Very much observable in the US, where rural and suburban population never WALKS. You need to supply artificial sources of movement (aka sports) to make up for the delta.
In cities, you walk more by default - your baseline energy expenditure is higher. Take the stairs to the subway, walk to work, get out for lunch ... all of that counts.
Driving around in your F150 and have everything as a drive through? You're the slob from the movie "Up".
Everybody was thin. It was sort of amazing when you stopped and really noticed it, then contrasted it to what you see on a day to day basis out on the streets. There just weren't any overweight people to be seen, at least nowhere near approaching the magnitude you see walking around today.
There's got to be some cultural component to all this too. I'm not sure the built environment is really all that much different than from what it was when I was a kid in the suburbs. It's as if people just collectively stopped using their bodies and started consuming more calories.
However, you do see more overweight people on modern films than in the 50’s. What’s really odd some characters where supposed to be noticeably overweight, but they don’t seem that way to modern eyes.
I don't think it's the industrialization so much as the quantity.
> bowl of Cheerios
carbs and added sugar
>whole wheat toast
better but still carbs
glass of sugar without fiber
better than juice and added sugar, but still natural sugars.
As others have said, it's an issue of quantity. Consuming 10-30 grams of sugar daily - table sugar, corn syrup, high-fructose corn syrup, or otherwise - does not cause obesity and health problems. The World Health Organization recommends no more than 10% of one's daily calories come from sugar. 
The average American consumes ! 125 ! grams of sugar a day, with empty carbs accounting for up to 40% of caloric intake . This 40% includes the simple, 'empty' carbohydrates found in processed breads, cereals, condiments, drinks - which are converted to glucose by the digestive system in minutes.
The amount - not the quality - of sugars in our diet is the problem.
The difference is, no one dumps a dozen teaspoons of sugar per serving in home prepared food and drink. Where drink and processed food manufacturers carefully buffer their recipes to accommodate the equivalent amount of HFCS.
 Read though that low end processed foods and drinks often contain very high levels of fructose.
That's the key. I have a low-sugar protein powder but rarely use it because it's too sickly sweet with sucralose and I have to bury it in a ton of other ingredients.
Go to almost any music festival, especially ones people love to hate on, and you will find lean young people from cities
Your conclusion can only be coincidentally accurate. Hot trendy folks go to music festivals. The BMI of whats considered hot has only gotten thinner since the 1960s.
OP's whole point is that everyone must have been lean and fit just because they were in a 50 year old documentary - about a music festival.
40 years later we’ve got laws against large sodas, sugar, vending machines. And maybe it is just the easier availability of all those calories - but I remember getting giant cokes at Carls Jr. in the early 70’s, the school cafeteria food was lots of carbs and fat and you could eat ice cream every day if you wanted to.
We all know that “Studies say exercise programs don't work because people don't stick to them.” But I think it misses the subtle difference between exercise as a planned activity and exercise thats built into your daily life. When I was young, we played in the streets every day. I walked or rode my bike to school. For my kids, that almost never happened. Everyone is inside. We drove everywhere.
But we also know no-one can stick to a diet. So “eat less” isn't the answer either.
So, whats the answer? Personally, I think its both. So, the answer is to build a little more exercise into your life. Walk to work or bike or learn to dance. Try to eat less - Maybe only eat 2/3rds or 1/2 of each meal. And avoid carbs since it stimulate hunger later.
But, it would be great to have an actual fact-based answer as to what has happened.
This would be inconvenient to the business models of Big Medicine and Big Food.
Good places to start an investigation are the official advocacy for replacing saturated fats with deodorized vegetable oils , the holy war against sweet forms of sugar (mix of fructose/glucose) instead of waging war on starch (chains of non-sweet insulin-stimulating glucose), the advocacy for chemical non-caloric sweetners (sucralose, etc), the contamination of the food supply with imitation foods (orange drink vs. orange juice, etc), and considering whether fortified grains is really the nutritional panacea it is supposed to be.
edit: added "non-caloric" and "sucralose"
I don't think you were having multiple channels with 24hours programming for kids.
I will grant you I'm smearing this out over time. Prime time shows in the 60s weren't the same as during the 70s, local TV cartoon hosts disappeared by about 1975 (no more Binky The Clown, or Cactus Jim or ...), and certainly what got re-run before network news and after 10 or 11pm local news changed.
This is totally ignoring the 6am - 12pm Saturday all-kids programming. Mostly badly-animated cartoons, some weird live-action ("Land of the Lost"), but all aimed at and advertised to children. You could waste all Saturday watching crappy animation, then reeling around because you had lost your stereoscopic vision.
