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EventsBefore the obesity epidemic
January 6 2015 by Dr. Andreas Eenfeldt, MD![Dr. Andreas Eenfeldt, MD]()
in The obesity epidemic
in The obesity epidemic 
What did the Western world look like before the obesity epidemic? Like this.
The picture is from a popular outdoor pool in the 70’s in Sweden. Not a single obese individual is to be seen.
Of course it is so common now that it's not a big deal to go out in public.
I was once standing on a corner in my town waiting for someone, and as people passed me, I thought, "Where are all the fat people?" I saw none. Then I went to a Big Box store (Walmart) and there they all were, pushing carts loaded with plastic junk and carby snacks.
So one photo or experience in one spot doesn't mean much.
Love it! That tourist was probably Grizzly Grashow
Me thinks you need to meet Razwell - you have SO much in common
http://i.imgur.com/ev2Jw.jpg
The photo is of a cruise; the caption says, according to Google translator, "No RCCL cruise is complete without a magplasktävling . The winner was not the man in the picture , or any of the other wide boys who attended without a perfectly normal plant youngster on a 70-80 kilos."
:-)
But, people did eat processed wheat/carbs and sugar back then and it was was absolutely common (I rembemer kids eating bread with butter and pure cane sugar on top - not uncommon either)
The main differences I see from back then compared to now are:
People cooked all their meals from scratch, pretty much no exceptions
People ate 3 times a day, maybe one snack that actually was a snack and not a full meal as snacks are these days
No food on the go or fast food restaurants- ready to eat foods/meals weren't available at every corner
No sugary drinks except for regular fruit juices
As much as I am a believer in low carb/no wheat/no sugar - bad carbs are not the problem, we simply eat too much and too often.
I believe it is still high amounts of refined carbs, especially sugary drinks added on top of regular meals that play the biggest role in making someone('s liver) insulin resistant. Of course there are other contributors like consumption of crop oils, lean meats over organ meats and preservatives that add to the low level inflammation.
An official reply to the picture posted above:
Sweden was obviously a poor country back then and most people could not afford to purchase enough calories for overeating. :)
So occasional binging on sugar with a healthy metabolism is a stress, but is only an insulin pulse. So long as insulin zeros out after the pulse, the metabolism can begin looking to fat cells for energy. So long as insulin is elevated, fat is locked in fat cells.
The problem has been the misguided, politically and ideologically driven fat phobia and food pyramid which advocated reduction of fat and increased carbs. This pushed more and more people to a state where the rate of insulin clearance was slowed to the point where insulin remains continually elevated. This results in loss of energy because sugar gets used up but insulin lags and remains elevated, so store body fat is not available for energy as blood sugar falls. Thus to get energy the person has to snack. They are advised to avoid fat, so they have carbs, which elevates insulin. Thus insulin never zeros out, except after a long sleep. (Note the studies linking long sleep to better weight management.) Chronically elevated insulin appears to be the cause of type 2 diabetes, and most every other chronic disease epidemic we have these days.
So it cannot be inferred from the past practices of occasional carb bingeing that carbs are not the issue. As you observe, three of the meals in a day were typically prepared from scratch, so with traditional levels of fat consumption the rate of carb overloading was not high, insulin typically zeros out and there was little genuine hunger or energy low between meals. These things always have to be examined carefully in context of dietary and cultural practices. Traditional Japanese, for example, eat rice, but the portions are small and much of it is cold rice as in sushi. Cold rice is a resistant starch that has much less effect on blood sugar (and therefore insulin), so it is metabolically much different than bread starch. Comparing across time and culture is always a difficult interpretive endeavour.
What I do wonder about is whether people have *always* been svelte in the past. It seems to me that 18th century gentlemen could be pretty large. I'm going here by old paintings and comments in novels and so on: I've no statistical data on this, and I doubt there is any. But take a look at some of the portraits around from this time, bellies bulging in the flowered waistcoats. David Hume would be a good example. He looks pretty porky. And how about Dr. Johnson? Banting himself would be a case in point, although he comes from a slightly later period.
