Writing Feedback / Alcohol and exercise are particularly important when it comes to balancing a healthy lifestyle [NEW]

Here is my rough draft of my research paper on Obesity. Please let me know how I can improve.

Some of what I wrote in this paper is simply common knowledge. I feel it would be best to locate articles that support the information I am disseminating. I would particularly like to support the information on alcohol and that of man's previous life as a hunter. I'm sure this will take a bit of research as I have already made a cursory effort on it already to no avail.

Alcohol and exercise are particularly important when it comes to balancing a healthy lifestyle. Alcohol is a huge factor in our society today as it seems to be pervasive in the lives of many people with health issues. I may need to expound further on the subject to get the necessary emphasis. I may wish to reference the lifestyle of the Amish where alcohol and exercise are not a factor.

I feel the article is very informative overall and I have tried to keep it interesting with a few areas that are less technical. I have added a light hearted quip about, "dancing with the stars instead of watching the stars dance", and I may add a few others. I may also add some quotations from my sources to take the place of or maybe in addition to information already provided.

When I was young and got up in the morning before my parents, Jack La Lane was on early morning television in glorious black and white. La Lane's exercise routine of calisthenics was an unheard of precedent on early morning viewing and often seen as something a bit risqué. La Lane was only a couple of decades ahead of the times but he left a lasting impression on many minds. In the near future, programs with scantily clad women performing aerobic workouts became all the rage, presumably as much for men to watch for entertainment as for women to join in and exercise in their own homes. While La Lane and those who followed him in the entertainment industry created a small niche among those who were self aware of their body's needs, the world became fat. Since those days of black and white television, the incident of obesity has grown to pandemic proportions. Research indicates obesity to be a behavioral risk factor which causes diseases rather than being a disease itself.

With the overwhelming growth in the number of obese people in the world, many studies have been done showing that obesity is a behavioral risk factor leading to other diseases and conditions. The resultant medical problems bring with them higher personal medical costs and a lower quality of life. Even though the general public is armed with this knowledge, the "growing" problem continues to grow. In 2003 there were 97 million obese people in the United States with 2.4 million people having become obese between 2007 - 2009. This number is increasing steadily and shows no signs of slowing down (CDC Vital Signs Adult Obesity). There are several reasons for the meteoric rise in obesity and most, if not all, come down to personal choice, a behavior.

With healthy foods being more expensive or unavailable in some parts of the world, and two income families with little time for home cooked meals, many people choose fast food with little nutritional benefit. The so called "fast paced lifestyles" are often blamed by many people to choose foods that are quick, easy and inexpensive. In the United States the choice of eating fast food is more of an excuse for being lazy as vitamin rich vegetables are plentiful. Fast foods which are low in nutrition, high in calories and sodium are generally chosen over the nutrition of home cooked meals which could be plentiful in vitamins, proteins and complex carbohydrates (Bowman PhD. and Vinyard PhD.). It is now understood that long term consumption of fast foods creates a metabolic state that self perpetuates obesity (Martin, Qasim and Reilly).

The 2003 Morgan Spurlock movie, "Super Size Me" is an extreme but very accurate depiction of what a fast food diet will do to the human body. In the movie, Morgan Spurlock begins eating at any convenient McDonald's restaurant for a period of one month. During the experiment, Spurlock was required to eat three meals a day and supersize them when asked if he would like to do so. Spurlock supersized his meals 9 times during the month of 90 fast food meals. He reduced his daily exercise to about 5000 steps each day. This computes to about 2.4 miles which is the average for most US citizens. At the beginning of the experiment, Spurlock who is 6 feet 2 inches tall weighed 185.5 pounds. By day 21 Spurlock was suffering from heart palpitations and was advised by his internist, Dr. Daryl Isaacs, to stop the experiment. In one month Spurlock gained 24.5 pounds and weighed 210 pounds, suffered from depression, reduced sex drive and reduced energy. The movie asserted that Spurlock had suffered from irreversible heart damage and would always have an increased risk for a heart attack even after losing the weight gained during the experiment (Contributors).

