Check the FATS: Eliminate Chronic Diseases

The world is in a global obesity epidemic and this is associated with thousands of chronic diseases. Obesity was rare in Western countries and absent in Africa, South America, and Asia at the beginning of the twentieth century, but the world has witnessed a dramatic rise in obesity incidence since then. According to the World Health Organization, obesity incidence has tripled in the past three decades, making it a global epidemic. The current global obesity epidemic suggests there is something fundamentally wrong with our genes, environment, or lifestyle. While there is evidence for a role of genetics in obesity, our environment has significantly changed in the last ten thousand years.

Our ancestors were mostly hunters and gatherers and barely had enough food to eat. We transformed how we eat and utilize caloric energy with the beginning of agriculture. We have shifted from being hunters and gatherers to growing food ourselves on an industrial scale. For the first time in human history, we can produce more high-energy, calorie-dense foods than we know what to do with. It is not just an excess of calories, but we are also changing the nature of foods toward ultraprocessed foods. These foods are low in fiber, full of fat, and padded with artificial additives, sugars, and salt. The answer to weight loss is simple and unchanging: eat more fruits and vegetables while cutting out (or at least cutting down on) processed convenience foods and sweets. Thus, the root cause of excess body weight or obesity is diet high in caloric content, ultra-processed foods padded with sugars, salt, and fat as well as sedentary lifestyle. Our goal then is to consume healthy nutritious foods and avoid excess caloric intake in the first place. Yet, many dietary approaches as well as exercise regime only provide short-term solutions and conventional treatment of chronic diseases at best can only manage these conditions.

The challenge with modern dietary intervention and physical activity clearly indicates that the current obesity epidemic defies simple solutions. Eating behavior is a complex physiologic process that is initiated in the brain, which communicates with the gut to release hunger and satiety hormones and thereby regulate food intake. The human gut contains bacteria and fungi (the microbiome), and this plays an essential role in food metabolism and health. In addition, the body’s circadian rhythm and sleep patterns control when these hormones are released to regulate food metabolism. Individual genetic mutations, as well as exposures to certain environmental toxins and drugs, affect food metabolism and health. The body has evolved biological processes to maintain homeostasis by integrating all these factors in sync. Thus, poor diet, dysbiosis of the gut microbiome, disruption of the circadian rhythm, stress and anxiety, sedentary lifestyle, and genetic mutations that disrupt this homeostatic state can lead to obesity, which is the underlying cause for hundreds of diseases, including diabetes, cardiovascular diseases, hypertension, kidney disease, and cancer.

In Check the FATS: Eliminate Chronic Diseases, Bernard Kwabi-Addo discusses how the human body has designed complex and integrated metabolic process that involves several factors such as hormones, gut microbiome, circadian rhythm/sleep pattern, genetic traits, and exposures to the current obesogenic environment in regulating energy intake from diet and energy expenditure as well as energy storage in the form of fat. Thus, disruption in any of these processes can and do contribute to obesity and chronic diseases.

Check the FATS then discusses lessons from our ancestors who did not have chronic diseases and presents the scientific evidence in support of the role of poor dietary components and sedentary lifestyle and their association with chronic diseases whereas healthy dietary interventions can reverse and even eliminate chronic diseases.