A provocative editorial ran in the British Journal of Sports Medicine recently claiming one important point about obesity and weight loss: it’s not because we don’t exercise.
If you look at physical activity levels across countries with a high or low prevalence of obesity, there isn’t much difference in daily calorie expenditure. For example, one study from 2012 compared energy expenditure levels of a hunter-gatherer tribe in Tanzania, called the Hadza, with “Western” populations. After controlling for body size, researchers found no difference.
Further, the editorial’s authors, which include well-known physiologists Tim Noakes and Stephen Phinney, argue we should drop our focus on a “healthy weight.” Why? There is no such thing, and as we’ve seen in research (and as I’ve written about before), weight is a bad indicator of health. In fact, one can be a “healthy weight,” while at the same time have markers of metabolic dysfunction. As they point out in the article, a significant proportion of “normal weight” individuals can possess markers for metabolic syndrome and heart disease, such as high blood pressure and high triglycerides. They state this figure is as high as 40%, but the reference they provide doesn’t back this up (something critics were quick to point out). Though there is research suggesting the figure could be around 30%. Either way, the phenomenon is possible and prevalent. The extent of which is, however, still somewhat debated.
Instead the editorial argues for a much stronger focus on “the type and amount of calories consumed.” The type of calorie is the major point here, with a big emphasis on sugar and refined carbohydrate. Despite overwhelming science that shows “sugar calories promote fat storage and hunger,” there’s still a big focus on calorie counting, fueled in part by successful industry PR, the weight loss industry, and reinforced by leading public health organizations and foundations.
It’s these so-called empty calories that are fueling a wave of disease across the globe. One study using data from 175 countries found that an increase in sugar consumption equal to about one can of soda per day was associated with an increased diabetes prevalence of 1.1%. Another review found that people who consumed the most soda and other sugar drinks had a 20% greater risk of developing metabolic syndrome and a 26% greater risk of developing type 2 diabetes compared to those who consumed the least.
The editorial does rightly point out that physical activity and exercise have a lot of health benefits. There’s no argument there. And we shouldn’t discount these benefits. But, when it comes to weight loss, as they state in their title, “You cannot outrun a bad diet.”