finding that links the tendency to bank fat to the production of the stress hormone, cortisol, which occurs more frequently in lower-income groups and thus offers a new explanation about why the rich tend to be thinner than the poor.

The fact that 50% of adult Canadians are overweight, 15% obese, is no longer a personal, cosmetic issue. It is now a full-fledged social concern in that overweight citizens place an increasing burden on the health-care system due to their higher risk for diabetes, heart attack, stroke, asthma and cancer, as well as a raft of other conditions.

The recognition that fat has systemic consequences has resulted in what Marion Nestle, chairwoman of the Department of Nutrition and Food Studies at New York University, referred to recently in a Time interview as a "shift in perception, from seeing obesity only as a personal or family responsibility to seeing it as a societal problem with societal solutions."

Nestle attacked the institutional causes of obesity in the recently published Food Politics: How the Food Industry Influences Nutrition and Health.

The misrepresentation of serving sizes on food labels, she claims, permits the American prepared-food industry to fill stores with portions equivalent to 3,800 calories per person per day when most people only need about 1,800.

More insidiously, the industry's reliance on cheap ingredients -- empty starches, high-calorie sugars and hydrogenated fats beloved for their ability to extend the shelf life of baked goods for months, even years -- in processed, packaged "convenience foods" tends to encourage greater consumption. Unlike a turkey sandwich on multigrain bread, which can provide hours of energy, Nestle explains, foods loaded with processed starches and sugars provide few nutrients and trigger a quick burst of insulin and energy that subsides within an hour or so, leaving us hungry even after ingesting thousands of calories.

Nestle's book is part of the burgeoning genre of anti-fast/anti-processed food literature, sparked by the success of Eric Schlosser's Fast Food Nation. In Fat Land: How Americans Became the Fattest People in the World, published this year, Greg Critser blames increasing obesity on the supersizing policies of fast-food conglomerates. Supersizing was the brainchild of movie-theatre executive David Wallerstein in the 1960s after he discovered people are far more inclined to pay extra for larger portions than they are to risk looking piggish by going back for seconds. (Wallerstein, we should not be surprised, now works for McDonald's.)

Critser also blames rising obesity on the ubiquity of high-fructose corn syrup, which replaced cane sugar and other sweeteners in processed foods in the 1970s. The cheap-to-produce ingredient is now listed in most processed foods -- bread, pasta sauces, bacon, beer, even protein bars and "natural" sodas. The problem is that it does not metabolize in our bodies the way other sugars do. Instead, it sets off a complex reaction that prompts the body to store more fat. It has also been implicated in elevating blood cholesterol levels, blood clotting and weakening the immune system.

So part of the solution to obesity seems obvious: Cut down portion size and try to eliminate fast and processed food. And that conclusion is borne out by a much-trumpeted research study published in the September issue of Psychological Science that explains why only 7% of French people are obese, compared to 22% of Americans, and why heart disease is so much lower in France despite higher cholesterol levels.

Apparently, portions are 25% smaller in France -- an average of 9.8 ounces versus the average of 12.2 ounces on the American plate. French supermarkets and cookbooks also present smaller portions. Candy bars in the United States are 41% bigger than the ones on Paris shelves; soft drinks are 52% bigger and hot dogs are 63% bigger.

But portion size does not account fully for the differences in girth. The French eat more fat than fat-phobic Americans but snack less and walk more. The net result is that they ingest fewer calories, which, when compounded over years, can amount to substantial differences in weight. There is also the fact the French do not wolf down their meals. Even at fast-food outlets, the French take longer to eat, which means they often feel full with less food in their stomachs.

But eating less and exercising more seems so old-school next to trendier solutions. Hence the obsession with the "magic bullet," be it the latest fad diet (this week it is the South Beach diet, endorsed by the Clintons, as outlined on the next page) or the latest surgery.

Once that meant liposuction, which is now the most popular form of cosmetic surgery. But the latest surgical boom is for extreme and dangerous bariatric surgery --now a $3-billion industry in the United States -- that shrinks the stomachs of severely obese people. More than 80,000 Americans had the procedure last year, up 40% over the previous year, inspired by the examples of Al Roker and Sharon Osbourne. As Sharon Kirkey reports next week, teenagers are increasingly undergoing the procedure.

