Korea has a similar lack of obesity. It's not just genetics because Koreans tend to become overweight when living in the US.
I think it comes down to two major factors:
1. Koreans tend to walk (exercise) more. Walk (partway) during commute, walk to lunch, walk to do errands, etc. In the US people just sit in their cars. I personally find I get 3000+ daily steps in Korea without even trying, while in the US I only get about 300 daily steps or so.
2. Diet + portions. My Korean friend was astounded by the amount of fries that came with every meal in the USA and Canada. The US is the only place where fructose is substituted for sugar in most processed food. I've heard fructose inhibits the sense of satiation after eating.
So walkable cities and better food options would probably reduce US obesity.
Americans do more exercise than ever and have also reduced their sugar intake on average, but obesity continues to rise. Is it possible that food additives or something less obvious is having an effect? GLP-1 agonists are a good indicator that even minor chemical interventions can have a huge long-term effect on obesity that dominates diet and exercise, so why do we rule out the possibility of other substances doing the opposite?
Are they really? Fitness socials exploded in the last 10 years, many more enthusiasts training harder/longer, but I haven't seen noticably more bodies at the gym.
The number of gyms has skyrocketed in the past few decades, though. Back when the obesity epidemic really took off ca. 1980, "the gym" was a place inhabited primarily by bodybuilders and professional athletes. Regular folks were mostly doing calisthenics/aerobics, often at home following along with Jack LaLanne or Jane Fonda. Today, Planet Fitness is a ~5.5-billion-dollar company.
Which is why I'm curious about time/scale of effect, and what exactly is meant with "Americans do more exercise than ever".
One indicator is # of gym membership: ~30m->~70m in last 25 years, from 10% of population to 20%. Hard to say how much of that is due to gyms getting better at selling memberships because we know they oversubscribe. But per capita figures still suggest that vast plurarity of Americans, the average American, likely 1.5SD / 80%+ of population, probably don't have habit of regular exercise that would overcome effects of increasingly sedimentary life style. So should be ber surprising that obesity continues to increase.
I haven't been going to the gym in a while, but when I did there were a lot of people mostly looking at their phones and not doing much exercise. It was noteworthy when I ran on the treadmill that I saw other people actually running on them instead of merely walking.
I'd guess that many people going to the normal gyms aren't getting much out of it. Combined with the drive to and from the gym, and often getting a snack or something along the way, I have doubts that going to the gym is an efficient use of their time.
(the expensive, specialized gyms like Crossfit or climbing that cost much more are completely different)
My understanding is that GLP-1 affects appetite, and thus affects diet. And one of the reasons people quit GLP-1 long-term is because they miss eating and enjoying food.[1]
> The drugs work by activating GLP-1 receptors in the body in a way that reduces appetite, alters gut function, and may impact addiction pathways.[2] However, adherence to the drugs long-term is a challenge, as many people stop taking them after some time.
Right. There is clearly a powerful system in the human brain and body that controls our appetite and weight set point. Medications that adjust that system seem to produce durable changes in appetite and obesity, while typical changes to diet and exercise see weight revert to the mean after a year or so.
So the question is whether there are other substances in our diet that are also affecting this system. This isn’t crazy: various gut bacteria produce proteins that increase natural GLP-1 in the body. So any substance that disrupts these bacteria could easily have this sort of effect. https://www.nature.com/articles/s41564-021-00880-5
when you are walking everywhere for a few minutes at a time, it adds up rather quickly.
most americans who go to the gym spend 60 ish minutes there. they also usually eat something after.
i don't think it's food additives, because japanese are no stranger to mass produced food and beverages from food conglomerates. it's the country that gave us instant noodles.
> don't think it's food additives, because japanese are no stranger to mass produced food and beverages from food conglomerates. it's the country that gave us instant noodles.
> Koreans tend to walk (exercise) more. Walk (partway) during commute, walk to lunch, walk to do errands, etc. In the US people just sit in their cars.
People are always going on about walking, but I have a very hard time believing that the lack of low-intensity walking is a major contributing factor for the 250-pound bodies that are so common in the US (especially south and midwest). When you're overwhelming your body with fried food every day and coke at every meal, you ain't gonna keep up with those calories by getting in more steps.
People think of the 250lb and 1000 steps in the context of one meal, or maybe a 6 month diet. But 250lb is not added in one meal, or over 6 months. It usually takes a couple of decades.
Let's say that's 10,0000 days. Because I'm Australian and like round numbers and am lazy (these numbers are all very rounded), call 250lb 100kg. 1,0000 steps a day consumes about 20 kiljoule. If those kilojoules come from eating fat, you either add 1/2 a gram of fat or walk those 1,000 steps.
I know, 1/2 a gram, 0.02oz - almost insignificant, right? Now multiply it by 10,000 and see that over those decades it contributed 50kg of the 100kg we are talking about.
