Not seeing the forest through the trees: Microbiomes and Obesity

Posted by ERV on August 12, 2010
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We are fat.

We are really, really fat.

While some people are overweight/obese for very real medical conditions (thyroid issues, side-effects of medications, etc), the fact of the matter is, most of us just eat/drink too much crap and we live sedentary lifestyles.

That doesnt mean that we actually acknowledge this.

There is no shortage of excuses for the obesity epidemic. Even the CDC, who has a nice list of suggestions, cant resist passing the personal-responsibility-buck:

# It is often easier and cheaper to get less healthy foods and beverages.
# Foods high in sugar, fat, and salt are highly advertised and marketed.

*nod* The Pepsi-Made-Me-Do-It defense, which we are all too familiar with here at SciBlogs. Forgive me for having no sympathy for people who prefer a 12 pack of Pepsi ($5), a bag of Doritos ($4), and a bag of peanut butter M&Ms ($3) or one drive-through dinner ($8) over a dozen eggs ($2), onion ($0.50), green pepper ($0.75), potatoes ($1), orange juice ($2), wheat bread ($2), peanut butter ($2), carrots ($1), half gallon of milk ($2) (prices lower if you dont mind store brands or catch things on sale). I cant afford to eat junk food all day every day, but I absolutely enjoy it as a treat every now and then.

While the Pepsi-Made-Me-Do-It defense is cliche, happily, now weve got a new scapegoat– ITS OUR MICROBIOMES FAULT!!!

“We live in a clean environment in the Western countries,” Lionetti says. “But we have a lot of allergies and obese children, and inflammatory bowel disease, autoimmunity diseases that we don’t have in Africa in this region. So, we have lost — maybe [because of] a change in the diet — healthy bacteria that can protect our guts and our organs from these bad conditions.”

To be sure, this is a small study. The researchers compared the stools of 15 children in Florence, Italy, with those of 14 children in Burkina Faso. The bacteria in the stools of African children were more varied and had a smaller proportion of microbes associated with obesity.

The paper itself could have been cool.

Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa

Of course our microbiome in the Western, developed world, is different than that of people in the rural Third World. I mean, it would be neat to know how our microbiomes are different just for fun. Knowledge for knowledges sake.

But we cant get that funded, can we? We have to justify our quest for knowledge, normally in public health terms. So, a neat information study turns into something different. People in the developed world (obviously) arent exposed to the same stuff as people in the third world. Part of that difference is what kind of bacteria we are exposed to in food and drinking water, thus what kind of bacteria make up our microbiome. Some people think that one of the reasons why some illnesses, like asthma, are on the rise, is because we arent exposed to the same ‘bad bugs’ as we used to be. The hygiene hypothesis. Knowing what bacteria inhabit kids in places where these diseases are low might help us treat kids suffering from these diseases here (or how to prevent them in kids here).

Well, they dont really focus on that. Its a very limited observational paper, and they completely overstretch their conclusions.

Our results suggest that diet has a dominant role over other possible variables such as ethnicity, sanitation, hygiene, geography, and climate, in shaping the gut microbiota. We can hypothesize that the reduction in richness we observe in EU compared with BF children, could indicate how the consumption of sugar, animal fat, and calorie-dense foods in industrialized countries is rapidly limiting the adaptive potential of the microbiota. This microbial simplification harbors the risk of depriving our microbial gene pool of potentially useful environmental gene reservoirs that allow adaptation to peculiar diets, as we observed in BF population and as recently shown by diet-induced horizontal gene transfer in Japanese individuals consuming algae in their diet.

You all know how pop-science media is going to represent this (go on, Google this). If only us silly Westerners would stop with ‘refined’ foods and meat and sugar and so on, and went back to the Golden Era, the Long Long Ago, The Garden Of Eden, when people planted and harvested their own food and were vegetarians that ate nothing but grains and vegetables! Our bodies would go back to their Natural State! Natural bacteria would colonize us, and we wouldnt be fat anymore!! We wouldnt have allergies! We wouldnt have enteric bacterial diseases anymore!!

Eve didnt eat an apple and curse man– SHE DRANK A PEPSI!!!!!

Yes, the differences between African childrens microbiome and Western childrens microbiome is neat, for scientific reasons and maybe medical reasons. I think there are many, many, many limitations to this paper. I also dont think they capitalized on a very valuable piece of data staring them right in the face:

The amount of calories (average) consumed varies considerably in the two populations (BF children: 1-2 y old, 672.2 kcal/d; 2-6 y old, 996 kcal/d; EU children: 1-2 y old, 1,068.7 kcal/d; 2-6 y old, 1,512.7 kcal/d).

So, completely excluding physical activity, a 6 year old in Europe has eaten 766,427 kcals more than a 6 year old child in rural Africa.

How do those African children maintain such slender physiques?

Must be their microbiome.

Last minute edit– Ohhhh I didnt guess the direction pop-science media would take this! They went with ‘Junk Food Causes Allergies’. Faaaaaantastic! NHS has a great break down and take down of this study and its associated media reports.

The researchers said that studying populations with different diets and gut bacteria may help to further our understanding of how a particular diet may contribute to health by promoting the growth of healthy bacteria. However, this study made no link between particular bacteria, diet and illness. Additionally they looked at a Western (Italian) diet in general and did not look specifically at junk food.

Part of this I blame on the media. But part of the blame is in the overreaching claims made by the scientists on this paper, in this paper, and in the media.

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Comments

  1. #1 BeamStalk
    August 12, 2010

    Did you happen to catch the Penn & Teller Bullshit! episode on fast food this season? They basically said the same as you do here. It is about how much you eat and how much exercise you get.

