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We know that many people have weight issues today. We think we can be of help — below is an excerpt from our book, The Healthiest Diet in the World, which we believe puts body weight in its proper context. We are encouraged by the two unsolicited testimonials directly below that appeared on the web relating The Healthiest Diet in the World to weight. (If you have had similar experiences, please let us know so we can share them with others. You can write to us at firstname.lastname@example.org.)
Please feel free to print these pages out or to forward them to others. (There is a forward feature at the end of this page.)
- - Nikki & David Goldbeck
From Long Beach, California:
I had given up on losing weight. For 47 of my 57 years I have struggled with being overweight. I read about “The Healthiest Diet In The World” in the Vegetarian Times magazine. I got the book and went on their very easy to follow program not to lose weight but for the health of it, and so far I have lost 17 pounds. The tips about combining a protein with a carbohydrate have really changed my life. For the first time I do not crave sweets and I am eating more than I did when I was on a DIET. The recipes are great! I love tofu and they really have some great recipes using it. I don’t know how to begin to thank the authors of this book. I have recommended the program to everyone I know and when people mention my weight loss I always give them the name of the book.
From Seattle, Washington
Forget trendy diets, this book is a great guide to changing your life! It is very informative and provides recipes and guidelines for a nutritional diet. If you want to lose weight, feel great, live long and healthy, this is the book.
From The Healthiest Diet in the World by Nikki & David Goldbeck
THE WEIGHT ISSUE: WHAT (YOU EAT) VS. WEIGHT
This book isn’t about body weight, but as the subject seems to be on virtually everyone’s mind, we would be remiss in not discussing it.
We want to state right off that a substantial volume of research validates that body weight doesn’t necessarily parallel health, although at both the upper and lower ends of the scale it does appear to have an influence. For most people who are “dieting,” however, the concern is appearance, not health. The connection between self-worth and weight, as well as the issue of public image and weight, are extremely important; but they aren’t within the scope of this book, which is about healthy eating, not healthy attitudes. When it comes to health and weight, though, we do have a few things to say.
According to U.S. government statistics, more than one third of adults are considered to be overweight (a figure that has gone up almost ten percent since the 1970s). Children also appear to be fatter than ever. What has never been adequately determined, however, is what does being “over weight” mean, as well as what are the effects of being “under weight.”
While the relationship between weight and health remains unclear, what we know with certainty is that the quality of one’s diet is fundamental to good health.
Weight isn’t just a question of numbers. When evaluating weight management needs, a knowledgeable health professional considers many factors which individuals trying to lose (or gain) weight should look at as well. But oddly enough, scores of people subject themselves to all kinds of weight loss schemes without these assessments. Moreover, they resist initiating sensible diet and lifestyle changes that are known to be integral to well-being.
Below are some questions you should examine before making a determination about your weight. They are each addressed in the discussion that follows.
- How much extra weight or body fat is too much?
- Is the location of fat (for instance, on the abdomen or on the hips and thighs) important?
- Does height, which is correlated with weight, play a role?
- Is the timing of weight gain or loss a consideration?
- Does food matter more than weight?
- Are weight and nutritional status connected?
People are Dying to Weigh Less
Statistics from the mid-1990s indicate that at any given moment in the U.S., 40 percent of women and 24 percent of men are trying to lose weight. Whether for reasons of health or appearance, these people average 2.3 diet attempts each year. As many as 16 percent of women age 19 to 39 consider themselves “perpetual dieters.” Many of these dieters aren’t actually above recommended weight. Among those who are, more than 90 percent are likely to regain most or more of their lost pounds within five years.
While people view their weight in terms of pounds, a figure known as body mass index (BMI) is the guideline used in health settings. BMI, a number based on a ratio of weight to height, is explained below in “Finding Your Body Mass Index.” Within a given range of BMI, people are categorized as being of healthy weight, moderately overweight or severely overweight. Though there is a big space beneath healthy weight in which people are presumably underweight, much less attention is paid to this segment of the population.
The criteria used to determine weight categories vary and are complicated by socioeconomic issues. Various public health agencies and researchers propose different cut-off points. The life insurance tables that have traditionally been the reference point for weight are widely criticized as being biased in favor of economically stable white men (the population most apt to have health insurance). A legitimate concern of many investigators of weight-health issues is what this means for women and people of different ethnic origins, whose biological programming doesn’t appear to parallel that of white males. For example, as a result of this stereotype, older white, non-Hispanic women, and black and Hispanic adult males and females are more apt to be considered overweight. U.S. government figures claim that 50 percent of Mexican American women and 52 percent of non-Hispanic Black American women are overweight! Data on Asian Americans is scant.
Although statistics indicate people are getting heavier, the vision of what people should ideally weigh is simultaneously getting narrower. In 1990, the official USDA weight guidelines raised the cut-off point for healthy weight after age 35 (in other words, they added a few extra pounds); in 1995 they withdraw this allowance for healthy weight to increase with age, although evidence confirms a natural trend in this direction and, within limits, improved health outcomes. Currently the USDA considers a BMI of 19 to 25 as optimal for everyone over the age of 19 years. However, a number of important studies dispute this.
Among the evidence that supports higher ideal weight is an impressive study from Cornell University to the effect that optimal weight for men is about 15 pounds heavier than most recommendations. Consequently, a BMI between 23 to 29 is more suitable for men, with the lowest risk of death related to a BMI of 27. Their conclusion comes from analyzing 22 studies correlating weight to all causes of mortality. About 1,000 citations were considered to find these studies in order to isolate what the researchers felt was the best controlled and least biased data. A British study published in 1997 (after the Cornell review), which followed over 7,700 men for almost 15 years, made a similar determination; mortality from all causes increased only in men with a BMI under 20 or when BMI reached 30.
