obesity, gogodoc

Is Obesity A Disease Or A Choice?

Obesity is a very important public health problem. The rates are now very high, with over 25% of the UK population and 33% of the US population classified as obese.

Obesity itself results in significant reductions in quality of life but it also leads to a range of serious health issues, such as type 2 diabetes, cardiovascular diseases and cancer.

Changes in diet and exercise seem to be the most sensible first-line solution, however health education programs have failed to halt the rising numbers of obese people. This suggests that intrinsic factors, such as genetics, might be important.

This raises an important question: Is obesity a disease or a choice?

 

Recent poll

A recent poll on Medscape revealed some interesting opinions about obesity among healthcare providers. One of the questions asked was ‘How often do you think lifestyle choices are the underlying cause?’ 75% of medical professionals chose either ‘often’ or ‘always’.

When asked what interventions they typically recommend for their obese patients, over 90% selected ‘diet and exercise’. Further, more than 30% of healthcare providers do not consider obesity to be a disease state. However, if obesity is viewed as a disease it may aid toward objectively assessing the factors that lead to it, thus offering better prevention and treatment strategies.

 

What makes obesity a disease?

Obesity is a complex entity that can have many causes. The first, most obvious, argument for why obesity is a disease is that it is associated with impaired body function. It causes, exacerbates, or accelerates more than 160 co-morbid conditions that arise as metabolic, structural, inflammatory, degenerative, neoplastic, or psychological complications. Further, it can significantly affect quality of life or impair longevity.

Taking this into account may prove effective in dealing with its biopsychosocial and economic ramifications.

 

Common assumptions about obesity

It is a common assumption among both healthcare providers and the general public that obesity is a self-inflicted condition. In other words, obesity is thought to be the result of a lack of self-discipline due to addiction to excess or unhealthy foods, and thus these patients are largely responsible for this condition. If patients are not losing weight with diet and exercise, it is because they are not trying hard enough or are cheating on their lifestyle modifications.

Another assumption is that obesity started only in the past 50 or so years. Although the incidence has increased significantly in the recent past, it is in fact a centuries-old condition.

Lifestyle modifications have an increasingly robust representation in evidence-based medicine. However, given the complex and multifactorial nature of obesity, management can fail despite earnest efforts by patients and is often successfully augmented by the addition of pharmacotherapy or surgery.

 

Treatment must be individualised

It is important to realise that for many patients, obesity is multifactorial. There is a wide heterogeneity in the causes and manifestation of obesity, which leads to wide interpatient variability in the response to different therapeutic strategies. It is for this reason that management of obesity needs to be individualised for each patient.

It is therefore important to accept that obesity is not merely a condition arising from ‘food addiction’. In fact, more than 100 aetiologies of obesity have been identified, and we’ve merely scratched the surface at recognising the causal factors.

 

 

Conclusion

The question of obesity being a disease or choice is like the false dichotomy of nature vs nurture. There is no simple either/or answer to this question. It is much more likely to be a combination of both factors.

Obesity involves a complex interplay of underlying medical conditions, such as genetic or endocrine factors, in addition to environmental influencers. Environment plays an important role. Factors such as eating schedules, physical activity, sleep health and medications, can affect weight management.

 

The ultimate consequence is failure of the homeostasis of weight and energy regulatory mechanisms, leading to an elevated body fat set-point.

Only when we recognise that obesity is a disease can we take the next steps of screening, diagnosing, assessing, preventing, and treating this condition.

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skin

Eat Back The Years With These 10 Youth-Boosting Foods

 

Want firmer, smoother skin and a brighter complexion? Try these top 10 anti-aging foods. Our diets have a huge effect on the rate at which we age, so it makes sense to keep them as varied, and antioxidant-rich as possible to prolong and preserve our youth. Team these foods with regular exercise, plenty of sleep and quality downtime, and you could turn back the clock.

eggs

1) Eggs

Eggs contain a compound called sphingolipids that aids in autophagy. Think of a brick wall. Sphingolipids are like mortar, the sticky substance that holds the bricks together. As the wall ages, the mortar can break down, causing the bricks to crumble and the entire structure to lose its strength. But you can keep your mortar strong by eating sphingolipid-rich foods. Doing so will benefit your skin, keeping it fuller, plumper, and smoother.

Sphingolipids also help regulate neurotransmitters, important in healthy brain function. Read better moods, better decision-making, increased critical thinking, and improved memory.

blue berries

2) Blueberries

Blueberries are rich in flavonoids such as myricetin, quercetin, and kaempferol. These are rich sources of vitamins C and K and other nutrients that have an anti-ageing effect and prevent cell damage. 

avocado

3) Avocado

Avocado is one of the anti-ageing superfoods with immense health benefits. It is rich in potassium, vitamins A, C, E, and K, and antioxidants that fight the effects of ageing. Moreover, it’s good for your overall health.

 tomato

4) Tomatoes

Tomatoes contain lycopene. This is a non-provitamin A carotenoid that protects your skin from sun damage. Moreover, the skin of the tomato has an anti-inflammatory effect on the human skin, and the flavonoids in the fruit slow down ageing.

spinach

5) Spinach

Popeye cartoons were exaggerating, but not by much! Spinach is a great source of beta-carotene, which protects your skin from sun damage, and lutein, which has been shown to help skin maintain its elasticity.

green tea

6) Green Tea

There are many kinds of green tea, but they all contain polyphenols, which get rid of free radical toxins in your body, and catechins, molecules that help prevent the sun from damaging your skin. So, drink up! Green tea should be in every anti-ageing diet.

