A Century of Obesity Epidemic

Why We Get Fat
by Gary Taubes

In 1934, a young German pediatrician named Hilde Bruch moved to America, settled in New York City, and was “startled,” as she later wrote, by the number of fat children she saw—“ really fat ones, not only in clinics, but on the streets and subways, and in schools.” Indeed, fat children in New York were so conspicuous that other European immigrants would ask Bruch about it, assuming that she would have an answer. What is the matter with American children? they would ask. Why are they so bloated and blown up? Many would say they’d never seen so many children in such a state.

Today we hear such questions all the time, or we ask them ourselves, with the continual reminders that we are in the midst of an epidemic of obesity (as is the entire developed world). Similar questions are asked about fat adults. Why are they so bloated and blown up? Or you might ask yourself: Why am I?

But this was New York City in the mid- 1930s. This was two decades before the first Kentucky Fried Chicken and McDonald’s franchises, when fast food as we know it today was born. This was half a century before supersizing and high- fructose corn syrup. More to the point, 1934 was the depths of the Great Depression, an era of soup kitchens, bread lines, and unprecedented unemployment. One in every four workers in the United States was unemployed. Six out of every ten Americans were living in poverty. In New York City, where Bruch and her fellow immigrants were astonished by the adiposity of the local children, one in four children were said to be malnourished. How could this be?

Fat in the Fifties
by Nicolas Rasmussen

Obesity burst into the public consciousness in the years immediately following the Second World War. Around 1950, the US Public Health Service (PHS) issued a brochure on “the greatest problem in preventive medicine in the USA”: obesity. The life insurance industry, working in collaboration with the PHS and the American Medical Association (AMA), launched a national drive, proclaiming “Overweight: America’s No. 1 Health Problem.” And no wonder, given that insurance company data and some local health surveys suggested that more than a quarter of the American population was significantly overweight or obese. By the typical measure of the day, anyone 10 percent above the “ideal weight” for a given height fell into the category of overweight—the ideal weight being that which the insurance industry found to predict maximum longevity. Those 20 percent overweight were classified as obese. The danger of excess weight was grave, because it was the leading predictor of heart disease, the nation’s top killer. […]

Stroke, cancer, and, most of all, heart disease leaped to the forefront as causes of death.20 By 1920 heart disease had taken the lead as the top cause of death; by the end of the decade, based mainly on evidence developed by Dublin and other insurance industry statisticians, health policy analysts came to believe that heart disease was also catching up with tuberculosis in terms of its total financial burden on the nation (despite the fact that heart disease tended to kill its victims later in their wage-earning years). Imposing double the economic burden of cancer, which would soon become the second greatest cause of death, heart disease had unquestionably become Public Health Enemy Number 1 by 1930. […] The [early 20th century] findings indicated a clear association between overweight and excess mortality. […] In 1930, Louis Dublin used this type of information as the basis for a groundbreaking actuarial study that specifically correlated overweight with heart disease.

2 thoughts on “A Century of Obesity Epidemic

  1. Gary Taubes sets it up as a mystery, but he goes on to explain what happened. The main thing was that carb intake shot up, in particular refined flour and added sugar. This was linked to two other simultaneous shifts. First off, meat and hence animal fat consumption dropped during that early period because of scandals involving the lack of cleanliness in the meatpacking industry. A helpful boost to the early vegetarian and vegan advocates, such as the rising power of the Seventh Day Advocates in the American diet, nutrition studies, and official guidelines (e.g., the invention of high-carb breakfast cereals). This was the beginning of the mainlining of a high-fiber, low-fat, and plant-based diet; where animal foods and animal fats were scapegoated.

    The seed oil industry also took this as an opportunity to push their product as the clean and pure alternative to animal fat, even though their product began as a sludgy industrial byproduct. Yet even when meat consumption returned to normal, animal fat consumption never did. By the 1930s, most Americans were getting most of their dietary fatty acids from seed oil, although prior to that Americans had been eating tremendous amounts of animal fats, which meant high levels of nutrition such as the essential fat-soluble vitamins. Those chubby children the European immigrants saw were the first generation of Americans raised on an industrial diet where the majority of the bulk and calories were coming from carbs and seed oils. This was the appearance of a new phenomenon, the simultaneity of malnourishment and obesity, that has been with us ever since.

  2. This is the entire world we have come to know. All of the living generations right now grew up on the industrial diet. And all of the living generations, including the oldest generation, has high rates of obesity. Only a small fraction of Americans at this point, most of them immigrants, early on experienced a traditional, rural diet that was animal-based and high in animal fats, but low in seed oils and refined carbs. Such a diet is no longer even part of the living memory of the general public. We’ve lost the capacity to even imagine how much meat and animal fats Americans used to eat.

