Obesity, Illness, and Infertility

By April 16, 2015 November 29th, 2016 Lifestyle & Stress, Nutrition

A Toxic Combo that Might Contribute to the Fall of the Human Race

Despite the slim odds, the earth can be hit by a devastating meteor. It has in the past – about 65 million years ago a relatively small meteor destroyed most animal and plant life. Or, the sleeping Yellowstone super-volcano may suddenly erupt, plunging the planet into ash-filled darkness. This would be the ultimate climate-change scenario. Game over for most species. But despite the fact that 98 percent of all animals that once roamed earth are now extinct, it may be more likely that countries and civilizations will continue to rise and fall on their own, just like in the past, as history has revealed. The Egyptians, Mayans, Incans, Roman Empire and others succumbed to both known and unknown causes. And, with nuclear arsenals spreading to “unfriendly” countries, who knows how long it will take for an atomic age Armageddon to become a reality. Try to imagine the political and radioactive fallout from a dirty bomb going off in New York City or Los Angeles.

Fall-out shelters are once again on the rise. These relics of the Cold War era have been updated and modernized. Business is brisk for “the-end-is-near” entrepreneurs. Fear is in the air, stoked by politicians, media, a lackluster economy, or perhaps due to the delayed PTSD effects of September 11, 2001. Rather than learning from our mistakes we seem to be accumulating them over time.

Perhaps the end is near. But not for the reasons you might think. It’s not due to the size of the Earth’s population, now numbering near the seven billion mark, but the size of humans.

The New Epidemic

Throughout history, the human race has flirted with destruction. Not from deep space like the early eons of earth’s existence, which seemed full of potential mass devastation from the cosmos, but from our own inadequacies, war, and greed. Each time enough humans overcame the problem and the race survived, even from such events as the Black Plague, which killed perhaps 100 million people – 30 to 60 percent of the population of Europe and West Asia. The results of these devastations? Our immune systems got stronger to fight off infectious diseases, we cleaned up the poor sanitary conditions, and in the modern age, we invented ways to live longer – artificial hearts and lungs, insulin and dialysis to name a few. All this despite the explosion of new bad habits and self-destructive lifestyles.


The continuous process of evolving through these lethal periods in our history, where mass numbers of humans either died or were seriously debilitated have been carefully plotted by scientists and are referred to as “epidemiologic transitions.” The theory was first described in the early 1970s by Abdel R. Omran. It states that death from disease, a major influence of life expectancy, is a fundamental factor in population growth and decline; and fertility sets the pace for population change.

Three epidemiologic transitions were initially described. They can occur in isolated areas of the world or are more global. This first included a phase that consumed most of human history. Famine was a dominant feature of this period, with early death from malnutrition and infectious disease keeping the average life expectancy of around thirty years of age.

The second transition – in the Western world it occurred during the late nineteenth century – saw a jump in life expectancy up to fifty years. This was the result of decreasing famine and disease from increased food availability and improved sanitation. However, the majority of mortality and morbidity – death and disease – was due to a continuation of various types of infections. In particular, bubonic plague and influenza were some of the ones commonly written about in the headlines of history books, but pneumonia and tuberculosis also killed millions.

The third transition follows as society brings increased medical services and healthcare to many more people resulting in greatly diminishing mortality, especially in children not dying soon after birth. Life expectancy rises into the sixties, with increased fertility becoming the crucial factor in population growth.

A fourth phase has been added to the first three phases of Omran’s epidemiologic transitions. In the West, this began in the middle 1900s, where “human-made” conditions such as cardiovascular disease and cancer became the major causes of mortality and morbidity. As medicine developed ways to keep these ill patients alive longer, longevity continued to increase at a rapid pace, hitting the mid-seventies. Longer life was hailed as the modern medical miracle. But the debate about quality of life vs. length of life began to emerge.

Today, the average American lives the last 12 years of his or her life in a state of dysfunction, unable to care for themselves and dependent upon medications, hospitalization, expensive end-of-life treatment, and nursing homes. This causes a dramatic rise in health care costs. Despite the fact that most of these diseases are preventable, most of the efforts, drugs, and money are spent on treating the symptoms.

