Our environment is obesogenic…

In

,

By

Yassine Damil

Episode 9

TL;DR
  • Obesity is on the rise worldwide, reaching 42.4% in the US in 2018.
  • One explanation is the obesogenic environment:
    • Urban infrastructures encourage a sedentary lifestyle, limiting active modes of transport such as cycling.
    • The food industry produces ultra-processed foods rich in fats, salt and sugars, to make them more addictive.
    • The omnipresence of vending machines facilitates access to junk food.
    • Advertisements for unhealthy food products, often targeting children, have a strong impact on consumption habits. But stricter regulation, as in Quebec and Chile, can be effective in limiting it.
  • Awareness of these stimuli is the first step towards solving the problem.

For today’s topic, I had the Oscar Wilde quote in mind, “I can resist anything but temptation”. And to make it less literary, when that annual ritual comes around where I realize I’ve drifted off with a few extra pounds and it’s time to pull myself together, I feel like I’ve been cast on Temptation Island. Except that it’s sugars and fats in all their delicious forms that are tempting me. And that junk food often wears you down…

Obesity on the rise

Let’s start with the hard statistics: worldwide, obesity1 is on the rise. The situation in the United States2 is one of the worst, at 42.4%. Nearby neighbors, Mexico3 and Canada4, fare better, at 36.7% and 24.3% respectively. By the way, 24% is also the European average but France5 and especially Italy6 are well below, at 17% and 10.4%. Not to mention Japan7 and its 4.5%… How could we be more alarmist? Well, consider that we could widen the scope to include overweight people: nearly 3/4 of the US population!

We won’t go into the reasons for the differences between countries here, but rather the explanation for the upward trend, i.e. the common factors, including the obesogenic environment.

More protective regulations can provide effective solutions

The obesogenic environment has been defined by Sunburn et al.8 as the “barriers (…) for the maintenance of healthy weight”. You know the drill, these are multifactorial: economic, socio-cultural and regulatory. Let’s illustrate:

  • First, consider our total energy expenditure. Needless to say, our urban societies are increasingly sedentary. But apart from a few initiatives here and there, the infrastructure is not very conducive to more active modes of transport. Perhaps I’m used to a Parisian lifestyle, but I’m always surprised to discover that in some cities with large populations it’s not possible to have all amenities within walking distance. It’s partly a question of density, of which Paris is a true model. Even when you consider cycling, you soon find yourself squeezed between a bus and a truck, due to a lack of dedicated and, above all, continuous infrastructure: it’s not the 2 miles stretch on your route that’s going to reassure you for your children…
  • But let’s talk above all about the agri-food industry, which rakes in over 9,000 billion in revenue worldwide in 20239, and which has never stopped reducing its production costs, by introducing more and more additives into already ultra-processed foods10. This new generation of food products high in fats, salt, and sugars, an explosive cocktail that can be described as junk food11 (high in calories and low in nutrients), has been formulated to thwart our natural mechanisms (notably satiety) and make them more addictive.
  • The introduction of nutrition facts does have an influence on our consumption habits, but even this can be circumvented by additives. I’m thinking in particular of sweeteners, whose health risk we don’t know very well, but is certainly not “zero”12.
  • Our urban environment is geared towards impulse buying of these high-calorie snacks: sometimes you literally can’t take 100 steps without coming across a vending machine (just think of public transport or the office café area). And the best sellers are rarely apple wedges (when there are any!). I was even recently surprised to come across one in the waiting room of a hospital, a so-called ‘health’ establishment. Fortunately, in France we managed to ban this from schools back in 200513, but unfortunately it’s not a widespread practice, even in Europe.
  • And what do you think of these oversized portions? Frankly, when the cup you’re offered for a latté is more grande than your mug, there’s a problem! And go and ask an Italian for an americano…
  • And let’s not forget the relentless advertising surrounding food products, which has been undermining us since our earliest childhood. In fact, advertising aimed at children focuses almost exclusively on products with very low nutrient density (Nutri-Score ratings of D or E, which are the lowest). The commitment of certain manufacturers14 to shift their marketing towards healthier products for the under-12s seems like wishful thinking, with ‘healthy’ criteria that are too loose. There are, however, some very interesting government initiatives. In Quebec, a law15 from 1980, the first of its kind and updated in 2023, prohibits the marketing of fast food to children under 13, which has enabled the province to maintain one of the lowest obesity rates in the country. Even better, in Chile, a more extensive ban (no more mascots on cereals!), started in 2016 and extended in 2018 has been very effective according to a 2023 publication16: a 64% drop in advertising for unhealthy food products! I don’t know about you, but I well remember buying a particular brand because it had toys in it…

Stimulus awareness too

There is some good news in all this, though. It seems we can strengthen our resistance to these ubiquitous food cues. A 2022 study17 conducted by UCSD, U Michigan, and Brown universities in the US has shown that personalized strategies can help.

