The World Health Organization (WHO) says the fundamental cause of childhood obesity is an “energy imbalance between calories consumed and calories expended.” If left untreated in childhood, obesity can lead to cardiovascular disease, diabetes, certain types of cancer and other health issues in adulthood. The WHO also notes the increase in childhood obesity globally is attributable to many factors including a global shift to diets that are energy dense, those that are high in fat and calories but low in vitamins and minerals.

While the study suggests that lack of physical activity is the biggest predictor of childhood obesity, Connie Diekman says other factors can contribute to obesity as well. “The study pointed to several behavioral risk factors – low physical activity, high TV viewing and short sleep – with each contributing in a different way. Overall, the study found that sedentary behavior is a key risk, and time spent in front of a TV is one of the strongest factors associated with obesity and inactivity,” she said.

Findings from the study reinforce those of other studies showing that a sedentary lifestyle and lack of sleep play critical roles in weight management and the risk of obesity. But while previous studies have indicated socioeconomic factors play a large role in childhood obesity, findings from this study suggest positive impacts of physical activity on obesity risk are similar regardless of income, geographic location or cultural differences. According to our own nutrition advisor Sarah Downs, RD, MBA, “The bottom line is that physical activity is important for everyone.”

So what can parents do to help reduce the risk of obesity in their children?

“As a registered dietitian, my message is for parents to always be a good role model for your children. How? Show them:

• how to make, and enjoy healthier food choices
• how to enjoy appropriate portions
• how to incorporate physical activities to establish a healthy lifestyle

“Being a good role model and doing things together are two very good ways to help kids develop healthy lifestyle patterns,” said Diekman.

So how much exercise should our kids be getting?

According to Diekman, the 2008 Guidelines for Physical Activity for Americans is a great guide for kids aged six and older. “In those guidelines, it is recommended that children and adolescents do 60 minutes of activity daily. While this might seem like a lot, this can include sports, walking, bike riding, games and many activities that kids would consider fun,” she said.

_{The image “Videogame” by dave.see is licensed under CC BY 2.0.}

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What can you tell us about the study overall?

Connie Diekman:

This animal study looked at high fat diets – 40 percent of calories – and found that certain types of fat appeared to contribute more to obesity. The study was attempting to determine how fats impact the genetic aspects of weight gain, but the results had some limitations. First, it was an animal study, not a human study, and human genomics are different from animal genomics. Second, the use of soybean and coconut oils combined makes it a bit difficult to determine how or which fat is impacting genetic changes. This is early research, and we need to learn more about how genomics impacts obesity, but choosing a diet with a fewer percentage of calories from fat is supported by other research. It’s an interesting study, but is very preliminary in terms of it changing or impacting human health guidelines.

Sarah Downs:

Researchers looked at the impact different types of dietary fats have on obesity-related health problems, including the influence on gene expression. The two types of fats studied were saturated fat (coconut oil) and polyunsaturated fat (soybean oil). They also observed the impact fructose (a type of sugar) has in comparison to the fats. The results showed that the mice on the soybean oil-enriched diet gained almost 25 percent more weight than the mice on the coconut oil diet and nine percent more weight than those on the fructose-enriched diet. However, because the study was conducted on mice, the implications on humans aren’t readily known at this point. Another limitation (that the researchers noted) is that additional studies will need to be done to find out the impacts of these types of diets on heart disease. Ultimately, while the results are interesting and should not be ignored or disregarded, additional research with similar results and human participants will need to be done to come to any meaningful conclusions.

You mentioned the study used both soybean and coconut oils. What are the differences between these two oils?

Connie Diekman:

Soybean and coconut oil are composed of different fatty acids, and this was the hope of the research – that the outcome would point to the fatty acids that seem to impact regulation of obesity more than others. Because the study looked at oils in combination – varying percentage of coconut combined with soybean – it’s difficult to say that one fatty acid impacts obesity. Soybean oil is an unsaturated fat and coconut oil is saturated. This difference impacts the fatty acids in each of them.