Charles Darwin wrote that it’s not the fittest who survive, nor the most intelligent, but those who can best adapt to their environment. Throughout history, humans who survived adapted by finding better food sources (especially fishing and hunting), storing food, farming, and, in later periods literally cleaning up their act through better sanitation. Today many survive because medicine keeps them alive, if they can afford it.

But now humans face a unique problem – the four phases of epidemiologic transition are no longer behind us. Instead, we are accumulating them rather than passing through them. We still have significant numbers of deaths throughout the world that reflect famine, infections, heart disease and cancer. For example, thousands of children die each day of malnutrition, antibiotic-resistance bacteria are as deadly as the old epidemics, and most people in the Western world will die of cardiovascular disease or cancer. But the picture gets worse.

The Fifth Phase: The Overfat Epidemic

In a recent editorial in the Journal of the American Medical Association, Dr. J Michael Gaziano highlights these four transitions and proposes a fifth one, an epidemic that we are in the midst of right now. Is this the beginning of the end? Gaziano writes that the fifth phase of the epidemiologic transition is obesity. It’s difficult to see what’s going on when you’re in the midst of a problem, but ultimately it may be at least as serious as any of the first four transitions, or worse.

For the first time in human history, the numbers of obese people have passed those who are merely overweight. The World Health Organization (WHO) showed that in 2000, for the first time in history, the number of overfat adults in the world was greater than that of underweight adults. Yes, there is still global famine in the third world, but the overweight epidemic is spreading.

The 2006 National Health and Nutrition Examination Survey (NHANES) found that about a third of U.S. adults 20 years and older are overweight, but that over 40 percent are obese. Please note that both groups – the overweight and obese – are part of the epidemic. Instead of calling one person overweight and another obese because the scale or body mass index gives one number or another, let’s just call the condition what it is: overfat.

The WHO tracks the overfat population. And we now know it’s not just the affluent Westerners. WHO’s 2005 estimates show that two billion people age 15 years and over are overfat. WHO also projects that by 2015, approximately three billion adults will be overfat. Considering that the fastest growing overfat segment of the population is children, more than half the world’s population will soon be overfat.

Children are a recent casualty of the overfat epidemic. WHO estimates that at least 20 million children under the age of five years were overweight globally in 2005, with the condition dramatically on the rise in low- and middle-income countries. Between 1978 and 2008, the problem skyrocketed, with obese adolescents aged 12–19 increasing from five percent to over eighteen percent. This does not include those who are overweight.

Why have so many people, from babies to the elderly, become overfat? For some of the same reasons cardiovascular disease and cancer (and most other chronic illnesses) are the major killers. Relatively recently, humans dramatically changed two key habits – they began eating large amounts of processed food, predominantly refined white flour and sugar, and their levels of physical activity were dramatically reduced. Each of these habits is devastating by itself, but combine them and you produce an epidemic.

Where are we headed? The human race could soon be 75 percent overfat. These individuals are not only the most diseased, but have rapidly declining overall brain and body dysfunction. In addition, a relatively large second group of people, perhaps another 10 to 12 percent of the population, have an overfat metabolism – they are not physically overfat but referred to as “metabolically obese” because they have the same poor health of someone overfat. And, a third group of the remaining population that is not overfat or metabolically obese has many end-stage diseases like the previous two groups. These individuals are chronically ill with cancer, heart disease, serious brain injury (such as cognitive dysfunction, i.e. Alzheimer’s), diabetes and other conditions rendering them unable to effectively care for themselves and unable to recover. This may be another 10 percent or more. What remains is a functional group of surviving humans of only three to five percent of the population. Do we consider this a “fall” of the human race?

