If the successes in technological development achieved over the past few hundred years teach us anything, perhaps it should be that individual members of a species that evolved in an environment of pervasive scarcity and intermittent famine are not well equipped for an environment of consistent plenty. Our biochemistry and our instincts lead us astray: eat too many calories and life expectancy and long-term health will suffer for it. This is not new. We are no different from our ancestors in this aspect of the human condition. The change lies in the fact that we now live in an age so wealthy and capable that consistent overeating is affordable for a majority of the global population. Since people, on average, tend to follow their incentives in the short term rather than in the long term, the result is a very rapid growth in lifestyle diseases.
Visceral fat tissue doesn't care that you think it is hard to avoid. Maybe it is hard. But that doesn't change the choice, or the fact that it is a choice: choose to eat less, or choose to suffer the consequences resulting from the visceral fat tissue that you gain. That means greater lifetime medical expenditures, more years of chronic age-related disease, more disability, and a younger death than those who did managed to stay slim. Visceral fat tissue interacts with the immune system to generate chronic inflammation, and may increase the burden of senescent cells that also contribute to inflammation. Inflammation accelerates the development and progression all of the common age-related diseases, particularly cardiovascular disease. Issues in the vascular system in turn accelerate the decline into dementia. There is no such thing as being both healthy and overweight. Excess visceral fat tissue at any age is a bad thing.
What lies ahead in the matter of cheap calories and consequent declines in personal health? Most likely a future of continued issues and an increasingly overweight population, at least until someone comes up with a low-cost technological fix that work well enough to gain widespread adoption. Zero calorie food bases, maybe, or an implementation for human medicine of one of the various ways in which mice can be engineered to resist fat deposition. For the individual, it will for a while yet remain a matter of willpower and choice. It is risky to let things go in the hope that medical science will rescue you from the consequences of poor choices. The future of rejuvenation therapies will not happen as rapidly as we'd like: it will be piecemeal, and roll out incrementally over decades. That is plenty of time for even the younger members of the audience to dig a deep hole of ill health through becoming overweight and sedentary.
Does your waist measure more than half your height? In developed countries up to 90 percent of adult males and 50 percent of children may suffer from this condition. In the top overfat countries, 80 percent of women fall into this category. The term overfat refers to the presence of excess body fat that can impair health, and may include even normal-weight non-obese individuals. Excess body fat, especially abdominal fat, is associated with increased risk of chronic diseases, increased morbidity and mortality, and reduced quality of life. Researchers reported earlier this year that up to 76 percent of the world's population may be overfat. Now these same researchers have focused their efforts on data from 30 of the top developed countries, with even more alarming findings.
The relationship between the overfat condition and poor health is a spectrum or progression in which the vicious cycle of excess body fat, insulin resistance and chronic inflammation lie at one end, causing abnormal blood fats (cholesterol and triglycerides) and glucose, and elevated blood pressure, which then produces a variety of common diseases at the other end. Being overfat is linked to hypertension, dyslipidemia, coronary heart disease, stroke, cancer, type 2 diabetes, gallbladder disease, osteoarthritis and gout, pulmonary diseases, sleep apnea and others. Traditional means of assessment, such as stepping on a scale or calculating Body Mass Index (BMI), are ineffective at determining whether someone is overfat. Instead, researchers recommend taking a measure of the waistline (at the level of the belly button) and comparing it to height.
It was recently estimated that between 62% and 76% of the world's population have reached body fat levels that can impair health. This condition, which can now be labeled a pandemic, was described by the catch-all term overfat. It is well-recognized that the overweight and obese conditions represent a continuing threat to world health, replacing more traditional problems of undernutrition and infectious diseases. Indeed, being overfat shares direct links to insulin resistance and chronic inflammation, and to hypertension, dyslipidemia, coronary heart disease, stroke, cancer, Type 2 diabetes, gallbladder disease, osteoarthritis and gout, pulmonary diseases, sleep apnea, and others. Global rates of these conditions in adults and children (including adolescents) have risen significantly over the past ~40 years, paralleling significant increases in the numbers classified as being overweight and obese, and considerably affecting people of all ages and incomes in both developed and developing countries.
While the prevalence of being overweight and obese is well known, many normal-weight and non-obese individuals exhibit excess levels of body fat that can adversely affect their health. Indeed, reliance of body mass index (BMI) for determination of being overweight and obese may misclassify up to 50% or more of patients with excess body fat who may have increased health risks. The notion of a metabolically obese normal weight (MONW) individual is based on the finding that obesity-associated disorders such as high circulating insulin levels in people with cardiovascular disease or Type 2 diabetes can occur in those with normal BMI. Many at-risk individuals have been identified in a BMI range of 23-25 or lower. Overfat individuals who are not overweight and obese include MONW individuals, those with sarcopenic obesity, and many who have increased abdominal fat stores. Abdominal and visceral fat accumulation, regardless of weight status, has been found to increase risk of cardiovascular and metabolic (cardiometabolic) disease to the greatest degree.
Based on BMI evaluations, there appears to be a leveling off of the trend in rising obesity rates in some developed nations. However, the incidence of central adiposity - the excess accumulation of visceral fat in the abdominal region, sometimes called abdominal obesity - is increasing. This form of overfat is concerning because the potential health risks of central adiposity are more pronounced than those for increased subcutaneous fat in other regions of the body. The continued increase in abdominal obesity includes those who are normal weight and non-obese, with US population averages of 54.2%, and an increased prevalence in women (up to 68.3%). The estimate of overfat in the world's 30 top developed nations is substantially higher than the prevalence of overweight and obese adults and children worldwide. Regardless of BMI values, overfat individuals have excess body fat, a high degree of cardiometabolic dysregulation that can promote disease risk factors and chronic disease, increased morbidity and mortality, reduced quality of life, and pose a rising economic burden.
The economic fallout from the overfat pandemic has raised a serious global challenge. In 2011, the WHO estimated that the economic burden of preventable, non-communicable disease (in particular cardiovascular disease, cancer, and diabetes) is expected to create a cumulative output loss of US$47 trillion over the next two decades. In 2010, this represented 75% of global GDP (US$ 63 trillion) - enough capital to lift the 2.5 billion people currently below the poverty line, out of poverty for more than half a century. While it is difficult to determine the absolute burden of the overfat pandemic, it is clearly a strong causal factor in the development of a significant portion of chronic disease and reduced quality of life.