Changes in Society: Childhood Obesity

[John Simkin]

The incidence of obesity among adult men has nearly doubled in just over ten years (13.2% in 1993 to 23.6% in 2004). For women it has increased from 16.4% to 23.8%. The real problem is with children. A recent study shows that one in three 11 to 15 year olds are obese. This has resulted in a large increase in type 2 diabetes. We are heading for an epidemic similar to that in the US. The long-term effects of diabetes can include blindness, amputations, kidney disease, heart conditions and stroke.

[Guest]

The food industry has claimed for some time that there is no link between fast food and obesity. They claim that the main cause of obesity is a lack of exercise and is not connected to the type of food people eat.

There is of course a great deal of truth in this.

Just look at how children get to school (in mummy's people carrier), how little children these days engage in active "play" at break time, the low participation rates in school sports and sports outside school. We must also factor in the largely unfounded fears parents and other assorted busybodies have in ever letting their children venture outside on their own.

Perhaps John and others of a like mind should be nagging us about moving about more? I am sure the world would be better and thinner place if we just did as we were told.

[Jean Walker]

Article in our local paper today in which a dentist says he is beginning to see scurvy in patients whose diet is largely sugar and fat. He says he is seeing " third-world mouths" - another horrifying result of unhealthy diets.

[John Simkin]

I have just noticed who our sponsors are today (probably requested by Andy Walker):

Certified Pure Hoodia

Desert burn 750mg South African diet pills. Curb hunger naturally. Watch 60 minutes clip plus hoodia news headlines and faq. Lose weight and feel great with pure hoodia diet pills.

Slimming Pills. com

Highly successful all natural diet pills, money back guarantee.

Slimming and Weight Loss Supplement

The Extreme Transformation System provides a personalized diet, exercise, and supplementation plan based on various individual body types and desired goals. Start losing weight today.

Lab88 Slimming Diet Pills Success

Metabo-Speed XXX diet pill of the stars. Lose up to 20 lbs in 30 days. Powerful fat burner, appetite killer, metabolism booster. 30-Day multi-bottle guarantee. Get 1 free with 2 bottles.

[Guest]

I have just noticed who our sponsors are today (probably requested by Andy Walker):

Certified Pure Hoodia

Desert burn 750mg South African diet pills. Curb hunger naturally. Watch 60 minutes clip plus hoodia news headlines and faq. Lose weight and feel great with pure hoodia diet pills.

Slimming Pills. com

Highly successful all natural diet pills, money back guarantee.

Slimming and Weight Loss Supplement

The Extreme Transformation System provides a personalized diet, exercise, and supplementation plan based on various individual body types and desired goals. Start losing weight today.

Lab88 Slimming Diet Pills Success

Metabo-Speed XXX diet pill of the stars. Lose up to 20 lbs in 30 days. Powerful fat burner, appetite killer, metabolism booster. 30-Day multi-bottle guarantee. Get 1 free with 2 bottles.

They all worked for me

(By the way as John as rightly discerns we can change the key words for the sponsored listing appearing at the bottom of the site. I felt that "diet" might be an appropriate one for the New Year given the tendency for us all to gain a little adipose tissue during the Christmas festivities!)

[David Richardson]

Did you hear the terrible news? The Coca-Cola Company are threatening to withdraw their vending machines from UK schools:

http://news.bbc.co.uk/2/hi/uk_news/education/4771676.stm

It rather puts the spotlight on the sponsorship schools receive for allowing unhealthy drinks and snacks to be purveyed on their premises, doesn't it.

[John Simkin]

Article by John Carvel in today's Guardian.

http://society.guardian.co.uk/health/news/0,,1758947,00.html

More than a quarter of children in English secondary schools are clinically obese, almost double the proportion a decade ago, and an official survey released yesterday also showed that girls were suffering more than boys from a crisp and chocolate-fuelled life of too much eating and too little exercise.

Colin Waine, chairman of the National Obesity Forum, said that the figures showed a "public health timebomb" in the making: children who were obese in their early teens were twice as likely to die by age 50, he said.

Researchers measured the height and weight of 11-15 year olds, and found 26.7% of girls and 24.2% of boys qualified as obese - nearly double the rate in 1995. Among children aged 2-10, 12.8% of girls and 15.9% of boys weighed above the obesity threshold - also well up on 10 years before.

The figures, based on 2,000 children, come from the National Health Survey for 2004, and have alarmed doctors as well as casting doubt on the government's ability to achieve its target to halt the rise in childhood obesity.

