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don's report archiveWellness in the Headlines
Tuesday September 17, 2002
The nicest thing about a nudist wedding is you don't have to ask - you can see who the best man is. The "average" American is fat. He knows he's fat, he knows why he's fat and what it would take to become non-fat. Knowing these things is not enough. If it were, all fat people would be slim by now and we would not read on a daily basis that 61 percent of the adult population is fat. What's to be done? For starters, it might help to simply things and in so doing eliminate some pernicious misconceptions. The latter often cause fat people to exercise too little, if at all. Another first step might be to give added attention to the fact that there is, in America, a crisis in the energy-balance equation. The energy (calorie intake and expenditure) balance equation is seriously out of whack. Americans are far more attentive to, devoted to, skilled about and otherwise focused on the intake side of the equation than the the expenditure side. Result: excess fat. Once this is clearly understood, the focus can shift to the next logical issue -- how to get more attention (and action) on the energy burning side of the equation? We all have genes and hormones that affect the energy-balance equation. Life is not fair -- some can burn more energy with less effort than others. In the distant future, there may be efficient and healthful ways to burn calories other than exercise (medications or fat-suction machines, for examples -- who knows?) but these techno-saviors are not coming to a retail outlet near you (or anyone else) anytime soon. The genes we came into this world with are not going to change. All manipulations must instead be made to the environment and to our lifestyles. Let's start with a focus on thermogenesis. Thermogenesis is the name given to the body's way of burning excess calories. As you might expect, some folks are genetically better at thermogenesis than others. The latter are the folks who become and remain obese, despite diet after diet. Some people have genes that are linked to obesity. These genes once provided an appreciable survival advantage but times (environments, actually) change; genetic markings that once conferred a benefit now function more as a curse. Such dysfunctional genes are referred to as "thrifty genotypes" -- they frugally prepare the organism for hard times by consuming and storing more calories than they expend. In short, they distort the energy-balance equation and make people fat. If food were scarce, this would be a good thing, but McDonald's and other fast food outlets are omnipresent so it is NOT a good thing. Until recently, the human biological system was more oriented to regulate weight by resisting weight loss than it was to protecting against weight gain. If we all exercised at levels most would consider exceptionally difficult (more than an hour daily of vigorous exercise), our systems would be exquisitely tuned -- and nobody would be obese. A person my size (6.2 and 175 pounds) would consume about a million calories a year and expend a million calories a year -- all without keeping track! The body would just do it, with the hypothalamus acting as the control center assuring an energy balance equation from cooperative genes and hormones (particularly leptin.) There is nothing to be gained by blaming the genes or the cruel hand of fate. If you are fat, you have to exercise more and eat less (and more wisely.) Dr. Walter Willett of the Harvard School of Public Health considers modern times at odds with the historic evolutionary pattern of energy-expenditure balance. It's a double whammy -- we are sedentary AND we live in a feedlot surrounded by a "cornucopia of food." Whereas our Stone Age ancestors had to chase breakfast, lunch and dinner in marathon hunts that sometimes lasted days, we sit, surrounded by prepared "game" and fruits, grains, nuts and all the rest. The ancestors moved (exercised) at extraordinary levels to obtain the game, wild fruits, grains and nuts, tubers and the rest. By contrast, we sit all day, every day, in a feedlot -- and wonder why we grow fat. We can't and would not want to go back to conditions of the Stone Age or anything remotely like it, but we better create equivalent activities or the feedlot will ruin us. Don't wait for society to change -- attend to your own energy-expenditure balance by exercising more. This will surely be difficult, but it is far more likely than the chances that you will eat less, living as you do in a massive feedlot. Be well, and always look on the bright side of life. (Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of exercise and fitness. Additional articles related to this theme may be found there.)
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