  2. #2 justawriter
    August 12, 2010

    Hmm, looking at the numbers (at nine calories per gram for fat) you EU six year old would consume the equivalent of and extra 187.5 POUNDS of fat per year, or about half a pound per day.

  3. #3 beardedbeard
    August 12, 2010

    Everyone thinks that being fit is freaking magic. Or that there must be some secret trick. I will tell you the secret get eat a SMALL bowl of granola with some yogurt. Get on the bike for two hours, or cross country skis if it is winter. Eat veggies for lunch and keep dinner small mostly veggies. AND NO SNACKS that’s the magic. Hot, sweaty, repetitive magic.

  4. #4 hibob
    August 12, 2010

    I have to disagree with you when it comes to the relative contributions of personal responsibility vs environment when it comes to obesity. Forty years ago, people in the US were thinner, but they weren’t more personally responsible – they were smokers and functional alcoholics. Their environment was different. Calories were expensive, processed food was less common, people had to walk.
    Most adults who are overweight today were overweight as children -are children overweight due to their lack of personal responsibility, or due to the environment in which they are raised?

    Also, while you included potatoes, you left out the other calorie-dense staples of a truly inexpensive diet: oil, flour, and sugar. And if you want to eat extremely cheaply (but you still have access to a car), you use coupons – which means you’ll be eating mostly processed foods.

  5. #5 Prometheus
    August 12, 2010

    justawriter@#2

    The average British kid can wipe out a pound of chipolatas, a two liter of White’s fizzy lemonade, a roll of hob nobs and a bag of cheesy crisps just waiting for the kebab van to show up.

  6. #6 beardedbeard
    August 12, 2010

    Everyone thinks that being fit is freaking magic. Or that there must be some secret trick. I will tell you the secret get eat a SMALL bowl of granola with some yogurt. Get on the bike for two hours, or cross country skis if it is winter. Eat veggies for lunch and keep dinner small mostly veggies. AND NO SNACKS that’s the magic. Hot, sweaty, repetitive magic.

  7. #7 beardedbeard
    August 12, 2010

    sorry about that, stupid S.O.C.T

  8. #8 Pettylinguist
    August 12, 2010

    @beardedbeard, not everyone has the time to spend 2 hours a day on their bike. Between low-paid temp jobs, lack of health insurance (which makes chronic but manageable conditions much more expensive, requiring more time at work), and raising kids, 2 hours of exercise per day is a luxury many just can’t afford. And the diet you prescribe for someone who exercises at that level is bordering on an eating disorder.

  9. #9 uqbar
    August 12, 2010

    Wow, I guess you told ‘em! I hope those lazy gluttonous and just plain nasty fat people will learn the error of their ways: All they have to do is eat right. It’s so simple! Seriously – I challenge anyone who thinks that losing weight is just about “eating right” to try this simple experiment: Start dieting now, and continue to diet until you lose 10% of your current body weight. Don’t give me any excuses about “I’m already at my proper weight,” – this experiment is all about showing how you, perfect as you are, can change your eating habits to lose a significant amount of weight.

    P.S. to “ERV” – I’m quite serious about this experiment. I challenge you to try it, and then report back with the results. I guarantee this will give you a fresh perspective on this topic (and a few blog entries as a bonus).

  10. #10 ERV
    August 12, 2010

    hibob– Potatoes, yes, plain white potatoes are a lovely food. A cup of roasted potatoes are full of fiber, protein, vitamin c, niacin, vitamin b-6, magnesium, potassium, and more– all sorts of wonderful things. If you think potatoes are ‘bad’ you need to step away from the anti-carb cult and start using FitDay

    Furthermore, I just went home, and Mom loaded me up on coupons: eggs, turkey products, juice, yogurt, cheese, cottage cheese, razors, make-up, shampoo…

    uqbar– If youre going to bitch at someone about this, bitch at the CDC. Or bitch at reality. In nine states, over 30% of the population is obese. Not overweight. Obese. You can be defensive and bitchy about it, you can scapegoat things to make yourself feel better about those statistics, or, you can accept the statistics and reality and try to improve said statistics and reality.

    Also, I wont lose 10% of my body weight. That would put me at 5’9″ and 120 lbs. I would be underweight for my height, and thats not healthy either. I *am* at a proper weight. So why dont we turn your challenge around? I can gain 10% of my body weight and stay in the ‘healthy’ range. What do you think would be the best way to accomplish this?

    If someone held a gun to my head and said “GAIN 15 POUNDS! NOW!!!” I would eat more calories than I need. Fastest way would be to eat a lot of junk food.

    Does it also make sense that the opposite would be true? To lose weight, you have to consume fewer calories?

    Im sorry, Im missing the elegant, complicated, insightful part of your challenge? Do you think not being obese *requires* the ‘obesity fighting’ bacteria in this paper? Not being obese *requires* a Neo-Neolithic diet?

    ???

  11. #11 uqbar
    August 13, 2010

    ERV – you miss my point. I’m not defending the microbiome theory; I’m reacting to the not-so-subtle hostility to overweight people in your article. Yes, obesity is a health problem, and (assuming you are not subject to the occasional famine), it is better to be “proper weight” than overweight.

    The point of my challenge is to show how difficult it is to change eating habits; especially when that change leads to feelings of hunger. You can, of course, be overweight and still “feel hungry.” Your article implies that people need not be overweight, they just need to stop making excuses.

    The point of my challenge is this: The connection between “feeling hungry” and weight is not straight-forward. However, by reducing your weight by 10% you will have to eat less than you normally do and you will “feel hungry.” See how long you can keep this up. I doubt you can do it long enough to lose 10% of your weight.

  12. #12 Rorschach
    August 13, 2010

    Abbie, the Pepsi defense might not apply in OKC, but it does in many american rural areas, where fresh food might simply not be available in the first place, and it certainly applies in Australia.And it’s obviously not the only reason for eating unhealthily, you are an educated privileged white kid who knows how to keep in shape and has the time to do it(sigh, we’ve been there lol), but a lot of people are not so lucky.