Figures claiming higher death rates for people with BMIs below the healthy weight range are often discounted due a belief that smoking or preexisting illness clouds the issue. The Cornell study found this to be a misconception. Contrary to expectations, when smoking and illness were controlled for, mortality rose in almost equal increments both below and above the 23-to-29-point range.
Unfortunately, there is limited information available on weight and mortality in white women, and even less on various ethnic groups, so no conclusions can be drawn regarding these populations.
The Nurses’ Health Study, one of the few long-term studies of women’s health and the most often cited, affirms that weight gains up to 22 pounds don’t increase mortality risks for women. And after age 70, higher weights are associated with the lowest mortality. Researchers at the National Institute of Health Obesity Center at St. Luke’s-Roosevelt Hospital in New York claim that for older women a BMI of 28 to 32 and for men 26 to 30 is most desirable.
Thus, despite the restrictive nature of the 1995 U.S. Dietary Guidelines, there actually appears to be a rather broad range of weight associated with low mortality. Note however, as you stray above and below this realm, what you weigh becomes increasingly risky.
Are You Sick of Your Weight
Of the hundreds of studies that have looked at the link between cancer and obesity, what has been found are mild to moderate associations with rates of prostate and colorectal cancer in men, and gall bladder, breast, cervical, endometrial, uterine, and ovarian cancers in women. Not all studies have found a connection, however, and in none of those that have could weight alone be considered conclusive.
One scientific explanation of how weight might be implicated lies in the fact that fat tissue is capable of converting a major hormone secreted by the adrenal gland into a form of estrogen. This, coupled with the fact that obese women and postmenopausal women exhibit other hormone changes, might account for the increased odds ratio for some of the aforementioned hormone-related cancers.
Another theory as to how extra body weight could effect cancer lies in the hypothesis that abdominal fat, which is where men have a tendency to accumulate fat tissue, is more biologically active. A link between this activity and cell development and proliferation may hold a clue as to why heavy men are more likely to get colon cancer.
On the other hand, it’s quite conceivable that certain foods and behavior patterns predispose towards both cancer and obesity. For example, colon cancer is consistently associated with increased consumption of red meat and some types of fat, decreased consumption of vegetables, and physical inactivity. Overweight men tend to consume more meat and fat, eat fewer vegetables, and get less exercise then lean men, making it difficult to separate weight from these other potential risk factors.
Although the incidence of heart disease parallels increases in BMI, several studies claim that the association is specifically with fat around the abdomen compared to fat deposited at the hips, thighs or buttocks. Likewise higher BMIs, and particularly abdominal body fat, correlate highly with a decline in insulin sensitivity, or the effectiveness of insulin to lower blood sugar levels. When this happens, the body compensates by producing more insulin, resulting in a condition called hyperinsulinemia. Many studies have shown that obese adults have much higher insulin levels in their blood than leaner people. The dangerous health implications of this situation are discussed in detail in GGG#1: Carbohydrate Compatibility.
Even though central girth (that is belly size) is cited most often in relation to illness, this may not hold true for all ethnic groups. This difference serves as a reminder that the health effects of weight could vary according not only to sex, but also genetic background.
Height and body frame size have also been considered in relation to cancer risk. Taller, larger framed adults appear to have a somewhat greater risk for both breast and colon cancers (and possibly other sites). Adult stature is a direct consequence of growth and maturation during childhood and adolescence; while this is genetically controlled, nutrition during these years play a big part in the realization of genetic potential. Again, hormone production could explain this relationship. Taller people have been exposed to more insulin-like growth factors, which play a role in the development of cancerous colon cells and breast tissue development.
In examining weight changes over time, small gradual weight gain during adulthood generally isn’t considered a concern. In fact, there is some indication that health is more compromised by recurrent fluctuations in weight (that is, a pattern of alternating weight gain and weight loss). As mentioned though, weight gain among adults of more than 10 kg (22 pounds), not weight per se, is associated with greater mortality.
As the preceding section on body frame suggests, obesity during childhood could create an environment that predisposes towards certain genetic inclinations, including insulin resistance. While serious health consequences during childhood are seen only in the severely obese, children who are fat are considered more likely to become fat adults, and thus perhaps more prone to certain outcomes linked to obesity later in life. On the other hand, it’s doubtful that coercing children to lose weight and withholding food improves their long-term health.
THE BIG QUESTION: Who Needs to Lose Weight?
Obviously, the relationship between weight and disease is extremely complex. Until the genetic determinants of weight can be separated from behavioral causes, predictions about the real effect of weight are speculative. Many heavy people will never develop any of the ailments that are often associated with weight, such as some cancers, heart disease, strokes, diabetes, gall bladder disease, respiratory illness, and osteoarthritis; likewise, lean people are certainly subject to all these conditions as well. However, it appears that in conjunction with other risk factors, including unsound food choices, low activity level, menopausal status, and a genetic predisposition towards insulin resistance, weight places people at higher risk. How much or how little, and how influential this is we don’t know.
Every responsible health practitioner would probably agree that the worst way to address weight is to jump from one restrictive diet to another. The reason for this is that getting to the “right” weight doesn’t mean your diet is sound, and conversely, as we have said, being over- or underweight doesn’t establish that someone is poorly nourished. What you eat is more important than what you weigh. A rational approach for children and adults is to maintain a healthy weight by making sensible food choices and keeping your body “busy,” that is through regular activity or exercise. Even if you aren’t satisfied with the weight that results, the health-protective effects of proper diet and exercise will prevail.