Do you think the study findings will have an impact on future recommendations for dietary guidelines?

Connie Diekman:

Since this is an animal study and is early research, it will likely not impact dietary recommendations. The high fat percent of the diet certainly could be a factor in the appearance of fatty liver in the mice and might be an issue for humans, but more research is needed to determine this.

Sarah Downs:

While this study likely won’t impact future recommendations for dietary guidelines, it does somewhat support the new proposed dietary guidelines that will focus on the type and quality of fat rather than the quantity.

Should consumers avoid products that contain soybean oil or use tropical oils like coconut instead when possible?

Connie Diekman:

Current scientific evidence indicates the healthiest oils are canola and olive oils. Coconut oil, due to its high saturated fat level, is not necessarily the most healthful choice. Since many commercial products use soybean oil, consumers should consider using olive or canola at home to vary their fatty acid consumption.

Sarah Downs:

While this study showed coconut oil (plant-based saturated fat) did not cause as much of an increase in weight and metabolic syndrome symptoms, it doesn’t give coconut oil a free pass – it still needs to be consumed in moderation. The bottom-line is this: Moderation and variety are key components of a healthy diet, and a focus on total diet and regular exercise is essential for human health.

_{Soybean Oil, Meal and Beans” by United Soybean Board is licensed under CC BY 2.0}

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Dr. Julian Alston from the University of California-Davis, doesn’t think so.

Dr. Alston:

For farm subsidies to have had a significant effect on obesity rates, each of several component elements must be true. However, the magnitude of the impact in each of these steps is zero or small, so the overall effect is negligible.

Let’s look at the first two steps:

1. Farm subsidies must have made farm commodities significantly more abundant and cheaper.

2. The lower commodity prices caused by farm subsidies must have resulted in significantly lower costs to the food industry.

Farm subsidies have had very modest (and mixed) effects on the total availability and prices of farm commodities that are the most important ingredients in more fattening foods. U.S. farm subsidy policies include both Farm Bill programs and trade barriers that raise U.S. farm prices and incomes for favored commodities. These policies support farm incomes either through transfers from taxpayers, or at the expense of consumers, or both. Thus, they might make agricultural commodities cheaper or more expensive and might therefore increase or reduce the cost of certain types of food. Indeed, for several important food products that have been associated with obesity – dairy, sugar and orange juice – barriers to imports are used to raise the prices paid by consumers in order to support the prices received by producers. In fact, balancing the effects of these types of policies with policies that make other food commodities cheaper, such as corn, wheat and soybeans, the effect of farm price support policies has been to make food commodities overall a little more expensive for buyers.

Such small commodity price impacts would imply very small effects on costs of food at retail, which, even if fully passed on to consumers, would mean even smaller percentage changes in prices faced by consumers. The cost of farm commodities as ingredients represents only a small share of the cost of retail food products; on average about 20 percent, and much less for products such as soda and for meals away from home, which are often implicated in the rise in obesity. Hence, a very large percentage change in commodity prices would be required to have an appreciable percentage effect on food prices.

Now, let’s examine the last two steps:

3. The cost savings to the food marketing firms must have been passed on to consumers in the form of lower food prices.

4. Food consumption patterns must have changed significantly in response to these policy-induced changes in prices.

Given that food consumption is relatively unresponsive to changes in market prices, the very small food price changes induced by U.S. farm subsidies could not have had large effects on food consumption patterns. Simple causation from farm subsidies to obesity is also inconsistent with international patterns across countries. For example, obesity trends for adult males and children in Australia are similar to those in the United States, but Australia phased out its farm commodity programs over the 1980s and 1990s.