    The microbiomes thingie, wtf LOL….

  13. #13 ERV
    August 13, 2010

    uqbar– …not-so-subtle hostility to overweight people…
    So obesity is like religion. Honesty and facts are treated as ‘hostility’.

    Where have I ever been ‘hostile’? Ever. In this post, in any post on this blog, on any comment anywhere on the internet. I consider this topic ‘Serious Shit’– its not something I joke or am ‘hostile’ about, even for humors sake.

    uqbar– The point of my challenge is to show how difficult it is to change eating habits…
    Where did I say changing eating habits is ‘easy’? What kind of moron thinks changing eating habits is ‘easy’? Conceptually, recognizing that one must consume the same/fewer calories than one expends is easy. But if actually changing poor eating habits and disordered eating were ‘easy’, we wouldnt have a multibillion-dollar industry built upon making weight management/loss ‘easy’.

    What does not help people do the easy step is piling on excuses for why they have no personal control over doing the hard step. Its not your fault! Theres an OBESITY VIRUS! Its not your fault! There are ANTI-OBESITY BACTERIA, and you just dont have them. Its not your fault! PEPSI BRAINWASHED YOU!

    If you take those claims to their logical conclusion, if I wanted to gain weight, I would go make out with a bunch of obese people to try to catch the obesity virus. I would take loads of antibiotics to flush my microbiome of those darn anti-obesity bacteria. I would sit in front of a video loop of Hardees Monster Burger commercials to brainwash myself.

    Thats obviously silly!

    Turning an issue that is hard but is under personal control into something that is easy but not under personal control is bullshit.

    uqbar– However, by reducing your weight by 10% you will have to eat less than you normally do and you will “feel hungry.”
    If you think you have to ‘feel hungry’ to lose weight, UR DOIN IT RONG. Once again, I must refer to FitDay.

    Rorschach– …but it does in many american rural areas…
    Its not your fault! YOU LIVE IN A RURAL AREA!

    Except I grew up in a town of 10,000 (only that high because of immigrants and our meat packing/processing plant), 1.5 hours away from anything resembling a ‘city’. And Mom didnt let us tank up on junk food or drive through. We couldnt afford it.

    I must repeat: Turning an issue that is hard but is under personal control into something that is easy but not under personal control is bullshit.

  14. #14 Beardedbeard
    August 13, 2010

    @Pettylinguist-

    First I will say, you missed the point. I was commenting to the post about “magical bacteria that will make you thin”. THERE IS NO MAGIC. Eat less exercise more that’s it.

    About your post. Hate to brake it too you but two hours a day is not that much. I don’t have health insurance, I work contract gigs for not much money and coach skiing for no money. Lot’s of people have kids and train, some a lot more seriously then I do. I hear people say all the time they don’t have time to work out but they would never miss American Idol. If it is important to you do it.

    Two other points, I know at least five people that can train 14 hours a week and still gain weight if they are not careful about their diet. So don’t give me any eating disorder BS. Second you will be shocked how much better most “chronic but manageable conditions” get when one sheds a few pounds.

  15. #15 Tyler
    August 13, 2010

    “Eating right” is overrated. Eat whatever you want, but just be sure to get your ass in the pool for an hour a day and swim hard. You’ll burn off more calories than you need to even if you eat like a fatty.

  16. #16 Orakio
    August 13, 2010

    So, this hits home a bit. It is possible to take command of your diet and exercise, and lose weight. It takes some minor determination to stick to the program. It does not even particularly take ‘healthy’ foods, though that helps, because you feel full on volume, not calories.

    That said, I’m eating like crap – my food diary should link in my name for proof of that. I’m eating much less crap, though, now that I’m aware of how much I’m eating. I’ve gone from ~220 lb to ~190lb in ~3 months, a 13.6% weight loss, and enough to take my 5’7″ self down on the BMI scale by about 4.5 points.

    No. Sympathy. For. Laziness. Because the only way to do it is to take control.

    That said, I think that the largest single problem in the country is ignorance, compounded by serving sizes matched unrealistically to packaging. The calories you eat in a day are a counting stat. No one bothers to count. That 500 calorie lunch sammich seems reasonable on its own. It’s not reasonable when you remember the 500 calorie breakfast sammich, the 400 calorie bag of fries, the 1200 calorie dinner, and 300 x 3 calories of soda and 120 x 5 oz of chips now add up to 4100 calories. That lb of oreos you ate in three days? That’s 2/3 of a fat-pound of calories you ate.

    Pay the attention and it gets real easy to eat.

  17. #17 Prometheus
    August 13, 2010

    I would like to see more comments describing how telling people not to eat a bucket of cheesecake filling before taking a nap is a form of class warfare and a vicious attack on the “invisibly handicapped”.

  18. #18 Kevin
    August 13, 2010

    Not saying I disagree with you about the conclusions from this paper – the causal relationship does seem a bit tenuous. On the other hand: http://www.nature.com/nature/journal/v444/n7122/abs/nature05414.html

    These guys took mice that are genetically predisposed to obesity (they lack a gene that allows them to recognize that they are full, so they eat a bunch) and noticed that their gut microbiome was different (there’s a similar difference in obese vs lean humans). Not too surprising – different diet = different bacteria. But then they transplanted these gut microbes to normal mice and the normal mice got fat.

    So, behavior changes gut microbes, gut microbes contribute to potentiating the weight gain. The solution is the same – eat less, exercise more to lose weight, but I think the microbes definitely have an effect.

