Posts Tagged ‘calories’

Myth Blown: Persons with Obesity Have Same Diet as Normal Weight

June 15th, 2011

One of the most pervasive beliefs about persons with obesity is that they eat an unhealthy diet and that persons of normal weight eat a healthy diet. Many, if not most, anti-obesity programs include teaching ‘healthy eating’ as part of their efforts to prevent and treat obesity. Ever since I started working in obesity in the late 1990s, I looked for evidence that the eating patterns of persons who were overweight or obese were different from those at normal weight. I was amazed that there was not any. I was even more amazed that many people  reacted with a “Why even ask?” attitude. They knew it was a given.

Hold on. New evidence indicates that  persons with obesity eat the same diet  as overweight and normal weight persons.

Jim Hill and colleagues looked at changes in consumption from NHANES in 1971-1975 to NHANES in 2005-2006. During this time, obesity increased dramatically. Carbohydrate consumption increased from 44% to 48.7%; fat decreased from 36.6% to 33.7% and protein decreased from 16.5% to 15.7%. But they, for the first time, could look at changes across BMI levels.

The percentage of energy from carbohydrates increased uniformly across both men and women across normal, overweight and obese groups. The percentage of energy from fat decreased uniformly across both men and women across normal, overweight and obese groups. Ditto, decreases in protein consumption. The authors note, “Furthermore, although the percentage of energy from fat has decreased, the total amount of fat consumer has not decreased in the setting of an overall increase in energy intake, primarily from carbohydrates. Even normal-weight men and women consume at least 33% of claories from fat, which could be considered a high-fat diet as absolute fat intake has not decreased but the proportion is smaller because of the overall increase in energy intake. The additional calories from carbohydrates combined with a high-fat diet may only further the propensity toward obesity.” Trends in carbohydrate, fat, and protein intakes a… [Am J Clin Nutr. 2011] – PubMed result

This finding has profound implications in terms of obesity policy. The assumption that obese people eat differently than the rest of the world is a powerful one which has gone unchallenged until now. Of course, this study does not address the quantity consumed nor consumption patterns on BMI levels above 30. Nevertheless, this study should spur researchers to take a closer look at this dietary pattern and its implications for policy.

Dietary Intervention

September 27th, 2009


Portion control The influence of food portion size and energy dens…[Am J Clin Nutr. 2005] – PubMed Result

Diets are not the answerMedicare’s search for effective obesity treatments…[Am Psychol. 2007] – PubMed Result

Low-carbohydrate diets, obesity, and metabolic ris…[Curr Atheroscler Rep. 2007] – PubMed Result

Comparison of a very low-carbohydrate and low-fat …[J Am Coll Nutr. 2004] – PubMed Result

Efficacy and safety of low-carbohydrate diets: a s…[JAMA. 2003] – PubMed Result

The role of dietary fat in body fatness: evidence …[Br J Nutr. 2000] – PubMed Result

Low-fat diets and energy balance: how does the evi…[Proc Nutr Soc. 2002] – PubMed Result

NIH: Very low calorie diets WIN – Publication – Very-Low-Calorie Diets

Health benefits of dietary fiber. [Nutr Rev. 2009] – PubMed Result

Position of the American Dietetic Association: hea…[J Am Diet Assoc. 2008] – PubMed Result

The Mediterranean Diet is widely promoted for its healthful outcomes which is supported in this review article Adherence to Mediterranean diet and health status:…[BMJ. 2008] – PubMed Result

Information on portion sizes Smallstep Adult and Teen; NHLBI-Portion Distortion Quiz

Routes to obesity Routes to obesity: phenotypes, food choices and ac…[Br J Nutr. 2000] – PubMed Result

High-fat and low-fat (behavioural) phenotypes: bio…[Proc Nutr Soc. 1999] – PubMed Result

Popular diets: correlation to health, nutrition, a…[J Am Diet Assoc. 2001] – PubMed Result

Dietary approaches that delay age-related diseases. [Clin Interv Aging. 2006] – PubMed Result

What are the long-term benefits of weight reducing…[J Hum Nutr Diet. 2004] – PubMed Result

Total calories available:

Diets of Americans need improvement:

Want to see what folks eat? This is not for weaklings! This is why you’re fat.

