I'll be back Thursday

So, you know how it goes - you think your schedule is such that you'll have plenty of time to get everything done. Except it doesn't always go that way. This week is no exception - we're leaving on vacation tomorrow, so I'll be traveling and unable to post.

UPDATE 01/27/08: I'll return to posting on January 31, 2008...thank you for your patience!

Poor Math Skills Leading to Weight Gain?

What if Willpower Matters Little in the Long-Term for Weight? provoked quite a discussion in the comments and led me to consider my own beliefs about the role of willpower in both weight loss and weight maintenance for the long-term after losing weight.

What got me thinking about the role of willpower is our collective belief that one must exert their will over their desire for food in order to overcome the strong desire to eat, often what amounts to too much food.

We're repeatedly told that we suffer mindless eating habits, a toxic food environment, and a host of other influences which lead us to overeat; all of which can be overcome if we simply set our minds to choosing foods wisely, strictly rationing our intake with portion control methods, and sticking to recommended intakes of each food group to target particular ratios of calories from carbohydrates, proteins and fats.

When doing these things fails to produce long-term weight management, the individual is often the target of blame - they failed by failing to follow the recommendations. They failed to have adequate willpower to continue as directed. They failed to restrict calories sufficiently enough for the long-term to maintain weight effectively.

Rather than challenge the concept - consciously restricting food intake - we instead accept that such is normal and focus on the failure as an execution problem by the individual, often stated many different ways, but always boiling down to calories in exceeding calories out if the individual could only get it right then all would be well.

This makes weight loss and management a math problem.

In order to lose and maintain weight one must then be good at math in order to be able to constantly be vigilant in counting their calories in each day to keep consumption within target outputs.

So, maybe it isn't willpower, but poor math skills leading to long-term failure to maintain weight loss?

No, I don't really believe that...but, it does open the door to consider the idea that weight isn't simply a math problem that is easily solved by changing inputs and outputs of numbers; that in the long-term exerting will to restrict calories over desire to eat is not really all there is to successful weight management.

If weight is not a math problem, then what is the problem?

If we look at the issue differently - set aside the idea that in the long-term one must exert willpower to maintain a calorie balance and seek to understand what truly drives our appetite, we find that weight is not a math problem, but a chemistry problem!

Weight is chemistry.

Chemistry thus influences obligate requirements for nutrients and energy, as well as our ability to exert our will over our desire.

Willpower then depends upon chemistry.

What does the data say about that concept? We'll take a look in upcoming posts - in the meantime, your comments and thoughts are welcome!

Bill Introduced to Mandate Restaurants Deny the Obese Service

MISSISSIPPI; HOUSE BILL NO. 282
An act to prohibit certain food establishments from serving food to any person who is obese, based on criteria prescribed by the state department of health; to direct the department to prepare written materials that describe and explain the criteria for determining whether a person is obese and to provide those materials to the food establishments; to direct the department to monitor the food establishments for compliance with the provisions of this act; and for related purposes.

Be it enacted by the legislature of the state of Mississippi:
SECTION 1.
(1) The provisions of this section shall apply to any food establishment that is required to obtain a permit from the State Department of Health under Section 41-3-15(4)(f), that operates primarily in an enclosed facility and that has five (5) or more seats for customers.

(2) Any food establishment to which this section applies shall not be allowed to serve food to any person who is obese, based on criteria prescribed by the State Department of Health after consultation with the Mississippi Council on Obesity Prevention and Management established under Section 41-101-1 or its successor. The State Department of Health shall prepare written materials that describe and explain the criteria for determining whether a person is obese, and shall provide those materials to all food establishments to which this section applies. A food establishment shall be entitled to rely on the criteria for obesity in those written materials when determining whether or not it is allowed to serve food to any person.

(3) The State Department of Health shall monitor the food establishments to which this section applies for compliance with the provisions of this section, and may revoke the permit of any food establishment that repeatedly violates the provisions of this section.

SECTION 2.
This act shall take effect and be in force from and after July 1, 2008.

Estimated 10% of Teens in US Have Metabolic Syndrome!

The February issue of the Journal of Pediatrics reports a recent study finding an alarming increase in the prevalence of Metabolic Syndrome (MetS) in teens in the United States.