  19. #19 scramton
    August 13, 2010

    I think that education about eating well and exercising is needed, your post should help with that. You are lucky that your family seemed to give you a good background in nutrition. Unfortunately people want fad diets that Oprah comes up with to work instead of thinking for themselves. Also exercise by itself can actually make you gain weight because it makes you hungrier.

  20. #20 Prometheus
    August 13, 2010

    Kevin,

    I read that study and had forgotten about it. thanks.

    But to go back to the O.P. Abbie identifies the problem in light of the loopy audience looking at this research. Fat people (+mice) have higher F gut flora at the expense of B gut flora and vice versa for thin people (+mice).

    The results with no-leptin mouse gut flora and skinny mouse gut flora introduced to no germ mice indicates the tendency to gain or remain lean is influenced by the proportions of the B and F flora.

    But what does that mean?

    For the audience Abbie is worried about, it means magic bullets and miracles. They are already ordering medical Bacteroidetes from Canada.

    Let’s say I give a hundred kindergartners Imipenem/cilastatin until they got seizures and the squits {school starts Monday, it would be easy} then give them Africanized high B low F gut flora to replace the microbiome I murdered.

    The indication is that they will stay a little leaner for a while but for how long?

    Our viscera are the ultimate selective pressure lab. If you live to 80 with enough dietary changes you might be the oven baking up a whole new species of opportunistic bacteria….twice.

    So how long is a B to F population shift gonna take and to what it is a response?

    The researchers are freaking out over how “counter intuitive” it is that fat people have a high energy harvesting gut flora profile while lean people do not.

    Nothing counter intuitive about it, obese people have a much higher demand.

    Lance Armstrong’s resting heart rate was 17.3 bpm compared with John Candy’s at 125bpm (now zero).

    The Flora just flourish or flounder in proportion to intake and metabolic rate.

    They are too simple to be tricked by whatever crap they sell at GNC which means we have to lay off the bacon bombs and buy a bicycle, to wit: Do hard stuff.

  21. #21 sinned34
    August 13, 2010

    Uqbar,

    I took your challenge (retroactively), starting about 18 months ago. I stopped drinking sugary (soda) pops, cut the amount of meat I eat in half (and do not make up the difference in other foods), no longer snack on salty or sugary snacks, and I brown bag it to work instead of eating out all the time. I did not increase my activity rate at all (I’m a sedentary computer tech who plays hockey once a week in the winter).

    In those 18 months I’ve gone from 230 lbs to 195 lbs, and I’m just above 5’11″ tall. I’m constantly getting compliments on how much better I look, but nobody believes me when I tell them how I lost that weight.

    Shit, I guess Abbie may have been correct after all…

  22. #22 stripey_cat
    August 13, 2010

    My own experience suggests that if I restrict my calories into the weight-loss range and increase my exercise I faint. A lot. And get hypothermic easily. And go to sleep on my feet. (No more than two at once!) There’s (for me, and I suspect for many people) a very narrow target window of “losing weight” between “maintenance” and “shutting down systems”. Hitting it is challenging, and requires a pretty good guess of what your calorific expenditure will be for the forthcoming day. It also, in my own experience, exacerbates mood problems – dieting and suicidal isn’t a joke in any sense.

    Also, while raw ingredients are (sometimes) cheap, ready meals and such require so much less time and fuel to prepare that they often push your meal into the cheaper bracket. (For the record, I cook fairly well for myself, and my weight has been steady at mildly overweight for years; but I’m not inclined to attribute this to much beyond lucky circumstances and a good domestic education.)

  23. #23 Kevin
    August 14, 2010

    @prometheus:

    No doubt. I don’t disagree with you at all. I think the thing that is so interesting about this study is that it was the behavioral effect first, and the microbiome change came along for the ride and potentiated the already bad behavior.

    But I think it’s important for the people who think the simple formula, “calories in, calories out,” describes everything about weight gain/loss. The take home (from my perspective) is that two people with the exact same diet and the exact same exercise regimen will not necessarily have the same outcomes. That said, it’s no excuse for shirking responsibility for personal choices or thinking a magic bullet will solve everything.

  24. #24 Prometheus
    August 14, 2010

    Kevin,

    This one might interest you.

    http://www.biomedcentral.com/1471-2180/9/123

  25. #25 Rob
    August 15, 2010

    While I don’t disagree with any of the author’s points, or even conclusions, I do have a slightly different point or two to make.

    Some time ago, years now, I saw a show on PBS that discussed a hypothesis that the “missing calories” (between intake and daily use) could be accounted for by looking at what the average person expended as recently as 100 years or so ago – even here in the US. When the researcher added up, to the best he or she could, how many calories it took to walk to wherever, farm, deal with livestock, churn butter, that they all added up to another 400-500 calories per day and more or less offset all the yo-yoing of excess caloric intake, dieting, and so on.

    I don’t believe that we’re ever going (voluntarily anyway) return to doing things ourselves if and when there’s 1) an easier way 2) a way that is faster 3) ways where there’s money to be made by making things that do things easier and faster. What I do believe could be a magic bullet of sorts in the war against obesity (that war word… like the war against drugs) is a simple one: help people find things they will do simply because they are fun, that burn up calories. For our group and people like us, action sports types, it’s things like biking, surfing, skiing, etc.

    Speaking for myself, I have messed up countless areas of my life ranging from my personal finances to relationships to my weather beaten, sun damaged skin. But the one thing most of us frequent surfers, skiers, and bikers haven’t a problem with, is the so-called metabolic disease progression, which seems to have a locus of excess weight.

    Again, I am not saying we are completely health, indeed, the most extreme in our “tribes” are, more or less, nuts. I am simply saying that we’re not obese.

    You can see one of our websites (the cycling one) and see what we’re up to at http://www.bikeskills.com

    Rob

  26. #26 embertine
    August 16, 2010

    I love how emotive this topic is for some people. I’m a fat b*tch, and I got that way by eating too much and having a desk job.