Corn is often the target of criticism as a contributor to obesity, especially because of its use to make high fructose corn syrup (HFCS), which is used as a caloric sweetener in many foods and beverages. Farm subsidies are responsible for the growth in the use of corn to produce HFCS as a caloric sweetener, but not in the way it is often suggested. The culprit here is not corn subsidies; rather, it is sugar policy that has restricted imports, driven up the U.S. price of sugar, and encouraged the replacement of sugar with alternative caloric sweeteners. Combining the sugar policy with the corn policy, the net effect of farm subsidies has been to increase the price of caloric sweeteners generally, and to discourage total consumption while causing a shift within the category between sugar and HFCS. In this context, eliminating the subsidy policies would result in cheaper caloric sweeteners and, if anything, more rather than less total consumption of sweeteners, with a switch in the mix back towards sugar.

Most corn, however, is actually consumed in the form of meat or dairy products. Corn and other feed stuffs represent less than 8 percent of the retail cost of meat such that a 10 percent cut in the farm price of corn would imply at most a 0.8 percent reduction in the retail price of meat, and similar calculations apply for other retail foods. Consequently, eliminating corn subsidies could not be expected to have large and favorable effects on consumer incentives to eat healthier diets such that obesity rates would be meaningfully reduced.

Farm commodities have indeed become much more abundant and cheaper over the past 50 years in the world as a whole as well as in the United States, but not because of subsidies. This abundance mainly reflects the effects of technological innovations and increases in farm productivity that have rescued billions of the world’s poor from the shackles of poverty and starvation, while at the same time reducing pressure on the world’s natural resources. If cheaper and more abundant food has contributed to obesity, then we should look to agricultural innovation rather than farm subsidies as the fundamental cause. Even so, it would be a dreadful mistake to seek to oppose and slow agricultural innovation with a view to reducing obesity rates. Eliminating U.S. farm subsidies would have negligible consequences for obesity rates.

The challenge for policy makers is to find other, more effective and more economically rational, ways to reduce the social consequences of excess food consumption while at the same time enhancing consumption opportunities for the poor and protecting the world’s resources for future generations.

_{“Combine Harvesting Wheat” by Charles Knowles is licensed under CC BY 2.0.}

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An abundance of confusion has complicated the use of high fructose corn syrup (HFCS) since it was introduced as an industrial sweetener – a substitute for sugar – in the 1960s. Some of the controversy derives from the dramatic increase in the prevalence of obesity in the U.S. (and in the rest of the world). The simultaneous occurrence of these two events is striking and it is tempting to relate one to the other.

Despite its name, HFCS is the equivalent of table sugar, nutritionally, chemically and functionally. It does not have significantly high fructose content if you compare it to sucrose, which is what it replaces in so many of the foods we eat. There are no differences in comparing sugar and HFCS in their impact on appetite or on levels of blood sugar, insulin or on a variety of metabolic measurements or hunger signaling hormones.

The realization that obesity is increasing with equivalent rapidity in many parts of the world in which HFCS is not commercially available further undermines the argument that HFCS is a cause of obesity.

HFCS lowers the cost of sweetening foods and producing certain kinds of foods and beverages. With lower costs we have increased consumption. HFCS is not the culprit, no more than sugar, but it is an innocent participant in the complex process of manufacturing and selling food.

There is no dispute that weight management mandates decreasing the consumption of high calorie foods. Nevertheless, there is no metabolic, nutritional or chemical reason to assign unique responsibility to HFCS. For weight management, it’s every bit as bad as sugar, but not worse.

We reached out to Dr. Arthur Frank, Medical Director of the George Washington University Weight Management Program Washington, DC for his thoughts.

_{“US Grades of Maple Syrup” by LadyDragonflyCC ->;< is licensed under CC BY.}

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True or Not? “Elimination of farm subsidies will reduce obesity and associated health problems.”

_{“20150624-FFAS-LSC-0087” by U.S. Department of Agriculture is licensed under CC BY 2.0.}

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In reviewing the reasons behind our obesity rate increase, the U.S. Department of Agriculture performed an analysis of our calorie sources and how they have changed over the last 40 years. It shows the number of calories available per person in 2008 was 23 percent higher than consumed in 1970.

