A USDA funded study with partial support by the National Confectioners Association recently published remarkable findings. Kids who eat candy are thinner and have lower BMIs than kids who don't.
The study's authors would like us to believe that this study published in Food & Nutrition Research shows that eating candy is a treat and can be consumed in moderation.
Thinner kids are eating the sweet stuff and show no discernible negative effect. No elevated blood sugar, lipids, or other bio-markers of disease. Sugar candy eaters even show a lower C-reactive protein level, one measure of inflammation.
I have a very different interpretation. I bet the thin kids just get away with it. At least for now.
More Than One Way to Interpret the Data
The USDA data is cross-sectional, a snapshot of our population's health status and food habits. There is no long-term perspective here. The data can show association, but cannot prove cause and effect.
In much of the world today, surviving scarcity is still a metabolic advantage. Some of us seem far better suited to surviving scarcity. We are the ultimate hunter-gatherers, able to store fat readily when food is plentiful.
It occurred to me decades ago that everyone does not enjoy the same metabolic advantages. I've heard more than one researcher suggest that people who don't store fat are the ones with the metabolic defect. What does this say about the thin candy eaters?
A Continuum of Insulin Sensitivity to Insulin Resistance
I suspect there is a wide continuum of relative insulin sensitivity and insulin resistance. At one end are people who are more insulin sensitive, at the opposite end are people who are more insulin resistant.
People who are insulin sensitive seem to burn energy like an incinerator. They eat whatever they want and rarely seem to struggle with weight.
The greater the insulin resistance, the easier it is to gain fat weight, especially when consuming excessive refined starches, sugar and unhealthy fats. It's as if those of us with more insulin resistance are far better suited to hunting and gathering. We survive scarcity. Surviving abundance is proving to be far more challenging.
Factors That Influence Insulin Resistance
Genetics play a role. So do lifestyle factors.
Calories make a difference, but they are not the only factor to consider.
Exercise and overall level of fitness influences how the body uses fuel. Food composition and food distribution influences how the body metabolizes energy. Inadequate sleep and other sources of stress influence energy metabolism. Prescription and over-the-counter pharmaceuticals impact metabolism. So do alcohol, nicotine and other recreational drugs.
What About Children?
So what could be happening when thinner children eat more candy than heavier children? Are these children better able to navigate the "calories in, calories out" balance over time, as the authors suggest? I don't think so.
The authors note that "overall diet quality was very poor in all groups, regardless of whether candy was consumed." This is an important point. Both thin and heavier children are basically eating the same thing. The thin kids were even reported to eat more calories.
Is Targeting Child Obesity the Best Approach?
I suspect that the thin kids merely get away with eating candy and a poor diet -- for now. Maybe they are merely more insulin sensitive than their heavier counterparts. We don't know, but we may want to consider the implications.
I question our current approach, specifically identifying and treating heavier kids. Targeting child obesity as if it is a moral failure, a matter of making better food choices or a disease is short-sighted at best.
There are enormous social and emotional costs when we assume just the heavier kids need to eat differently. There is just as much damage when we let thin kids think they can eat whatever they want. Inevitably they grow up and can't.
Thin kids may never become obese adults. But they certainly can become metabolically "obese" and develop diabetes, hypertension and other cardiovascular disease, even cancer.
Time to Rethink the Goal: Health at Every Size
Body size is not a good litmus test for what one gets to eat. All children deserve to experience the energy and well being that is possible by eating a healthful diet. All children deserve an opportunity to learn what balance of protein, carbohydrates and fat works best for them. All children deserve an approach to food that doesn't increase their risk of lifestyle disease states as adults.
We know obese children are more likely to be obese as adults. It is also true that most overweight and obese adults were thin as kids. From 1971-1974 only 5 percent of children were identified as obese. Over 60 percent of adults are considered overweight or obese today. Maybe we need to rethink our strategy.
We can start by focusing on health at every size. Decreasing incidence of child obesity is important, but not more important than creating a food environment where all children can thrive. Ultimately we are faced with a dilemma: Will we be more successful treating individuals or transforming the physical environment and social conditions that contribute to the problem?
Follow Bonnie Modugno, M.S., R.D. on Twitter: www.twitter.com/morethanfoodinc
Dr Khandee Ahnaimugan: Children Going on Diets: What's Really Causing This?
Helene Pavlov, M.D.: Obese Children: Is It Nature, Nurture or Both?
There are several issues that are worth examining. One is the obesegenic environment prodded by the food industry that seeks to profit by exploiting an addictive culture even though it kills them.
Another issue is the need for these obesity prone individuals to develop a way to solve their problem despite the existence or elimination of that culture. If the junk food were eliminated, we'd have less of an obesity epidemic, but the obesity prone people would just be getting overweight on healthy food!
I solved my obesity problem through behavioral medicine and now help others. Feel free to contact me for collaboration. I have had some exchange with Dr. Katz, an impressive scholar and contributor to society's welfare, and have also been working with Dr. Robert Pretlow, a pediatritian and childhood obesity expert, on a new treatment approach to childhood obesity.
William Anderson, LMHC
Author of 'The Anderson Method - Secrets of Permanent Weight Loss'
Blog: http://theandersonmethodblog.wordpress.com/2011/05/28/how-do-you-kill-a-craving/
The authors want us to believe that somehow candy is innocuous in the diet. Their reasoning is that because thin kids eat it and there is no apparent harm, there must not be a problem with sugar in the diet.
My counterpoint is that not all kids get away with eating sugar. In addition, thin kids who eat a lot of sugar eventually don't get away with it as well (hence the 60% rate of overweight in adults today compared to 5% obesity as children in the 1970's).
Ultimately, I am questioning why we continue to perpetrate this myth about thin kids and candy. Body size is not a good litmus test for health, well being or decreased risk of disease. Every child deserves to learn how to eat well. It doesn't serve anyone to grow up believing that eating as much sugar (and refined starch) as they like is their birthright just because they are thin.
but with all that said sugar is not the evil it's made out to be, esp when consumed in moderation
Not everyone responds to a dose of sugar (and refined starch as well) in the same way. What is moderation for one person is not moderation for another. The globalizing myth about moderation masks the true nature of sugar and refined starch intake for a very diverse population.
The authors state that all kids were pretty much eating the same food. I don't think the thin kids were somehow magically matching their calorie intake needs. I think they are more insulin sensitive and they just get away with--at least for now.
The difference between rate of overweight/obesity for children in the 70's and rates of overweight/obesity in adults today underscores my point. Most people don't get away with eating whatever they want forever.