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Eating is no longer a simple matter of eating nutrient rich food. (Photo by Stefan Sauer / image alliance via Getty Images)
Food is a language we all understand.
Along with touch, it is the way we are invited into our physical body moments after we are born.
We are designed to seek nourishment in many forms — for pleasure, strength and growth and development. Amazingly, this simple, basic fact of life and modernity has turned out to be the root of much of our well-being.
And while our waistlines are much wider, our nutritional deficiencies as well as disease burden are heavier.
In the latest investigation into the food intake and nutrition of South Africans, the Human Sciences Research Council looked at 100 variables affecting a cohort of 34 000 people.
It found that 69% of obese adults lived in resource-constrained households, where food options lacked nutrients. 30% of women of reproductive age are iron deficient.
More than half of the world’s population is vitamin D deficient. More than two-thirds of women are obese or overweight. KwaZulu-Natal had the highest incidence of obesity, at 39.4%.
At the same time, 4% of women will be diagnosed as anorexic in their lifetime, and a much larger percentage will fall on the spectrum of disordered eating habits and body dysmorphia.
Too much of anything is not a good thing. Your fat cells are metabolically active, and while we all need some subcutaneous fat for hotter and colder days, and a cushion to break a fall, excess genital tissue contributes to an inflammatory soup coursing through your veins and all organs are affected.
Regulation of the nervous system is a central concept in popular wellness culture today. Everyone is thinking about his vagus nerve.
We are all familiar with the accelerators and decelerators of the nervous system. What the body ends, it also goes down and somewhere on that fulcrum there is a harmonious balance that keeps your heart beating and your psyche mostly serene.
This is, of course, in ideal circumstances or in a mind that reigns psychic maturity and perspective. The mental health crisis, where more than a third of South Africans have received a common mental health diagnosis during their lifetime, makes the serenity of this balance increasingly understandable.
Many pieces contribute to this great decline, but crisps and chocolate are a common response to physical and psychological ailments.
Since fast food and junk food are the cheapest and easiest to find, self-indulgence with refined carbohydrates is even easier than self-indulgence with alcohol.
I feel like a broken record going on about the food and advertising industry and how they contribute to this burden of disease.
How often do you see a billboard of a muscular, toned human body, enjoying a bowl of organic spinach or munching on a carrot? No, the images idealize alcohol, burgers, chips, sugary drinks and vapes. They are even starting to glamorize bodies that carry unhealthy excess tissue.
Cultural norms should not shift towards diabetic bodies with hypertension and heart disease. I know this is delicate ground. There are so many factors that contribute to body shape, but if we only age 50 and compare, we are really changing shape — and not in a healthy way.
It’s no accident that Big Pharma is among the other major arms of the capitalist beast fueling this problem, with a side order of anti-depressants and a needle full of appetite suppressants. Saves for the diseases that spread our food system.
One of the challenges we face when treating psychiatric illness is the adverse metabolic effects associated with most of the drugs in this arsenal.
For patients whose mood symptoms may be linked to their body image or an underlying inflammatory problem, adding an antipsychotic or antidepressant will often result in weight gain.
And what about endocrine disruptors? These molecules can mimic our endogenous hormones and stimulate or block the receptors they act on. According to the Endocrine Society, there are nearly 85,000 human chemicals in the world, and 1,000 or more of these may be endocrine disruptors.
This discovery began when studying the harmful effect of the drug diethylstilbestrol, which was administered to pregnant women to prevent miscarriage. This woman’s baby girl suffered from a rare form of vaginal cancer.
Many links and associations have been drawn between conditions such as attention deficit hyperactivity disorder, cancer and certain chemicals we are all exposed to through skin, diet, air and water.
What makes these associations difficult to prove is the multifaceted influences of the disease profile.
Another contributor could be the steroid hormones we are exposed to through our water systems. There is concern over the levels of sex hormones excreted through the sewage after a study looked at the femininity of aquatic life. More and more data is being collected to reveal a new type of pollution that few of us think about.
Designing hyperpalatable foods is a career option for adults and children that did not exist before the obesity pandemic. Perfect combinations of fat, salt, sugar, crunch and unnaturally occurring carbs are messing with our satiety signals and tricking our brains into wanting more.
The jury is out on whether we can compare drug addiction to food addiction.
In rodent experiments, healthy cocaine-addicted rodents will choose a sugary drink over a dose of cocaine.
Our brain’s reward system is designed to seek out calories to fuel us against leaner times. Hyperpalatable food not only fosters unhealthy bodies, but reduces cognitive function, memory and learning – especially in the developing brain.
According to the World Health Organization, the global prevalence of obesity has doubled from 1990 to 2022. Other than our environment, what could be the reason for that increase? Twin, family and adoption studies have estimated the heritability of obesity to be between 40% and 70%. But it probably represents less than 5% of the increase in the current burden of disease.
We also know that less than 5% of other chronic diseases are heritable, so it feels too convenient to blame obesity solely on evolution.
We know that our genes load the gun, but our environments and choices pull the trigger. We can turn off obese genes by choosing lifestyles that support healthy bodies.
When we use our bodies the way they were designed to be used (moving, performing, dancing, jumping); When we seek nutrition for the amino acids and fatty acids that our bodies need for basic health, then we turn off these obesity genes and prevent diseases such as hypertension, diabetes, depression and cardiovascular disease.
When a body is obese for a long period of time, it becomes almost impossible to lose the accumulated weight. the body keeps on fat. Given a reduced calorie diet, an obese body will increase its appetite for extra calories and slow its metabolic rate.
The battle against weight loss for an overweight body is real and measurable. The discomfort of carrying extra weight on your joints is real and measurable. The impact of obesity on the patient’s quality of life is profound and enormous.
We have a responsibility to our children and our species to stop the engines that feed this indomitable beast. Say no to Coca-Cola and fruit juice. Do not add to deep fried chicken and processed meat. Say no to microwave dinners in front of the TV.
Say yes to the bounty and wisdom of the Earth. What you feed your body shapes your brain. We can no longer dumbing down.
Dr Skye Scott is a GP and co-owner of Health with Heart.