Heard of the DASH diet? Here it is: Lowering Your Blood Pressure With DASH, NHLBI

Need Help with portion control? See:

Take the portion distortion test: NHLBI-Portion Distortion Quiz

Volume Substitutions: Fruits & Veggies More Matters » Volume Comparisons

What Fruits and Vegetables are in Season and how to prepare them: Fruits & Veggies More Matters » What’s In Season? Winter

Type of vegetarian diet, body weight, and prevalen…[Diabetes Care. 2009] – PubMed Result

Vegetarian diets and weight status. [Nutr Rev. 2006] – PubMed Result

Physical Activity

September 27th, 2009


The first thing to realize is how much exercise is needed to burn calories. Don’t get discouraged but it takes a lot of time. See: Lighten Up and Get Moving! | The Calorie Control Council

Physical activity patterns and prevention of weigh…[Int J Obes (Lond). 2009] – PubMed Result

Pedometer-based walking programs show modest weight loss A meta-analysis of pedometer-based walking interve…[Ann Fam Med. 2008 Jan-Feb] – PubMed Result

Using pedometers to increase physical activity and…[JAMA. 2007] – PubMed Result

Exercise alone of minimum use Effects of a popular exercise and weight loss prog…[Nutr Metab (Lond). 2009] – PubMed Result, especially it would seem, among women Exercise is not an effective weight loss modality …[J Am Coll Nutr. 1993] – PubMed Result

Exercise in weight management of obesity. [Cardiol Clin. 2001] – PubMed Result

American College of Sports Medicine position stand…[Med Sci Sports Exerc. 2001] – PubMed Result

Treatment and prevention of obesity: what is the r…[Nutr Rev. 2006] – PubMed Result

Physical activity considerations for the treatment…[Am J Clin Nutr. 2005] – PubMed Result

Exercise for overweight or obesity. [Cochrane Database Syst Rev. 2006] – PubMed Result

Regular exercise trumps metabolic drive to regain after weight loss Regular Exercise Attenuates the Metabolic Drive to…[Am J Physiol Regul Integr Comp Physiol. 2009] – PubMed Result

US self-reported physical activity Prevalence of Self-Reported Physically Active Adults — United States, 2007

Prevalence of adult physical activity Prevalence of Regular Physical Activity Among Adults — United States, 2001 and 2005

Physical activity may matter a lot less than you thought. Study compares energy expenditure between Chicago and Nigerian women Energy expenditure does not predict weight change …[Am J Clin Nutr. 2009] – PubMed Result

Physical activity is associated with risk factors …[J Am Diet Assoc. 2008] – PubMed Result

Physical activity decreases cardiovascular disease…[Am J Prev Med. 2004] – PubMed Result

Active Commuting Active commuting and cardiovascular disease risk: …[Arch Intern Med. 2009] – PubMed Result

Physical activity, obesity and cardiovascular dise…[Handb Exp Pharmacol. 2005] – PubMed Result

Downey Fact Sheet 2 – Quick Facts

September 27th, 2009
The Downey Obesity Report

The Downey Obesity Report

Printable PDF


The adult obesity rates have risen dramatically from 1960 to today; rates of overweight (BMI >30) have doubled, rates of obesity (BMI 30-39.9) have nearly tripled and rates of extreme or morbid obesity (BMI >40) have nearly increased seven fold.

ADULT (age 20-74) Prevalence 1

Overweight (BMI 25-30) Percentage

1960-1962 31.5%

2005-2006 33%

Obese (BMI>30)

1960-1962 13.4%

2005-2006 35.1%

Extreme or Morbid Obese( BMI>40)

1960-1962 0.9%

2005-2006 6.2%

The rates of obesity only tell half the story. During this period, the total US population has also increased. Therefore, the raw numbers of Americans affected have also increased. Looking at the numbers of people affected, the overweight population has doubled, the obese population has increased 5 fold and the population with extreme or morbid obesity as increased by a factor of nearly 12!

Number of Americans Overweight in 1960: 56.5 million

Number of Americans Overweight in 2006: 94.5 million

Number of Americans Obese in 1960: 24 million

Number of Americans Obese in 2006:
40 million

Number of American with extreme or morbid obesity in 1960:
1.6 million

Number of Americans with extreme or morbid obesity in 2006: 18.6 million

Since 1960-61 to 2006, the number of American adults who became obese or extremely obese*: 61.1 million

Average number per year: 1.3 million

Average number per month: 110,779

Average number per day: 3,693

Average number per hour: 153

Average increase per minute: 2.5

Since 1960-61 to 2006, the number of American adults who became  extremely obese*: 11 million