For the same reason exercise doesn't make a lot off difference to a 6 month or even 2 year diet. But when you are trying to explain to difference between trim Koreans and 250lb Americans those extra 3,000 steps a day explain the entire difference, then some.
I think you're doing bad math. My point is that a shitty, low-cost middle-American diet greatly exceeds the caloric burn of walking, across any time window you choose.
I mean, it's obviously better to walk than to not, but I'm claiming the dominant factor is sugar-bomb drinks and fatty foods (which isn't at all a novel claim anyway). Walking only barely chips away at that.
If you’re moving around and walking, you don’t get as hungry. Outside of a handful of cities in the us, most of the country is basically designed to limit walking
Using public transport (aka walking) means to me to burn 500-1000 additional calories per day compared to using cars the whole day. That’s not insignificant at all. Of course, you need to live somewhere where this is a possibility.
I don’t know the science of it but for me at least walking suppresses my appetite. My hunch is that by not walking the body goes into “must be sick, should probably eat some more” mode.
The first few days of a long hike, my appetite and my wife's are suppressed. We live mainly on trail mix that we consume during the day. And chocolate covered coffee beans in the late afternoon, when we need a stimulant.
The appetite starts to come back around day six. Normally I've lost about two kg by then, after allowing for trail dehydration. After two weeks or so, I'm down about 4 kg.
I hate the join the "unreliable anecdata faction" in a thread where we are talking about well-established science-backed points (eating 1000+ extra kcal of trash most days contributes to being overweight; walking 10x more every day does the reverse), but I too believe there is something magical (meaning we don't fully understand the science) about walking.
I have three kids, and after each one of them, I tend to put on 10-15kg of body mass, mostly the wrong kind. So I have three experiences of "fixing it".
The first two times, I ran, lifted weights, ate salads and dropped alcohol, all that shit... it worked, but it was hard. Hard like when I quit smoking cigarettes (before the first kid). I was hungry. Irritable. Sometimes, I'd be like "oh, fuck it!" at 1AM and make a big ass instant Japanese ramen with scrambled eggs on the side, I was so hungry.
The third time, I eventually bought one of those under-desk treadmills, because despite my vows to walk 10km per day I just "don't have time".
It took about a day to acclimate. After that, and forever more, I can easily do computer work (writing code, reading code, architecture diagrams, writing docs) while walking 3kph (slow). When I am just reading stuff, I ramp it up to 4-5kph.
There are a bunch of other things that made me feel dumb for not doing it years earlier, which one day I might blog about or something. I suspect it actually helps my productivity — including learning rate and retention — for some reason (bleeding off extra energy that my mind might otherwise use to poke me with small, fascinating distractions?). But sticking to this topic, the main point is this: I was no longer super hungry with only 2000 kcal a day.
When I would run 750kcal off, sure I burned the calories, but I was soo hungry later that I would override my caloric restriction plan, and often end up eating more extra than I'd burned off.
Not at all the case with walking, either on the desk treadmill, or in the relatively uncommon case that I get to walk 10km in the real world (maybe once a week I will walk to/from work and take some detours).
My weight dropped steadily — which, of course, it does any time I manage to consistentely burn ~500kcal per day more than I consume — but the point is it dropped easily. Walking 10km/day, I can eat at a deficit without it being so... annoying. Eating to maintain weight is also easy.
And unlike lifting weights, or HIIT, or running hard — you can literally walk 10km every single day. You can take a day off if you want, but you don't need to[1]. Your muscles don't need rest. Your joints don't wear out. It's literally the activity your body was designed for. You can do it every single day for 10 years if you want.
I should really write that blog post.
I suspect some science-type should dig into it more and write a whole book.
[1]: the only real worry is that if you have already gotten super out of shape (very fat, very low cardio fitness, etc) then you should start with less walking per day, and work your way up gradually.
Basically it's all about Calories and Americans have added 25% to their caloric intake since 1961 when it started increasing.
Its also not really magical, they didn't just add sugar, they added meat, sugar, grains and oil (replacing butter mostly) - all together it adds up to 720 kcal extra per day per capita.
Koreans eat about 1500 kcal less per day (they are also quite a bit smaller on average so it's not 1 ot 1 of course.) Japanese eat even less (like 200 kcal less) but are also even a bit smaller on average. Both countries happily eat terrible food just as much as Americans do these days, they just eat a lot less food in total.
There's an idea that American eat out more and that the calories at dining establishments about increased about 35%.
If it were walking what keeps Asians slim, you'd see more variation, imo. The small portions and generally healthier food are what keeps them slim. True that the Japanese eat fried chicken and cakes, but not as often as Americans, and not as much each time.
There's a certain positive status associated being "fat and happy" in the US.