A Fall of Life Expectancy

For the first time in recorded history, life expectancy has decreased – only by a mere four to nine months, but that may be significant as it’s a reversal of the trend of longer longevity. In 2008 life expectancy was around 77 years in the U.S. In Canada, Australia, Japan and parts of Western Europe life expectancy is about 80 years, but Eastern Europe and India are in the 60s and much of Africa is in the 50s. These areas of lower longevity may be even more vulnerable to the overfat epidemic, not to mention the increased probability of death from compromised immune systems and infection – including both the “old” diseases such as tuberculosis and relatively new ones like AIDS.

The drop in life expectancy may have been first predicted by the National Institutes of Health (a part of the U.S. Department of Health and Human Services) in 2005. They produced a stunning research study, which appeared in that year’s March 17 issue of the New England Journal of Medicine. The study shows that over the next few decades, life expectancy for the average American could decline by as much as five years, unless aggressive efforts are made to slow rising rates of obesity.

This research shows that obesity is shortening the average life spans by a greater rate than accidents, homicides and suicides combined. And it noted that childhood obesity is growing so rapidly that today’s children could be living two to five years less on average – an effect on life span that could be greater than that caused by cardiovascular disease or cancer.

In a New York Times interview (March 17, 2005), two of the study’s authors spoke out about the just-released study. “Obesity is such that this generation of children could be the first basically in the history of the United States to live less healthful and shorter lives than their parents,” said Dr. David S. Ludwig, director of the obesity program at Children’s Hospital Boston, and one of the study’s authors. He stated, “We’re in the quiet before the storm. It’s like what happens if suddenly a massive number of young children started chain smoking. At first you wouldn’t see much public health impact.” He added, “But years later it would translate into emphysema, heart disease and cancer.”(Indeed, a national survey of almost 10,000 American adults suggests that obesity is associated with more chronic disorders than smoking.)

Ludwig also said that, “There is an unprecedented increase in prevalence of obesity at younger and younger ages without much obvious public health impact.” What is more obvious is that this problem will soon be devastating for the population and society.

The report’s other lead author, Dr. S. Jay Olshansky, a professor of public health at the University of Illinois, Chicago, said he considered the report’s projections of reduced life expectancy to be “very conservative, and I think the negative effect is probably greater than we have shown.”

I should mention that I’m not a doomsday naysayer. In fact, my holistic outlook on life is very positive. And I certainly don’t dislike overweight or obese people – throughout my healthcare career I’ve helped many lose 30, 50, 100 pounds or more of weight and body fat.

Healthcare Catastrophe

One of the key problems is that the current health care system, a model that is basically quite similar worldwide, is not financially capable of addressing the overfat epidemic with all its fallout. In fact, it has allowed it to happen. This is due to the presence of companies that develop medical equipment and drugs to treat symptoms (rather than causes), and politicians who are influenced by industry lobbyists whose companies produce the very foods that contribute and maintain the epidemic. The signs and symptoms of the overfat epidemic are the surging problems of diabetes, cancer, heart disease and many other expensive conditions. As the crisis worsens, financial and budgetary collapse could occur if companies and governments don’t drastically change. But this change probably won’t happen, so the problem will continue and nature herself could determine the final fate.

A Bigger Problem

While most of the discussion about an overfat world focuses on medical care for the side effects of the problem, an even bigger dilemma has appeared as another side effect. Overfat women who give birth have children with extremely high risk for earlier-than-ever chronic disease, especially cardiovascular disease and cancer. But worse is that overfat women are more infertile. Both are potential reasons for a declining population as discussed above, and, even though you’ll hear reports that the obesity epidemic is slowing, it does not take into account the next generation of overfat children and their health problems.

Men’s fertility is also compromised if they are overfat. Men who are overfat often have reductions in testosterone and elevations in estrogen leading to infertility. Impotence leading to infertility is associated with erectile dysfunction, a condition in half of men over the age of 40. Certainly if one side effect of the epidemic is reduced population growth (which some might say is a good thing), this could signal a dramatic change in the course of human history, and I believe could mark a sixth phase of epidemiologic transition. Where we come out at the other end no one knows.