Among children, it's more dramatic - with kids watching 4.5 to 5 hours a day in the 90's.
Such as, documentary producers had enough footage to exclude it from anyone who was not photogenic. Or the obese people who attended Woodstock didn't live to their 70s.
Yes. That's true. But that's not why the obesity rate is so high. We know this.
As for depression, fair play. But let's not forget that many insist exercise is an effective way to deal with depression. Let's also be mindful that excess weight causes hormonal changes that are also mood-altering. So perhaps your cause v effect - at least in a good number of cases - is in reverse?
Finally, I never said shaming, nor did I imply it. What I said was, if we're going to normalize certain behaviors for individuals then we should not be surprised when those things spread "virally" throughout the rest of the society. So, to your point, when we normalize food as a means for self-medicating depression we're not doing anyone any favors.
To clarify. I agree with your thoughts in general. However, they are the 20% (at best). What about the other 80%?
I also like to add, we're doing it "your way" and frankly, it's clear to see, it's not working. The medical costs associated with T2 diabetes is massive. In nearly all cases, T2D is generally preventable.
I don't think literally anybody is normalizing that. Everyone knows that's unhealthy. You won't get criticized for pointing it out.
> Finally, I never said shaming, nor did I imply it.
> Mention anyone else's unhealthy habits (e.g., weight or lack of exercise) and you're label a bully.
You specifically mentioned not just habits, but weight, as something to be criticized. I think we've gotten pretty good as a culture about encouraging the right habits, but the weight itself is what many people have limited or no control over.
For the last couple hours I watched a few dozen+ people order 20oz+ high-sugar coffee drinks from that place with the green logo. The everybody you're talking about is not here, nor is it at my local supermarket when every week I see people load up on soda, cookies, etc. People that clearly don't need the calories. So where is this awaremenss and knowledge?
> "the weight itself is what many people have limited or no control over."
Yes, I realize it's a fairly complicated issue (e.g., gut bacteria likely play a role). However, that doesn't mean we normalize unhealthy decisions (like the ones I've mentioned above) and then cry about the cost of healthcare. We can't openly promote "love your body no matter what" and then purposely fail to add "and btw, you're going to die younger." We can't deny the value of exercise and replace that with "beat your depression with ice cream. it's ok..." That's just not working.
Yes. Agreed. Some people have medical issues (e.g., some neuro meds are notorious for putting on weight) but that's not everyone. That doesn't explain the obesity rate. And that certainly doesn't prevent humans from "gravitating to the norm."
p.s. For the record, I drink my coffee black. And there's a good reason why I've learned to do that.
"1 in 5 kindergarten children in NYC is obese."
"Nationally, healthcare expenses related to obesity is $1.72 TRILLION, which is almost 10% of the GDP."
Eating less isn't "work". It's literally the opposite of work. (I understand that some people find this emotionally difficult.)
> Research suggests that for some people, genes account for just 25% of the predisposition to be overweight, while for others the genetic influence is as high as 70% to 80%.
Using Google also isn't "work", and neither is being considerate of others who don't have your exact same set of strengths and weaknesses.
Being considerate is great, but making excuses and pretending that the laws of thermodynamics don't apply doesn't help anyone.
For really rural areas where there is no “town center”—perhaps just intentionally park your car a good distance from wherever you’re going so that you have to walk the last bit of the way? (Sort of like the campaign a number of MTAs have going where they encourage you to get off one subway stop early and walk from there to your destination.)
You'd be borderline suicidal to do that regularly in the US.
I fear for anyone who bikes in a city without the infrastructure for it in the US.
It's also not so uncommon for their to be a trail with similar connectivity to the highway (lots of rail trails do this). I can ride to the next town/village over with about ¼ mile of actual highway riding. That's pretty recent, what with a casino paying for lots of trail and a new bridge being built on the US route, but there you go.
That is very much location dependent. You are right that some locations are extremely poorly designed for this. The cost/benefit of improving the designs isn't always obvious.
Biking to work in Mountain View was a pleasure and seemingly very safe. I'm now in a rural area with unmarked roads that barely fit two cars. The state highway between me and the nearest town has a paved shoulder that might be a foot wide. If I ride on it I commit the mortal sin of riding against traffic because I have a wife and kids and need to make eye contact with everyone coming my way before I even think of trusting them.
>commute between most suburbs and small town centres
I commuted to work on a bike every day in Mountain View. If I tried that from where I live now it wouldn't work in my favor.
I've almost hit bicyclists because I couldn't see them (their fault; black clothing with no reflectors) on both of those routes. You coudln't pay me enough to bike to work.