The propensity to look for external excuses for obesity is most apparent in the despair being voiced for the growing ranks of obese Canadian children.

Statistics on this subject vary according to source, though all of them are troubling. The most recent data from the Heart and Stroke Foundation indicate 37% of children aged two to 11 are overweight. In 1999, The Canadian Fitness and Lifestyle Research Institute reported 25% of Canadian children were obese. Between 1981 and 1996, the rate of obesity tripled for boys aged seven to 13, while the rate for girls of similar age doubled, according to the May, 2001, Canadian Medical Association Journal. And according to StatsCan, one-third of all Canadian children aged two to 11 were overweight between 1998 and 1999.

Most children do not become fat on their own, of course. It takes a village, as we know. Mark Tremblay, a University of Saskatchewan researcher and co-author of Is the Canadian childhood obesity epidemic related to physical inactivity?, published last August, blames childhood obesity on Canada's waning emphasis on physical education, a lack of grassroots sports development, too many fast-food options, not enough emphasis on such alternative transportation as cycling, and hours spent watching television and playing video games.

Yet despite the deluge of statistics linking childhood obesity to video games and television viewing, the fact is computers and video games do not make children overweight. The adults who do not monitor their use and who use television as a babysitter do. Children do not buy the food that comes into the household; parents do, even though, increasingly, children have a say. According to one U.S. analyst, parents spend 10% to 40% more on food when children are shopping with them.

But the problem is more endemic: Parents' own sedentary habits inculcate attitudes in their children. More than 50% of Canadian adults do not engage in regular exercise. Basic physical activity has become extraneous to the way most people live. Cars have replaced walking, even for short journeys. Going to the gym to sweat has to be scheduled into the Daytimer.

So why are we surprised children are turning into inert slugs? They do not engage in the kind of informal activities -- street hockey, dancing, tennis at community courts -- that form lifelong habits. Tremblay's study also linked childhood obesity to lower-income families, specifically single-parent families. It concluded a lone parent often has less time to prepare healthy meals or ensure their child is not spending too many hours staring at a television or computer screen. But that it takes more time to prepare healthy meals is yet another myth perpetuated by the food industry, whose use of "healthy" only rivals its use of "natural" in Orwellian doublespeak.

A commercial currently airing for McCain Superfries reflects this misinformation. In it, a mother returns from a run to find father and son bonding over a plate of fries. The item is sold as a "healthy" choice because they are made with unhydrogenated oils. But if you look at a package of Superfries, one serving (a mere 17 chips) is 167 calories and includes traces of trans fat and few nutritional benefits. Are parents reading such packaging? Do they not know that a baked potato is far healthier, cheaper and easier to prepare? Clearly there is a market niche to be exploited, teaching people how to prepare interesting, nutritionally sound and quick meals.

But it is much easier to assign external blame, whether it be municipal policies, school board cutbacks to physical education programs, or greedy corporations. While we are at it, perhaps we should take aim at the fat infrastructure that increasingly buffets us from our own responsibility.

It may be true that fat has become a societal issue. But society does not spoon-feed us, or take us out for walks, at least not yet. Our increasing tendency to fat has to be seen as the fleshy evidence of the way we live now -- of our dependence upon cars, of our physical inactivity, of our addiction to fast food, of our reliance on what we believe to be convenience, of our lack of attention to our children. It is the consequence of the instant gratification, reward and comfort provided by food, and of living in a society where civility is on the wane to the point families do not sit down to meals. In this instance, the political is the personal. Which means the Big Mac has to stop with us.


Part one of a six-part series.; On Monday: Scientists now think of fat as an organ, much like the liver and spleen, that pumps out toxic chemical signals. Think of it as a tumour -- one that's caused by pop and french fries, says one researcher. Also on Monday, the Atkins diet that has helped B.C. Premier Gordon Campbell shed at least 35 pounds.; Don't miss Tara Nelson on the low carb/no carb phenomenon. On Monday's Global National.; akingston~nationalpost.com