One of the shifts in calorie consumption in recent years involves wheat, barley and rye – all containing gluten, which cannot be digested by those with celiac disease (CD) or who are gluten sensitive. In the U.S. less than 1 percent of the population has CD and only 6 percent are thought to have gluten sensitivity.

A new book titled Wheat Belly, authored by a preventative cardiologist, claims wheat is a primary driver of the modern day rise in obesity. The contention is that because of genetic tinkering, modern wheat is really a ‘super carbohydrate.’ What are your thoughts?

Dr. Baenziger:

“I believe that ‘wheat belly’ and obesity is more likely due to overeating and physical inactivity than to wheat. Among the major cereal grains, wheat actually is relatively higher in protein (therefore lower in carbohydrate) than many other cereals (e.g. rice and corn). The higher protein content in wheat is because you need protein to make bread. If protein gets too low, you cannot make a loaf of bread.”

There seems to be growing concern about wheat. Specifically, more people are moving toward a gluten-free diet as a way to eat healthier. What are your thoughts on this?

Dr. Baenziger:

“A lot of people have suggested that modern wheat breeding has made people more sensitive to the Celiacs disease. But I can give you a sample of wheat that is 100 years old and it will still have the problem. For some reason, it is assumed that modern technology has hurt the healthful qualities of food and that is not the case.”

Most farmers today are planting genetically modified corn and soybeans but this is not the case with wheat. Why is that?

Dr. Baenziger:

“Genetically modified wheat exists in the laboratory but it is not commercial and has never been sold. There are tremendous needs that could be met through transgenic approaches with wheat. One company developed a gene that is resistant to fusarium head blight, which causes tremendous grain yield losses, but they’ve never been able to use it. With such a gene we could reduce a mycotoxin in the food supply called vomitoxin. So, not only would it be of value to protect the crop but it would be a valuable food safety tool.

“The reason it is not commercially available is because of trade issues. Since 45% of the U.S. wheat crop is exported it would be economically damaging for other countries to reject our wheat because of genetic modification issues.”

_{Image: “Banana Zucchini Squiggle Loaf” by Meal Makeover Moms is licensed under CC BY-ND 2.0.}

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Do fatty foods cause brain damage?

Dr. Melinda Sothern:

This is plausible. Simply stated, your environment and behaviors (like eating fatty foods) can alter the makeup of your brain – which can ultimately cause unwanted changes to brain tissue and chemicals. Since this is emerging information, we are still trying to understand all the implications.

Consuming certain unhealthy fats has been linked to neurological changes that promote obesity. Since the brains of living humans can’t be explored, this idea is being studied in lab animals at this point – primarily rats and mice. Usually, there is study looking at specific genes that have changed over time because of the environment or the person’s behavior. The changes to the genes cause the gene receptor (the part of the body that receives the gene messages) to not receive the gene or to receive a different gene. This is called a gene variance. When this happens there is a potential for the brain to develop in a different, undesirable way that may make the individual more likely to develop obesity.

How do fatty foods cause brain damage?

Dr. Melinda Sothern:

For example, let’s say for one year’s time, you are a real couch potato. You don’t exercise, and you eat a lot of unhealthy foods. You eat a lot of sugars and saturated oils, or partially-hydrogenated vegetable oils. In new research studies these unhealthy sugars and oils can disrupt neurological messengers and metabolism messengers. Once they are disrupted it may not be possible to repair the messengers even if after that year, you change your behavior and change your eating habits. At that point, the damage may already be done.

One way the damage may show up is that it may affect the part of your brain that listens to the messages coming from the stomach and the intestines. Those messages may come to the brain differently because you over-indulged in unhealthy fats or ingested too much refined sugar, or didn’t get enough physical activity. An unhealthy lifestyle doesn’t just affect a person in real time. Changes that promote a variation in the genetic messengers that control appetite may be sustained throughout the development of a child’s life. This is why scientists suggest that individuals who experience an altered genetic profile may have to manage their weight throughout their lifetime.