Average number per year: 240,217

Average number per month: 20,018

Average number per day: 667

Average number per hour: 27

Adolescents Obesity age 12-19 3

Percent overweight/obese 2005-2006 18%

Young adult Obesity
Ages 18-29

Percent obese 1971-1974 8%

Percent obese 2005 24%

Childhood 2

Ages 6-11 15%

Ages 2-5 11%

Year at which each group will reach 80% obesity 4

All 2072

Men 2077


African American Women 2035

African American Men 2079

Mexican American Women 2073

Mexican American Men 20 91

White Women 2082

White Men

Adipose Tissue (Fat Cells) 5

Age at which typical body has acquired its full number of fat cells: 13

Number of fat cells in average American Adult: 23-65 billion

Number of fat cells in persons with morbid obesity: 37-237 billion

Number of fat cells lost in weight-loss efforts: 0

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report


Daily Calories Needed and Available 6

Recommended calories per day by typical American adult:

Men 2,400 to 2,800

Women 2,000 to 2,200

Mean (meaning half were above and half below) adult daily calorie intake per day 7 :


1971 2,450

2001-2004 2,593


1971 1,542

2001-2004 1,886

Percent increase in food available for consumption per person from
1970 to 2003: 16%

Amount of food available for each person increase from
1.67 pounds in 1970 to 1.95 pounds in 2003

Daily caloric intake has grown by 523 calories from 1970 to 2003. Leading the way were fats, oils, grains, vegetables and sugars and sweeteners.

U.S. Government Biomedical Research 8

2008 Budget of National Institutes of Health $29.6 billion

NIH Spending 2008 on selected diseases:

$5.6 billion

HIV/AIDS funding $2.9 billion

Cardiovascular Disease
$2.0 billion

Heart Disease $1.2 billion

$664 million

U. S. Government Infrastructure on Combating Obesity

Name of coordinator of U.S. global anti-obesity efforts:

(Trick question: no such position exists)

Name of White House coordinator of federal anti-obesity efforts:

(Another trick question: no such position exists)

Name of coordinator of Department of Health and Human Services***anti-obesity efforts:

(No such position exists)

*Calculations were made by taking the CDC prevalence figures for 1960-1962 and 2005-2006and multiplying them against US census data for 1960 and census data for 2006,respectively. See Census Bureau Home Page

**Available in this context means the total US calories available for consumption, less spoilage and waste. See ERS/USDA Data – Food Availability (Per Capita) Data System)

*** Department of Health and Human Services includes the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, Office of the Surgeon General, the Agency for Healthcare Research and Quality among others.)


1. N C H S – Health E Stats – Prevalence of overweight, obesity and exreme obesity among adults: United States, trends 1960-62 through 2005-2006

2. FASTSTATS – Overweight Prevalence


4. Studies of human adipose tissue. Adipose cell size…[J Clin Invest. 1973] – PubMed Result

5. Will all Americans become overweight or obese? est…[Obesity (Silver Spring). 2008] – PubMed Result. In this estimate, by 2030, 86.3% of adults will be overweight or obese and 51% obese; black women at a level of 96.9% will be the most effected, followed by Mexican-American men (91.1%). By 2048, all American adults would be overweight or obese but black women would reach that milestone by 2034. In children, the authors estimate, rates will nearly double by 2030.



8. NIH Research Portfolio Online Reporting Tool (RePORT) – Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC)

By Julie Snider for the Downey Obesity Report

By Julie Snider for the Downey Obesity Report

Brain and Gut

September 26th, 2009

Frequently, when persons with obesity are depicted in the media, they are headless forms (butts and guts I call the pictures) for we think of obesity in terms of body fat accumulation. But obesity really starts in the brain with multiple signals coming from the gut. Adipose tissue itself generates hormones such as leptin and adiponectin; the GI tract generates ghrelin which signals the brain to initiate feeding . Other products which may stimulate feeding or signal time to stop feeding include leptin, insulin neuropeptide Y among others. Parts of the brain involved are the hypothalamus, the dorsal vagal complex and the reward system.

Researchers now appreciate that food acquisition, preparation, and intake are the result of a several physical signals by which the body communicates to the brain that it is hungry and needs to start feeding or full and needs to stop. MD


So, just how does the body regulate its weight? The body needs to get its weight just right. Too little nourishment and the body becomes ill and cannot reproduce. Too much also a problem. Look at the precision needed. If one ate the recommended 2,200 calories per day (and a lot eat a lot more) they would consumer 792,000 calories in a year. If they are just 1% more calories, they would add 2 pounds per year or 20 pounds over a decade of life. That’s just an extra 22 calories a day – about half a lower fat Oreo cookie. 100 extra calories a day – about 2/3 of 1 ounce of potato chips – can result in a 5-pound weight gain a year. To keep within these narrow boundaries of health body weight, our bodies have evolved a sophisticated, redundant system to gauge its body weight and when to feed and when to stop feeding.

