Today we’re going to take a look at the most pressing health issue of the last 2 decades, and probably the next 3. Obesity is now rampant globally, and we’re struggling to account for why we can’t find a solution. The finger was initially pointed at our lazy, overindulgent lifestyles and how we need to eat less and exercise more. The first wave of “fitfam” (?????) began in earnest. Then, when the backlash came, many said it was diet related with “big food” like Kraft etc. filling our aisles with processed, sugar laden crap (it’s hard to argue with that). But after substituting to a more natural diet many still struggle to lose weight! This issue is far more complex than main-stream media portrays, and not simply a case of “maybe if you ate less crap, you’d lose weight” (still advisable), which seems to be the prevailing theme.
What today’s article is about is taking a look at what we now know about obesity from 4 separate, but related, perspectives. The first and fourth parts are primarily to do with weight and weight management, while the second and third parts look at the overall health aspect of food and obesity. It shouldn’t get too heavy (no pun intended), as we’ll dedicate a whole article to each of these individual topics in the future, but today should serve to bring you up to date on where our modern diet puts us.
What do WE know?
Before looking into some of the more interesting aspects of our modern diet, it’s probably good to take a minute to look at obesity in its most basic sense. It is probably the biggest killer in wealthy nations owing to its effects on heart health, diabetes, organ health, and overall cardiovascular health. Obesity can even indirectly play a role in the onset of dementia and cognitive decline related health issues due to it causing increased blood pressure which has a direct impact on brain health as we age.
How does it happen??? Our body has a basic energy need (called our Basal Metabolic Rate or Resting Energy Expenditure) which accounts for the majority of our caloric needs. We then also need fuel to live our daily life: walking, work, driving, eating, exercising (hopefully), these all require energy. When we consume more energy (calories) than we use, that excess energy needs to be stored for later use. You’re now gaining weight, and more than likely in the form of adipose tissue (fat). As you gain more fat, your body becomes more and more likely to store additional excess energy as fat due to how it allocates resources (nutrient partitioning).
In the most basic sense, weight gain IS simply a case of consuming more than you expend, but being clinically “overweight” or even obese (BMI 25-29, or 30+) doesn’t necessarily correlate to poor health. There are a host of other factors involved that make obesity the health scare it is (including lifestyle factors, diet factors, genetic factors, social environment, etc.). Below, we’ll look at some of the primary factors involved in obesity. But ultimately, for now, we have to accept the fact that our bodies obey the laws of nature: Consume more calories than you use, you will gain weight.
1. The Elephant in The Room
Ok, yes… we could have made this number 4 on the list, but that really wouldn’t have been fair. Our diets have gone from poor to outright sh*t in the last 5 decades. Add to this the prevalence of automation and therefore lack of anything manual and you have: an increase in simple carb’s, an increase in calories in general, AND an increase in sedentary behaviour. You may have guessed that an increase in calories will necessarily equate to an increase in weight and that a decrease in activity will, again, lead to an increase in weight, AND that an increase in simple carb’s will cause health problems… But, did you think it would be quite so catastrophic? From this perspective, it’s not difficult to see why things have escalated so rapidly. We have highly processed food, DEVOID of nutrition, DESIGNED to be “hyper-palatable”, CHEAPER than wholefoods, and absolutely EVERYWHERE!
Right off the bat, the NUMBER ONE thing you can do for your health is exercise. If you get your heart (vascular system) and lungs (pulmonary system) healthy, you are in a really good position to avoid many, MANY, ailments plaguing western (and now many eastern) nations.
So, the elephant in the room right now is (of course) the thing you’re all saying to yourselves: the increase in simple carb’s (think almost everything in a package that isn’t pretend meat) and the increase in unhealthy saturated fats (think everything that pretends to be meat) and add in a lack of any need to move… and things are going to get bigger… FAST. Our environment is pretty conducive to weight gain. Not many people are born with the SM gene (and hence a love for exercise), so watching what you eat is now a MUST, though exercise will add life to your years AND years to your life! But anyway, let’s look at something a little more interesting…
This is THE new holy grail of health and modern diet… but what does it really mean??? Science has, over the last few decades, begun to slowly realize just how important our guts really are (important enough to be nicknamed our “second brain”). Our micro-biome is the collection of all the bacteria that live in our gut and actually allow us to live. The relationship is MUTUAL. Every time you eat a healthy whole food meal, you strengthen them, and they strengthen you. Every time you take antibiotics, you destroy a little bit of them, which destroys a little bit of you. There is now believed to be a connection between gut health and obesity, allergies, various pathogenic bacteria, diabetes, and many other illnesses.
