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Food labelling Chile

Obesity -who is to blame? Part 4

By | About obesity, About obesity, Food and drink, Food and drink, Food and drink, Food and drink, News, Obesity prevention, Online resources | No Comments

In Sweden we have laws and regulations!

We have traffic legislation: we drive on the right, we have to take a test for a driving licence, have the car inspected regularly, drive sober, wear a seat belt and comply with speed limits. We even have special traffic police. The cars themselves are made increasingly safe, they are also crash tested.

We also have alcohol legislation; with age limits, Systembolaget, alcohol tax, warnings in alcohol ads. Tobacco is the same: age limits, warnings on packaging, tobacco tax and recent ban on smoking in outdoor dining areas. Drugs are completely criminalized.

 

Why do we have all this?

Couldn’t people just “take responsibility” and discipline themselves?

We have it because we know that without all this, people would be in harm’s way:

In Sweden, 324 people died and 2195 were seriously injured in traffic in 2018 (Swedish Transport Agency). Approximately 12,000 people die from smoking each year, while 100,000 fall ill with smoking-related disease (National Board of Health and Welfare/Public Health Agency of Sweden). About 2,000 people die as a direct effect of alcohol per year, in addition, alcohol caused just over four percent of the total burden of disease in 2017 (data from the international global burden of disease(GBD) project).

Society/the government thus chooses to take responsibility for the population as a group through legislation, to steer it in the right direction. One can have political opinions on the details of the above, but no one would want to abolish all the laws and regulations. Right?

 

How much does overweight and obesity cost? More than you know

At the same time, obesity disease causes at least 3,400 deaths in the country per year. The total cost of overweight is SEK 23.4 billion per year, obesity an additional SEK 25.2 billion (report IHE). Every other adult Swede is currently overweight or has obesity(Public Health Agency of Sweden).

In response to this overweight and obesity epidemic, Swedish society is currently doing -what?

Almost nothing. (Well, we have a 15-year age limit if you want to buy a can of Red Bull and there are certain rules for what advertising to children may look like.) If we translate this approach to traffic, it would be equivalent to having right-hand traffic -but forget the rest (driving licence, speed limits, alcohol, seatbelt, traffic lights)…

We have petrol, alcohol and tobacco taxes. “Fetmainitiativet” (the obesity initiative) proposed a Swedish sugar tax, but this was dismissed by the then responsible minister,who instead wanted to see a “holistic approach”. There is still no sign of this “grip”.

On the contrary, we are unbridledly exposed to advertising of high-processed foods, snacks and sweets almost everywhere. (Public service even allowed Melodifestivalen to have pure junk food as its main sponsor this year). In my large supermarket at home you have to step 20 steps(!) from the checkout to get out of the “zone” with nothing but sweets, chocolate, chips and snacks -there is now even a mini shelf at the checkout between the merchandise band and the customer with small pieces of chocolate (just at eye level for accompanying children). No warnings, no age limits. Nothing.

The same government and society that otherwise impose traffic rules, age limits, extra taxes and warning labels choose to watch passively while the population becomes increasingly exposed to highly processed foods that we know lead to obesity disease. So now we as citizens are suddenly supposed to “discipline ourselves” and take responsibility ourselves, apparently?

This is unreasonable and in every way illogical. In addition, the problem already costs us 3400 deaths and SEK 48.6 billion every year. (Let that sink in).

 

Then why doesn’t anyone do anything?

No one “knows” exactly, but let’s speculate:

Do people realise that obesity is a disease, or do they think it is a poor lifestyle choice made by the patient? Considering Swedish healthcare professionals are basically not educated about obesity disease at all, then how much do our politicians and decision-makers know? Do they think high-processed food is harmless? How strong is the food industry’s own lobbying (quite strong, one might suspect)? How much public opinion is there to help people avoid overweight or obesity?

 

The Four Black Dots

In the next part of the series we will list our proposals for society measures, but you will get a little sample here: in Chile you have a pronounced overweight and obesity problem (75% of the adult population is overweight or obese). Since 2016, there has been an action plan in place to tackle this at the community level. The reason for this: Senator Guido Girardi, who is also a trained physician.