In a vehicle-bicycle/pedestrian incident at the posted speed limit, no matter who is at fault, it's the bicyclist/pedestrian who will be dead. If someone wants to be alive, as well as correct, they'd do well to make themselves as visible as possible.
But that's too practical a view to hold here on HN, I realize that.
EDIT - I just realized this is likely in response to 'their fault' in my original message. I stand by it though. Riding a bike at night on an unlit 50mph rural road with no reflectors while wearing black is, as the GP said, suicide by car.
You'd still be criminally at fault, and if you can't stop in time for a cyclist you're over-driving your headlights, but the cyclists would be well served by buying a back light for visibility. Keep in mind that wild animals can't, and they'll have roughly the same visibility as the cyclist.
Night, day, twilight - a bicyclist can only increase their likelyhood of surviving their trip by adding reflectors and wearing bright clothing.
It's pretty rare for somebody who hits a deer to be charged with reckless driving, so it's not like there is actually an absolute responsibility to never out drive your headlights.
Besides the legal aspects, anyone riding a bike after dark without any illumination is being irresponsible. Whether the car is at fault or not, it's not going to be the guy in the car who dies from it.
A car with high beams cresting a hill behind you. A car with high beams cresting the hill in front of you. An animal. A drink. A radio station change. A text message.
Reflectors make that big of a difference; they don’t look or move naturally, and thus play well to our night vision strengths, even to a distracted driver.
This is absolutely your fault. You're driving too fast for the conditions. You're the one who can't see what's ahead; you're the one who has to drive slower.
There's a baseline amount of exercise you're going to get regardless.
It's what and how much you eat that matters.
> There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
It's pretty widely accepted that nutrition trumps exercise in weight loss. I will say that my observations align with OP, urban lifestyles tend to be less sedentary then suburban/rural. But my observations could also be skewed by age differences, which presumably this study controlled for (didn't read the whole thing).
I spend a decent amount of time in a small (~3k) town in the American west that's the largest place for about two hours in any direction. It has one grocery store. Prices and selection in this (non-chain) store are genuinely appalling. Fresh fruit and veg is expensive and generally low in quality. As a result, nobody but the occasional out-of-towner fisherman buys it, so there's no incentive to stock more/better stuff. It's kinda like a slightly scaled up version of the basket of brown bananas in the bodega: a desultory corner of the store where there's visible dust on the apples.
What do many folks buy instead? TV dinners. Lots of them. It's not uncommon to see a cart in the checkout line that's nothing but about twenty TV dinners, cheap beer and maybe a loaf or two of wonder bread. Not everyone lives like that, but it's common enough that it's rare for me to leave that store without feeling kinda sad.
So, yeah, food deserts aren't just an urban problem.
n.b. on reflection, a partial counterexample: the Walmart in the nearest larger (~20k) town, despite having more produce and similar goodies on offer, also does a very brisk trade in TV dinners. Access to nutrition is probably relevant, but there's got to also be broader cultural/economic/wellness issues at play.
I've lost and kept off about half my bodyweight, so I feel entitled to the opinion that that's horseshit dreamed up by marketing to tell people what they want to hear. There is one definitive way to lose weight, time tested and provably infallible: consume fewer calories than you expend.
Now certainly there are some factors involved in both sides of that equation that can be adjusted by what you eat, but take it from a food addict that weight loss is most definitely more about how much you eat.
I hear a lot of people use the word the same as I do. It's not that I'm arguing "100 calories of kale will effect your weight differently from 100 calories of powdered sugar" or any other fad-diet nonsense. But I would certainly argue that one of those options will lead to eating fewer calories over the course of a day.
I notice that I have a baseline of appetite, hunger. Going below that makes me deeply uncomfortable. At the same time, I know that I don't need too much exercise to come to a calorie neutrality or slight deficit - but I can't reach that energy expenditure with a sedentary lifestyle.
If I do a 30min run every day, plus walk to work (another 30min), I spend enough calories so I can eat comfortably (still healthy).
A tracker like the Apple Watch helps to see this in action. Closing your rings in the city? Easy. Closing your rings while car centric? Hard.
People should not need to diet. They should spend enough calories to burn off excess food. Note I am talking about healthy BMI, not Instagram fitness model levels. Dad bod, etc. Not morbidly obese.
This is bad advice, it's been shown over and over again that in the long term people don't manage to lose weight by exercising. They give up, don't exercise enough, overestimate how many calories they burnt, over-compensate by eating more and/or unhealthier ('because I earned it after taking a run'), etc.
You don't have to 'diet' to lose weight, just try to eat a little less each day, and watch what you are eating. Only 100 calories less than what you need each day, and you'll steadily lose maybe ~3KG a year.