Amanda Eden, care adviser at Diabetes UK, said: "We will soon be seeing our children growing up losing limbs and becoming blind, as they develop the serious complications of having the condition. A firmer line needs to be taken to force the food industry to adhere to foodlabelling guidelines, so people know what's in the food they buy.

"They also need to ban junk food advertising to kids, and find more ways of encouraging people to exercise."

The increase in obesity accelerated sharply in 2004, especially among girls, the survey said. Figures for the 11-15 age group showed the proportion of obese girls grew from 15.4% in 1995 to 22.1% in 2003. But in 2004 it shot up to 26.7%.

Over the same period, the proportion of girls who were overweight, but not enough to qualify as obese, increased from 12.6% to 14.8%. In 2004 a total of 46% of girls and 30.5% of boys were either overweight or obese.

A report by the National Audit Office in February said that the government would fail to halt the rise in obesity without clearer leadership from the top.

The target of stopping the rise by 2010 had been set in 2004, but plans to change children's diet and exercise at school and home had hardly got off the starting blocks, it said.

Caroline Flint, the public health minister, said yesterday: "We have taken huge steps forward and are starting to change attitudes through the Five A Day campaign, the school fruit scheme, and more investment in school food and sport."

However, she added that the government recognised that it needed to do more to meet the target.

Prof Waine said that the latest obesity figures were disturbing. "This is serious news, because obesity in adolescence is associated with the premature onset of Type 2 diabetes and cardiovascular diseases.

"It really augurs very badly for the future health of the population as these children move from adolescence to adulthood. We are in danger of raising a generation of people who have a shorter life expectancy than their parents."

He said that increased inactivity among children, such as not walking or cycling to school, coupled with more "energy dense foods" was fuelling the crisis. "Being obese at adolescence increases the cancer risk by 21% for girls and 14% for boys.

"In my youth, playing cricket and tennis were the norm. These have now been replaced by watching television and playing video games."

The survey also found that the obesity rate among adults had risen to 24%, in spite of people exercising more and eating more fruit and vegetables.

The proportion of men eating at least five portions of fruit and vegetables a day increased from 22% in 2001 to 24% in 2004, while the figure for women went up from 25% to 27%.

However, more men gave up smoking than women, and in 2004 there were for the first time more women smokers (23%) than there were men (22%).

Andrew Lansley, the shadow health secretary, said: "In the last decade, British children have got fatter faster than anywhere else in western Europe. We are at risk of an epidemic of vascular diseases as a result. We need active and competent, cross-governmental measures, and we need them now."

[John Simkin]

In a recent article in the Guardian, Alex Renton investigated the subject of trans fats. Here is a brief extract from the article:

The brick of vegetable fat is tacky to the touch, grey-white and translucent - like the skin on a corpse, I think, but this is unscientific. We are here to test the semi-solid vegetable fat Cookeen against butter and we must be objective. But the butter looks so much prettier on the baker's rolling board: its genteel yellow makes you think of primroses and little-girls' dresses, not of morgues.

Drew Massey, the baker, makes his mind up pretty quickly. "It just doesn't feel right," he says, as he rubs the vegetable fat into the flour and baking powder. "It's really tough." But he smiles when he turns to do the same with the butter. "That's better." When the eggs and milk are mixed in and both lumps of dough are lying like deflated footballs on the board, ready for cutting into scones, Massey tries to articulate the feeling. "I haven't got the words - it's 30 years of doing it that tells you. This one is ropey, tough. It's not going to be a nice product. But this is nice - it's short. There's no pull on it."

Pull is bad and short is good if you are a scone-baker: the scone will have a crumbly texture because the butter has properly coated the gluten molecules, preventing it from making the chains that will result in "pull" - the elasticity you want in bread but not scones. The hydrogenated vegetable oil (HVO) of the Cookeen, by contrast, seems to have penetrated the gluten.

While the two sets of scones bake, Massey reveals his philosophy of ingredients: "I do what my dad did and he did what his dad did."

Massey's father, Ivan, was a traditional master-baker with a chain of shops around Lincoln. He held out against the rise in the 60s of the mega-bakeries, which exploited the new technologies. "He just didn't do any of the new things - no vacuum-processors for the bread, no instant yeasts, no industrial fats - he just didn't see that he was going to bake better."

With these principles as their business plan, Drew and his two partners opened the Manna House in Edinburgh just over a year ago on Easter Road, not the smartest street in central Edinburgh. But despite the presence of a chain-store baker, Gregg's, and a Co-op half a minute's walk down the road, there are queues every morning outside Manna House for rye loaves, bloomers, sourdough and pains au chocolat.