tumeric

7) Turmeric

It’s almost impossible to believe the number of anti-ageing benefits turmeric provides. It’s great for your skin, joints, and brain, and it fights inflammation. It may also reduce the risk of neurodegenerative disorders and some cancers.

garlic

8) Garlic

Add it to your stir-fry, and you just might boost your heart health. Garlic is said to prevent heart disease and strokes by slowing the hardening of the arteries. The herb may also help fight inflammation and cartilage damage associated with arthritis.

nuts

9) Mixed Nuts

In one study, regular nut intake was connected with a lower risk of dying from cancer, heart disease, and respiratory disease. Make a to-go mix of peanuts, almonds, pistachios and walnuts for an easy way to avoid hanger. 

salmon

10) salmon

Salmon and other oily fish, such as sardines, trout and mackerel, are packed with anti-inflammatory omega-3 fatty acids. These essential fats are vital for healthy cell membranes and for keeping your skin looking smooth and soft, as well as maintaining healthy, flexible joints and cognitive function. Since inflammation in the body is linked to the development of chronic diseases, such as heart disease, cancers and diabetes, omega-3 fats are a vital anti-ageing nutrient.

By Punam Vadgama

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meat-vegetable-vegan-vegeterian

Meat And Health: Assimilating The Facts

Still having dinner according to your grandmother’s advice of ‘meat and two veg’? How very 2017 of you.

 

 

 

 

 

 

 

 

According to Mintel’s Meat-Free Foods UK Market Report, more than one in four Britons are now favouring a vegetarian lifestyle.

Vegetarians have many reasons for not eating meat, including concern for animal welfare, health benefits, and reduced environmental damage. Here are some of the benefits of leaving meat off your plate.

 

Are humans meant to eat meat?

The dietary status of the human species is that of an ‘unspecialised frugivore’ – an animal specialised for nuts, grains, seeds, fruit and vegetables, but can handle ‘unspecialised’ food sources too. Biochemistry, comparative anatomy and genetics do not support the contention that human digestive tract is specialised for meat-eating. ‘But we have canines!’ is the all-too-common quickfire rhetoric.

 

Our pathetic, short and blunt canines may be useful to take a bite out of an apple. But try lunging for the throat of a cow and see if they are of any use then.

Due to limited resources our ancestors became habituated to eating meat, and through evolution our gut can handle it to some degree. But it is not the case that we are specialised for meat eating or need it in our diet to be healthy. In fact, the opposite is the case.

 

The WHO report

A wealth of research indicates that vegetarians have reduced incidences of diseases, and overall greater longevity. In support of this, the World Health Organisation (WHO) has classified processed meats as a Group 1 carcinogen. Tobacco smoking and asbestos are classified in the same category. As stated on their website, ‘this classification is based on sufficient evidence … that eating processed meat causes colorectal cancer’.

Moreover, red meat is classified as Group 2A, which means it’s ‘probably carcinogenic to humans’. My gut feeling is that it is only a matter of time that additional evidence will confirm this positive association.

Put it this way: if you had a choice between a meal that is proven to be protective against cancer (e.g. a wholefood, plant-based meal) and one that is ‘probably carcinogenic’ (e.g. a meal that contains red meat), which one would you choose?

Nevertheless, there are other health risks that are associated with meat eating such as coronary heart disease and diabetes, to which we now turn.

 

Backed up by research

In a study published in The American Journal of Clinical Nutrition, the authors state that ‘Vegetarians had a 32% lower risk of [ischaemic heart disease] than did nonvegetarians’. And a study published in Annals of Nutrition and Metabolism showed that vegetarians had an overall 18% lower cancer incidence. Moreover, the largest study to examine the effects of different sources of dietary protein found that a high intake of proteins from animal sources – particularly processed and unprocessed red meats – was associated with all-cause and cardiovascular mortality, whereas high plant protein intake had an inverse effect. The authors note that, ‘substitution of plant protein for animal protein … was associated with lower mortality, suggesting the importance of protein source’.

To be fair, a limitation of some epidemiological studies is that they do not consider the food source and the quality of the meat. However, in a study published by JAMA Internal Medicine, 73,308 participants were analysed and were controlled for important demographic, lifestyle and food confounders. They found that even a modest amount of red meat, regardless of the source, led to an increased rate of mortality. Whereas vegetarian dietary patterns were associated with reduced all-cause mortality and increased longevity.

In a study published in American Journal of Epidemiology, researchers found that a higher intake of red meat and poultry is associated with significantly increased risk of developing diabetes. Further, in a 2017 Sweden study, it was found that beef, pork and poultry are associated with colorectal cancer, which is considered one of the most common forms of cancer in the Western world. In fact, heart disease and cancer are the biggest killers on the planet, both of which have been directly linked to meat consumption.

 

Colossal damage

Aside from the health issues, rearing livestock for food is highly inefficient and wasteful. Every year over 56 billion animals are slaughtered by humans, not to mention sea creatures whose deaths are so great they are only tallied in tonnes. The crops fed to industrially-reared animals worldwide could feed an extra four billion people on the planet.

Let us not forget the devastating effect of the meat industry has on the environment. A staggering 51% of global greenhouse-gas emissions are caused by animal agriculture, according to a report published by the Worldwatch Institute. Grass fed, and ‘humanely slaughtered’ (an oxymoron) is even more unsustainable.

 

Conclusion

Humans have been facultative meat eaters for a long time, but recent research suggests that a diet with minimal meat is much more healthful. And we certainly do not need meat nutritionally in our day and age.

But the health benefits of keeping meat of the menu is only one side of the argument. For many, it is the ethical implications that make meat indigestible.

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