Life Extension Magazine®

Issue: May 2020

The Rising Rate of Obesity and its Consequences

Obesity is now responsible for about 20% of deaths in the United States. By year 2030, nearly half of all Americans will be clinically obese. Mediterranean-style diets and other strategies are urgently needed to reduce body fat mass.

Scientifically reviewed by: Dr. April Parks, MD, MS, on April 2020. Written By Chancellor Faloon.

Chancellor Faloon
Chancellor Faloon

In February 2020, the Centers for Disease Control and Prevention presented data on obesity rates in the United States.

The results showed a startling 42.4% of adults are obese.1

An additional 31.8% were overweight, according to a prior study.2

The situation is projected to worsen.

A study published in the New England Journal of Medicine estimates that by 2030 the percentage of obese American adults will rise to 48.9%.3

The increase in medical costs due to obesity are around $3,429 per obese person per year.4 This totals over $446 billion annually.

Unless the rise in obesity rates is prevented, the financial burden for obesity-related medical costs will skyrocket in the next decade.

Women, African Americans, and those with a low socioeconomic status are affected at a significantly higher rate.3

Excess body weight increases the risk of developing and dying from a broad spectrum of cardiovascular diseases, cognitive disorders such as Alzheimer’s, and at least 13 different types of cancers.5-7

Obesity has been determined to be the underlying cause of approximately 20% of deaths in the United States.8

A collaborative analysis (900,000 individuals from 57 studies) published in 2009 found that every 5-point increment in BMI (a weight-to-height ratio) was associated with a 30% increased mortality risk.9

We are in the middle of a surging obesity epidemic. Much as public warnings against tobacco use, which debuted in 1964, have had to be repeated over and over to induce meaningful reductions in cigarette smoking.

The public needs continual reminders about the danger posed by obesity and what can be done to reduce excess body weight.

Woman measuring waist

Medical Definition of Obesity

The Obesity Medicine Association defines obesity as a:

“… chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences.”10

 

Foods that Kill

There are many factors that are contributing to the rise in obesity rates.

Lifestyles and occupations are more sedentary, while more unhealthy, ultra-processed foods are being consumed.11,12

A processed food tends to be high in added sugar, salt, oil, and unhealthy fats.

Ultra-processed foods are so altered that they hardly resemble their original whole-food state.

An ultra-processed food can be thought of as an industrial product.

In addition to having the bad qualities of a processed food, an ultra-processed food contains ingredients that are rarely added to homecooked meals, such as modified starches or hydrogenated oils. An ultra-processed food also commonly uses additives that mimic the sensorial qualities of raw food or disguises undesirable qualities of the finished product such as emulsifiers, humectants, and sequestrants.

Living 10 Years Longer

Ultra-processed foods are often “ready-to-eat” or require minimal preparation, and are highly marketed and branded.12

Some examples of these types of foods are carbonated and artificially flavored drinks, ice cream, breakfast cereals, chips, and heat-and-serve dishes.

Ultra-processed foods account for more than 60% of dietary energy in the U.S.13

Populations that have the lowest intake of ultra-processed foods—in Sardinia, Italy; Ikaria, Greece; Okinawa, Japan; Loma Linda, California, and Nicoya, Costa Rica—live an average of 10 years longer than those with a standard diet in the U. S.11

An observational study of Spanish university graduates followed participants for a median of 10.4 years. Consumption of an average of 5.3 servings of ultra-processed food per day, compared to an average of less than 1.5 servings per day, was associated with a 62% increased risk for all-cause mortality. For each additional serving, this risk increased by 18%.14

The Effects of Diet Soda vs. Regular Soda

A meta-analysis published in 2017 found that regular consumption of sugar-sweetened soda was associated with an 18% increased risk of obesity.15

More surprisingly, regular consumption of artificially-sweetened diet soda was associated with a 59% increased risk of obesity.15

One might assume that diet soda is healthier than regular soda, due to the minimal calorie content. However, artificial sweeteners can lead to significant changes in the gut microbiota, an effect that is believed to at least partially explain the obesogenic effect of diet soda.15,16

Human and animal research show that non-caloric artificial sweeteners cause alterations in gut microbiota composition that impair glucose tolerance, resulting in poor metabolic responses.15,16

In a large-scale observational study in postmenopausal women, with an average of 8.4 years of follow-up, drinking two or more diet sodas per day increased the risk of type II diabetes by 21% compared to women who drank less than one diet soda per week. But the risk was more than doubled to 43% in women drinking the same amount of sugar-sweetened soda.17

More research is needed to fully understand this association. But the key is that research has shown both types of sodas to be harmful to our health.

Being Overweight or Underweight is Not Healthy

It is a commonly held belief that as long you’re not obese you can be overweight and still be healthy. This is not always true. Studies have shown significant dangers associated with being overweight compared to a normal weight.