Curiously, when the scones emerge from the oven after 15 minutes the vegetable fat one is a clear winner on looks. It's gold and brown on top, with that classic toppled look, aching to be filled with cream and strawberry jam. Massey starts looking nervous for his butter scones, which are rather squat. But when it comes to the taste test there is no contest. The butter scone melts on the tongue. It crumbles. It's sweet and nutty. The Cookeen scone is sort of rubbery when broken and the taste is metallic, a tap- water flavour: if I hadn't watched the process I would swear it was made with different flour. The Cookeen scone has hydrogenated vegetable oil in it. The Food Standards Agency describes what hydrogenation means: "Hydrogenation is one of the processes that can be used to turn liquid oil into solid fat ... During the process of hydrogenation, trans fats may be formed. This means that foods that contain hydrogenated vegetable oil (always declared in the ingredients list) may also contain trans fats."

When Massey's father was baking in the 50s with eggs and milk, Canadian flour and butter, his colleagues were modernising. That meant using chemical bread-improvers, preservatives such as ascorbic acid, powdered eggs - "My dad hated those" - and, of course, the new hydrogenated fats. These were the result of a simple process perfected at the end of the 19th century. By attaching hydrogen atoms to oil molecules in the high-temperature process called hydrogenation you could raise the melting point of all sorts of previously useless oils - thus making them more stable and suitable for manufacturing everything from soap to axle grease.

In 1911 Procter & Gamble, then a soap and candle-maker, spotted how hydrogenation could be applied to food oils. It made a vegetable fat, Crisco, from cottonseed oil, using unwanted seeds from cotton mills. Tinned Crisco was an immediate hit in US households, cheaper than the lard it replaced and with a life of two years at room temperature before it went off. A replacement for butter followed: the oils for margarine precisely hydrogenated to remain solid at room temperature but giving the sensation of melting in the mouth.

The hydrogenated fats usefully mimicked the properties of pork and beef fats so they went into halal, kosher and vegetarian foods. By the 60s, 60% of American vegetable oils used in food were partly hydrogenated, and some research declared the trans fats actively healthy. In the baking business, the oils were crucial for the new fast-mixing and proving techniques, that needed oils that kept their solidity at widely different temperatures. The fact that these fats didn't go off, like butter or lard, gave bread and pastries a longer shelf life. They also had higher flashpoints, making them safer for frying. And best of all was that the hydrogenated oils - whether they first came from whales or palm trees, soya beans or rapeseed - were fabulously cheap.

Before, the process of baking was designed around the ingredients: now the ingredients were altered for the process. As with so many additives, once the food industry had found the cheapest method (and catering fats based on hydrogenated oil are about 12% the price of butter) it set about justifying it in other ways. Always ready with a euphemism, the industry sold HVOs as "vegetable fats" or "shortening", which certainly sounded nicer than animal fats. And it worked. British home cooks turned from lard and butter to margarine and vegetable fat.

To ascertain what an ordinary consumer might be told about this, I rang the Liverpool helpline of Princes Foods, Cookeen's manufacturers, and asked if I should be worried about the hydrogenated vegetable oil listed on the back of the wrapper. "It's been used for years and we haven't had any problems with it whatsoever," said a friendly woman on the customer-care line. "It's not a health issue."

But, I said, I had read about coronary disease. "Oh, it's just had some adverse publicity. There's been some newspapers talking about heart problems. But it's been used since the early part of this century."

Despite what the helpline said, Cookeen has announced that it will be "reformulating" in the autumn to remove trans fats.

Trans fats, or trans-fatty acids, are the more popular name for HVOs (which, confusingly, are more correctly PHVOs, partially hydrogenated vegetable oils). They have been the food scare of this summer. TF or TFAs are - a quick Google will tell you - the "killer fat", the "Franken-fat that will not die", "more deadly than saturated fats", "furring up our bodies like old kettles". Look a bit further and you can find trans fats "linked" - that dangerous health campaigner's verb - to disorders from Alzheimer's to autism. "Over the years there has been some very good research on TFAs," says Tom Sanders, professor of nutrition and dietetics at King's College, London. "And there has been some ridiculous crap written about them."

But it seems generally agreed that trans fats, like saturated fats, can raise cholesterol levels, put "plaque" on our artery walls and thus in some cases bring about heart attacks. Our bodies find the hydrogen-altered oils hard to break down - in a standard campaigner's formulation: "Would you melt Tupperware and put it on your toast?" Or as the Food Standards Agency puts it, in less loaded language: "The trans fats found in food containing hydrogenated vegetable oil are harmful and have no known nutritional benefits. They raise the type of cholesterol in the blood that increases the risk of coronary heart disease. Some evidence suggests that the effects of these trans fats may be worse than saturated fats."