I have seen sarcastic references in 19th century writings to tables that had had parts cut out of them to accomodate the gut of their 18th-century owner. And the Victorian novelist Robert Smith Surtees has a whale of a time in his novel _Mr. Facey Romford's Hounds_ making fun of 18th-century foxhunting people - Simon Heavyside (who rides at 18 stone) and the Heavyside Hunt. The point of the joke is that modern Masters of Foxhounds, like Romford, ride lighter and go faster.
http://www.rssurtees.com/products-page/r-s-surtees/mr-facey-romfords-...
I don't know for sure, and don't know how one could establish it, but my sense is that some 18th century people could be pretty large, and we only returned to slimness as a norm in the 19th and early 20th century, getting derailed in the second half of the twentieth by "healthy" eating and government "health education" advice. If this be true, it would be interesting to look at how the diet changed in the earlier period. I have a feeling that although it's often the poor who are obsese - a point made by Gary Taubes in refutation of the overeating hypothesis - in the 18th century it was mainly the rich, and specifically rich males at that. Interesting to know what wealthy males of the period were scarfing down - lots of bread and cakes and a heck of a lot of wine, including sweet and/or fortified wines like maderia, sherry and port, I suspect.
IIRC, Paul Johnson has a little on changing eating habits among the wealthy in _The Birth of the Modern_:
http://www.amazon.com/Birth-Modern-World-Society-1815-30/dp/0297812076/
It would be interesting to look deeper into the matter, though. I think we just don't know as much about the past as we sometimes think we do.
http://www.britishmuseum.org/explore/highlights/highlight_objects/pd/...
Well worth a look as revealing contemporary attitudes: what people thought about the Prince's figure and perhaps what they thought caused it - namely, being a "voluptuary".
Wikipedia has a listing of 18th century Swedish people, but I didn't try to find pictures and check them all out. Swedenborg looks fairly slim in the picture I found. But Linnaeus does look on the heavy side in at least some paintings - a hint of a double-chin and a rather bulging waistcoated stomach.
Widespread obesity likely hit the well-off first because sugar was a luxury. Much of the 18th century was driven by the dynamics of sugar trade and rise of slavery as a necessary means to the production of sugar for that trade. As a luxury item, it would be the well to do who got sugar first. Another factor was the introduction of potatoes. After famines due to crop failure, the government promoted crop rotation with potatoes as nitrogen-fixing so that fields would not have to go fallow every few years. No one much enjoyed potatoes, so the government really pushed them. The French, ever resourceful regarding cuisine (they make snails a delicacy, after all), invented French fries. But potatoes added carb load and decreased tolerance for processed carbs, which pushed obesity, and early 19th century writers noted the fattening effects of a heavily saccharin and farinaceous diet (I.e., lots of processed carbs). So these class and cultural factors would affect the distribution and frequency of obesity.
I don't remember any superfat people despite all those potatoes, although I wasn't paying much attention to this sort of thing.
But I think it's dangerous to generalize about how people ate in the past. There were many eating patterns.
http://www.nytimes.com/2015/01/07/world/on-the-open-road-signs-of-a-c...
Interesting that despite the fact that there are almost no working cars there, so people have to walk a lot, and average income is $20 a month, so they're obviously not pigging out on expensive snack foods, there are still overweight people. See photo 10.
They may be drinking a lot of sodas. And probably eating a lot of rice and very little meat.
My mother Always cooked simple foods: meat from the butcher potatoes and a vegetable from the green grocer. The supermarkets were just starting to emerge. We Always cooked fresh, nothing out of a tin, a packet, nothing over processed by the food industry.
I recently came across this very enlightening article over Big Food.
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pm...
Traditional long-established food systems and dietary patterns are being displaced in Brazil and in other countries in the South (Africa, Asia, and Latin America) by ultra-processed products made by transnational food corporations (“Big Food” and “Big Snack”).
So true, so true.
All local specialities are being replaced by frankenfoods by the big food companies. Look at the sweet aisles, all the same products whether you are in the UK, Germany, Jordania, USA, etc.
The same goes for our adults. At beaches and public pools, there were very few overweight people while today, it appears that the majority are overweight or "skinny fat"...with a thin build that has a high percentage of bodyfat.
