Why we’re so fat….

Dad’s note:  what follows is a post from our daughter, Carolyn.  At the Baylor Medical Center in Dallas, they call her Dr. Matthews.  She is a cancer surgeon who has shifted some of her attention recently to creating a center for integrative medicine at Baylor.

           Carolyn is a frequent writer and lecturer, the mother of two, and a partner in Thistle Hill Devon.  Here’s her post:

In our lifetime we are experiencing never before seen rates of obesity,  with a 60% rate of overweight in adults.  In my field of gynecologic oncology, our surgical cases have become tremendously challenging due to the large size of our patients. When I was in residency training in the mid-eighties, it was rare to have a patient over 200 pounds.  Now it is uncommon to have a patient under 200 pounds.

Our hospitals have had to make accommodations for the rising tide of obesity, increasing the size of beds, wheelchairs, OR instruments, and scales. I’ll never forget the time when a good friend came to Baylor for an MRI in 1998 and was turned away because he was over the weight limit of 375 pounds. Now we have machines that can perform MRI’s on patients up to 600 pounds.

No one chooses to be obese. Science has shown that gluttony and sloth are not the major culprits.  While some genes will predispose to obesity
and insulin resistance, our genes wouldn’t have changed enough in 20 years to
account for the drastic change from1990, when NO state had a 20% obesity rate to 2010, when ALL states had obesity rates of 20% or greater.

There has to be a reason why we’ve had such a drastic change in the human phenotype –the way we look- in the last 20 years, because our genes just don’t evolve or change that quickly. If our genes haven’t changed, what has?

Our environment. While there are multiple factors that contribute to obesity, I believe the major game-changers in the last few decades that contribute to this perfect storm are foods which have never before in our evolution been consumed: genetically modified foods, high fructose corn syrup and ever increasing quantities of refined sugar and grains, and persistent organic pollutants.

Genetically modified foods, most commonly soy and corn, were introduced in the 1990’s, just as the obesity epidemic was starting.  Humans never before consumed GMO foods, yet they are now rampant in our grocery stores and are typically found in processed foods and fast foods, which we know from Morgan Spurlock’s experiment (eating only fast foods for one month, he
gained 24 pounds) promote obesity.

Until there is long term safety data in lab animals I don’t think GMO foods should be allowed in our foods, and certainly Americans should have the option, like Europeans, of knowing whether the food they are eating contains molecules of GMO food or not.

We’ve been evolving for millions of years, yet we’ve only had farming for 10,000 years. We’ve only had grains in our diet for the blink of an eye in evolutionary terms. Both grains and sugar are readily available in massive quantities year round, and we are now eating (and drinking) grains and sugar in unprecedented quantities. In the Paleolithic age medical anthropologists suggest that we consumed  20 teaspoons of sugar a year in the form of
vegetables and fruits.

Since the advent of farming, followed by the industrial revolution which enabled us to refine both grains and sugar, we are eating huge quantities of high-glycemic index carbohydrates, which are digested and absorbed quickly. It is commonplace and socially acceptable to sit down with a soda; most sodas have close to our Paleolithic ANNUAL intake of sugar in one fell swoop – oops, I meant swallow!

Not only is the quantity of the sugar a problem, but the fact that much of it has been replaced by high fructose corn syrup is also problematic. High fructose just doesn’t occur in nature. Fructose is found in some vegetables and fruits in small quantities, but we consume huge quantities with the most common form of HFCS which is 55% fructose and 42% glucose.

A technique to industrially produce HFCS was first developed in 1966 by a Japanese scientist, Dr. Y. Takasaki. It was first introduced to the American market in 1975, when it was very rare to see an obese person. We are now consuming an astonishing 63 lbs. of HFCS per person in this country, often in baked goods but also in sodas and other foods. Why? It is cheap! It is supported by our tax dollars, subsidizing the growth of inexpensive corn.

Another major contributor to these environmental changes are the persistent organic pollutants that surround us – the billions of pounds of chemicals that have been poured out into our environment mostly in the last 100 years, in the form of industrial by-products, pesticides, herbicides, and now pharmaceutical by-products (for example from oral contraceptives and hormone replacement therapy) that are contaminating our water supplies.

We’ve never before been exposed to chemicals like these before in our evolution. Many are known carcinogens and have been banned (like DDT, banned now in the United States but still used in many countries) but are persistent in nature. It is thought that many act as endocrine disruptors, interfering with our hormonal system, which is intimately involved in the way we burn and use energy.

We do know through the work of Dr Duk-Hee Lee and collaborators that there is a striking dose response relationship between blood levels of persistent organic pollutants and the prevalence of diabetes, with those individuals having the highest level of persistent organic pollutants having a 37-fold increased risk of diabetes.

So what can we do about this? It is clear that something has to change…this path of ever-increasing obesity with its associated diseases is not sustainable as a society. My recommendation is to vote with your fork and your pocketbook- if we don’t buy it, big ag will adjust accordingly. Lobby your representatives to encourage sustainable farming practices and end subsidies for corn and soy, limit GMO foods and intake of refined grains and sugars, and avoid high fructose corn syrup. Eat in the way we have evolved over the millennia- vegetables, fruits, nuts, seeds, berries, and pasture-raised or wild meats.