    I’m now only 10 pounds overweight, having lost 20 since the beginning of the year. I did it by eating less and going to the gym. And yes, I was hungry sometimes.

    While I certainly think that education about food, combined with responsible marketing, is a huge step in helping obese people help themselves, the first step for me was facing the fact that I DID THIS TO MYSELF.

    Calories in, calories out. It’s not rocket science.

  27. #27 Prometheus
    August 16, 2010

    embertine,

    “I’m a fat b*tch, and I got that way by eating too much and having a desk job.”

    Yay. I now like Embertine

    There are lot of variables. Maybe the bowling ball on the teeter totter is the B and F gut flora ratio or maybe thyroid or complex carb uptake versus simple sugar or sleep patterns or gremlins.

    Or any combination of the former, with the gremlins.

    But those are minor variants on the major theme of calories in, calories out you recited.

    While interesting and potentially helpful unless the researchers qualify the hell out of these studies they are going to get knee jerked into an Oprah wonderdiet.

    While we are waxing anecdotal….

    I had a secretary that complained about being overweight. I told her to take the casters off her chair. She lost 25 lbs that year and announced “I was spending a third of the day in a wheelchair!”.

    I know a lawyer who was orca fat who took out his desk and installed a standing bar around the walls of his office. He is thin now and he said a pedometer indicated he did 7 miles a day just circumnavigating under the florescents.

  28. #28 violet
    August 16, 2010

    I must repeat: Turning an issue that is hard but is under personal control into something that is easy but not under personal control is bullshit.

    But so is ignoring environmental factors entirely. Look, I know for a fact that I ate differently when I lived in Berkeley and had no money, versus when I lived in the suburbs, versus when I lived in the city. Maybe I’m a totally unique snowflake, but it would be quite surprising if that weren’t indicative of a larger trend. Food access matters. Improving food access helps.

    What doesn’t help, generally, is telling people on the Internet that gosh, if they only exercised more and ate less, or if they had only had your mom while growing up, then they wouldn’t be such fucking fatties. Admittedly, I haven’t done a study (perhaps someone should), but I have a suspicion that shaming statements along those lines have zero or negative value in terms of actually getting the effect you want—which is, I presume, people getting healthier.

  29. #29 ohknow
    August 17, 2010

    Uqbar:

    The point of my challenge is this: The connection between “feeling hungry” and weight is not straight-forward. However, by reducing your weight by 10% you will have to eat less than you normally do and you will “feel hungry.” See how long you can keep this up. I doubt you can do it long enough to lose 10% of your weight.

    I dropped the unhealthy parts of my diet – soda, mayo, etc – and started eating reasonable portions about a year ago. I went from 240 lbs to 190 lbs at 5’11″. That’s almost 21%.

    I also did this on a salary that is a little over half the average American income.

    You are a jackass.

  30. #30 daedalus2u
    August 17, 2010

    I agree that the microbiome is important, but the gut is not the only place there are bacteria that are important. The bacteria that live on the external skin are important, I think even more important than the bacteria in the gut. The skin bacteria set the basal NO/NOx level and that sets a very large number of things related to energy status, immune system, mood, and sleep cycles.

    http://books.google.com/books?id=a3mwmXzpsjkC&lpg=PP1&pg=PA103#v=onepage&q&f=false

    Weight gain is a setpoint issue. If you eat more calories than you expend, then you will gain weight. The body is pretty efficient and the conversion of excess calories to depot fat is pretty efficient. In other words, every pound of excess fat represents only 3500 calories. It doesn’t matter when you eat them, or over what time frame or even whether the calories are fat, carbohydrate or protein. Your body can only store the excess as fat, so that is what it does.

    If your “setpoint” is off, then unless you eat enough to satisfy it, you will feel like you are starving. It is difficult to starve oneself to death while food is available.

  31. #31 daedalus2u
    August 17, 2010

    I looked through the paper and through the supplement. No where do they mention the size or weight of any of the children.

    Since they don’t consider any other explanations, not a surprise they conclude gut bacteria are what are most important.

  32. #32 davidp
    August 17, 2010

    beardedbeard is right, especially “AND NO SNACKS”. My wife achieved no snacks or soda, no dessert plus moderate incidental exercise (ride to school with kids, walk to shops) and lost 12Kg – well over 10% Uqbar. She’s asking “where should I stop?” But snacks are too yummy, they give me pleasure, I keep wanting them (sometimes to cheer me up) and they’re very more-ish, so my weight loss stopped at 3kg. I am really impressed by my wife’s willpower, but that’s probably just an excuse.

    Pettylinguist, try find a way to make getting to/from work give you exercise. I combine a bicycle and a train. I virtually never exercise for its own sake or for fun, and I add about 10 minutes a day to my travel time but get over an hour’s exercise. Admittedly the U.S. tendency to no sidewalks and malls/stores/work miles from anywhere make this harder than in Australia where I live.

    Hunger, in our societies, is also a setpoint issue – we make our bodies/stomachs used to having lots of food in them all the time. Exercising makes me tend to eat more. Once I am doing that, stopping exercising (e.g. because I’m unwell) leaves me wanting to still eat the larger serves I’ve got used to – the stomach’s setpoint insists on it.

    Almost everyone gains weight as they age. We have lower metabolic rates, get less exercise, and have often have more access to food, especially snacks. I was slender at 25, but have gained gradually. Nowadays it takes intentional action to not gain weight. I think I need more fun videos (and friends) to replace snacks when I feel blah.

  33. #33 daedalus2u
    August 18, 2010

    daviddp, you are mistaken. The metabolic rate of obese people is higher than the metabolic rate of thin people. When obese people lose weight, their metabolic rate goes down. When thin people gain weight their metabolic rate goes up.

