The Daily Telegraph - Features
‘Not all fat is bad, it depends where it is. But gut fat is deeply unhealthy’ Move more
Stanley Ulijaszek, the author of a new book on the ‘slow-motion car crash’ of the obesity epidemic, tells Ed Cumming that big backsides shouldn’t worry us
Scientists are also excited about a gene called FOXO3. Studies dating back more than a decade show that it activates autophagy – the process of cells getting rid of old and damaged parts – which is vital for increasing healthy lifespan.
While, as with all genes, everyone has two copies of it, three in 10 people in the UK have one “supercharged” version, while one in 10 have two – meaning they have a “jet engine” FOXO3 gene, according to Dr Craig Willcox, a professor of public health and gerontology at Okinawa International University in Japan. Only a genetic test can reveal which version a person has. “Our studies have shown that FOXO3 is at the centre of an ageing hub. It integrates signals from dozens of other genes that affect the ageing process. Think of it as a superintendent gene that is directing the ageing process as well as protecting against agerelated disease,” he says.
Research has shown that FOXO3 protects against cardiovascular disease – one of the leading causes of death in the UK – and cardiometabolic disease, which includes heart attack, diabetes and non-alcoholic fatty liver disease.
Exercise can switch on FOXO3 by alerting it “that it needs to get to work” and counterbalance the stress that physical activity puts the body under, Dr Willcox explains. In response, FOXO3 triggers the release of antioxidants that reduce inflammation.
How quickly the gene is activated depends on a person’s genes and lifestyle. But it will likely occur slowly over time, “just as working out will change your body shape over time”, he says. “The key point about lifestyle change is persistence and continuity,” Dr Willcox adds.
Prof Stanley Ulijaszek has spent his career trying to understand why populations become overweight. “Nobody chooses to put on excess body weight,” he says, sitting in an office at St Cross College, Oxford, where he is emeritus professor of human ecology. “So to try to understand why obesity should emerge as an issue, in the context of all the choices we make, is an interesting thing to think about.”
At 69, Ulijaszek’s new book, Understanding Obesity, gathers a career’s worth of learning into a readable, practical volume, looking at the many different factors – the “imperfect storm”, in his words – contributing to the international obesity crisis. He examines the influence of processed foods, societal norms and stigma, lack of exercise, snacking, genetics.
“Fat, in many contexts, is good,” he says. “We all carry it for good evolutionary reasons. It regulates so many different things. But at what point does it become excessive, and for whom? Not all fat is bad. Many women have large hips, bums and thighs. It’s difficult to shift that, it’s often a genetic predisposition. Recent evidence suggests that it is healthy protective fat. But the kind of fat I’m likely to deposit, around the gut, is deeply unhealthy. Where you deposit fat matters hugely. It does different jobs in different places.”
Ulijaszek completed his doctorate in Papua New Guinea in the 1970s. When he returned 25 years later, he was startled by the change in the population’s health. “Type 2 diabetes was an issue, hypertension was an issue, overweight and obesity was an issue, from people who had been extraordinarily lean. Trying to understand how a group of people in a very remote place could suddenly develop what they call diseases of civilisation. It didn’t fit.”
What he observed in Papua New Guinea was happening around the world. “The first thing that people do when they have a bit of money and want to improve their food is put salt on it, because it’s cheap and improves the taste,” he says. “Sugar follows. We have an evolutionary predisposition to like sweet foods.”
In Britain, he says, our predisposition to sugar is partly a consequence of our history. “This country historically produces so much sugar, and there’s a strong sugar lobby, and that’s part of what we’ve seen in terms of obesogenic environments.”
In America, since the 1970s, one potent source of calories has been high-fructose corn syrup (HFCS), the sweetener that arose from a corn surplus and replaced sugar in many soft drinks. In 2012, Ulijaszek co-authored a paper that showed that large amounts of HFCS could be contributing to the rise in Type 2 diabetes.
“It doesn’t satisfy appetite, it results in fat being deposited in the wrong place, it gives you an insulin spike,” he says. “In terms of long-term, nobody just eats HFCS. It’s an ingredient as part of a diet. The food industry will say time and time again that nobody just eats a Mars Bar. To prove the negative effects of some aspects of diet you have to eat diets that are mostly composed of those.”
Obesity rates have become particularly high in the Britain and the US, but other societies as consumer-driven as Britain offer hope, he says. Working in Japan, Ulijaszek saw far fewer overweight and obese people. “Eating a snack in the street in Japan, people tut at you,” he says. “There’s a strong social sanction against snacking. There’s also a culture of hara hachi bu, eating to 80 per cent, rather than until you’re completely full.”
The current food industry villains are ultra-processed foods. “We’re reasonably clear how those things operate, but you can’t definitively say ‘if you buy this, it will kill you,’ he says. “With cigarettes you could say that. The one thing governments can do is regulate. If you get in a car you put on a seatbelt and there are speed limits. We accept that regulation because it keeps us safe. Why not do that with food, when it’s clear that this food is not safe?
The difference is that it’s a slow-motion car crash, unfolding in front of us. That’s the tragedy in the work that I do: you can see the car crash coming.” He says the sugar tax was a step in the right direction.
Above all, he wants governments to take a compassionate and holistic approach to obesity that doesn’t blame individuals. “My BMI takes me into the overweight category, which prompts the clinician on my app to say ‘do you want to see someone about your weight?’ That really annoys me. Everyone knows where they sit in relation to their body size.”
FOUR FAT MYTHS All body fat is bad
The especially harmful fat is inside your abdomen and around your gut, as well as in the liver. Fat on the outside – subcutaneous fat – might be aesthetically displeasing, but doesn’t carry nearly as much health risk. Fat on the bum and thighs, especially in women, is actually protective against chronic disease.
It’s all due to my genes
Unless you carry extreme levels of body fat, being overweight is unlikely to be down to genetics. If it is, it is also down to expression of your genetics by environmental factors, especially diet.
It’s all due to slow metabolism
Metabolism is important, but mostly not in terms of being either fast or slow, but in terms of being flexible. True, some people burn more energy and can eat all they want and not put on weight, while others cannot, but the vast majority of people are along a continuum of metabolic rate.
It’s because I don’t exercise much
Physical activity can help match appetite to calorie intake and help maintain a healthy weight, but on its own, it is not a way to lose weight. However, it is a great way to get to feel good about yourself.