Chile has introduced a number of interesting reforms in this area:

Soda tax: sweetened beverages have an 18 percent tax.

The four Black Dots. If a food item is unhealthy in terms of sugar, salt, caloric content or saturated fat respectively, each of these categories results in a black stop-shaped label being put on the packaging. The customer can thus directly see if an item has zero, one, two, three or, in the worst case, four black dots. The effect is obvious and immediate: no more guessing what the small print in the table of contents really means, and extremely difficult for the producer to get around the problem via misleading advertising or the like.

Result: accompanying children often point out to mom or dad themselves that they don’t want food with black stop signs on -and the industry self-adapts to avoid the black labels. (Read more in the New York Times atricle.)

– ban on junk food advertising on radio and television between 6 a.m. and 10 p.m.

– ban on mascots and cartoon characters linked to junk food (e.g. Tony the Tiger at Kellogg’s).

So it is possible to make changes -if only the will to do so is there.

In the next blog section we will list our suggestions for action – follow us!

/Carl-Magnus

Obesity -who is to blame? Part 3

By | About obesity, Body weight regulation, News, News | No Comments

On a normal day…

On the burger joint’s drive-thru: the taste of hot fresh grilled burger, a little sweetness from the dressing and bread, salty fries, bubby cola flavor from the soda -just what I needed now! (This is what a bliss point tastes like, see below!)

At the same time, at one of our info meetings: “obesity is of course my own fault, no one has forced me to eat this much…”

Meanwhile, in a social media comment field: “fat people have themselves to blame, no one has forced them to put all that rubbish in their mouths…”

At the same time, in a boardroom: “… we see excellent growth in all markets, especially the Nordic market has developed favourably since we…”

Is all this connected? And if yes, then how? We’ll talk about that today.

 

Bliss Point

Let’s start with the meal we descibed. Now it was a Burger Meal of some kind, but might as well have been a microwave lunch, sweetened drinking yogurt or a Friday snack in front of the TV: here we need to learn about the term “Bliss Point”. The following quotes are from Svenska Dagbladet’s article series on obesity the other week:

“Bliss point is a term that describes the proportion of sugar but also fat, salt and other flavors, which is maximally alluring to our reward system. If the point is exceeded, we feel disgust because it becomes too sweet or too salty. But all the way up to the “disgust point”, the product gradually becomes increasingly attractive. The term bliss point has been used in the food industry since the 1970s when it was explored in detail.

An important discovery was when sugar, fat and salt are combined, the respective disgust point is raised and the product instead becomes super rewarding. For children, the disgust point is just over 25 per cent sugar, for some up to 36 per cent. That’s just over twice as high as for adults, and explains why products aimed at children are often made sweeter.

In addition, some ingredients can shift the disgust point upwards for other ingredients, thus increasing consumption, such as sugary soft drinks together with salty snacks.”

 

Bliss Point: the perfect combination of sweet, salty, fat

So it’s no coincidence that a Burger Meal looks the way it does – it’s the perfect, super rewarding, combination of sweet, salty and fat that releases the most rewarding neurotransmitters (endorphins, dopamine) in our brains. Once there, the various companies have gradually increased portion sizes and thus the profits – compare a burger meal in 1950 against today in the first picture, or how, among other things, our “Friday in front of the TV” habit has increased Swedish potato chip sales in the second picture:

And so the “no one has forced me” reasoning tags along, doesn’t it? This food is scientifically expert designed to produce as much reward hormones as possible in our brains every time we eat(!).

 

Study: High processed food -weight up

This spring, a very well-crafted study on just that was published by Kevin D. Hall in Cell Metabolism (“Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain…”). 20 adult participants, weight stable with BMI around 27, were stayed at the clinic for two weeks. They were randomized to either eat high-processed food or unprocessed food. They could eat as much or as little as they wanted. The result? Those who lived on high-processed food ate an average of 508 kcal more per day than the others, through eating more fat and carbohydrates, but not protein. After the study period, those who ate high-processed food had gained an average of 0.9 kg, those with unprocessed instead lost an average of 0.9 kg! See also the chart in the title image of the blog here above.