  34. #34 skeptifem
    August 18, 2010

    No honest talk about what “really” causes obesity can exclude psychology and behavior. You have no idea how it works, and neither do I. To what degree is our behavior determined by influences (internal or external)? Does it have something to do with why almost no one who loses significant weight keeps it off for more than five years?

    When a patient comes into a doctors office and is weirdly thin they may get a talk about eating disorders or at least be screened for them, referred to a psychologist and has their primary medical complaint checked out. Thin people who don’t exercise are not under as much scrutiny as overweight people who do, despite how this clashes with evidence about what should prompt concern over cardiovascular disease. Fat people who go to doctors get all kinds of crazy shit blamed on their weight, don’t get the same kind of diagnostic testing/treatment as a result, and get guilt tripped about their laziness instead of referred to a psychologist when they feel out of control with their eating and say so. This doesn’t work. People are still getting a lot heavier and very few lose significant weight permanently. Theres a big clue of how well “just don’t eat so much, fatty” does to help anyone lose unhealthy weight. People who really do give a shit about public health never talk about it in the shame inducing way so many people here have. You all just want to feel better than other people. How petty.

    Forgive me for having no sympathy for people who prefer a 12 pack of Pepsi ($5), a bag of Doritos ($4), and a bag of peanut butter M&Ms ($3) or one drive-through dinner ($8) over a dozen eggs ($2), onion ($0.50), green pepper ($0.75), potatoes ($1), orange juice ($2), wheat bread ($2), peanut butter ($2), carrots ($1), half gallon of milk ($2) (prices lower if you dont mind store brands or catch things on sale). I cant afford to eat junk food all day every day, but I absolutely enjoy it as a treat every now and then.

    Being poor is about being time poor. You work all the damn time at a low wage, you can’t bargain shop because you don’t have a car/time to do it, and a shitload of people in poverty eat out of the corner store specifically for those reasons. Those stores don’t have vegetables. They don’t have much that can be cooked, if the person has time (or things like a stove or stuff to cook in). “Prefer” isn’t what it is all about, but you frame it that way. It is because you don’t care about how any of this actually works.

    Why am I even trying? You always make such a huge effort to not understand what others are saying and try to mock what you imagine the position to be. Enjoy feeling righteous while everyone feels embarrassed on your behalf.

  35. #35 skeptifem
    August 18, 2010

    What does not help people do the easy step is piling on excuses for why they have no personal control over doing the hard step. Its not your fault! Theres an OBESITY VIRUS! Its not your fault! There are ANTI-OBESITY BACTERIA, and you just dont have them. Its not your fault! PEPSI BRAINWASHED YOU!

    So ERV, tell us all how much it did/did not help you when you were obese to be talked down to instead? You are the expert on what helps fat people, after all (don’t bother ASKING THEM or anything).

    It is all about your wanting to feel better than other people. Really, really transparent.

  36. #36 ohknow
    August 18, 2010

    Being poor is about being time poor.

    No, it’s not. It’s about not having money. Are you drunk or something? Maybe instead of spending your time writing a shitty blog, you could use that time to ride your bike to the store and buy some fucking apples. I definitely fit into the “poor” category and have very little free time, and I still find time to wander into the vegetable aisle at the store. Your list of excuses is exactly that…pathetic excuses.
    Society isn’t forcing you to do shit. A little personal accountability is what’s missing from the message. Less people suing McDonald’s and more people just not fucking going to McDonald’s every day is what will reverse this trend.

    So ERV, tell us all how much it did/did not help you when you were obese to be talked down to instead?

    I’m not erv, but I will say it helped me immensely! Shame and ostracism are powerful sociological forces. Being called “bitch tits” by your friends falls into that category. Before they started that, I didn’t even notice how shitty I looked and felt.
    The other side of that sociological coin is the absurd amount of praise and encouragement I received when I started to make noticeable physical improvements.

    Instead of making a list of excuses, maybe you should go outside and take your big fat ass for a walk. Everyone who has to look at you will be grateful.

  37. #37 davidp
    August 18, 2010

    daedalus2u, your correction is wrongly targeted. I was saying that our metabolic rate goes down as we age, not as we gain weight. If that is wrong (corrected for constant weight) please tell me. Certainly the middle age bulge is a pretty consistent observation, but the metabolic cause claim might be ill-founded.

  38. #38 ERV
    August 19, 2010

    skeptifem– Where did you get the idea I want to help? You commented on the post where I made it very clear that I dont want to help.

    I am, however, a blogger and a microbiologist. So I have no problem quoting the CDCs brand spanking new obesity stats (stating reality isnt ‘mean’, whether you are talking about obesity or religion, go bawww at the CDC if reporting the statistic that in nine states, over 30% of their population is OBESE), or addressing a scientific paper where the authors and the media have totally stretched their conclusions beyond their data, to the point where even the NHS feels it necessary to issue clarifications for the public.

    I did this before with adenovirus and obesity, and you didnt seem to mind.

    I do this with HIV-1 research over and over and over, and you didnt seem to mind.

    Why do you mind now?

    If you dont think the general public is going to get the idea that ‘obesity is caused by bacteria’, or ‘junk food causes allergies’ from this irresponsible science and journalism, thats fine, but dont act like Im doing anything wrong by correcting that perception, just in case there are people out there that do get this impression from these press releases.

    And, you shouldnt have bothered because someone else already tried to make the same ‘points’ as you. Theyre no less a failure now than they were the first time they were posted here. That has nothing to do with me.

