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Just a spoonful of sugar, to help the obesity epidemic go down

Kamal Mahtani
Last edited 19th October 2011

Teaching on an Evidence Based Practice workshop recently I came across a truly jaw-dropping projection. A participant used a clinical scenario about obesity to bring up a paper about the US Obesity epidemic.The study is three years old now, but the authors use data on adults and children from the National Health and Nutrition Examination Study (NHANES), between the 1970s and 2004. The projections are frightening for the burden and health-care costs of obesity and overweight in the US if current trends continue. By 2048, all American adults would become overweight or obese. Depending on your ethnic background it could even be worse with the authors stating that Black women and Mexican-American men are likely to reach that state even earlier. However, the authors point out that they make a number of assumptions. Firstly they assume that the increase in obesity will be at its current rate. They also ignore the effect that all future policy, environmental and behavioural changes may have. Finally they ignore the possibility that some individuals may be genetically protected from becoming obese.

In the UK the predictions are not that much better. A recent four part series on obesity in The Lancet journal included a paper co-authored by Professor Klim McPherson of The University of Oxford. Their study stated that by 2030 there would be an additional 11 million more obese adults in the UK. This would have a knock on effect of an extra 6-8 million cases of diabetes, 5—7 million cases of heart disease and stroke and approximately 600,000 additional cases of cancer. This sort of news travels fast with The Daily Mail being one of the first to report these finding to the public.

So is it all doom and gloom? Not necessarily. In the same paper the authors go on to suggest that a 1% reduction in BMI (equivalent to a 1kg loss) across the entire population could avoid up to 2 million incident cases of diabetes, nearly 2 million new cardiovascular disease cases, and 73 000–127 000 cases of cancer. The authors further infer that this could be achieved through a reduction of 20kcal/day sustained over 3 years i.e. less about a teaspoon of sugar a day. Better still, if we were all able to give up 200 to 400 kcal/day, obesity levels would drop to 1990 prevalence levels.

So small changes may be the best way to start beating this epidemic. Something to think about before adding that spoon of sugar to your next tea or coffee.

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