The study has, quite rightly, already received a great deal of attention. And note that these were weight-stable study subjects who did not have obesity, yet it becomes so obvious in just two weeks.

So you see, it’s all connected! Developing overweight/obesity is not the individual’s “fault”, our food society is today like an ingeniously rigged minefield with “bliss points” everywhere. (And so far, the government is doing nothing about this basically, but more about their responsibilities in the next blog section).

 

Big business

So to the boardroom we mentioned in the beginning: who are these companies?

Well, it’s Nestle (including Mövenpick and Dreyer’s ice cream, PowerBar, NesQuick, KitKat, Smarties), Pepsico (including Tropicana, Mtn Dew, Gatorade, 7Up, Pepsi, Pizza Hut, KFC, Taco Bell), Unilever (including GB Glace Group, Ben&Jerry, Knorr, Becel), Coca Cola (Fanta, Sprite, Monster, VitaminWater, etc.) -add the companies Mars, Kellogg’s, Kraft, McDonald’s, Restaurant Brands Int groups (including Burger King and Tim Horton’s), Orkla Foods (OLW m.m.) and a couple more and you have the majority of all processed foods in your own store at home.

This is big businessnothing is left to chance. Including our taste buds and reward systems.

A hefty cynicism can be found in these large companies’ product ranges: the same companies that have had full control of “bliss points” since the 1970s, and are actively contributing to our ongoing obesity epidemic, are engaged in -you guessed it! -the weight loss industry: a quick Google search shows a market report on the globalWeight Loss and Obesity Management marketand finds some familiar companies listed there -Coca Cola Co., Nestle, Pepsico, Unilever, Kellogg’s…

So the same companies that create our highly processed, bliss point-optimized foods make sure to then also offer weight loss methods and make money off us once more, so to speak.

We can only imagine how perfectly orchestrated these companies feel that it is, when the consumers who suffer healthwise from weight gain only blame ourselves -or each other..!

The next section will be about society, government and politics. What should they be able to do to help us out of this? What have other countries already done and succeeded in? Follow us!

ww_dieting

Dieting -warning issued..!

By | Best Weight, Body weight regulation, Body weight regulation

Virtually all our patients have tried to lose weight at some point before they eventually come to us. The stricky thing about all the calorie counting/dieting (“just move more and eat less…”) is that it seems to work at the beginning -you lose weight the first 1-2-3 weeks. Then sooner or later there will be a plateau phase, followed by a gradual weight gain, as a rule, to a higher final weight than the one you started at. The biological cause is the body’s internal weight thermostat (“set point”), which we told in more detail about in previous posts (see, for example, this blog from us, this article from Baribuddy or this information film). The result is that the risk of weight gain within five years after a diet is 95-97%. (This risk is something that the dieting industry never tells you about. And for obvious reasons: they have a turnover of 300,000,000 SEK per year in Sweden alone.).

Yo-yo dieting

The end result, weight down and then up again, is what you call “yo-yo-dieting”. But is it that simple? “Yo-yo” indicates that you easily regain your weight after a diet, but also suggests that you may not have very much to lose – the worst thing that can happen is that you are back on “square one”. Or?

… set point up

Unfortunately, it’s not that simple. What typically happens after a failed diet is that the brain’s set point is elevated by 2-5-8 kg (you regain more than what you lost in the beginning). Thus, the dieting triggers the brain to want to weigh even more. Most patients we meet describe how the first half of their gained weight probably came from genes + environment + a trigger (knee injury, smoking cessation, disease, etc.) -but that then the repeated yo-yo diets themselves pushed up the brain set point the remaining extra kilos. A diet risks triggering the body’s defense against starvation, and afterwards the set point is even higher. (It would therefore have been better to avoid the diet and instead accept the original weight.)