In the past decade the mechanics of obesity have come to light and researchers have determined that obesity creates bodily responses and triggers which promote the storage of fat. These responses are genetic in origin and are designed as feast or famine survival responses. Prior to modern farming, storage and transportation methods nutritious food was not always plentiful. It was common for people to put on a few extra pounds while food was readily available and then drop in body weight when times got lean. The human base genetic responses are generally not required today with readily available food sources (Bowman PhD. and Vinyard PhD.). As fat stores increase so does the production of the hunger control hormone Leptin. The logical assumption is that the body would become less inclined to crave food through the rise in body fat and leptin.

At a critical point the increase in leptin brings with it the same response as the body has with drugs. The body becomes resistant to leptin (Martin, Qasim and Reilly). What precipitates the critical point of leptin resistance is still being studied. It currently appears leptin resistance occurs at a point where the Body Mass Index (BMI) rises above 30. Insulin resistance also appears to occur at this same point and inhibits the body's ability to utilize stored energy (fat) (Kahn and Flier). Both of these changes in metabolism occur as fat is stored on the abdomen. Abdominal fat is now understood to function in the creation of the hormone leptin. Subcutaneous fat (white fat under the skin) is just as integral as visceral fat (brown fat around the organs) in this bodily response although visceral fat appears to be preferred. Visceral fat which is responsible for the condition commonly known as "beer belly" increases strain on the heart and reduces blood flow to the internal organs and lower extremities.

Educating the public on the mechanics of obesity is the first step in overcoming the problem. Over the past two decades we have seen public schools cutting physical education and health programs from the curriculums. During the same period the most noticeable rise in obesity has occurred. For some children the school physical education programs have been the only source of physical activity. Health programs were also the only tool to educate children in proper nutrition especially if their parents are unaware or unconcerned about their children's diets. With the advent of our technological society we have video games, internet and 300 channels of television viewing choice. Putting these changes in our society together is a recipe for metabolic disaster. Our food choices and lack of physical activity become a land mine to our children who will continue these same choices into adulthood. Most people do not understand that being driven to eat is a natural bodily function fueled by hormones (Martin, Qasim and Reilly). There is no magic pill that can be taken to cure obesity. The importance of diet and exercise must be taught to people as the only proven methods to control weight (Phillips and D'Orso).

As a modern society we should now understand that obesity is not a disease in itself but that it is the root cause of a host of other diseases. These diseases include but are not limited to diabetes, hypertension, chronic heart disease, liver problems, depression, stroke and joint and back deterioration. Without regular blood work, there is no way to know when these diseases can get a foothold on the victim. That is why everyone must be vigilant in maintaining a strict diet and exercise routine. Everyone should visit the doctor at least once a year for the proper blood work to determine if changes must be made in that routine. Having high triglycerides and abnormal cholesterol levels are two prime indicators of serious problems. People who are obese generally have high triglycerides which can lead to Type II diabetes. Triglycerides are fatty sugars that are used to fuel the muscles. Unused blood borne triglycerides must be filtered out by the liver. The liver is forced to work harder to strain the fatty substance from the blood. The liver can easily become "clogged" with waxy fat which reduces its ability to function. Blood tests can reveal elevated liver enzymes when the triglycerides are high. A diagnosis of high triglycerides is a sign of metabolic syndrome and a pre-diabetic condition (Grundy). Diet is almost always the culprit for elevated triglycerides. Exercise helps reduce body fat and utilize triglycerides.

