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The Pervasive Health Issue That Costs More Than $1.4 Trillion a Year in the US

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Story at-a-glance -

  • Obesity rates are rising precipitously in both adults and children and are responsible for over $1.4 trillion in direct and indirect costs
  • United Nations is calling the availability and marketing of junk food a human rights issue, as it significantly contributes to obesity and malnutrition
  • U.S. Dietary Guidelines for Americans published in 2015 did not account for research published in the previous five years on saturated fats or low-carbohydrate nutritional intake, perpetuating the myth that a low-fat diet is healthy

By Dr. Mercola

Recommendations to eat a low-fat diet began in the late 1950s following the publication of several studies that reportedly found a link between eating fat and rising cholesterol and heart disease.1 However, as further research has gone on to resoundingly demonstrate, this conclusion was false.2

Unfortunately, the follow-up research was not well publicized by the media or acknowledged by the medical community and, as a result, the American public paid a terrible price. Since the 1960s adult obesity rates have risen precipitously,3 and childhood rates are following suit.4

According to data from the U.S. Centers for Disease Control and Prevention (CDC) in 2010, 12 states reported 30 percent or more of their population was obese.5 In 2015, that number rose to 25 states, with four of those 25 reporting a 35 percent or greater obesity rate.6

These mounting numbers are also reflected in the number of people suffering from illness and diseases triggered by obesity.

In a landmark decision, the BMJ (formerly the British Medical Journal), stood by a peer reviewed study published in 2015 that effectively refutes the U.S. Dietary Guidelines for Americans recommending low-fat diets.

Obesity Rates in the US Rising Precipitously and Costing Trillions

This short video is an excellent visual representation of the increasing numbers of states reporting rates of obesity in the U.S. While the numbers of individuals suffering from obesity in the U.S. are staggering, the condition is a global problem.

According to statistics from the World Health Organization (WHO), the U.S., Saudi Arabia and Libyan Arab Jamahiriya (known as Libya) hold the infamous position of having the highest percentage of obese population of all countries in the world.7

Recent research suggests that measurement of the proportion of fat to total body weight may provide a better explanation of health risk exposure to being obese.8

Optimally, distinguishing location of fat on the body, as abdominal fat poses greater risk for health conditions, would also improve the ability to determine relative risk for a variety of disease categories.

According to research reviewed by the Milken Institute Lynda and Stewart Resnick Center for Public Health,9 the direct and indirect cost of diseases attributed to obesity tops $1.4 trillion.

The largest portion of costs were credited to hypertension, type 2 diabetes, back pain, osteoarthritis and Alzheimer's disease. Type 2 diabetes incurred the largest amount of direct cost and hypertension the largest amount of indirect cost. Indirect costs were related to lower productivity, absenteeism and lost work time.

The total cost in 2014 was $988.8 billion. However, this didn't include costs for informal caregivers for individuals suffering from dementia, or the full cost of lost work performance and output. The Milken Institute believes these numbers, which are included in the $1.4 trillion total, may be a conservative estimate.10

In an effort to curb the cost of type 2 diabetes, WHO is calling on governments to regulate the fat and sugar content in foods, improve urban planning to allow for walking and bicycling, and encourage breastfeeding.

WHO is also urging the food industry to responsibly reduce fat and sugar content in processed foods and stop marketing unhealthy foods to young people.11

United Nations Calling Access to Junk Food a Human Rights Issue

The United Nations (U.N.) has also begun calling access to junk foods a human rights issue that has had a significant impact on the health of people worldwide.

The U.N.'s special representative on the right to food, Hilal Elver, Ph.D., is concerned about industrial food production flooding the market with cheap, nutrient-poor food, noting that:12

"Within the human rights framework, states are obliged to ensure effective measures to regulate the food industry, ensure that nutrition policymaking spaces are free from private sector influence and implement comprehensive policies that combat malnutrition in all its forms."

Minimum requirements for survival may be nutritionally inadequate, fueling the obesity problem with empty calories while simultaneously contributing to malnutrition.

Nearly half the world population may be without access to adequate food, as almost 800 million people live in hunger, more than 2 billion have micro-nutrient deficiencies and another 600 million are obese.13

Marketing strategies to promote junk foods in developing countries are not based on a sustainable system. U.S. government recommendations include half your plate being filled with fruit and vegetables; however, subsidies are aimed at commodity crops used to make junk food cheap and plentiful.14 Elver cautions:15

"The first step is to recognize nutrition as an essential component of the human right to adequate food, reinforced by monitoring accountability and transparency."

More Children Suffering From Type 2 Diabetes

With the rise of obesity has come a rise in the number of children who suffer from type 2 diabetes. In a nationwide representative study between 2001 and 2009, researchers discovered some stunning statistics.16

While the prevalence of both type 1 and type 2 diabetes increased, the rate of increase of the preventable type 2 diabetes was significantly higher than type 1. Dr. Robin Goland, co-director of the Naomi Berrie Diabetes Center at Columbia University Medical Center, calls these "big numbers" and went on to say:17

"In my career, type 1 diabetes was a rare disease in children and type 2 disease didn't exist. And I'm not that old."