In his book, The Diet Myth, Tim Spector outlines some interesting facts about our micro-biome:
- The living cells in our bodies are 10 percent human and 90 percent microbe
- A handful of garden soil holds more microbes than there are stars in the known universe
- Fasting diets work by beneficially altering our microbes and their metabolism, and therefore skipping breakfast may be a healthy strategy for many people
- The average twenty-year-old today will have already had eighteen courses of antibiotics and will have abnormal microbes increasing risk of obesity
- The diversity of microbes in our bodies is 30 per cent lower than fifty years ago
- Gut microbes, when disrupted, are a major cause of obesity and diabetes but they are also essential for health
- Microbes in your gut can affect your brain and mental health, and contribute to autism and depression and even the urge to eat more
- Much of our food is contaminated with low levels of antibiotics used in farming, making us fat
The most curious of discoveries was found recently, which was the impact of these bacteria on our genes. It turns out there is a relationship between which of our genes are active and our micro-biome. They can literally signal to your DNA (via epigenetic triggers) which genes need to be activated based on the environment you provide them, and that environment is what decides which of them live; both a wonderful and terrifying prospect, depending on how you feed your microbiome. Certain gut bacteria are strongly linked to weight gain and health issues.
“For every one human gene we have, there are 100 associated genes within our microbiome. More than 100 trillion microorganisms live in our gut, mouth, skin and other mucosal surfaces of our bodies. These microbes have numerous beneficial functions relevant to supporting life such as digesting food, preventing disease-causing pathogens from invading the body, and synthesizing essential nutrients and vitamins.”
The Second Genome Project
In this section we’ll take a brief look at how genetics impact our weight AND vice-versa. Scientists have, over the past few decades, managed to discover a lot about our DNA and to map it. Along the way it has become apparent that certain genetic traits are characteristic of certain body/personality types. This might not seem that shocking, but knowing that you’re born to be more nervous than other people, or that you’re more prone to obesity because it’s tied to your family genetics can be both liberating and worrying. The good news is that in recent years the discovery of “epi-genetics” was made, which means that it really is a case of nature AND nurture, and not just being destined to turn out like your parents (god forbid).
With regards branches of science that deal with genetic traits and disease, epigenetics is now a very central theme. Up until recently, we believed that our body was constructed using a map, a type of coding if you will, called DNA. DNA is the blueprint from which everything in our body is made. It tells stem cells what to become, and encodes new cells with their properties (as seen above). This is all still true, but what we are now discovering is that there is ANOTHER layer in this already incredibly complex system. Epi-genetics is the study of small triggers that tell our body what genes to activate. A gene is a piece/strand of DNA that contains a specific set of rules/information. This means that not all of our genes are active, which is essential, as if all our genes were active at the same time they could give conflicting information or completely wrong signals, which is what gives rise to many diseases. Epi-genetics is, effectively, at its root a “nature vs. nurture” debate, the result being that we now know that it is a complex combination of the two, and that certain genetic traits and diseases can be controlled by environment. The interesting part that we can take away from all this is that a) many epigenetic signals are triggered by our environment, and b) epi-genetic traits are passed down through generations. You are given, at birth, a set of triggers (some of which are ALREADY ACTIVE) that when given the right environment will all start to fire, and once they have, it will take a very concentrated effort to change your environment and thus switch these genes off. So, while you may be prone to putting on weight, or age related diminished cognitive function, OR even just nervousness, there are steps you can take to address and even prevent these issues from ever occurring. Diet and lifestyle (stress-load, relaxation time, time spent in nature etc.) seem to be the biggest triggers.