The Remedy is Free

In the early 1980s, while in private practice, it became evident that in the course of helping patients lose weight with my newly developed Two Week Test, some women previously unable to conceive did just that. While the Two Week Test is a way to jumpstart a patient’s metabolism to help increase fat burning and weight loss, and can help improve many other problems because insulin levels are reduced through a reduction of high glycemic refined carbohydrates, it’s also an effective way to balance hormones. One problem in many women who can’t easily conceive is hormone imbalance (associated with ovulation). The Two Week Test quickly became a very successful way to help many women conceive who could not do so through other means and who wanted to avoid using drugs. (It also was a successful approach to significantly reduce body fat – for free.)

Eventually, small published studies began to show what was clinically evident: that reducing insulin levels through dietary changes could improve hormone balance and help some women who previously could not conceive get pregnant. Ultimately, the Nurse’s Health Study, one of the largest research endeavors of the health of American women, showed the same. The authors of this study looked at the health of over 18,000 women. In those with the most common type of reproductive problem (ovulation and the hormonal problems associated with maturation of the egg) they could become pregnant through changes in diet – in particular by eliminating refined carbohydrates, including sugar. Two of the researchers, Dr. Jorge Chavarro and Dr. Walter Willett of the Harvard School of Public Health, wrote a book on the subject called The Fertility Diet, released in 2007.

This was great news for the millions of women who are infertile. A relatively simple change in diet could significantly improve fertility, and reduce body fat for a more successful and healthy pregnancy, and a healthier baby. But it’s nothing new. Even my clinical observations in the early 1980s were not new. And the high level of effectiveness I saw was not proof as I did not publish my data. But the Nurses Health Study should now make women and healthcare professionals rely more on diet change for infertile patients. Instead, fertility clinics are booming and people are spending (often borrowing) large amounts of money in the hope of getting pregnant. Why not use diet as a first treatment? It’s free, safe and it’s effective for very large numbers of women.


Since the same dietary problem of excessive refined carbohydrates that could cause infertility can also make people overfat, removing these foods, now a staple in the daily diets of people throughout the world, could be a first step in quickly resolving the overfat epidemic. It will unlikely happen on any large scale – there is too much money involved and too tight a political connection.

No one knows if or how our longevity will change, or if the human race will completely fall or find a way to recover. But there’s no doubt that there’s a problem, and that many are looking the other way. A human race that’s mostly overfat will potentially have many more problems than those described here.

A question that often comes up is this: How many people today could survive, even if the earth was hit by a meteor and what’s left of the population is living like we did thousands of years ago? Everyone would be off the grid. I’m reminded of the story of when many people stockpiled canned food in the event of a widespread problem such as an extensive power outage. When it occurred, many people could not open their canned food because they only had electric can openers.

No one knows if the human race will survive. Chances are, even if there was a relatively rapid deterioration of the human population, perhaps triggered by worldwide social collapse or a long-term plummeting birth rate, some would survive – and these will be those who are best capable of adapting to the environment. There’s no time, genetically speaking, to adapt to refined carbohydrates, processed food, sugary snacks and soft drinks. So it will be those who avoid them that best adapt. History has already proven that with the alarming rates of disease in our current population.

If we’re not going to help save the world, let’s at least be selfish. Let’s have fun in the time we have left. In the Epilogue of my book In Fitness and In Health, I explain this positive, forward-thinking mindset as follows:

An old proverb says we should approach death with dignity. While living a long and healthy life past age 100, your physical and mental activity should be relatively high right up to the time of death — an event that should also be optimal. Perhaps on that day, you wake with the sunrise to a freshly made cup of organic coffee. You settle in for a vegetable omelet and after reading e-mail from your children, grandchildren, great-grandchildren and their younger ones, you correspond to all. You spend some time writing in your diary, then head out for a beautiful hike through the woods. After returning for a healthy lunch, you nap for an hour or so. You dawdle in the garden that afternoon, and follow that up with some easy paddling in the canoe. You watch the sun set with your significant other during a fine dinner complemented by a glass or two of Bordeaux, then share a healthy but delicious homemade dessert. You head to bed, make love and fall asleep by 10:30. Just past midnight, you die peacefully during a sound sleep.

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