First, let's look at the definition of MetS for teens used to determine how many teens are estimated to have the condition:

• a waist circumference at or above the 90th percentile for age and sex;
• blood pressure at or above the 90th percentile;
• a high triglyceride level at or above 10 mg/dL;
• a low HDL cholesterol level at or above 40 mg/dL;
• and an impaired glucose metabolism at or above 100 mg/dL (pre-diabtes)

Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999-2002, the researchers found that an estimated 9.4% of teens meet the definition MetS; and that 33% of obese teens, classified by BMI, fall within the definition.

This is pretty disturbing when we consider the last time such data was reviewed, back in 2003 (using earlier-years NHANES data), it was found that 4% of teens met the difinition of MetS above.

To be fair, some quibble that the definition for teens is less stringent than adults, and that if the adult definition is used, then 5.8% of teens meet the adult definition of MetS and 25% of obese teens meet the adult definition.

The bottomline is that no matter how you slice and dice the data, there is a rising prevalence of metabolic syndrome among teens in the United States.

Back on October 2006 I wrote about the increasing prevalence of hyperinsulinemia in the adult population in the United States. At the time, I wrote, "[l]ike the canaries in the mine, slowly dying in the presence of odorless but harmful gases, we're slowly dying in the presence of seemingly logical yet harmful dietary recommendations. All the researchers can keep repeating is eat less and move more; while encoraging us to eat more more whole grains, more fruits and vegetables, more skim milk and non-fat dairy, more beans, more soy and limit saturated fat by eating less meat."

Now today, we're seeing an alarming rise in the incidence and prevalence of metabolic syndrome in our teens - tomorrow's adults - and being spoon-fed the pab that "that the increased prevalence is driven by the rise in obesity."

As the Editor's Perspective noted in the journal, "The obesity epidemic in children is out of control. Our children are living in an obesiogenic environment that fosters all of the components of the metabolic syndrome, regardless of the definition used. It is very likely that a high proportion of youth today who have all the components of the metabolic syndrome will go on to develop cardiovascular disease and type 2 diabetes in adulthood. Clinicians must continue to increase their awareness of the existence of the syndrome and begin to treat it before it becomes even more of a health hazard for our youth."

Here's the big, glaring problem - the elephant in the room if you will - it isn't weight gain per se that is driving up the incidence of metabolic syndrome in our young population - it is the diet they're consuming that's driving up their blood glucose and insulin; and that is causing elevated triglycerides, suppression of HDL, hypertension, visceral fat accumulation and impaired glucose metabolism in a state of chronic hyperinsulinemia!

This is happening despite improvements to school lunches, greater awareness about limiting sweetened beverages, increasing activity in and out of school, and consistent messages about healthful "low-fat" eating inundating our kids today; this is happening because they're still being encouraged to consume a diet rich with carbohydrate, the message now being whole grains are better than refined grains.

It's excessive carbohydrate driving the bus here and until we're able to, as a population, wrap our head around the idea that we cannot continue to feed our children a diet rich with excessive carbohydrate - whole grain or otherwise - that is also concurrently deficient in micronutrients and essential fatty acids and amino acids, we will not see these trends reverse.

Tweaking the Don't Feed the Obese Bill

Many will recall the bill introduced in Mississippi that would ban restaurants from serving obese people.

Now it seems some recognize that such a law would be unworkable, so they're trying to tweak it along to be more palatable for passage.

A press release today touts the ideas of public interest law professor John Banzhaf, who suggests "Focusing your bill on protecting children rather than adults would remove the major objection to it, and provide a strong argument for it - one likely to be echoed by many groups concerned about child health and welfare."

BELOW IS A DRAFT OF THE MAIN PROVISIONS OF THE REVISED BILL BANZHAF PROPOSES:

No employee of a fast food chain outlet shall serve to any child who appears, to a reasonable person, to be under the age of 16 and to be obese, any single food item reported by the company to contain more than 500 calories, nor any meal where the calories in all of the food items in the meal (including any drinks, but not including sauces not provided at the counter) as reported by the company exceed 1000 calories.

However, all such food items may be served if the child is accompanied by a parent or guardian, or if the child presents a letter or note on the letterhead of a physician, hospital, or other health care entity certifying that he is not obese or that for medical reasons he should be served such food items, or if he or she provides such proof in a form or manner approved by the State Department of Health, including but not necessarily limited to, a wallet-sized card from any of the above sources or from the school which the child attends.

Oy!

Read the full press release here.