When does the food get too much?

When eating and drinking make you sick

Who can still imagine this in the western world, which is dominated by industrially produced food? A life in which there is not something to eat on every corner, in which there is not even something to eat every day. That was the case with the early humans, for example. They ate what was there, sometimes while they were still hunting, stored the energy in the body and were able to draw on these reserves on less successful days. In the lean times, they also switched their bodies to a program of economy, reduced calorie consumption because they could not eat anything.

A tough undertaking. In any case, our ancestors only secured their survival by inventing cooking around 1.9 million years ago. Evolutionary biologists from Harvard University described this development in 2011 in a paper for the specialist magazine PNAS described. The higher-quality, higher-calorie diet increased reproductive capacity; this would not have been possible with raw food alone, the researchers wrote.

Cooking also saves a lot of time, it can be viewed as pre-digestion and makes life easier for us as cooking primates: According to the studies, we do not even spend five percent of our life on eating while awake. If we didn't cook, we'd have to spend almost 50 percent of our day chewing. Hard to imagine in a world of work that is all about maximum productivity.

No advantage without disadvantages: Benjamin Franklin, a scientist and one of the founding fathers of the USA, is said to have said: "Since the invention of culinary art, people have been eating twice as much as nature demands." As food became easier to prepare as industrialization progressed, it also became more accessible. Nowadays we are exposed to a seductive mix of scents. Pizza stands, sausage stands, kebab vendors - everything smells like the eagerly awaited satiety for the hungry. "Anyone who is hungry needs a lot of willpower to just pass by," says endocrinologist Christian Schelkshorn.

Unhealthy fat deposits

At the same time, however, because people do far too little sport, because they have become comfortable over the millennia with increasing civilization and technological development, they become overweight: The necessary stores of early human history are becoming fat pads around the hips, they are not only unsightly, They also lead to social problems and are extremely dangerous to health: According to the World Health Organization (WHO), around 2.8 million people die every year as a result of obesity, which can be cardiovascular diseases and type 2 diabetes. The development of cancer has also been linked to obesity.

With a body mass index (BMI) from 25 one is considered overweight, from 30 one is considered obese (obese). The growth rates are dramatic. Current figures show that 15.6 percent of men and 13.2 percent of women in Austria belong to the group of obese people. In Germany, a total of 25 percent is added. Studies on the problem in children and adolescents have recently come to quite different results. While some assumed that the peaks had been reached, i.e. that the increase had flattened out and that a decrease seemed possible, scientists at Duke University Medical Center in Durham, North Carolina, USA found that a total of 35 percent of children and adolescents were overweight in 2016 . That was almost five percent more than two years ago.

The problem varies from region to region, but it is present worldwide: In November 2017, a study based on the criteria of the Childhood Obesity Surveillance Initiative (Cosi) of WHO Europe was presented in Vienna. According to experts, the results were sobering. According to this, around 30 percent of boys in the third grade are overweight or even obese. The rate is lower for girls and varies from 21 percent in western Austria to 29 percent in the east. If left unchecked, overweight children will turn into overweight young adults.

High risk of cancer

Cases of type 2 diabetes, the development of which is supported by an unhealthy diet and lack of exercise, occur at a young age as well as cancers, which so far have mainly affected those over 50. As early as 2002, the International Cancer Research Agency (IARC) stated that five types of cancer are favored by high body fat percentages; in an updated version of the 2016 study there were already 13. Some results from the IARC indicated that weight loss reduces the risk, which was clearly the case Expert opinion in this case not.

A recent paper from the Case Western Reserve University School of Medicine, published in the journal Obesity, concludes that obesity permanently increases a young person's likelihood of developing cancer. Even after losing weight, the risk of cancer persists. Study author Nathan A. Berger is quoted in a broadcast with a gloomy statement: "Those who are overweight have a higher risk of cancer. If you lose weight, the prognosis improves and can lower your risk, but it never goes away completely." Obesity would cause changes in DNA that would add up over time.

Traffic light system for food

Overeating is therefore recognized as a major health risk, greater than hunger. However, the people affected find it very difficult to change their lifestyle, which, according to experts, has several reasons: Healthy food costs money, more than a high-calorie menu. Economists at the University of Hamburg therefore propose a staggered traffic light system for the taxation of food. Healthy products such as vegetables would be marked in green, while industrial foods rich in sugar, fat and salt would be marked in red. Such taxes have already been introduced in some states, and according to studies in Berkeley, California, sales of soft drinks containing sugar fell sharply.

One of the reasons for overweight and obesity that is not so popularly discussed is the level of education: One of the many studies that prove this comes from the Organization for Development Cooperation (OECD) in 2013. While only ten percent of academics in Austria were extremely overweight at the time, it was Percentage for people without high school diploma or apprenticeship 20 percent. Schelkshorn therefore criticizes the school system: "Actually, one should discuss nutritional issues from kindergarten onwards, which at least does not happen in Austria." In Finland, on the other hand, he had already seen this. From his point of view, the consequence is logical: Far fewer children have weight problems there.

Gerit Schernthaner, internist at the Vienna General Hospital, warns against stigmatization. Obese people may have a longer life expectancy if they exercise than thin people who do nothing.

Genetic causes

Too much weight on the scales can, however, also have genetic reasons. Findings in this regard go back to earlier work by the biochemist Douglas Coleman from the 1960s. In the mouse model, he showed that there can be a hereditary predisposition to obesity. The hormone leptin is normally released after meals and makes you feel full.

In healthy people, there is a hormonal interaction that sets limits when they eat. If we are hungry and are given food, the reward system in the brain releases endorphins, i.e. happiness hormones. However, the stomach and intestines produce appetite-suppressing hormones as the meal progresses, which inhibit feelings of happiness and increase the degree of satiety. The pleasure is no longer felt as strongly as at the beginning of the meal. However, industrial foods, mostly high in fat and sugar, can stimulate the reward system of socially and psychologically stressed people in such a way that they find it difficult to quit. The feeling of happiness is constantly sought. But if it is satisfied too often and too intensely, the person becomes dull - and can no longer feel satisfaction even with larger quantities. He's asking for more.

In all addicts - including people with obesity - addiction is controlled by dopamine. It drives those affected, puts pressure on them to continue with their unhealthy habits. The Salzburg psychologist Elisabeth Ardelt-Gattinger has pointed out the problem several times and noticed the difficulties in healing. Obesity patients could never be "dry" or "clean" like alcohol or drug addicts, because everyone has to eat. But Schernthaner warns against categorization here as well. Obesity doesn't have to be the result of addiction. If you regularly eat too much, you gain several kilos a year, but you don't have to be addicts. Obesity is a complex problem with no simple solutions. (Peter Illetschko, July 2nd, 2018)