An observational study published in the New England Journal of Medicine in 2010 followed 1.46 million white adults for a median of 10 years. Those who had preexisting illnesses or were cigarette smokers were excluded from this study analysis.18

The results showed that those who were overweight (BMI 25-29.9) had a 13% increased risk of death compared to those who were normal weight. Additionally, out of the patients who participated in the study longest (followed for 15 years or more), there was a 12% to 19% increased risk of mortality in the overweight group compared to the normal weight group. Among this group, higher weight was associated with a higher risk of dying.

In a more recent study, researchers compared the heart rate variability of underweight, normal weight, and overweight adult women.19

Heart rate variability measures the differences in the time interval between each heartbeat. It is conventionally measured with an electrocardiogram, though there are now smartwatches and small devices that can test it as well.

A heart rate that is more variable at rest is most beneficial, as this allows you to respond better to stress. Those who have a more variable resting heart rate also have better exercise performance and decreased risk of cardiac disease.20

The results of this study revealed that those who were underweight (BMI < 18.5) and those who were overweight had reduced heart rate variability compared to normal weight individuals. A special analysis revealed a U-shaped curve, where too little or too much fat mass was associated with worse heart rate variability.19 In other words, individuals with a healthy BMI of 18.5 to 24.9 and healthy extent of fat mass have a higher resting heart rate variability.

A noteworthy study published in 2015 showed a significant relationship between a BMI over 25 and postmenopausal invasive breast cancer incidence.21

The researchers pooled data from 67,142 postmenopausal women from a previous clinical trial and followed them for a median of 13 years. The results showed a positive relationship between BMI and the incidence of invasive breast cancer. Those who were overweight had a 17% increased risk and those who were obese had as much as a 58% increased risk.21

Patient having blood preassure checked

WHAT YOU NEED TO KNOW

The Dangers of Obesity

  • Obesity rates in the U.S. are skyrocketing. By 2030, it’s projected that nearly 50% of American adults will be obese.
  • Genetics play a role, but sedentary lifestyle and diets heavy in ultra-processed foods (carbonated and artificially flavored drinks, ice cream, breakfast cereals, chips, and heat-and-serve dishes) are largely responsible for the increase in rates of obesity.
  • The diet with the most research supporting its use for weight loss and overall health is the Mediterranean diet, which is high in vegetables, fruits, whole grains, beans, nuts and seeds, extra virgin olive oil, fish and seafood, and includes moderate amounts of poultry, eggs, and dairy, with only very occasional meats and sweets.
  • The AMPK-activating drug metformin can also aid in weight loss. An extract of the plant species Gynostemma pentaphyllum works in the same way, and has been shown to reduce belly fat, BMI, and other indicators of obesity.

An Optimal Diet

Life Extension® has written extensively about the benefits of certain diets and compounds to maintain healthy weight and support longevity.

Although there are numerous data regarding the health benefits of vegetarian or vegan diets, we believe that the Mediterranean diet has garnered the greatest research support.30-32

A meta-analysis of randomized, controlled trials concluded that following a Mediterranean diet may be useful to reduce body weight, especially when it is energy-restricted, combined with physical activity, and sustained for more than six months.33

A Mediterranean diet is high in vegetables, fruits, whole grains, beans, nuts and seeds, extra-virgin olive oil, fish and seafood, moderate amounts of poultry, eggs, and dairy products. Red meat and sweets are limited.34,35

Whatever the dietary pattern, one that emphasizes whole, mostly unprocessed foods will yield significant health benefits over the typical Western diet, which is high in ultra-processed foods.

A recent meta-analysis evaluated the mortality benefit of weight loss diets. The analysis included studies that lasted for a median duration of only two years, yet still found that these diets resulted in an 18% relative reduction in all-cause mortality.36

Woman running

Additional Negative Effects of Excess Weight

  • Excess weight increases the risk for an array of serious conditions: fatty liver disease, kidney disease, gallbladder disease, and sleep apnea.22,23
  • Being overweight or obese is associated with an increased risk of chronic pain and pain syndromes, including low-back pain, headaches, irritable bowel syndrome and abdominal pain, fibromyalgia, jaw pain, and body-wide chronic pain. A study in twins found that compared to their normal weight twin, obese or overweight twins had significantly higher odds of low-back pain or generalized body pain, respectively.24,25
  • Excess weight promotes osteoarthritis as a result of both increased wear and tear, and because of increased chronic inflammation.26
  • Obesity is strongly associated with depression. A meta-analysis that included data on over 58,000 individuals found that obesity significantly increased the odds of developing depression, while depression significantly increased the odds of becoming obese.27
  • A host of negative pregnancy outcomes, such as gestational diabetes, pre-eclampsia, caesarean birth, fetal defects, and preterm birth are all more common in overweight or obese mothers.28
  • Excess weight makes it more difficult to absorb vitamin D and other fat-soluble vitamins.29

Compounds that Aid in Weight Loss

Gynostemma pentaphyllum

Life Extension® has long been one of the most vocal proponents of the incredible and multi-targeted benefits of metformin. It is an FDA-approved drug to treat type II diabetes. In addition to a remarkable list of benefits, studies show that it can also aid in weight loss.37

An extract of the plant species Gynostemma pentaphyllum has been shown to work on one of the same mechanisms that metformin does, by activating the enzyme AMPK (adenosine-monophosphate protein kinase).38

Activated AMPK mimics some of the most important benefits of calorie restriction and exercise by increasing insulin sensitivity and glucose utilization.