Alex Richardson is senior research fellow at Oxford University's department of physiology, and director of the campaigning charity Food and Behaviour Research. She believes that Britain should follow Denmark, which has had legislation since 2003 limiting the amount of trans fats in food. "There's nothing to say in trans fats' defence," she says. "They appear to be more dangerous than saturated fats, they have no nutritional value, they are an artificial, toxic fat that we don't need. I don't see just why we can't have them out of the food supply. We have a major public-health problem here with diabetes and heart disease, and losing one contributory fat is a step towards the solution."

The novelty of trans fats in Britain, as opposed to the US, is that they are virtually invisible, lurking on most food labels only in the gap between the number given for "total fats" and the sum of poly-unsaturated, mono-unsaturated and saturated fats listed. If they are listed. Thus, unless you shop with a calculator and a magnifying glass, you are consuming unknowable quantities of trans fats in "healthy" butter substitutes, pastries, cakes, breakfast cereals, snack bars, pizzas, doughnuts, processed cream and ice cream, prepared food designed for vegetarians and, most significantly, deep-fried food.

There is more. Trans fat-laden pastries are abnormally stable - there is a campaigning nutritionist in Chicago who goes on television with a 22-year-old cupcake that still looks as fresh as the day it was baked. And - get this - the invention of the hydrogenation of oil was the trigger for the mechanised slaughter of whales during the 20th century. Whale oil, stabilised by the hydrogenation process, became the most valuable part of the animal. It provided up to 40% of margarines such as Stork and Echo whose taste spoiled so many childhood sandwiches in the 50s and 60s. And so campaigners such as Oliver Tickell, who runs the British anti-trans fat campaign, TFX, now maintain that butter may be healthier for you than trans-fatty margarine.

http://environment.guardian.co.uk/food/sto...1881919,00.html

[John Simkin]

There was a follow-up article in the Guardian by Prof Rod Bilton and Dr Larry Booth, of the School of Biomolecular Sciences, Liverpool John Moores University. They are also the authors of Get Healthy, Beat Disease:

Tuesday October 3, 2006

The Guardian

Alex Renton's article on trans fats was excellent, but further to his comments, we believe there is overwhelming evidence to support the case for banning plant derived trans fats from all foods (Grease is the word, September 27).

Trans fats can be considered cumulative poisons: they are only slowly broken down by the body and are difficult to excrete - this means they build up in our arteries and cell membranes.

A recent scientific study demonstrates this with the finding that up to two-thirds of fat found in arterial plaques at autopsy in heart attack sufferers is trans fat. Trans fats are also particularly harmful to diabetics as they interfere with insulin receptors that are responsible for control of blood sugar. It has also been proven that consumption of trans fats increases the ratio of "bad" cholesterol in the blood, which is associated with an increased risk of heart disease, diabetes and obesity. A worrying quality of trans fats is that their dangerous health effects take time to develop and are hard to detect until a disease condition arises - and we've all been eating these fats every day for years!

An extensive literature review for our book Get Healthy, Beat Disease, revealed some highly alarming misconceptions regarding the consumption of saturated fat.

Contrary to popular opinion, total blood cholesterol is no longer considered an accurate indicator of heart disease risk. The Framingham heart study, conducted over 50 years, was unable to establish a link between total blood cholesterol and heart disease. In fact, 40% of patients suffering heart attacks have "low" total blood cholesterol.

It is becoming apparent that the ratio of "good" cholesterol to "bad cholesterol" in the blood gives a far better indication of heart disease risk. And eating natural saturated fats, as part of a calorie-controlled diet and exercising regularly, can actually improve your good blood cholesterol.

Better still, a far more accurate indication of heart disease risk can be achieved by measuring Lipo protein A, homocysteine and C reactive protein levels in the blood. The Framingham study also revealed that Lipo protein A was the component of "bad" cholesterol which sticks to the artery walls.

Total blood cholesterol receives massive publicity and has become almost a national obsession. We have reached a stage where some physicians are recommending statin therapy for healthy middle-aged subjects. This is an extremely questionable alternative to healthy diet and exercise: some statins have very toxic side effects and have been withdrawn from the market; and other anecdotal evidence from statin users indicates a rapid loss of energy and disinclination to exercise.

Junk food is unhealthy, in fact, because of the high levels of sugar, refined carbohydrate and trans fat it contains. Sugar and refined carbohydrate have been found to raise blood cholesterol, particularly "bad" cholesterol, and trans fats have been seen to do the same. Eating this kind of rubbish and not exercising will really increase your chances of obesity, heart disease, diabetes and cancer.

http://www.guardian.co.uk/comment/story/0,,1885983,00.html