Giving a detailed account of how all our hormones interact with our weight would take an awfully long time, so we’ll focus on 3 aspects:
∗ The Thyroid Gland (Hypothyroidism)
∗ The Adrenal Gland (Cortisol)
∗ Leptin & Ghrelin (The Hunger Hormones)
The Thyroid Hormones (and therefore Gland) are probably the most important hormones in weight regulation insofar as they’re important in regulating metabolism. Given the prevalence of thyroid issues (primarily hypo-thyroidism in the form of Hashimoto’s or, generally in less wealthy countries, iodine deficiency), this is a good place to start!
The thyroid is a small gland in the base of the neck, responsible for a lot of bodily functions. In particular, in the impact of T3 and T4 hormones on metabolism is of extreme importance to us, as they can increase (or decrease): the speed of our digestion (gut motility), our heart rate, our appetite, the absorption of nutrients, our cholesterol levels, and our resting metabolic rate. This is why low levels of thyroid hormones can make weight management exceptionally difficult, and should be dealt with under the supervision of a doctor. Thyroid disorders are up to 10 times more prevalent in women than men, increase in incidence with age, and are quite common in both men and women over 60 (which is of great significance as the Thyroid gland also produces calcitonin, a hormone that regulates calcium uptake and therefore bone health). Given the implications of thyroid disease – at any age – it’s something we need to be aware of.
*As a side note – T3 and T4 are so named due to the number of iodine molecules they contain (Triiodothyronine contains 3 and Thyroxin contains 4), hence the impact of iodine deficiency on our thyroids ability to function. In general, though, we don’t suffer from huge levels of iodine deficiency (though there are those who would argue otherwise), so Hashimoto’s is the most prevalent form of hypo-thyroidism (and therefore thyroid condition in general) countries with a higher standard of living, but HERE COMES THE TRICKY PART.
If you have iodine deficiency related hypothyroidism, increasing your iodine intake will increase your thyroid hormone levels. That said, if you have Hashimoto’s, an autoimmune condition in which the body attacks the thyroid gland, it can actually be aggravated by increasing your iodine intake. Fun… right!? This means that if you feel you have low thyroid function, you should have it checked before jumping straight into iodine supplementation. ON THE BRIGHT SIDE, regardless of whether your low thyroid function is autoimmune or iodine related, ensuring optimal SELENIUM intake will be beneficial (within reason, obviously!)
The Adrenal Gland is responsible for producing cortisol, also known as the stress hormone. As you can see in the diagram above, the corticotrophin releasing hormone (CRH) sends a signal via the pituitary gland telling the body to release adrenaline and cortisol. This is our body’s “fight or flight” response and it happens in response to ALL stressors! Your body does not distinguish between that annoying driver in front of you and that argument you had at the shops, it only dictates the degree of the response based on how agitated you are.
Unfortunately, the adrenal gland is responsible for a rather complex variety of hormones and processes and it’s not as simple as saying “it’s the adrenal’s fault”. Doubly unfortunate is the fact that cortisol is also somewhat mis-labelled as the culprit in all our modern ailments. Cortisol plays a role in fat breakdown and is necessary in many important bodily process as well as part of our circadian rhythm. If we remove all stressors, we probably wouldn’t remove cortisol, we’d just lower the bar in terms of when the stress response kicks in. So the goal is balance and the ability to deal with stress in a healthy way (not to just avoid all stress). We discuss cortisol and all of the hormones related to body weight regulation more in the “Why Diets Aren’t The Answer” article here!
*Side note – Planning an imminent escape from danger, your body switches to using glucose (its quickest source) for energy. Some now suggest that as the adrenaline has subsided (the stressor is gone) your body will then seek to replenish its glucose stores, the only problem being that you haven’t burned any glucose (unless you really did run away from that argument). So, every time you get stressed, your body’s response will be “give me something sweet”, and this is the same if you reach for crisps or fast-food, it’s all just processed carb’s and easy glucose for your body, NOT GOOD! There is also an issue with cortisol being connected to higher insulin levels, providing the added problem of stress on your pancreas and additional glucose needs!