Americans are also, on the whole, gigantic people. Tall, wide, huge frames and/or a lot of meat on the bone. Only some of that is accounted for by diet.
I think there's more to do in Japan locally, or at least more general social/physical freedom, which I attribute to low costs and high mobility. Nature in the US is generally privatized, far out of the way, or has limited access or parking. If you travel by walking in the US, middle class people think you're poor or your car has broken down. There's a bit of a stigma in some cases and places against not being sedentary and large (or, having to move and sweat for anyone).
It's really quite simple to me. I don't quite understand why folks seem to argue about why the US is obese and Japan isn't. It comes down to one thing but I suspected aided by another three things:
In Japan a mindset of just enough seems to be prevalent. They do not seem to be as prone to glorifying excess in all ways like us Americans tend to be. I think this is a / the key aspect which is supported by these:
Americans are not active. Japanese people tend to be active and walking absolutely contributes to this.
Americans eat low quality food. We eat a lot of food with added sugar. We feed candy to children in sugary water-fat for breakfast. We eat processed and ultra processed foods regularly even when we primarily prepare meals at home.
Americans are anti-conformist. Japan is very conformist. This relates to social pressure(fat shaming, diet) and social activity cohesion (exercise, dieting).
It seems quite evident at even a glance why one country would be overweight while the other tends to be fit. In the US our culture rewards excess. We value cars more than people. We care about profits over people, too, really. Things like healthcare and food come to mind here.
Only 25% of Americans are getting the recommended aerobic activity. Which is 20 minutes per day of moderate activity (walking).
It is difficult to comprehend how little most Americans walk. In many suburbs, the local store is more than a mile, which would equate to a 40 minute round trip walk. How often do you walk for 40 minutes when you can drive in 8 minutes. Of course, delivery services only exacerbate the issue, as you're not even walking through the parking lot now.
Japanese people fry all kinds of food. They have plenty of soda as well, and there are plenty of Americans who struggle with obesity despite not drinking much soda.
It 100% has to do with walking/biking and portion sizes. Low intensity exercise throughout the day is as if not more effective than high intensity exercise for burning calories and keeping your metabolism from crashing.
I know a person with sort of an odd type of diabetes that requires multiple different ways of treating to keep her blood sugar low. She was taught to walk daily, not to help her blood sugar today, but to literally help it tomorrow. Her data seems to back this up.
Whatever the cause, there seems to be a causal relationship with brisk walking and lower blood sugar the following day.
Food in the US seems designed to make people obese.
When you look at ingredient labels in Japan or Germany, you see a short list of what you would expect, plus maybe a preservative.
In the US, you see an entire chemistry lab: artificial colors and flavors, bizarre substitutes for real sugar, oils that a hundred years ago would not be considered fit for human consumption, and so on.
Granted, this is hardly accurate/scientific - try out a solid hour walk on a treadmill.
A lot of steps for a pittance of calories [based on whatever hand-wavy math it's doing, admittedly]. We're frustratingly efficient. I forget exactly, it was something dumb like half a candy bar.
I've heard people say "you won't outrun your mouth", in this context... and others.
It's true. I've managed to drop my body weight ~half, it happened by controlling what I ate; not how I exercised. When I stopped skateboarding due to an injury, I ballooned. I stopped eating like that over a decade later, I shrunk.
In that time I also got older, moved, and went to college. It's worth considering what's easier/more likely/realistic to maintain
I think that pittance of calories is only the surface benefit. Consistent activity keeps your metabolism much higher, meaning you burn more calories throughout the day even when you aren’t moving.
Absolutely, very good to keep things burning. It's also good to not need to burn them.
We can be remarkably efficient with the right conditioning. I eat once/day and would do less if not for literally boredom.
I do next to nothing physically all day. I'm fine, I just don't need a lot of upkeep. I have all the metabolism I need!
My health may be suffering for it, but I enjoy getting back a solid chunk of the day. Eating is such a time sink... now it's exercise too?!
I know it's nuts, I have an unhealthy relationship with food lol. Even the social side, it's hard to explain but people get mad when you don't want to eat with them.
Put a morbidly obese person on a treadmill for a solid hour, and they'll likely spend a fair amount of time in zone 4-5. Walking is excellent exercise for some, not so great for others. Generalizing here is pointless.
Comment sections summarized excellently in four words. None of this was presented as universal truth, so I'd appreciate some leniency like I'm giving to you
My post provided a personal anecdote. What does yours have? Criticism we'd all be better off without.
It's clear the effect exercise had on me, it was keeping my eating in check. I can do that too at intake. I didn't even need a miracle drug.
I just stopped eating so much, but here I go slipping into moral judgement. I'm trying to help people, not reinforce a lifestyle.
