The Problem of Overcooked Doughy Humanoids

Listen. What’s that sound? Is it the rising reverberations of an imminent existential threat? Yes. Why, you ask. Well, look around you and what do you see. A world full of doughy humanoids with even less respect for the planet than they do for themselves. Rising in size and number like a sickly loaf overcooking in the oven. What led us to this point? Unfortunately, our prosperity and success in turning the Earth into our playground. As such, we are completely inundated with food. Tasty, sugary, fatty, salty, delicious, refined, oversized and processed food. Do diets help? Not really. Does exercise last? God, no. Will any of us survive to see the planet explode into a ball of greasy flames? Let’s wait and see.

Obesity is one of the most serious public health issues of the 21st century according to that arbiter of all that is true, the World Health Organisation. Among an array of other diseases like cancer and neurodegenerative disease, cardiovascular disease (CVD) is linked to obesity. CVD continues to be the leading cause of death worldwide, and at the time of writing, ¼ of UK adults are obese and nearly half will be by 2030, which is an estimated 6.5 million extra cases of CVD.

Silence! I hear you say. You do not wish to be burdened with any more guilt. Fair enough, we are all guilty enough as it is without my condescending factual waft. Well look, you can alleviate some of that guilt by realising that according to a study of over 4000 twins from Finland, 75% of your BMI is determined by your genes. Your genes then interact with lifestyle factors such as an unhealthy diet, a lack of exercise, smoking and alcohol consumption to determine your risk of CVD. Reassuringly, research shows that modifying these risk factors leads to an 80% reduction in CVD risk. So, there is more power to you! Let’s get this bread!*

If you hadn’t had enough of those crazy Finns, here’s an example of them using their superior common sense to use this information to reduce CVD in a provincial town. A Finnish physician called Pekka Puska began witnessing the effects of an unhealthy modern lifestyle in the 1970s. He developed a program that reduced deaths from coronary heart disease by about 73 percent in North Karelia by encouraging people to change their diets from traditionally fatty, salty stodge to plant-based diets and introducing no-smoking programs. Life expectancy rose by seven years for men and six years for women! A win for epidemiology! Puska’s approach has shown that fostering an environment that facilitates a healthy lifestyle can ultimately benefit an entire town, so why not a city, country or… planet?

Global public health is no more imperative than during the age of COVID-19, where being obese carries the greater risk of increased severity and hospitalisation from the virus. A study from China has shown that COVID-19 patients with CVD have a significantly higher risk of mortality, while higher BMI was also observed in those with severe COVID and who died. Analysis from a large academic hospital system in New York showed that 37% of COVID-19 patients were obese, which is in line with obesity rates in the population at large. This percentage grew to over 50% when looking only at patients under the age of 60. In fact, obese patients under 60 years old were roughly twice as likely to be admitted to ICU. Even with our more modest obesity rates in the UK (27%), 73% of people admitted to ICU with COVID-19 were overweight or obese.

Obesity leads to an increase the risk of developing CVD by interacting with genetic susceptibility, disrupting important cellular processes and increasing systemic inflammation. More food increases the metabolic burden on our bodies and releases molecules that will damage cells. This activates the immune system so that it produces constant low-grade inflammation, thereby making obese people more susceptible to infections because of an impaired immune system. The effects of higher oxygen demand in other parts of the body also increases the likelihood of severe complications from viral infection. Notably, obese people are more likely to suffer from seasonal colds and flues, suffer for a longer amount of time, are more infectious and experience more severe outcomes.

The way things are going, society is only getting fatter. As populations get larger, diseases like CVD are going to become more common, and so too are communicable diseases like viruses as the potential for zoonotic transmission increases. This makes for a heady, depressing cocktail that means more and more people are going to suffer severe viral infections and die earlier due to their comorbidities. The future demands that we address obesity through radical policies that reduce fat, salt and sugar intake, increase physical activity and develop better ways of discouraging drinking and smoking. Ultimately, it will be of immeasurable benefit to the health of our ageing populations, our individual quality of life and the health of our greasy little planet.

*metaphorically – literally might exacerbate the whole weight situation