For weightloss _diet and exercise_ is the way to go: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429709/.
>Prospective studies, however, find little evidence of the more physically active members of a population gaining less excess weight than those who are the least physically active.
>TEE adjusted for weight and age or PAL did not differ significantly between developing and industrialized countries, which calls into question the role of energy expenditure in the cause of obesity at the population level.
Citing a bunch of studies about obesity changes nothing about the fact that _exercise_ is more important to health outcomes than _weight_.
Another source for you: https://care.diabetesjournals.org/content/27/1/83
> There was no significant trend across BMI categories for mortality after adjustment for fitness.
Being skinny isn't being healthy, being _fit_ is being healthy.
This is pretty funny. They directly address and contradict the point your trying to make. Even the source you posted contradicts what you are trying to argue. Nice try though
An Olympic level athlete might burn 30 kcal per minute at their best. I would bet a regular person burns at most 15 kcal per minute while running, so that's 450 kcal for a 30 min run, and maybe a couple hundred more for a walk. People consume that in a single large sugary coffee or soda drink. You can't ignore inputs.
My personal numbers for my regular training runs are about 11-12 kcal per minute. I can exceed 15 kcal per minute for very hard workouts or racing but I cannot train appropriately while doing that regularly. I'm a relatively seasoned runner but I don't focus on 800m-1500m which is where it might be possible to see numbers exceeding 20 kcal per minute.
In order for this to make sense for the purposes of lifestyle modification, you also have to subtract the calories that you would have burned had you not been exercising. IE if you had not run for that 30 minutes, you would still have been burning calories, either completely sedentary BMR or some other NEAT. This makes it even a worse deal to exercise for the sake of burning calories.
I recommend to get an Apple Watch (or any good fitness tracker) and a smart scale. After some time you can pretty easily and reliably predict your daily weight development simply based on your most recent diet and exercise.
Let's take a 5"10 male aged 25 weight 170 pounds. According to some calculator they will have a basal metabolism (how much you use if you stay in bed all day) of 1850 kcal / day. Lets say they eat 450 kcal / day too much. i.e. 2300 kcal / day. By running the metabolism calculator backwards we find that they stabilize on a weight of 245 pounds.
Thats a seriously overweight, to be sure, but it is also well below 200 pounds of extra weight.
Anyway I could have been clearer, but my point wasn't to suggest that you would end up exactly 200lb heavier, but that your calorie surplus adds up to roughly 200lb - exactly what happens to it depends on a lot of things.
This is response to someone who suggested they hadd seen a lot of clearly obese people who couldn't have got there on a few hundred extra kcal per day - however that doesn't seem accurate.
It's unlikely a 30m run and a 30m walk is going to burn off their excess calories.
Experience and anecdote does not substitute for real scientific evidence. Research suggests that your body compensate for any activity expenditure to maintain caloric burn within that specific range. This is known as constrained total energy expenditure.
I don't trust smartwatches and other devices to track caloric expenditure accurately given that they seemed to have constantly overestimate how much I burn.
This does not dissuade me from making sure that I get at least an hour of exercise everyday.
I agree that people should not do anything special, but here we are in a food environment that makes this difficult.
>> Experience and anecdote does not substitute for real scientific evidence. My research suggests that...
Can you cite your research. It's hard to criticize someone for giving an anecdote then going on to cite 'your research without citing it.
>Objectively measured physical activity may not be the key determinant of unhealthy weight gain in children.
I have heard some anecdotes of professional athletes who have horrible diets. I believe Chad Johnson survived off of multiple Mcdonald meals a day during his career. Those are unique cases of individuals having the required genetics and being able to spend hours a day with elite trainers
> > Breakfast: Three fried-egg sandwiches with cheese, lettuce, tomatoes, fried onions and mayonnaise. Two cups of coffee. One five-egg omelette. One bowl of grain. Three slices of French toast topped. Three chocolate-chip pancakes.
> > Lunch: One pound of pasta. Two large ham and cheese sandwiches with mayonnaise on white bread, plus energy drinks.
> > Dinner: One pound of pasta, an entire pizza, and even more energy drinks.
It's only how much you eat. Conservation of energy still applies, and 3500 kcal are still a pound of fat. It doesn't matter where the calories come from, they always end up either burned or as fat.
The "how much" is regulated by negative feedback. Whenever you eat sugar, insulin is secreted, which ends the craving. Whenever you eat fat or protein, leptin is secreted, which causes a feeling of satiation. Leptin is secreted by fatty tissue, so the fatter you are, the earlier you are satiated. As a result, everyone has an equilibrium weight at which he will eat exactly enough to replace the expended energy.