Many of these statistics hold true for children. David S. Freedman notes that atherosclerotic lesions were present in obese children and neonates of obese mothers in the Bogalusa Heart Study. He states in his article that 40-77 percent of obese children will stay obese into adulthood which increases the likelihood of coronary heart disease. Of the five risk factors studied, 20% of the children had at least one of the five risk factors for heart disease. There was also noted a substantial increase in childhood diabetes among obese children. The glimmer of hope in Freedman's study is that among adults of normal weight who had and had not been obese as children; there was little difference in risk factors (Freedman, Khan and Serdula).

Generally speaking, hypertension is related to a high BMI. Obese people who have a BMI in excess of 30 are at high risk for developing hypertension (CDC Vital Signs Adult Obesity). There are 2 primary functions in the body which trigger hypertension due to high BMI. One is a high fat diet. High fat intake over a 5 week period has shown to significantly increase hypertension (Kotsis, Stabouli and Papakatsika). High fat intake is shown to increase sympathetic nervous system activity which causes hypertension. The second function is over consumption of sodium. Sodium retention occurs as a result of increased renal tubular re-absorption which is a control mechanism of infinite feedback gain increasing hypertension (Kotsis, Stabouli and Papakatsika). Hypertension is common among obese individuals with Type II diabetes.

The onset of Type II diabetes is caused by obesity and sedentary behavior. Research indicates that television viewing is a primary cause of sedentary behavior. Television viewing is shown to be more sedentary than working at a desk and driving a car. Most obese people spend at least 20 hours per week viewing television or movies. On average, obese women view television for 34 hours per week and obese men for a whopping 44 hours per week. This calculates to an average of over 5 and a half hours per day. Television triggers a desire to eat and drink based on commercials seen while viewing (Hu). It is also a behavior of boredom which is known to increase appetite. This behavior results in the highest accumulation of visceral abdominal fat especially if alcohol consumption is involved on a regular basis. Abdominal fat is the preferred fat that triggers Type II diabetes (Grundy). Most drinkers are unaware of the number of calories consumed while involved in sedentary activities.

Alcohol has been strongly associated with high BMI's, metabolic syndrome and Type II diabetes. Alcohol is metabolized into sugar creating a spike in insulin production. The spike in insulin continues throughout and beyond the drinking period. The sugars created by drinking are then converted directly to visceral fat deposits which increase leptin and insulin resistance in individuals with a BMI of 30 or higher. In this manner, alcohol can be directly responsible for increased blood pressure (hypertension) although the mechanism is not yet fully understood. Alcohol is also responsible for depression and causes an infinite feedback response of depression drinking. One interesting response of the body to alcohol is that although binge drinking increases hypertension, minimal (1 to 2 a day) drinking on a regular basis lowers blood pressure. This is believed to be an effect of increased insulin sensitivity but drinking can dramatically increase weight and BMI. One shot of vodka is equivalent to 80 calories and more sugary drinks can carry an incredible 500-700 calories per drink. There are 3500 calories in 1 pound of fat so it becomes easy to understand how 5-7 drinks a night, even as little as two nights a week can pack on the pounds. Add to this count a good high carbohydrate meal at the Olive Garden before a drinking binge which in itself can be as much as 3500 calories. A weekend of festivities can turn into a 4 or 5 pound experience.

Modifying lifestyle and nutritional behaviors is the key to reversing obesity and these related diseases. Even minor increases in activity have been shown to be beneficial in improving health. Reducing the amount of sedentary time has shown much improvement in overall health (Hu). A reduction in overall weight can begin to reduce blood indicators of metabolic syndrome (Grundy). Including moderate to high activity for a minimum of 40 minutes per day can result in a reduction of the indicators for most obesity related diseases (Mitchell, Mattocks and Ness). Activity must be maintained as a lifestyle change for continued improvement and reversal of obesity related diseases. Both strength training and cardiovascular exercise are required for maximum use of stored energy in the body. Cardiovascular exercise is necessary for optimal heart and vascular health. An increase in muscle mass assists in improving the fat burning process and overall musculoskeletal health (Phillips and D'Orso). Reduced overall fat levels in the body lowers leptin resistance which helps to control hunger (Martin, Qasim and Reilly).