Permanently altered biology à la Biggest Loser

The next problem is that several of the mechanisms that counteract weight loss never disappear – even though you regain weight. The most famous study of this was done in the United States on a season of Biggest Loser participants. The study measured the contestants’ metabolism as well as various weight hormones before competition (when they had a large body), at the end of the competition (when they had done massive weight loss) and six years later (when all but one had regained all the weight again). Results: metabolism and the saturation hormone leptin were -as expected -clearly lowered immediately after the competition. What surprised however was that six years later, despite weight regain, the participants still had a lowered metabolism and lowered leptin(!). Dieting had thus permanently impaired the weight physiology of the participants.

Yo-yo dieting causes a change in body composition

For example, if you lose 10 kg with any traditional diet, you have not lost 10 kg of adipose tissue; you have probably broken down 7-8 kg of adipose tissue but at the same time 2-3 kg of muscle mass. Less fat is good, but less musculature is definitely not good. When you then regain the kilos back, let’s say 12 kg up, then in the worst case it is 12 kg of adipose tissue –no muscle mass. Failed dieting thus remodels the body’s composition for the worse. If you imagine that a person living with a large body makes repeated diets maybe 5-10 times in life, then you understand better why muscle pain, fatigue and impaired strength is so common -the person has lost more and more muscle mass.

… and lower self-esteem

In the end, we have the psychological aspect: repeated failure at weight loss is extremely psychologically stressful for the person himself. Most people blame themselves for weight failure (you have “lack of character” and so on) and people around them (often including health care staff) indirectly confirm this by agreeing, or not contradicting.

Dieting -warning issued!

Thus: one can defend the idea of one serious weight loss attempt through changing lifestyle habits or some type of diet program. This is to see what your particular set point for weight in the brain “accepts” regarding weight loss: 3-5% of us have a set point that is more flexible (and one can then imagine that weight loss can persist even in the long run). The other 95-97% will have a fixed set point corresponding to their higher starting weight -thus it will be a yo-yo effect. If you experience this, repeated new dieting attempts are potentially dangerous to your health: set point will be pushed upwards more and more, the body metabolism will be lowered and the level of saturation hormones will be lower, your body will be remodelled to less muscle mass and you will feel worse and worse psychologically. Better if possible to accept the weight you have and instead try to avoid further weight gain (here the concept “Best Weight” can be used, read more about this here). The alternative will be to choose treatment methods that lower the brain’s set point, i.e. medical treatment or obesity surgery.

What we are strongly opposed to is the almost reckless view of diets as something where the customer has “nothing to lose”: weight loss advertising and products are marketed through pharmacies, tabloids, commercial operators online, apps on the phone – but also by the health care system itself. This as a rule without the slightest warning about the risks we reported above, and never ever with information about what set point is. This problem needs to be highlighted and discussed more in society in general. Feel free to share!

Dieting

Canada’s Food Guide-Amazing free resource

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Canadian Obesity Summit 2019

GB Obesitas Skåne participated in the meeting 6th Canadian Obesity Summit In Ottawa last week. Obesity Canada is a network of healthcare professionals, researchers, policy makers and other people with an interest in the disease obesity.

In conjunction with the meeting, they presented the new version of Canada’s Food Guide -A free online database that contains easily accessible advice, support and tips for those who want to eat and feel as good as possible in their everyday life.

Canada’s Food Guide

You go through:

What food you should choose-more natural food and less processed, drink water instead of sweetened drinks, read on the labels what the food contains before you buy, watch out for what the food advertising contains, and more.

thinking about how to eat: Cook food yourself more often, take your time when you eat, feel when you start to be satisfied, plan your meals in advance, enjoy the food, eat together with others.

Recipes. The Guide has a variety of free recipes of all kinds: breakfast, lunch, dinner, snack. All with variations and tips.

hints and tips for different situations-to eat right on a limited budget, to shop right in the grocery store, food at festivals and parties, training, meal planning, food at school and at work, food for young, adults and the elderly -and more.

further facts -All content is double-checked and adapted to current health research. There are materials to download for health professionals, links to research and the “Food Guide Snapshot – a short version of the Guide for everyone to be able to use anytime and virtually anywhere.

Your own food guide!

Canada’s Food Guide may just as well be your guide -just browse to their website, address https://food-guide.canada.ca/en and then save the page on the home screen of your smart phone, so that you always have the guide in your pocket with you. Good luck!