Daily intake of Gynostemma extract for 12 weeks was shown in a study to result in significant reductions in body weight, total abdominal fat area, body fat mass, percent body fat, and BMI, compared to a placebo group of comparably obese patients.39

Summary

If Americans continue to opt for more sedentary lifestyles and consume more ultra-processed foods, obesity will continue to rise at an exponential and alarming rate.

If current trends continue, almost 50% of the American population will be obese by 2030, resulting in catastrophic health consequences.

Being overweight or obese increases the risk of the most prevalent diseases afflicting humankind. The financial costs to our healthcare system are unsustainable.

While the media have been sounding the alarm on this issue for decades, not nearly enough is being done to help Americans attain and maintain healthy weight, to avoid terrible and deadly diseases, and to enjoy their lives to the fullest.

We need to be better informed and motivated about maintaining a healthy body weight.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

References

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  2. Available at: https://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Accessed January 30, 2020,
  3. Ward ZJ, Bleich SN, Cradock AL, et al. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med. 2019 Dec 19;381(25):2440-50.
  4. Biener A, Cawley J, Meyerhoefer C. The High and Rising Costs of Obesity to the US Health Care System. J Gen Intern Med. 2017 Apr;32(Suppl 1):6-8.
  5. Alford S, Patel D, Perakakis N, et al. Obesity as a risk factor for Alzheimer’s disease: weighing the evidence. Obes Rev. 2018 Feb;19(2):269-80.
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  12. Available at: https://worldnutritionjournal.org/index.php/wn/article/view/5/4. Accessed February 25, 2020.
  13. Gupta S, Hawk T, Aggarwal A, et al. Characterizing Ultra-Processed Foods by Energy Density, Nutrient Density, and Cost. Front Nutr. 2019 2019-May-28;6(70):70.
  14. Rico-Campa A, Martinez-Gonzalez MA, Alvarez-Alvarez I, et al. Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ. 2019 May 29;365:l1949.
  15. Ruanpeng D, Thongprayoon C, Cheungpasitporn W, et al. Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis. QJM. 2017 Aug 1;110(8):513-20.
  16. Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014 Oct 9;514(7521):181-6.
  17. Huang M, Quddus A, Stinson L, et al. Artificially sweetened beverages, sugar-sweetened beverages, plain water, and incident diabetes mellitus in postmenopausal women: the prospective Women’s Health Initiative observational study. Am J Clin Nutr. 2017 Aug;106(2):614-22.
  18. Berrington de Gonzalez A, Hartge P, Cerhan JR, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010 Dec 2;363(23):2211-9.
  19. Triggiani AI, Valenzano A, Ciliberti MA, et al. Heart rate variability is reduced in underweight and overweight healthy adult women. Clin Physiol Funct Imaging. 2017 Mar;37(2):162-7.
  20. Electrophysiology TFotES. Heart Rate Variability. Circulation. 1996;93(5):1043-65.
  21. Neuhouser ML, Aragaki AK, Prentice RL, et al. Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women’s Health Initiative Randomized Clinical Trials. JAMA Oncol. 2015 Aug;1(5):611-21.
  22. Available at: https://www.cdc.gov/healthyweight/effects/index.html. Accessed February 26, 2020.
  23. Available at: https://www.niddk.nih.gov/health-information/weight-management/health-risks-overweight. Accessed February 26, 2020.
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  25. Wright LJ, Schur E, Noonan C, et al. Chronic pain, overweight, and obesity: findings from a community-based twin registry. J Pain. 2010 Jul;11(7):628-35.
  26. Wang T, He C. Pro-inflammatory cytokines: The link between obesity and osteoarthritis. Cytokine Growth Factor Rev. 2018 Dec;44:
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  29. Savastano S, Barrea L, Savanelli MC, et al. Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord. 2017 Jun;18(2):215-25.
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  31. Dinu M, Abbate R, Gensini GF, et al. Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Crit Rev Food Sci Nutr. 2017 Nov 22;57(17):3640-9.
  32. Berkow SE, Barnard N. Vegetarian diets and weight status. Nutr Rev. 2006 Apr;64(4):175-88.
  33. Esposito K, Kastorini CM, Panagiotakos DB, et al. Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord. 2011 Feb;9(1):1-12.
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  37. Solymar M, Ivic I, Poto L, et al. Metformin induces significant reduction of body weight, total cholesterol and LDL levels in the elderly - A meta-analysis. PLoS One. 2018;13(11):e0207947.
  38. Wang J, Ha TKQ, Shi YP, et al. Hypoglycemic triterpenes from Gynostemma pentaphyllum. Phytochemistry. 2018 Nov;155:171-81.
  39. Park SH, Huh TL, Kim SY, et al. Antiobesity effect of Gynostemma pentaphyllum extract (actiponin): a randomized, double-blind, placebo-controlled trial. Obesity (Silver Spring). 2014 Jan;22(1):63-71.

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