In the past 20 years, new cases of type 2 diabetes in children have jumped from less than 5 percent of all newly diagnosed cases to more than 20 percent.18

This progression to impaired glucose tolerance in children and adolescence is multifactorial, although the most important piece is the balance between insulin sensitivity and insulin secretion.19

Childhood obesity leads to insulin resistance and type 2 diabetes more quickly than in adults, and is associated with both metabolic and cardiovascular complications in children and adolescents.20

Severe insulin resistance is associated with an increase in morbidity and mortality in young adults and a higher risk of hypertension, non-alcoholic fatty liver and metabolic syndrome.

This rising tide of children suffering from obesity and type 2 diabetes speaks to an ever increasing indirect and direct cost of care and loss of life in coming years. Once thought to be an exclusive adult metabolic disorder, type 2 diabetes is now affecting youth in numbers that are dangerously high.

US Dietary Guidelines Founded on Weak Science

In September 2015, the BMJ published investigative journalist Nina Teicholz's article detailing the background of the U.S. Dietary Guidelines for Americans recommending a low-fat, high-carbohydrate diet.21

Her research pointed out how the guidelines failed to reflect much of the current research and literature, giving the public a misleading picture of a healthy diet.

The guidelines, based on a report from an advisory committee, were grounded on weak science. In the development of the guidelines, the most recent research on saturated fats was not included, even though the topic merited re-examination. The recommendation to not evaluate the prior five years of research also held true for low-carbohydrate diets.

The report stated this recommendation occurred since, in their exploratory searches of the literature since 2000, the committee found:22

". . . [O]nly limited evidence is available to address the relationship between low-carbohydrate diets and health, particularly evidence derived from U.S.-based populations. The most evidence available focuses on low-carbohydrate diets and body weight."

Teicholz's work came under attack for nearly a year as the advisory committee attempted to justify its recommendations. However, as noted in a press release,23 independent experts hired by the BMJ could not find any grounds for retraction of Teicholz's article. The reviewers noted that the guidelines were indeed developed using out of date methods and insufficient details. Professor Dr. Mark Helfand was one of two experts who reviewed Teicholz's article after publication. He concluded:24

"It is clear that further investigation of the composition of the committee, as well as its conflict of interest policies and work group structure, are warranted."

Have the US Dietary Guidelines Driven the Obesity Epidemic?

Nutrition is one of the more important disciplines as it is the foundation on which your body and cells function daily. Teicholz commented on the BMJ decision, saying:25

"I am very grateful to The BMJ editors for their profound commitment to verifying the facts of my article and for their professionalism and integrity throughout this process. I am also grateful that they are providing a space for rigorous scientific debate, especially on a subject so important to public health.

I hope the original intention of that article can now be fulfilled — to help improve nutritional advice, so that it is based on rigorous science. This will help us to better combat nutrition related diseases that have caused so much human suffering around the world."

In order for the guidelines to have driven the obesity epidemic, the majority of Americans must have reduced their fat intake.26 There's no shortage of controversy surrounding the issue of whether the guidelines are responsible for driving obesity skyward. However, evidence does suggest that fat intake has decreased while carbohydrate intake has increased,27 thus increasing the overall energy intake. The quality of fat being consumed is also an issue when identifying risk potential for obesity and disease.

Obesity is multifactorial, driven by lack of exercise, excessive energy intake, the type of macronutrients consumed and your body's response to the combination. At the same time the guidelines have recommended low-fat diets, the junk food industry has blossomed and Americans are eating more nutritionally empty calories, higher in carbohydrates, than ever before.

Eating Habits Driving Insulin Resistance, Obesity and More

Obesity is often a function of insulin resistance driven by poor eating habits. One imbalance abundant in the Western diet is between omega-3 and omega-6 fats. Many of today's junk food options are full of harmful fats, high in damaged omega-6. However, humans developed on a diet with equal amounts of both omega-3 and omega-6.28,29

A balance of these two fats is critical to the development of the neurological system during pregnancy and in the early months of life.30 However, with a diet high in processed foods, vegetable oils and baked goods, the ratio of omega-6 to omega-3 is now closer to 16:1,31 with omega-6 fats secretly feeding the obesity epidemic. High levels of omega-6 may also lead to a chronic inflammatory process and an increase of white fatty tissue.

Both of these developments are linked to obesity, type 2 diabetes, cancer, heart disease and metabolic syndrome.32 Damaged omega-6 fat may also prevent your body from converting white fat to brown and may increase the risk of blood clotting, a contributor to heart disease and stroke.

Although your body requires both omega-3 and 6 fatty acids, it is the balance in a 1:1 ratio that is necessary for good health. The fats are metabolically and functionally different. In recent research scientists commented:33

"The scientific evidence to balance the omega-6 to omega-3 ratio is robust and necessary for normal growth and development, prevention and treatment of obesity and its comorbidities including diabetes, cardiovascular disease and cancer."

As your insulin hormone function is integral to the way your body metabolizes food, it's important to pay close attention to the food you eat. Having a significant link to over 15 different chronic illnesses and diseases,34 responsible for over $1.4 trillion in direct and indirect costs — nearly half of the total healthcare costs in the U.S. — obesity is an epidemic that cannot be ignored.

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