Obesity rates continue to rise, continuing a process that began in ernest more than 20 years ago. A survey this year by the Centers from Disease Control (CDC)1 identified over 32 states with more than 25% of its adult population in the obese category. Six states (Alabama. Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia) had obesity rates of over 30%.
These numbers have an effect on health care costs. The cost of treating an obese person in 2001 was $3450.00, and by 2006 it was $5150.00. Comparable figures for the overweight were $2800.00 and $3315.00.
To many who study the causes of this overweight and obesity epidemic2, one of the main dietary culprits is the increasing consumption of high fructose corn syrup (HFCS). Very little (20%) of the fructose consumed by Americans is in its natural form in fruits and vegetables. In its whole food form, fructose is accompanied by fiber which slows absorption, has low calories, satisfies hunger, and controls weight.
High fructose corn syrup, found in many soft drinks and processed foods, lacks fiber and other nutrients, and not only fails to satisfy hunger, but stimulates it. Fruit juice has similar effects when separated from the whole fruit.
Dr. Miriam B. Vos and colleagues of Emory University reports3 that in adolescents aged 12-18, over 12% of daily energy comes from HFCS, and a quarter of them get over 15% of daily energy from it. The main source is sweetened soft drinks.
What are the effects of this choice of beverage? High fructose intake is associated with increased fat production by the liver, and increased blood fats, insulin resistance, and obesity. Total fructose intake also predicts formation of small low-density LDL, which is strongly linked to heart disease.
In addition to the weight gain and disease risk effects, soft drinks are taking the place of milk which provides calcium and vitamin D, both of which are essential for bone formation during adolescence, particularly for girls.
So how much greater is your risk of disease or death when you are overweight or obese? By looking at the results of 57 different studies together4, involving almost 900,000 people in Europe and the U.S., researchers found that death rates were lowest in those with a BMI of 22.5 – 25, i.e., in the healthy range.
For every 5 points the BMI increased:
- Overall death risk went up by about 30%
- Heart disease death risk rose by 40%
- Risk of death from diabetes and its associated diseases of the kidney and liver rose by 120%
- Cancer death risk rose by 10%
- Death from lung disease and all other causes each rose by 20%
The authors of this study also comment that it is probably easier to avoid excessive weight gain in the first place, rather than trying to lose it later in life.
A direct outcome of a diet which contains too much refined carbohydrate such as HFCS, white bread, potatoes, rice cakes, processed breakfast cereals, and pretzels is not only weight gain but also high blood sugar. New research shows that high blood sugar is now one of America’s most common killers.
According to Harvard researchers5, there were between 163,000 and 217,000 deaths caused by high blood sugar that could have been avoided. High blood sugar levels are associated with overweight/obesity and diabetes risk, but also other metabolic diseases which may be untreated for a long while.
This point is made in a presentation6 by Dr. Adam Tabak of University College London describing how insulin resistance due to high blood sugar levels begins up to 13 years before type 2 diabetes is diagnosed.
This means that if you are overweight/obese with high blood sugar levels, you are probably insulin resistant. Your pancreas is working hard producing insulin in an attempt to get your blood sugar lower, but insulin resistance won’t allow blood sugar to fall. This is an inflammatory state, and damage is being done to blood vessels and organs like heart and kidneys.
According to Dr. Tabak, this situation can continue for up to 13 years before your pancreas becomes exhausted and no longer produces enough insulin. At this point you receive a diagnosis of type 2 diabetes. Already, a great deal of irreversible has been done which increases risk of heart disease, kidney disease, and nerve damage leading to amputation.
This makes obvious why the overweight and obese incur higher medical costs. The kinds of diseases mentioned are expensive to treat, not to mention devastating to quality of life.
So yes, it does matter whether or not you are carrying a few extra pounds. Even at quite low levels of overweight, risks increase significantly. The overweight and obesity in both adults and even more worryingly, children are a ticking time bomb, the costs of which we all will contribute to in one way or another. Tragically, the great majority of this accelerating disaster is avoidable if the right lifestyle choices are made.
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References
- Centers for Disease Control. News Release, 08 July, 2009.
- Medscape J Med. Published online 09 July, 2009.
- M.B. Vos et al. Medscape J Med. Published online 09 July, 2009.
- G. Whitlock et al. Lancet. Published online 18 March, 2009
- G. Danaei, E.L. Ding, D. Mozaffarian, et al. Public Library of Science Medical Journal. 2009; Vol 6.
- A.G. Tabak. American Diabetes Association 69th Scientific Sessions: Abstract 1050-P. Presented June 8, 2009.