In this study, several groups of overweight or obese people received different types of coaching. One group received “Regulation of Cues” coaching. This group learned to recognize the situations and thoughts that drive them to overeat, and to use techniques to reduce their reactivity to these cues.

Remarkably, while this group lost a modest amount of weight during the trial, they continued to lose weight long afterwards. They didn’t have to watch their food intake or restrict their energy intake. Instead, they focused on understanding their internal hunger cues.

Remember, obesity is a multifactorial topic. I’m convinced that part of the solution lies in regulation, because we can’t let these food manufacturers manipulate us chemically and emotionally. The other part of the solution lies within us: greater awareness is already a good start, and that’s even the aim of this podcast series and the Libra Wellness Assistant. Other topics could be explored, such as emotional eating, Non-Exercise Activity Thermogenesis or NEAT, or even going green (outside)…

Here’s a personal hack: don’t let “the fox into the henhouse”. Let me explain: when I’m in a readjustment phase (i.e. losing fat and maintaining muscle mass), I simply don’t buy high-calorie foods anymore. Of course, I could work on my willpower, but we saw in the Episode on Decision Fatigue that it’s pointless to exhaust your mental capacities in this way…

Fun Fact

The oldest known18 vending machine actually sold holy water. It was designed by Heron of Alexandria, and used an ingenious system whereby a coin was exchanged for libations (offerings to a deity).

Going further

References

  1. https://www.who.int/health-topics/obesity ↩︎
  2. https://www.cdc.gov/nchs/about/factsheets/factsheet_nhanes.htm ↩︎
  3. https://data.worldobesity.org/country/mexico-139/#data_prevalence ↩︎
  4. https://data.worldobesity.org/country/canada-36/#data_prevalence ↩︎
  5. https://data.worldobesity.org/country/france-71/#data_prevalence ↩︎
  6. https://data.worldobesity.org/country/italy-102/#data_prevalence ↩︎
  7. https://data.worldobesity.org/country/japan-105/#data_prevalence ↩︎
  8. Swinburn B, Egger G, Raza F. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med. 1999;29(6 Pt 1):563-570. doi: 10.1006/pmed.1999.0585. https://pubmed.ncbi.nlm.nih.gov/10600438/ ↩︎
  9. https://www.statista.com/outlook/cmo/food/worldwide ↩︎
  10. https://en.wikipedia.org/wiki/Ultra-processed_food ↩︎
  11. https://en.wikipedia.org/wiki/Junk_food ↩︎
  12. https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline ↩︎
  13. https://www.santepubliquefrance.fr/determinants-de-sante/nutrition-et-activite-physique/documents/rapport-synthese/exposition-des-enfants-et-des-adolescents-a-la-publicite-pour-des-produits-gras-sucres-sales ↩︎
  14. https://bbbprograms.org/programs/all-programs/cfbai ↩︎
  15. https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating-strategy/policy-update-restricting-food-advertising-primarily-directed-children/proposed-policy.html ↩︎
  16. Dillman Carpentier FR, Mediano Stoltze F, Reyes M, Taillie LS, Corvalán C, Correa T. Restricting child-directed ads is effective, but adding a time-based ban is better: evaluating a multi-phase regulation to protect children from unhealthy food marketing on television. Int J Behav Nutr Phys Act. 2023;20(1):62. Published 2023 May 26. doi: 10.1186/s12966-023-01454-w. https://pubmed.ncbi.nlm.nih.gov/37231508/ ↩︎
  17. Boutelle KN, Eichen DM, Peterson CB, et al. Effect of a Novel Intervention Targeting Appetitive Traits on Body Mass Index Among Adults With Overweight or Obesity: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(5):e2212354. Published 2022 May 2. doi: 10.1001/jamanetworkopen.2022.12354. https://pubmed.ncbi.nlm.nih.gov/35583870/ ↩︎
  18. Sherwood AN, Milorad Nikolic, John William Humphrey, John Peter Oleson. Greek and Roman Technology: A Sourcebook of Translated Greek and Roman Texts. Routledge, An Imprint Of The Taylor & Francis Group; 2020. https://www.routledge.com/Greek-and-Roman-Technology-A-Sourcebook-of-Translated-Greek-and-Roman-Texts/Sherwood-Nikolic-Humphrey-Oleson/p/book/9781138927896# ↩︎