Leptin/Ghrelin – Two hormones you’re probably now familiar with, these are the hunger hormones! Leptin (meaning “full” in Greek) is released from adipose tissue (your fat cells) and tells your body to eat less if there is an adequate store of fat. Ghrelin, on the other hand, is produced by the stomach, and sends your brain hunger signals. Ghrelin can override your body’s Leptin signals, and can, in some cases, cause you to over eat. These are both interesting and complex hormones, and research is still ongoing (Ghrelin was only discovered in 1999), but here are some points that may be useful to note:
Leptin resistance can become an issue for people who are overweight
Recent research has shown Leptin levels can impact on Ghrelin secretion
Ghrelin levels are effected by hydration and effect hydration
Drinking a glass of water 15 minutes before meals can (temporarily) lower Ghrelin levels
Macro-nutrient style diets can increase levels of Ghrelin in the body
Ghrelin increases the amounts of Growth Hormone and Cortisol in the body, which can lead to weight gain
Fasting reduces baseline Ghrelin levels (after a few days of fasting)
Recent research has shown Ghrelin levels can affect intestinal motility
Poor sleep, or lack of sleep can increase Ghrelin levels
4. Exercise, Diet & Metabolism
As we mentioned earlier, the bulk of your body’s energy needs are used without you ever having to do anything. After that, your lifestyle plays a huge role (the second most important) in how much energy you use (with exercise playing a small part in this), and the thermic effect of food coming in last on the energy burning hierarchy. Does the fact that exercise is only a small part make it less important? Does that mean all of those people who say you just need to juice daily, buy “active wear” (aka. pants that don’t fit), and frown at people who don’t eat organic are right??
First things first. BMR (Basal Metabolic Rate) is an abstract measurement of the minimum energy required to survive under ideal conditions. I say abstract because we are never in ideal conditions. This is why REE (Resting Energy Expenditure) has overtaken BMR as the most accurate/realistic means of estimating your minimum energy needs. Your baseline energy requirement is generally calculated as 22XFFM(kg) + 500 (where FFM stands for Fat Free Muscle in kilograms) though there are many factors involved in accurate measurement (age, gender, body surface area, etc.). If you want to know more about this you can have a look here, but the key points I want to take from our REE formula are:
a) The amount of muscle you have plays a substantial role in how much energy you need
b) The bulk of your daily calorie expenditure happens before you’ve even moved (~60-70%)
c) The 30-40% of the energy left can dramatically effect both (a) and (b)
So, to get your TEE (Total Energy Expenditure), you multiply your REE by an activity coefficient to get your approximate daily energy needs (this may or may not account for the thermic effect of food – digestion – depending on the calculator). This is an important starting point to know how many calories you should aim for!
Exercise, while it is only a small part of the overall picture, can make a big difference… if you use the right kind of exercise. Compound movements with relatively heavy weights will: increase your resting metabolism, increase your muscle mass (which further increases your metabolism – don’t worry, you don’t need to go all Ronnie Coleman on it), AND it will increase your bone density (which is awesome for EVERYONE!). ON TOP OF THIS, knowing that increasing the general amount of activity you do will impact on metabolism means that you can try to make a few small changes to your daily routine (where possible walk/cycle instead of driving, have a kettlebell hidden in the living room and do swings while you watch TV, use the GTG method to develop incredible pull-up skills while also increasing your overall activity rate). There’s actually quite a lot you can do to speed up your metabolism!
The unfortunate flip-side of this is DIETING! If you run a caloric deficit for any appreciable length of time, your metabolism will slow down in line with the caloric deficit. The snag here is that eating at maintenance calories and trying to increase your activity levels enough to bring about any appreciable level of weight loss is pretty unrealistic (unless your thinking very long term). The other, more obvious, snag is that increasing your exercise levels while maintaining caloric intake will still eventually result in a deficit, meaning depressed metabolism no matter how you work it.
Please, don’t take this as a sign to follow those misguided diets that say “eat as much as you want, exercise daily, and your body will figure it out”.
You can restore your metabolism by bringing up your calories temporarily (aka. cheat days) thought it has been found to be most effective when done 2 days in a row. In this sense, the best thing to do will be to cycle your caloric intake and have two days (back to back) per week at maintenance level calories… basically just Intermittent Fasting with a twist!