Apologies for my rudeness, I'm afraid I let a pet peeve get the better of me. I often read health and wellness content on Reddit. There you'll find highly ranked comments expressing opinions such as "you should never eat below 1200 calories", or "walking on a treadmill burns a pittance of calories".
In my opinion, these sorts of observations are uninteresting at best, and misinformative at worst. Hacker News, as you may well know from your nearly three year comment history here, is a place where detail and nuance are roundly appreciated.
The walking may not be what actually loses the calories but it probably also affects how you look at your own fitness. It gets a lot harder to walk when you're heavy, and you'll notice quickly when you get start getting winded just going to work every day.
I recently wore a FreeStyle Libre for 10 days and one of the most positive things I learned from it was 10-15 minute walk after a meal significantly dropped glucose levels. It would reduce the spike in the range of 5-10% immediately. After I noticed that effect, a quick Google search presented many articles confirming it.
I strive for 7k steps per day since Covid hit March 2020. Some days I may fall a little short if really tired or sore from golf or coaching little league the previous day, but most days I easily achieve it or go well over. I surely don't think 7k is an unreasonable goal for ANYONE - it just takes a little bit of mentality change and effort that just seem taken for granted in the USA from what I have observed last few years.
Things like parking near the rear of parking lots when going to stores. I am amazed now at how often I see people wasting many minutes in their cars just to wait or "hunt" for closer spots when they could have just parked in back and be walking into the store already. Or parents at the park sitting and reading their phones for an hour while their kids play in playground. Teenagers riding electric scooters/ebikes instead of walking or regular bikes, etc.
I was at my in-laws over Christmas and everyone sitting around eating one of the many appetizers to choose from and drinking alcohol, I decided I wanted to go for a quick mid-afternoon walk just for some fresh air. I remember sort of being giggled at when I asked if anyone wanted to go, with a few bewildered looks on some faces. Again it is a change of mentality that needs to happen if obesity is going to be addressed in the US anytime soon. Now, with these drugs available, I'm afraid it will be even harder to get to the root of the problem.
My brisk pace would be about 120 steps a minute, with 80 cm step (I have long legs), that is about the speed I can sustain for longer time without any sweating.
I don't know the proper sources, but I've read in several places that the Netherlands continues to have rising obesity despite making exactly those sorts of reforms over the past ~40 years.
Netherlands is a bicycle country. There are fucking bicycle highways and extensive safe, multimode traffic design patterns everywhere. I've ridden them from Amsterdam through the countryside to Belgium.
And you haven't been to Los Angeles, Texas, or Florida if you call Netherlands a "car country".
As like most places, you cannot generalise a country.
Netherlands has bike lanes _everywhere_. People use it.
The cities (Randstad) encourages bike commute for everything. Driving a car around is almost cumbersome. Traffic, parking etc. Bikes are easier.
The countryside, life in farms and farmhouses are obviously more car friendly and in need of a car for better quality of life.
Food in the Netherlands has both extremes. Fried food, and pre-processed food? Check.
However, you can also find healthy option almost everywhere including vegetarian/vegan options, non alcoholic beverages everywhere, and portion sizes are normal compared to American sizes.
I used to live in the US, and now in Netherlands and do own a car for those weekend trips and occasional long drives across Europe. I would not categorise NL as a car country. Majority of the times, one does not need a car to get groceries.
Well, the local diet isn't particularly great, with a strong preference for preprocessed food (kant en klaar). And it could could be argued that the quality of the fresh produce coming from their greenhouses is also suboptimal, from a nutritional point of view..
Average Japanese walk 2000-2500 steps more per day than Americans. India has walkable cities, but still they don’t walk, and they have lower longevity despite an even lower average bmi.
Yes, I lived in Japan for a few years and those are the exact same two conclusions I came to, with the only additional one being much less added sugar/high fructose corn syrup. Food is generally much less sweet there.
> I've heard fructose inhibits the sense of satiation after eating.
You’re pretty much on track until this. The idea that a specific subtype of sugar has slightly different effects on the body might technically be true, but it’s a small drop in the bucket when compared to the huge increase in calorie intake in general. When this idea started circulating, it seemed like a food company misinformation campaign.
Mhhh apple contains fructose and my doctor suggested it to calm down big hunger without overeating (which it does), but i don't know if there are differences when it's pure vs inside an apple
I think it comes down to two major factors:
1. Koreans tend to walk (exercise) more. Walk (partway) during commute, walk to lunch, walk to do errands, etc. In the US people just sit in their cars. I personally find I get 3000+ daily steps in Korea without even trying, while in the US I only get about 300 daily steps or so.
2. Diet + portions. My Korean friend was astounded by the amount of fries that came with every meal in the USA and Canada. The US is the only place where fructose is substituted for sugar in most processed food. I've heard fructose inhibits the sense of satiation after eating.
So walkable cities and better food options would probably reduce US obesity.