What about obesity?

Dr. Melinda Sothern: 

Obesity becomes very resistant to healthy lifestyle changes such as a balanced, low-calorie diet and exercise. This is particularly true in growing children. It’s not as well understood in adults, but we do know that there are key periods where all of the neurochemicals (chemicals that send messages to and from the brain to all of the other parts of the body) reset during childhood. Those periods are at birth, toddler age, right before puberty, and then again during puberty. What the child does during all of those periods will determine their physiology, biology, hormones and activity levels/potential as adults. What current studies are finding is that the resetting of these neurochemicals is greatly affected by the interaction of the child’s behavior, environment and genetics.

If someone is obese, is the regular method of diet and exercise to try to lose weight more difficult?

Dr. Melinda Sothern:

Yes. Your genes may have been re-wired or programmed for a certain part of your brain that would typically tell you, ‘You’re full! You’ve eaten enough!’ That particular part of the brain has been re-programmed due to some insult. The causes of insult may vary. The potential causes could be too much fatty food, too much sugar, not enough activity, or some other factor, like a child whose mother smoked during pregnancy, or a child who wasn’t breast fed. The insult is what happens to an individual as they are developing, which can alter the gene variance. We are currently studying these insults and their effects on the brain, and more specifically, inflammation. Inflammation leads to a higher risk for obesity and a higher risk of asthma.

Can you explain a little bit more about how the insults work?

Dr. Melinda Sothern:

Most people understand basic genetics. For example, if you have blue eyes, then you have the gene for blue eyes, and you inherited that from your parents. This concept is a little more difficult to understand than those basic genetics. Basically, there are certain genes that need to be received by a receptor at certain times of your development, and because you were in a less than healthy state during that time, that gene isn’t received or perhaps a different gene is received, which may alter your ability to be healthy. So, the insult is your unhealthy choices and the outcome is an altered genetic profile that may make you more prone to obesity and other related diseases, such as diabetes and heart disease.

So how can we keep ourselves healthy?

Dr. Melinda Sothern:

In my opinion, eating healthfully is no longer a choice; it is an absolute necessity. If you eat unhealthy foods in excess, you’re more likely to become obese, and that, in turn, is going to drive other health problems like type 2 diabetes, heart disease, cancer, high blood pressure and stroke. You need to select healthy, highly nutritious foods.

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In my opinion, eating healthfully is no longer a choice; it is an absolute necessity
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• Select foods with healthy fats – monounsaturated fatty acids like olive oils and avocados. Incorporate vegetables and fruit into your diet, which provide antioxidants.
• Limit the amount of saturated fat. Foods that contain saturated fats like meat, milk and eggs, also contain valuable nutrients, so don’t stop eating those foods, just choose the versions with lower saturated fats. For example, instead of choosing ribeye with higher saturated fat, choose a cut with lower saturated fat such as sirloin or round steak. The same is true for milk – choose fat free.
• To reduce your intake of calories, choose fresh fruits and vegetables and lean protein, such as chicken, fish and seafood.

It’s important to remember that there are many benefits of making positive lifestyle changes no matter how unhealthy you’ve been in the past. Scientists don’t know yet if it is possible to undo prior alterations in the brain due to unhealthy lifestyle choices. However, they do know that healthy eating and physical activity will help manage chronic diseases, such as diabetes, hypertension and heart disease and, if begun early enough, may actually prevent them from developing. Even more important are the mood benefits you’ll gain from eating healthy and being physically active. Positive changes in your mood are associated with lower inflammation and a better immune system. Together these will lead to decreased risk for developing chronic disease and an increased ability to manage your condition.

For more information on healthful choices, read Healthful Eating: It’s not rocket science and What does the new MyPlate icon from USDA mean for consumers?  Also read Trim Kids (Harper Collins Publishers).

_{“Brains” by Neil Conwaymizo is licensed under CC BY 2.0.}

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