The four parts of this system are (1) the nervous system which connects the brain, gut and adipose tissue, (2) hormones, including those made by fat cells, (3) neuropeptides which act as messengers and (4) messenger molecules in the immune system called cytokines. These molecules control body weight. The pancreas and adipose tissue make leptin, insulin, adiponectin, visfatin and resistin. The brain makes NPY, melanocortin and cocaine and amphetamine regulated transcript called CART. The stomach makes ghrelin, PYY and CCK.

The process can begin before you eat. Even the sight, smell or thought of food can trigger the “cephalic response.” This can start the production of insulin. Ghrelin increases the desire to eat. PYY can signal an end to feeding. Under stress, the sympathetic nervous system is activiated. This promotes storage of fat, decreases metabolism and promotes insulin resistance. Weight increases and metabolism slows down when this system is activated. The key hormone is insulin which is produced in the pancreas. It is designed to use carbohydrates or store them for later use.

The signals to the brain come from both the central nervous system and the peripheral nervous system Central and peripheral regulation of food intake a…[Obesity (Silver Spring). 2008] – PubMed Result

They appear to converge in the hypothalamus region of the brain.Hypothalamic control of energy balance. [Curr Drug Targets. 2004] – PubMed Result

No fewer than ten possible automatic and largely uncontrollable responses to the modern food environment have been proposed to understand why people can consume more calories than they need without their full awareness or control over their behavior Neurophysiological pathways to obesity: below awar…[Diabetes. 2008] – PubMed Result

Obese individuals appear to respond differently to food visual cues Obese adults have visual attention bias for food c…[Int J Obes (Lond). 2009] – PubMed Result

Obese and overweight persons appear to have lower brain volume Brain structure and obesity. [Hum Brain Mapp. 2009] – PubMed Result

Gut Hormones

Leptin has been identified as one of the most powerful hormones involved in appetite regulation. Appetite control and energy balance regulation in …[Int J Obes (Lond). 2009] – PubMed Result Now, newer techniques like brain imaging can be used to understand the role the brain and central nervous system play in eating behaviours.Leptin regulates striatal regions and human eating…[Science. 2007] – PubMed Result and Neuroimaging and obesity: mapping the brain respon…[Ann N Y Acad Sci. 2002] – PubMed Result

Another class of signaling substances are neuropeptides. Orexin is one of several currently of interest to scientists. Orexin/Hypocretin: a neuropeptide at the interface…[Pharmacol Rev. 2009] – PubMed Result and Orexin neuronal circuitry: role in the regulation …[Front Neuroendocrinol. 2008] – PubMed Result

Chronic stress and obesity: a new view of “comfort…[Proc Natl Acad Sci U S A. 2003] – PubMed Result

Maternal corticotropin-releasing hormone levels du…[Obesity (Silver Spring). 2006] – PubMed Result

The role of gut hormones in the regulation of body…[Mol Cell Endocrinol. 2009] – PubMed Result

Gut hormones: a weight off your mind. [J Neuroendocrinol. 2008] – PubMed Result

Gut hormones and appetite control. [Gastroenterology. 2007] – PubMed Result

Cord blood leptin and adiponectin as predictors of…[Pediatrics. 2009] – PubMed Result

The leptin/adiponectin ratio in mid-infancy correl…[J Pediatr Endocrinol Metab. 2008] – PubMed Result

As research progresses, new theories of evolutionary development are looking at Build-ups in the supply chain of the brain: on the…[Front Neuroenergetics. 2009] – PubMed Result

Ghrelin is a gut hormone which appears to be very significant and is the subject of much research.Lean Mean Fat Reducing “Ghrelin” Machine: Hypothal…[Neuropharmacology. 2009] – PubMed Result


Viewing photographs of fattening foods, compared to non-food objects can result in greater activiation in parts of the brain. Activation in brain energy regulation and reward c…[Int J Obes (Lond). 2009] – PubMed Result In one study, obese women had greater brain activity in response to pictures of high fat foods than did non-obese women. Widespread reward-system activation in obese women…[Neuroimage. 2008] – PubMed Result and Effective connectivity of a reward network in obes…[Brain Res Bull. 2009] – PubMed Result

Gut peptides and the regulation of appetite. [Obes Rev. 2006] – PubMed Result