Do GMO Foods Cause Obesity?

Genetically modified organisms (GMO) refers to any living thing that has had its DNA modified by genetic engineering techniques.  GMO foods have been developed to be resistant to pests and herbicides, and/or for better nutritional content.   With the introduction of GMO foods, we have seen a parallel rise in obesity rates.  Could GMO foods have a role in this?

There is very little data on this issue. One study looking at American food trends and obesity found that consumption of corn products correlates with the rise in obesity.  Most American corn that is grown is genetically modified - so is it an increased calorie intake from corn products, or that it is genetically modified, that may be responsible correlation?  Or is the correlation purely coincidental? More research needs to be done.

A comprehensive review of dietary and policy priorities for cardiovascular disease, diabetes, and obesity published in the journal Circulation in 2016 found that existing evidence does not support that GMO food causes harm, but that the data are limited.   They point out that any potential effect of a GMO food on human health (positive or negative) would relate to specific compositional changes in the food, not to the GMO method itself.

As these authors state:

Based on current evidence, whether a food is organic or genetically modified appears to be of relatively small health relevance in comparison with the overall types of foods and diet patterns actually consumed. 

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Breaking News - Canada's Report Card On Access To Obesity Treatment

Obesity is a treatable chronic medical condition that affects over 25% of Canadian adults.  But how well are we doing at treating obesity in Canada?

Today, the Canadian Obesity Network has released the Report Card On Access To Obesity Treatment For Adults In Canada. This is the first rigorous assessment of the degree to which Canadians with obesity can access publicly funded treatments such as dieticians, psychological counselling/support,  medically supervised weight management programs, medications for obesity, and bariatric surgery.

The Report, not unexpectedly, showed that access to care for obesity in Canada is extremely limited.

• There is very little publicly funded access to dietary counselling, mental health support, cognitive behavioural therapy, or exercise professionals. 
• There is no public coverage for anti-obesity medication, and only about 20% of private medical plans offer coverage. 
• Bariatric surgery is available to only 1 out of every 183 adult Canadians per year who may be eligible for it (this varies widely by province, with the best availability of 1/90 in Ontario, and the lowest availability of 1/1,312 in Nova Scotia).  

So why is access to obesity care in Canada so poor?

1.  Despite the Canadian Medical Association declaring that obesity is a chronic medical condition (and not a lifestyle issue) in 2015, neither Health Canada, nor the federal government, nor any provincial governments have followed suit. This results in a lack of policies that support obesity care.

2.  Medical schools have little to no formal obesity training, and very few Canadian doctors pursue additional obesity training of their own accord.   Only 40 out of 80,544 doctors in Canada have completed certification through the American Board of Obesity Medicine. (there is no formal obesity training equivalent in Canada)

3.  There remains a powerful and pervasive obesity stigma in Canada, which has been shown to be even worse in the medical community than in the general population.  Person-first language is often not used in government resources nor in medical literature - meaning that obesity is used as a description of a person rather than as a diagnosis. (The correct terminology is a 'person with obesity', not an 'obese person'.)

4.  Government programs tend to focus on health promotion and obesity prevention, which is important, yes, but with a lack of attention to helping people who have obesity and need treatment for it.


So, where does this leave us?  The Report recommends:

• Government, employers and the insurance industry need to adopt the position that obesity is a chronic medical condition and orient their approach and resources accordingly;
• Government needs to recognize and help break down weight bias and stigma;
• Obesity training for health care professionals needs to increase;
• Governments need to increase funding and access to interdisciplinary care, weight management programs, anti-obesity medications, and bariatric surgery; 
• The Canadian Clinical Practice Guidelines, last published in 2007, need to be updated (and we are starting work on this!)

It seems we have a lot of work to do. 

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Could Yo-Yo-Ing Weight Increase Risk Of Heart Attack?

In the effort to manage excess body weight, many people have experienced the 'yo-yo' effect: start a diet, weight goes down... end the diet, weight goes back up (and then some, in many cases).  We already know that this fluctuation in weight is damaging to metabolism, in that our bodies essentially remember the highest weight we have ever had, making powerful hormonal and metabolic changes to drive us back up to our highest weight.  Now, a study in the New England Journal of Medicine demonstrates that fluctuation in body weight is associated with a higher rate of heart attack and death in people who have coronary artery disease.

The study evaluated fluctuations in body weight amongst 9,509 people with heart disease, who were enrolled in the TnT trial of cholesterol medication atorvastatin, taking the opportunity to evaluate whether fluctuations in weight made a difference in terms of risk of having a cardiovascular event.  In a post hoc analysis, they found that the greater the weight fluctuation, the higher the risk.  Specifically, for every 1 Standard Deviation (SD) in weight, there was a 4% increase in risk for any cardiovascular event, and a 9% increase in risk of death, independent of other cardiovascular risk factors.  Among patients in the top 20% for fluctuations in body weight, there was an 85% higher risk of a cardiovascular event and over a double increased risk of death, compared to those in the lowest 20% for fluctuations in body weight.  The risk associated with weight fluctuation was higher in those with obesity or overweight, compared to those of normal body weight. Also, a greater body weight fluctuation was also associated with a higher risk of developing type 2 diabetes.

One wonders whether these findings could simply reflect that people who had wide fluctuations in weight were sicker in general (eg big weight loss with illness), though this clinical trial did exclude people with a poor prognosis. The study also did not assess whether the weight fluctuations were intentional (eg dieting) vs unintentional (eg illness).

We cannot infer causality from this study - in other words, we can't be sure that the weight fluctuations were the cause of the increased cardiovascular events - but the association between weight fluctuation and cardiovascular events was nevertheless strong.  Given these findings, it seems more important than ever to avoid yo-yo weight changes by making permanent lifestyle changes rather than engaging in temporary solutions/programs to optimally manage weight.

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www.drsue.ca © 2017

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