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nevent1q…3jdpPrompted by recent discussions about the issue of obesity in the EU and the US, as well as personal reflections on the problem, I've decided to offer my two cents coming from a biochemical, anthropological and medical perspective.
tl;dr People in developed countries are obese due to modern diets that don't align with human evolution. Grains are harmful to humans. The only effective diets for long-term weight loss are the vegetarian and a paleo-ketogenic diet (PKD). The PKD, or carnivore diet, is superior and better suited to human evolution.
Firstly, a brief overview of epidemiology and the obesity issue. The proportion of overweight adults in the EU varied in 2019 between 37 % in Italy and 58 % in Croatia for women, and between 53 % in France and 73 % in Croatia for men. The prevalence of obesity and overweight individuals is consistently increasing worldwide, along with rates of type 2 diabetes (DM2) and cardiovascular diseases. Cardiovascular diseases (CVDs) are the number one cause of death globally, with diabetes, arterial hypertension, obesity, and smoking being the main contributing factors. Other factors, such as physical inactivity and hyperlipidemia, also play a role but to a lesser extent. Smoking rates are declining, making diabetes and obesity the most significant health problems in modern society (arterial hypertension being a complication of diabetes). Both type 2 diabetes (DM2) and obesity are consequences of modern dietary patterns, and they are mutually connected.
So, how do we address the obesity problem? First, let's talk about the Randle Cycle. It is a biochemical concept in human physiology where cells preferentially utilize fats in the presence of excess fat and inhibit glucose consumption, while in the presence of excess glucose, they preferentially utilize glucose and inhibit fat consumption. The worst thing for the human body is a diet rich in both glucose and fat because it leads to simultaneous fat storage and inhibition of glucose transporters, preventing glucose entry into cells. Elevated insulin levels, which fail to decrease blood glucose levels, lead to insulin resistance (i.e. DM2), and also contribute to obesity due to fat storage. Moreover, this excess fat accumulates as visceral or deep fat, which is hormonally active and negatively affects human health.
Foods that are simultaneously rich in fats and carbohydrates naturally occur only in breast milk. However, throughout history, humans became adept at combining these two macronutrients, which is evident in most junk foods and unhealthy diets today. It's not even necessary for them to be chemically combined in the same mass; one only needs to look at a typical household lunch plate. Lunch typically means a combination of a fatty meat portion and some rich source of carbohydrates, usually bread, potatoes, and/or pasta. This is often followed by dessert, such as ice cream or cake, which again combines fats and carbohydrates.
Now, let's address the caloric method of counting calories (Calories in, Calories out, i.e., CICO). A calorie is a unit of energy released by burning food in a calorimeter. It means that a piece of wood and a piece of meat can have the same number of calories. Calories are a unit imported into human physiology from physics and should never signify more than a simple approximation of the energy value of food because our body is not a closed thermodynamic system or a furnace. You can lose a lot of weight by counting calories (I have in the past), but in the long run, it always leads to a nutritional deficit, and you are in a perpetual battle with hunger, constantly mentally keeping track of how many calories each food has. This is an inferior approach to nutrition because it's not sustainable in the long term and reduces quality of life.
If you follow the biochemical reality of human physiology, i.e., the Randle Cycle, you'll see that you have two choices: either consume carbohydrates with minimal fat or consume fats with minimal carbohydrates. It's time for some anthropology. It's simply not true that humans are omnivores, as we were taught in schools. For the last 10,000 years, humans were omnivorous because we adopted a sedentary lifestyle and started doing agriculture. For 300,000 years before that however, we were hunters-gatherers, and our diet was predominantly composed of meat. The plant matter we gathered consisted mostly of fibrous substances with little sugar, occasionally supplemented by feasts when we had access to honey and berries. It's worth noting that modern fruits and vegetables are completely different from ancient varieties and contain significantly more sugar. Just look at the wild variations of today's fruits to understand the conditions our ancestors lived in. Wherever the remains of hunters and farmers are found together, we see that hunters were on average taller, had perfect dentition (no cavities), and lacked arthritic bone changes (since they weren't plowing the ground all day). From a health perspective, the agricultural revolution was a catastrophe for humanity. We depleted all large game and started farming.
Enter grains. Grains are a type of grass that humans domesticated at the beginning of the agricultural revolution. People never consumed them before that time. In short, grains are not suitable for human consumption, and the standard food pyramid has caused significant harm to the human race by including this type of food as its foundation. If there's one thing you take away from my post, it's that grains are the most unhealthy food that people can eat, but which make up 70% of all consumed human calories. Like all plants, but with grains even more so, they contain antinutrients, are generally poor in other nutrients in general, and contain a type of starch that is rapidly absorbed into the bloodstream. Technically, it's better to eat a teaspoon of white sugar than a slice of bread if you're diabetic. Wheat is in a particular category of its own since it contains psychoactive substances. People are literally addicted to bread; just try to give up this food for a few days, and you'll probably understand why it's so challenging. Grains have no place in any "balanced" diet, and their presence on the plate should be 0%. Therefore, the number one advice for weight loss and improving health is complete elimination of grains and fast-food junk from your diet.
Considering that humans are evolutionarily closer to carnivores than omnivores and especially herbivores, I believe that the optimal choice for a healthier diet is the paleo-ketogenic diet (PKD), also called the carnivore diet. You can also opt for a vegetarian diet, consuming lean meat (protein needs to come from somewhere, and plant-based proteins are inferior to animal proteins), with predominantly fruits and vegetables, but you need to be aware that you eventually will develop a severe deficiency in certain nutrients. You'll need to supplement your diet with iron, vitamin B12, and other substances. As I mentioned earlier, plants are generally less nutritious than meat, and you need to eat a larger volume of plants to extract enough nutrients from them. However, these nutrients are a) of lesser quality and less bioavailable than animal variants, and b) are typically accompanied by a large amount of anti-nutrients such as lectins and similar molecules, which block the absorption of other nutrients (e.g. having green salad with chicken breast reduces the nutritional value of the chicken).
If you decide to try PKD, please consult your doctor first. I'm not sure how it would affect people who are already burdened with CVD, but from personal experience, I can tell you that I lost 15 kg in 2 months and feel better than ever before. I monitor my blood parameters every 3 months, but I'm not interested in going back to my old diet and obsessively counting calories. If you have excess weight and are otherwise healthy, give it a try; it might change your life as it did for me.
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