    The first generation of Americans to become mass urbanized and industrialized was the Lost Generation, actually several decades before the 1930s. But the Lost generation at least grew up prior to the meat industry scare, and so it was at a time when urbanites were still eating lots of animal foods and many rural practices like hunting and fishing lingered. It was the Lost Generations’ kids and grandkids that finally experienced the full industrial diet that we know today. Processed foods had fully taken over the market by the Second World War and especially following, as did the pharmaceutical and chemical industries, along with industrial farming (monoculture, agrochemicals, mass transportation, etc).

    That brings us to the present crop of leadership: politicians, CEOs, upper management, corporate boards, etc. Joe Biden was born in 1942, the same year as our father. And Donald Trump was born in 1946, a year after our mother. This is the generation in power right now and are refusing to retire. Our father, for example, remains active in influential leadership positions of civic organizations. Medical science, food fortification, and nutritional supplements have kept these people alive longer; but not healthier overall — consider the obvious neurocognitive decline of both Trump and Biden, by comparing to videos of them back in the 1980s and 1990s; and then also compare them to similarly aged traditional people from Blue Zones and hunter-gatherer tribes.

    We are being ruled by the senile and demented. The sickly are leading the sickly, in an entire society that is sickly in every way; sick in body, mind, and soul (all three being directly linked). This older generation has among the highest rates in history of nearly every category of disease, other than infectious diseases. And every generation this past century is getting these diseases of civilization, primarily metabolic diseases, earlier and earlier in life. Of course, obesity has been shooting up, to the point that not just overweight has been normalized but morbid obesity has become so common as to be barely noticeable. Our parents notice that among their peers in the Silent Generation, as many of them are so fat as to be barely be able to walk.

    Yet our parents are old enough to remember the world wasn’t always this way. Their own grandparents and other older family members were highly active and physically capable into older age. Most people didn’t get serious diseases until shortly before death. They just kept on working and then usually died quickly. Old people back then also were showing signs of the times. My maternal great grandmother, of the Lost Generation, was a workhorse her entire life; but she did get quite fat in the latter part of her life. The thing is that she would’ve spent the early decades of her life on a mostly pre-industrial diet that consisted of an abundance of wild-caught and pasture-raised animal foods, an eating pattern that persisted even when processed foods were increasingly added in.

    So, my great grandmother’s early life development happened on an extremely nutritious and healthy diet, and that makes a massive difference. It’s early development that is the primary determinant of later life health, no matter how bad one’s diet and lifestyle gets later on. Those who grew up in the pre-war era experienced a different early life, the reason it was rare for them to be chubby children. That is what was seen with the long-lived populations studied after the war, as they were people who had spent most of their lives prior to the changes that happened during and after the war; such as the decimation to the traditional animal-based food system.

    Interestingly, these changes can be tracked directly opposite to what is shown among the famous: tv actors, movie stars, beauty queens, models, etc. In the early 1900s when the average person was still skinny and when skinniness was associated with sickly emaciation, the ideal of beauty and health was to have show signs of extra body fat. The women idealized in the media at the time were, though not obese, certainly were well-rounded and curvaceous; sometimes even a bit chunky. That was idealized back then, prior to the full industrial diet (of refined carbs and seed oils), for the very reason it was so rare; and because it was a sign of being well-fed on a healthy, nutritious diet. Having some extra body fat from a low-carb, high-animal-fat diet is far different than the same from a high-carb, high-seed-oil diet.

    It was precisely as more Americans were getting fatter that the ideal of beauty was getting skinnier. By the 1920s and 1930s, vivacious young women in the media were quite skinny, probably with the help of stimulants like cocaine and new pharmaceuticals that were accessible to the wealthier classes. Think of the Flappers in the 1920s, stereotypically super-skinny. That was a dramatic change from what was idealized only a generation earlier. The use of stimulants to suppress hunger and weight-gain really took hold in the post-war period with a growing middle class who could afford to maintain a personal supply of such drugs, not to mention a highly-profitable medical industry willing to push drugs onto the public.

    The poor, at the same time, were being hit the hardest by the emerging obesity epidemic and health crisis. Simultaneously, the government was pushing food programs for the poor that, sadly, increased the refined carbs and seed oils in their diet; a great boon for the profits of the farming and food industries. As inequality of wealth rose, so did the inequality of health, in terms of inequality of both healthy foods and healthcare, including legal and illegal drug access. By the time of the cocaine-fueled 1980s of skyrocketing inequality, the ideal of health combined with the ideal of wealth was represented by the near-emaciated supermodels. Such extreme skinniness was being held up as an aspiration precisely because the average American was getting fatter and fatter, and the average poor person fatter still.