    I do, however, ‘feel better’ than most people because of my diet and fitness attitudes. Do you think PZ feels good about thinking he just had a heart attack? Do you think Hitchens feels good about cancer? I think its bullshit that its ‘cool’ for skeptics to be overweight/obese, chain smokers, and drunks. And while you are giving people excuses not to even bother trying to lead healthier lives, I will happily be there to counter your position. Everyone can be a healthy weight and have a healthy relationship with food if they put forth the effort. Several people have commented on this thread about their own journeys.

    *shrug*

  39. #39 violet
    August 19, 2010

    skeptifem– Where did you get the idea I want to help? You commented on the post where I made it very clear that I dont want to help.

    Huh. So why did you? I don’t think skeptifem had an issue with you linking the CDC stats. I didn’t. It’s your microrant about the “Pepsi-Made-Me-Do-It defense”—in which, incidentally, you decide that the CDC is a great source while they’re saying things you agree with, but they’re obviously spraying bullshit when they say something you don’t—which is irksome. You aren’t an expert in the field of public health. You aren’t an expert when it comes to health management or weight loss; your opinion about how and why people are fat doesn’t carry any more weight than mine or my mother’s, but you decided, for some reason, to bless the world with it anyway.

    That’s fine. I mean, it’s your blog. But then you don’t get to say, “hey, I wasn’t trying to help”—unless, that is, you would like us to conclude that you were saying something unhelpful and, frankly, untrue just for fun.

    I do, however, ‘feel better’ than most people because of my diet and fitness attitudes. Do you think PZ feels good about thinking he just had a heart attack? Do you think Hitchens feels good about cancer?

    That’s awesome for you. I dunno how PZ feels. Hitchens says he would do it all again (is that just to make himself feel better? You’d have to ask him.). I, personally, am much happier more-or-less ignoring diet and fitness than I was worrying at either or both, and judging from the neuroses and disorders of those around me, I think a fair number of people would benefit from giving far less of a fuck.

  40. #40 ERV
    August 19, 2010

    Yes, violet, sometimes people and organizations say both things I agree with, and things I disagree with… I dont know why you think this is shady or odd…

    I stated exactly why the “healthy food is too expensive!” and “advertising brainwashed me!” is bullshit. You do not need a Masters in Public Health to see price tags in a grocery store and do basic math. You do not need a PhD is physiology to know that subliminal messaging and brainwashing are bullshit.

    But ‘junk food is cheap!’ and ‘PEPSI MADE ME DO IT!’ are common excuses for obesity. Excuses even the CDC uses… when fundamentally, the problem of eating too many calories and leading sedentary lifestyles are to blame. Do you disagree with me on this point? Do you think overweight and obese people are not eating more calories than their body requires? Do you think obesity, in its entirety, is really the result of our microbiome or viruses?

    Or do we actually agree– People eat too much and dont exercise. But I think people are in control of this, and you want me to be ‘nicer’ and give people excuses for inaction regarding that fundamental fact?

  41. #41 violet
    August 19, 2010

    Or do we actually agree– People eat too much and dont exercise. But I think people are in control of this, and you want me to be ‘nicer’ and give people excuses for inaction regarding that fundamental fact?

    I think, on the individual level, that telling people they’re fat fucks who need to eat less and exercise more has highly limited value, and not insubstantial potential for harm. And whatever value it might have has probably been exhausted by the entire rest of the media universe. I mean, that message is out there. It borders on the fantastic to imagine someone in the U.S. who doesn’t know that they’re fat and need to eat less and exercise more.

    And then, on the macro level, I’m not sure it’s helpful at constructing policy or directing activism. Why is health so closely correlated to class in the U.S.? What environmental, social, and political changes might be useful in improving poor people’s health? By your accounting, that’s… what, exactly? That poor people are lazy? I think there’s an outside chance that there’s more to it than that (and so, apparently, do the public health experts at the CDC).

  42. #42 skeptifem
    August 20, 2010

    But I think people are in control of this,

    good for you, that has nothing to do with the reality of it.

    and you want me to be ‘nicer’ and give people excuses for inaction regarding that fundamental fact?

    It is like you can’t conceive of a world where people have different priorities than you. Some people don’t give a shit about losing weight or being like you, they are happy just the way they are. You present fitness as if it is an issue of moral importance.

    I want you to stop being such an asshole to people who put up with the exact same message you give all day, every day. Strangers soliciting advice. Insults yelled from cars. Insensitive doctors. Don’t add to it, you really aren’t accomplishing anything outside of being a jerk, you are just adding to the heap of comments and advice that made fat people feel even shittier about themselves and didn’t make them thinner. You are kicking people who are down.

    You are also looking at only one side of the evidence science wise when it comes to fat. Kate hardings website has a lot of information about how being overweight is not necessarily a health problem in and of itself. How much we *don’t* know about how metabolism and weight work is the best evidence that I shouldn’t get all judgey about it though. If I don’t know for sure and I am an asshole about it anyway, I am also a dishonest asshole for behaving like that without proof.

    http://kateharding.net/faq/but-dont-you-realize-fat-is-unhealthy/

    there you go. Just give it a shot.

  43. #43 skeptifem
    August 20, 2010

    I do, however, ‘feel better’ than most people because of my diet and fitness attitudes. Do you think PZ feels good about thinking he just had a heart attack? Do you think Hitchens feels good about cancer?

    Uh yeah, I work in a hospital. There is a wide variety of reaction to health problems caused by preventable causes. You don’t know what you are talking about, at all. There isn’t a “correct” way to live, there is no right way for sick people to feel about their illness. If you walk around thinking that you are as flawed and problematic as anyone else in the world it is impossible to act the way you do towards others. You wouldn’t put fitness habits on this weird pedestal that makes the non-compliant fair game for your bullshit.

    I wasn’t even talking about feeling better about you in that manner anyway, i was talking about feeling better about yourself in relation to other people. People with an internal source of self esteem don’t feel the need to put down others like this (because their self esteem isn’t conditional). If you understood this I can only conclude that you think people who have histories of unhealthy habits should feel really shitty about themselves in addition to being sick, which is something I completely disagree with.