We used to eat as the Swedes do...three meals per day with few carbs ( a potato or two slices of bread at most). Today, families tend to eat out often and the bulk of those meals are made of tasty, simple carb dishes. In some restaurants, one can order a meal of macaroni and cheese as the main dish..with a few rolls on the side.
We can thank Dr. Keyes for destroying the theory that Mr. Banting correctly wrote during the late 1800s, and the subsequent adoption of high carbs as a "safe" lifestyle by the medical establishment.
I have a picture of the swiming pool on the River Sava in my living town Zagreb.from the year 1958.
There is o a lot of people but no one is obese. No one!!
But now all of them are obese, with glasses and witout hair!
Very interesting!!
When I go to a Cuban restaurant, they look at me as if I'm crazy when I ask for an order of pork, onions and a salad.
My father always taught us to stay away from any food that was packaged or had ingredients that a kid would have trouble pronouncing. (tetra sodium tyrophosphate....preserves milk)
It has to be the environment, with the finger firmly pointing at sugar as the main culprit. We ate a lot of carbohydrate, mainly potato and white flour (no pasta and rice consumed as a pudding) coupled with a lot of natural saturated fat, yet diabetes(type 1) was something to be pitied as a bad luck thing, and type 2 something I never heard mentioned. Soft drink if you wanted it was delivered by the Corona lorry once a week - something we didn't subscribe to - and sweets were severely limited. We never, never snacked.
Though I now largely follow a LCHF lifestyle I would guess I would do just fine by returning to the diet I enjoyed as a child.
by hyperinsulinemia and is an appropriate adaptation to the increased need to store fat in adipose tissue without causing hypoglycemia. Thus, insulin resistance is an adaptive response that successfully maintains normal circulating levels of fat and glucose as long as the b-cell is able to maintain sufficiently elevated insulin levels (57). Perhaps the time has come to expand our research focus to carefully investigate the environmental changes that have accompanied the epidemic of obesity and diabetes"
http://diabetes.diab...61/1/4.full.pdf
Maybe this is simply wrong with respect to sugars. Possibly total mols of glucose or mmol/kg of lean bodyweight is a better metric.
As a MAXIMUM, considering that mammals don't need dietary sugars in the first place.
However they are another spices and are adopted to that, our problem is that we are adopted to hunt and forage all day long.. and have a very limited storage facility for carbs.
And a very low capasity for denovo lipogenes!
North european bear lives almoste of berrys and ants at autumn and eats about 9000 Kcal a day and much is converted to fat and then it lives on that in hibernation the whole winter!
I am not a scientist but my mother was not encouraged to breastfeed, so she fed me formula, and as early as 3 weeks (to get me to sleep thru night) she mixed it with rice cereal. She thought a chubby baby was a good thing...and also there were very few female athletics when I grew up. I was not allowed to go outside for fear of being molested. So I had literally no physical activity. As young lady I weighed only about 140 pounds, went to college (sit in classes) and tried to start a running regimine, which hurt my knees so I had to stop. Then I got a desk job and went up to 160. After marrying and having a few kids I went up to 180. Now I am in peri-menopause, and hover around 210. The only time a diet "worked" was a year of low-carb, which was extremely difficult. However when I returned to eating my normal diet (semi-vegetarian and all whole grains) the 30 pound I lost, returned in less than a year.
I am considering return to a low-carb or Paleo diet, but it is extremely expensive and difficult to get the entire family to support me on this. Also when I am on the road for work, it's hard to find foods that fit the low-carb/Paleo. I just wish other people would not be so judgemental, it is a life-long problem for some people like me, and those of you who are naturally skinny have absolutely no idea what it is like to live my life in my predisposed-to-be-fat body.
I suggest you have a look.....http://intensivedietarymanagement.com/
There are several lectures and blogs to peruse. I wish you the best and keep at it. I've been there.
Never give up folks, you can get to the weight you want to be, I know it can be very hard, but never give up. Never let anyone tell you what you can't do.
Good luck and health to all.
Eddie
I was it. Having been overweight all of my life, I was used to being the fattest person in the room. I no longer have that problem. I am sorry to say lots of people are fatter than me now :(