The debate rages. The public appears desperately confused. What’s causing it? We refer of course to obesity, the ‘epidemic’ of excess human body weight that’s weighing down society with a healthcare bill it can ill afford, but also seriously lowering the quality of lives of the nearly 1 in 4 Westerners who suffer the condition as adults.

Mainstream medics and dieticians still try to convince the public (and governments) that it’s a simple matter of our food intake not being matched by our energy expenditure. While at some level this is correct, it is actually such a gross over-simplification of the problem that to continue to cite it like a mantra does nothing to resolve the issue. Rather, it compounds it as more and more put their heads in the sand, hoping the medical or pharmaceutical worlds will soon come up with a slimming pill that actually works. No surprises that there has been no magic bullet thus far. Barring various bariatric surgical procedures, which bring with them their own series of complications and side effects, the medical profession has been spectacularly ineffective at delivering solutions. And the food industry, ever more reliant on highly processed foods, has exacerbated the problem.

The top 10 causes of adult obesity

  1. Over-eating & the quality of calories. It’s not just too many calories in and not enough out, it’s the quality of those calories e.g. the effect on the body of 100 kcal of white bread is entirely different to that of 100 kcal of broccoli or oily fish. Diets rich in plant-based foods are also extremely rich in a wide range of micronutrients that support metabolic processes and act as anti-inflammatory agents and antioxidants
  2. Many people are over-dependent on carbs as their primary energy source. The body can derive its energy from carbs (4kcal/g), fats (9kcal/g) or protein (4kcal/g) - but modern diets are over-reliant on starchy and simple carbs. The UK (and other) government/s propose that 50% of our energy should be derived from carbs, we (as per ANH Food4Health guidelines) say this should rather be around 35%, with healthy fats providing the most important source (more than 50%) of energy
  3. Fat-burning is compromised by contemporary diets/lifestyles. Regular eating and snacking, along with increasingly sedentary lifestyles, means that many people are not accessing their fat burning pathways (beta-oxidation of fatty acids) that help burn adipose fat
  4. Addiction. We become physiologically addicted to simple carbs/sugars (in order to avoid hypoglycaemia when our fat-burning capacity is latent). It is likely that we are also psychologically addicted (via reward/hedonic circuitry within the brain, CNS and ENS)
  5. Government advice. Advice from government health departments, such as the UK Department of Health’s Eatwell Plate and the USA’s MyPlate is part of the problem and NOT part of the solution. See ANH-Intl’s 4 plate shoot-out for more information.
  6. Cyclic ketogenesis should be the normal metabolic human state. We are supremely well designed for irregular patterns of feeding and resting, as well as energy utilisation and storage. To do this, intermittent fasting and varied exercise, including exercising in a fasted state, should be incorporated into our daily lives. We should be in nutritional ketosis (ketone bodies: 0.5-3.0 mM/L blood) for at least a small period of most days
  7. We’re all different. Every individual has a different way of metabolising energy and processing food. Men have different requirements to women and our requirements change as we age. Therefore, blanket recommendations tend to fail. Our health is the amalgamation of a very complex set of interactions between our genes and our environment, and science is teaching us that some of these differences may even be inherited. The rapidly emerging scientific discipline of epigenetics is now providing us with more and more useful information to help us find personalised approaches to overcoming obesity and other metabolic disorders.
  8. Misprogramming of children. Most of our dietary and lifestyle behaviours are programmed by the age of 5. Low levels of outdoor activity, team sports, excessive screen time, limited outdoor exposure, junk food, etc is causing children to adopt diets and lifestyles that will result in an even higher rate of health dysfunction than those we see in adult populations today
  9. Psychological factors. Excessive levels of stress drive people to seek sugary ‘comfort foods’ because they satisfy the reward system in our enteric nervous system (ENS)
  10. Processed foods/inappropriate cooking & food preparation. The UK has one of the highest rates of out-of-home eating in Europe and the highest obesity rate. Highly processed carbs are broken down to glucose very quickly. Processed foods are often rich in the wrong (n6) fats, skewing our n3:n6 ratios even further in the wrong direction (healthy ratios are around 1:2, but often 1:16-20 is found!). High temperature cooking denatures protein, damages heat-sensitive fats likes olive oil, cross-links sugars, creates carcinogenic compounds (e.g. heterocyclic amines and polyaromatic hydrocarbons) on browned/blackened meats, and yields acrylamide (on baked cereals, roasted coffee, fries, chips/savoury snacks, toast, etc), which is classified as a probable carcinogen by the IARC/WHO.

Three top tips for resolving adult obesity

People are looking for someone else to solve the problem, be it a doctor, a pharma or other healthcare company or government.Yet, none of these have so far delivered on this subject.

Instead, we should be taking the matter into our own hands and self-regulating. So, if you can manage just three things, these would be our top choices:

  1. Prepare and eat wholefoods at home most of the time (follow our Food4Health guidelines for adults and children), or in restaurants that understand healthy cooking/eating concepts
  2. Engage in intermittent fasting. Try to maintain at least 5 hours between meals, and over 12 hours on overnight fast. For many middle-aged adults 2 meals a day is often ample, even without snacks in between. Three meals and snacks in between leads to excess energy intake for many and in turn gives rise to the low-grade inflammation that underlies all chronic diseases.
  3. Be active every day. You cannot separate diet from activity. They work together synergistically and organising the timing and type of meals around activity is key. In general: one hour of activity should be the minimum per day, even something as low impact as walking (many devices e.g. smartphones, Fitbits etc can measure this). Try and incorporate longer periods of lower intensity activity with other days of shorter more intense activity (e.g. HIIT). It is beneficial for most people to exercise in a fasted state twice weekly.

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