But that's not what's happening right now. We tend to constantly gain weight. Slowly, but without an apparent limit or any kind of feedback. That's where the "what you eat" comes in. Something is fouling up the feedback mechanism. Maybe something that causes the release of neither insulin nor leptin. Something we now consume in bulk, but didn't use to. Maybe we shouldn't do that.
And to the person you're replying to's point, where the walking/stairs/etc. involved in city life might serve keep that expenditure constant for someone who's otherwise sedentary, that's not the case for someone driving everywhere and topping out at 1000 steps a day.
There's a floor to how far your body can compensate for reduced intake - starvation. There's not such a simple ceiling to stop you from eating back up to what you exercise.
No, it won't. You need about 2000 kcal/d just to maintain body temperature. That's assuming a constant heat output of 100W. A bit less is surely possible, muss less isn't. Reduce food intake below that, and you will lose weight. Because physics.
Research shown that those expenditure doesn't matter. Your body adjusts. Nevertheless, we should create an environment that encourages everyday physical activity.
However, when it comes to supporting your current weight, it is fairly easy to hit equilibrium with exercise.
Case in point: I drove on a road trip through the southern USA recently. In rural areas, you had highways with truck stops and gas stations with tons and tons of very tempting fried, sugary, tasty treats. I saw barely anyone eating a vegetable-based dish that wasn't fried. Salads? Forget about it...There's a reason it's called The Stroke Belt, and why Southerners are known to eat poorly. Look at even Jim Gaffigan's routine on Southerners, he aptly characterizes their ridiculous diets, poking fun at biscuits and gravy, for instance.
So, while exercise is important, really just look at the foods on offer in rural areas. It'll be less healthy by default.
These factors combine to make unhealthy-eating a simple matter of habit for a large percentage of people in those areas. Even if you really do work physically hard every day, it's not enough to cancel all that out.
I simply walk more when I'm on a trip for something. Because often, I'm either going to cities or I haven't taken my car.
When I'm home, I'll drive to where I need to go. Then it's just whatever few steps I need to take around my place. Not even really trying, I walked over 6 miles total in a day while in a city for an event where the main activity is sitting down and playing cards.
Which character are you talking about?
My parents live outside of town, but they get exercise because they have to walk their dog. Otherwise they probably wouldn't get any either.
It is pretty scary, and while I know I could exercise I don't.
- much easier to access gyms or play pick up games in the city
- poverty is higher in rural areas
Specifically in the U.S., isn't it true that the population landscape is rapidly shifting from Rural => Urban? I intend to read more to see how this may/may not be a confounder in this type of temporal analysis.
Tldr: If the rural population is decreasing, then your denominator is smaller and estimates of disease proportion would increase over time.
These confounders are commonly addressed in systematic reviews - just haven't found it specifically in this one.
Well, what we would see over time is faster rising obesity in rural areas than urban areas. But that's simply a manifestation of the sorting effect. The underlying populations (the educated vs. uneducated) have not fundamentally changed, just relocated.
Without considering this we might be spuriously fooled into misunderstanding the causality of obesity. Under this model, rural living itself has absolutely nothing to do with rising obesity. It's merely serving as a proxy for a more important variable.
A little back-of-the-napkin math suggest that what we think of as the "urban" population (people living in cities) shrank from ~35% in 1920 to 25% in 2000.
Perhaps percentage wise, but the overall population in America is going up as well. As a result, rural areas aren't really declining, the population increase is simply mostly happening in the urban areas.
The rural area I live in is, instead, growing significantly (a rural definition of significantly) as people age out of urban areas and use the millions from their property sales in CA to purchase a summer home here.
If the younger, more health-conscious folks are likelier to leave, it makes sense the people left behind are older and less healthy.
This wouldn't happen from the denominator decreasing per se, but from the emigrants being skewed healthy. Which is pretty plausible, given that you'd expect emigrants to skew eg younger.
* I used to walk and cycle as my only means of transport (well, 99% of it at least).
* This is kind of a desert for decent food. The local shops have candy, chips, cakes, beer, and some almost-rotten bananas and apples.
* .. well actually that's about it. Though everyone else being heavier probably hasn't helped on a subconscious level.
The hacking of the american mind.
By the time someone acquires the maturity to accept this, their lifestyle has been too deeply established for change to be possible.
In related news, eating too much too often is more a cause of weight gain than how much screen time you get.
> This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity
The study's findings are that the rise in overall weight is attributed primarily to rural areas, contrary to the current consensus that it's driven by urbanization. Let alone not reading the link before commenting, it seems you didn't even read the full title of the post.
I was like, no - that’s what everyone looked like.