    PZ didn’t have a heart attack, btw. He had symptoms, but the tests came back negative.

  44. #44 skeptifem
    August 20, 2010

    Kinda serial posting here, but this part from the kate harding blog really hit home:

    In any case, shaming teh fatties for being “unhealthy” doesn’t fucking help. If shame made people thin, there wouldn’t be a fat person in this country, trust me. I wish I could remember who said this, ’cause it’s one of my favorite quotes of all time: “You cannot hate people for their own good.”

  45. #45 windy
    August 20, 2010

    in many american rural areas, where fresh food might simply not be available in the first place

    Did you mean “urban areas”? I don’t know why this would be more of a problem in rural areas (with the exception of tundra or the desert)

  46. #46 Stephen Wells
    August 20, 2010

    I think erv’s point is that once everyone’s point of view has been understood, and everybody is very accepting of each other for who they are, and no shaming is involved, it is still the case that most obese people are obese because they eat too many calories and don’t move enough; this paper’s reaching for a “my gut flora made me fat” doesn’t take this into account.

  47. #47 windy
    August 20, 2010

    being overweight is not necessarily a health problem in and of itself. How much we *don’t* know about how metabolism and weight work is the best evidence that I shouldn’t get all judgey about it though.

    If empty calories aren’t making us fat and/or being fat is not much of an issue anyway, why are many people convinced (like in the discussion at GrrlScientist that ERV linked to) that Pepsi causes obesity and ‘hastens our deaths’?

  48. #48 Prometheus
    August 20, 2010

    skeptifem@#42

    “You are also looking at only one side of the evidence science wise when it comes to fat. Kate hardings website has a lot of information about how being overweight is not necessarily a health problem in and of itself.”

    Oh goody a Kate Harding link.

    Now Abbie’s blog has something in common with support forums where 22 year old women show solidarity against sizism by discussing the green cholesterol calculi sliced out of their gallbladders.

    *high five*

    My friend Sue was in surgery for several hours working on one of Kate Harding’s regulars just last week. The lady was having 70 thousand dollars worth of surgery for a condition that in a non-obese person is treated with acetaminophen and a heating pad.

    When Sue was doing post-op interview and suggested bariatric surgery (they were shifting the lady around on a Dayton engine lift) Sue got to hear all about Harding and how the National Association to Advance Fat Acceptance had changed her life.

    She was not sick anymore she was just healthy in a “different way” that conventional medicine refused to recognize.

    Sue smiled, said mkay then ran out into the parking lot to scream her outrage in my ear until her cell phone died.

    Kate Harding is a self serving idiot.

    Sumo wrestlers eat the healthiest diet around. chankonabe: Fresh veg, tofu, free range roasted chicken stew with a side of rice.

    They have a rigorous exercise regimen and their health is constantly monitored proactively for vitals range of movement etc..

    They still die 10 years sooner on average because they eat 20,000 fucking calories a day.

    They die because they are very fat and being very fat is to be de facto ill.

    Telling people what they want to hear and giving them reasons to avoid accountability for their actions is not how people get well. It’s how cult leaders pay their mortgages.

  49. #49 ERV
    August 20, 2010

    violet and skeptifem– I think its pretty clear to everyone here that you havent read this post or the comments on it, and this is simply your knee-jerk response to any post anyone would make on this topic. Other people here get the point of this post and others comments just fine, so my conclusion is that its you, not us.

    You have not cited or quoted one instance of me being ‘mean’ to someone who is overweight, yet you (and others with this knee-jerk response) have repeatedly accused me of– harassing ‘fatties’, calling people ‘fat fucks’ and ‘lazy gluttonous and just plain nasty fat people’, ‘poor people are lazy’, that I ‘put down other people’, etc.

    I have never, and would never do this, yet you insist upon characterizing me this way. Why?

    You have also moved goal-posts around with such ease, a Creationist would view this comment thread with envy. I havent commented on a couple dozen ‘topics’ you all have brought up because they have nothing to do with this post or the comments on it.

    At this point, I think youre both just emotional wrecks when it comes to talking about obesity, who dont really have anything substantial to add to this discussion.

  50. #50 zilch
    August 21, 2010

    I’m sixty, and when I grew up, in El Cerrito, near SF, I didn’t know one single kid who didn’t walk to school. The streets were full of kids playing and people walking to the store or to visit friends.

    Nowadays, the sidewalks and streets are empty of pedestrians. Kids are driven to school, and if they play outside, they are invisible: even the park near my parents’ house is usually abandoned nowadays.

    I notice this especially strongly because I have been living in Europe for thirty years, and only going back to visit occasionally, so the change is striking. I suspect this change from kids being relatively active to being relatively sedentary, in just the last fifty years, is a big part of why Americans are becoming so obese. Unfortunately, Europeans are doing their best to catch up.

    cheers from crickety Vienna, zilch

  51. #51 SK
    October 13, 2010

    You oversimplify the problem.
    It is quite true that through personal responsibility a most of the overweight and some obese individuals would go into the recommended range.
    But you underestimate the potential of the body to self regulate. When the balance shifts behavioral changes would get you next to nothing.
    There are Mendelian mutations (FTO) that have nothing to do with personal responsibility. Same could be true for other factors, including microbiome.
    Finally, taking personal responsibility will always work for a relatively small part of the population. It’s the nature of the beast (mankind that is).

  52. #52 Susann Eskew
    March 7, 2012

    If empty calories aren’t making us fat and/or being fat is not much of an issue anyway, why are many people convinced (like in the discussion at GrrlScientist that ERV linked to) that Pepsi causes obesity