    Now we are at an unusual transition point. Sugar intake that had been steadily rising for centuries suddenly leveled out right at the turn of this past century. Yet that doesn’t mean total carb intake has not kept on growing. And some evidence indicates that artificial sweeteners might be as bad or worse, for metabolic health, than sugar itself. Certainly, obesity isn’t declining, nor is the prevalence of seed oils. Processed foods are more common now than ever before. Red meat intake has remained the same for generations now, and animal fat intake has never recovered from the precipitous decline a century ago. Most of the bulk, calories, and macronutrients, not just carbs but also protein and fat, in the 21st century American diet comes from highly-processed plant foods: grains, wheat flour, rice, rice flour, corn, corn meal, tubers, legumes (peanuts, soy, beans, etc), nuts, seeds, seed oils, high fructose corn syrup, cane sugar, beet sugar, and on and on.

    It’s only been the past few decades that obesity came back to public attention and public health concern. That is the point made by Nicolas Rasmussen. Excess body fat has been increasing every generation for more than a century now. Yet it’s increased so much that what was called obese a century ago would barely register as overweight now, if anything would appear as far below average in comparison to present abnormal norms. The strange thing, though, is what inspired Rasmussen to write his book. Following the 1950s, the public awareness and concern about obesity largely disappeared; precisely as a new emphasis emerged on animal fat scapegoating, calorie-counting, and fitness mania. Instead of being a public health issue, the blame was placed on the individual and the capitalist market was seen as the arena for the playing out of this morality play; as opposed to other Western countries that nationalized their healthcare systems.

    Yet about three-quarter of a century later, we are now realizing that public health officials had been correct back in the 1950s and earlier. The capitalist model blaming the individual, as we’ve done these past generations, has completely failed. It’s not the individual that is at fault, not a natural consequence of the sins of gluttony and sloth; a point that Taubes returns to again and again. The entire food system, healthcare system, and political system has failed the American public. The very official dietary recommendations and guidelines are promoting sickliness. The individual has been mostly doing what they were told. It’s true Americans are eating more sugar than recommended, but even that can be blamed on the official position rationalizing for generations that sugar was mostly harmless, at worst an empty calorie; the complete opposite of scientific fact, as was proven in the data long ago. While talking out of one side of their mouth, officials were subsidizing the farm and food industry that was pumping out cheap high fructose corn syrup, the worst of the worst.

    Besides, whether from cane or beets or corn, sugar is just one source of carbs among many others. For decades, high-carb foods like grains were being praised as supposed health foods, while the tremendous harms of sugar were being rationalized away; at the very time that systematically under attack were the healthiest and most nutritious foods: meat, organ meats, bacon, eggs, dairy, and animal fats. American health declined and obesity increased precisely as Americans ate more and more of what they were told to eat: vegetables, fruits, grains, legumes, etc — all of which have had increased intake this past century with the development of industrial agriculture, improved storage methods, and mass transportation that made them more cheaply available year round.

    Early last century and in the centuries prior, Americans rarely ate many plant foods for large parts of the year, because they were out-of-season and simply unavailable or else extremely expensive. Eating plant foods in the winter once was a sign of immense wealth, of privilege and prestige. That is something described by Nina Teicholz, following from and extending upon the evidence-based argument of Taubes. She looks back at historical records to show that, prior to industrial agriculture and agrochemicals, farming was a much more difficult business and gardening certainly wasn’t a reliable food source. Most Americans, out of necessity of survival, were forced to eat mostly animal foods year round and particularly from winter into spring. Besides, animal foods were so abundant, cheap, and accessible in America until the industrial era.

    That was true going back centuries into European history as well. When gardening first became popular in the 19th century, those who kept gardens were mostly the rich; as Bryan Kozlowski makes clear in his book The Jane Austen Diet. To keep out pests, it required to build and maintain large expensive walls, along with hiring a large staff to take care of the garden such as picking off insects by hand. Poor people didn’t have the surplus free time, energy, and resources for much gardening, other than keeping around a few hardy semi-wild plants like dandelions to occasionally throw in a stew. During the Middle Ages, the poor relied mostly on foods that were pasture-raised, hunted, fished, and gathered; with farmed plant foods like grains being a small and irregular part of the diet. Eating lots of carbs and seed oils or even lots of fruits and vegetables simply was not an option for most people until the industrial era.

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