#212 Obesity

Longevity

In the twenty years to 1991 the global prevalence of male “overweight and obesity” has increased by 155%. In 2021, there were 2.1BN people globally who were medically overweight or obese. Our lifestyles and diets are making us ill.

A Five-Minute Read

Perhaps the most striking impact of diet can be seen in Japan. In 1923 the average daily calorie consumption was 2365Kcal. It increased only slightly to 2433Kcal by 2012. However, the source of those calories changed significantly. In 1923 only 3.7% of the calories came from meat, eggs, milk, fish and other animal products. By 2012 that had jumped to 41%. The bulk of that increase came in the years after the Second World War. In those 50 years the height of boys entering primary school increased by 11.8cm. Girl’s height increased by 12.8cm.

Recent data suggests this Western diet may not be flowing through to Japanese obesity. In 2019 male obesity was only 5.5% compared to a US number of 39.8%. Female obesity was only 3.7% compared to 40.6%. This could be due to diet but a lot must be genetic effects.

Genome or Exposome

There have been many studies trying to understand what determines our body weight. Studies have looked at adopted children. Especially children adopted at an early age. Others have looked at twins. Twins who are raised together and twins raised separately. All look to separate the impact of genes from environment and diet. All the studies point to a significant impact of your genes on your weight. The range is from 40% to 70%. Conversely lifestyle choices do make a difference. What we eat, how much exercise we take and how much sleep we get. All have been shown to have an impact

The Obesity Pandemic

China has the largest population of overweight and obese people at 402m (2021). This is followed by India at 180m and then close behind the USA at 172m. However, this does not allow for the relative sizes of their populations. The US has an incidence of 75.9%. This compares to China at 38.6% and India at 20.4%. The prevalence in all three is growing fast. By comparison Europe is at 63.8%. In the UK 29% of adults were living with obesity in 2022, while the 35% were overweight. (In the USA 42% of adults are obese, and an additional 30.7% are overweight).

The highest prevalence of “overweight and obesity” is in countries in Oceania, north Africa and the Middle East. Many of these countries have more than 80% of adults who are overweight or obese. These are also the regions where obesity is spreading fastest. In the Middle East it has trebled for men and more than doubled for women.

By 2050, the forecast is that there will be 3.8 billion sufferers. This is nearly half of the global population. The African super-region is forecasting an increase of 255%. In Nigeria, the number of adults with “overweight and obesity” is forecasted to rise to 141 million by 2050. This will make it the country with the fourth-largest such population.

A Disease for the Young(er)

Obesity is related to age. The highest levels occur in the years just before and after retirement. Researchers have looked at different generations or cohorts. The older generations suffer less than those in the younger generations at the same age. The curves are drifting to the right but are rising. By the time the younger generations reach today’s retirement age, the prevalence of obesity will be higher. The older generation had longer on a potentially healthier diet. The incidence of childhood obesity is increasing dramatically.

In other Newsletters I have discussed possible solutions. There are now medical treatments, but their long run impact is not known. Many people stop taking the injections. Weight gains afterwards may be very high. Exortations to healthy lifestyles may or make not work. It will increase disparities, with the impact more likely to be on the better educated.

Many argue that food has now been engineered to be addictive. To contain combinations of high-fat, high-sugar, high-salt that would never be found in nature. For them the only solution is legislation to improve the national diet.

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