Obesity and depression have long been thought to go hand in hand but most studies have been inconclusive or have failed completely to verify a correlation. In the article, "Depressive mood and obesity in US adults: comparison and moderation by sex, age and race", subjects were categorized and a linear correlation was discovered. Young obese people, women significantly more than men, were more likely to suffer from depression. This was especially so for young Hispanic women. Older obese people showed there was little association to depression although it was slightly higher in women. In previous studies there have been no moderators for sex, age, race or socioeconomic status. The study admits there may be other confounding factors that have not been considered (Heo, Pietrobelli and Fontaine). It should be noted that obesity can be a result of depression. Depressed individuals are less likely to be active and may participate in extreme sedentary behavior such as television and movie watching.

The obese person must make dietary changes to achieve the goal of good health. These may be made in increments or massive and intensive changes may be required in extreme cases. Modification of dietary habits must be incorporated to reduce fat, cholesterol, blood sugar levels and control obesity related hormones. Removing high fat fast foods from the diet reduces saturated fats, high calories and excess carbohydrates (Bowman PhD. and Vinyard PhD.). Changing the type of fats consumed will reduce LDL and increase HDL (Phillips and D'Orso). Consumption of sugars and other simple carbohydrates should be removed from the diet to prevent insulin spikes and reduce triglycerides (Kahn and Flier). Replacing high sugar and carbohydrate foods with healthy vegetables and fruits reduces hunger, calories and ultimately, overall body fat. Minimizing red meats and increasing intake of poultry and free swimming fish as opposed to shell fish provides the necessary nutrition to reduce obesity and regulate hormones for improved health (Phillips and D'Orso).

Exercise is becoming more of an issue in the control of weight and maintaining good health. Today more than ever, exercise is becoming a behavior modification known to be a paramount factor in cardio and mental health as well. Consider that humans once had to work all day long to feed themselves and store food for the winter. Early man is now understood to have run as much or possibly more than twenty miles chasing his prey. Man could run down animals such as deer and rabbits to the point of exhaustion in order to kill them for food. Then there was the long hike carrying the kill back to the home, cleaning it and preparing the meat for the meal. That was real exercise. Times are very different now and humans must make the time and devise ways to get sufficient exercise. Very few individuals today are motivated enough or can make the time to get the 40 minutes of vigorous exercise each day that is required for good health. It is a realistic goal to be dancing with the stars instead of watching the stars dance from our couches and easy chairs. National campaigns and doctors have failed miserably to motivate children or adults to exercise. It is up to every person to make a conscious decision to change their personal behaviors, diet and exercise in order to attain a healthy body with the proper BMI.

An easy way to keep track of overall health is the BMI. If it is not possible to visit a doctor or afford the required blood tests, BMI can be maintained with a bathroom scale and a simple calculation. The formula to calculate Body Mass Index or BMI is weight (kg) divided by height in meters squared. The easier formula for those of us in the US in imperial pounds and inches is: (weight * 703) / height in inches squared. If a person is 6 foot three inches tall and weighs 225 pounds their BMI would be (225 * 703)/ 5625 = 28.12. This person is overweight but not obese but still needs to lose 25 pounds to attain a BMI of 24.9. Another option is to buy a relatively cheap electronic scale that will calculate BMI for you. A BMI of 20 to 25 with a minimum of 30-40 minutes of vigorous exercise each day will keep most people on track. Keep in mind that a person with a high BMI can still be muscular with a lean body mass so BMI is only a relevant measure of health. It is intended for the average person but is still a very effective measurement for most.

After due diligence in researching whether obesity is a disease or a behavioral risk, it is very apparent that it is a behavior with devastating effects on health and quality of life. Only in very uncommon cases is obesity a standard condition for the human body. Hypothyroidism is one of the few genetic or disease related causes for obesity and in most cases there are effective medical treatments for these situations.