The Evolution of Obesity
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Conclusion: Published literature on the history of obesity reveals that obesity has been present all along. There seems to be an acknowledgment of obesity as a disease recently, politically and medically. This acknowledgment would facilitate treatment options and policies aimed at curbing increasing obesity. Obesity is defined as an excessive fat accumulation that may impair health .
It is a common public health issue and the prevalence is increasing worldwide. The global age-standardized prevalence of obesity doubled from 6. This paper will address the evolution of obesity from the Paleolithic era to the present era. It will highlight the presence and perception of obesity in each era. Furthermore, emphasis will be on obesity as a disease from medico-political and socio-cultural perspectives. This is based on a narrative review of available literature.
The Paleolithic Era is a period of prehistory from about 2. Obesity studies from the Paleolithic era are based on figurines of that time. Paleolithic humans used primitive stone tools and they survived as hunters and gatherers . As nomads, their food source depended greatly on the environment and climate changes. Figurines curved during the Paleolithic era may depict the sociocultural perspectives of the individual population. In this section, we reviewed studies based on the figurines to emphasize the presence of obesity in the paleolithic era.
Pontius , described two important terms for use in studying pre-history; heuristic and iconodiagnosis. In simple terms, she suggested the use of experience-based techniques to study and interpret prehistoric art within a medical framework. The author highlighted two types of obesity- gluteal and abdominal.
It has provided the earliest depictions of obesity [4,7].
The Evolution of Obesity
This figurine depicts generalized obesity, central adiposity, and large waist circumference. Venus to the Romans , attributed to representing Aphrodite, the Greek, goddess of love and beauty . Seshadri . Ninety-seven of those studied were females of whom 24 were skinny mainly young women , 15 were of normal weight, whilst more than half of them 51 were either overweight or very obesity. They found that the figurines examined revealed various types of obesity ranging from belly only, belly and hips, belly and gluteal and hips, belly and hip and gluteal and femora, and diffuse obesity.
Furthermore, the paper reported that only 7 statues were in the state of advanced gravidity. We can deduce from this study that in the Paleolithic era there might have been double effect malnutrition with underweight, normal weight, overweight, and obesity. We can further deduce that based on the figurines studied there were fewer statues in the state of gravidity and this question the rationale of Venus figurine obese females representing the goddess of fertility. In the present time, we know that obesity is associated with the polycystic ovarian syndrome and reduced chance of conception .
We can conclude that obesity existed during the Paleolithic era as depicted in arts.
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The incidence and prevalence at the time are unknown. The presence should be analyzed based on the sociocultural perspectives of people of the time. They depended on hunting and gathering and were prone to the effects of climate change and may be gaining extra fat was survival self-defense at times of famine. Intuitively, it is safe to postulate that due to the sources and nature of food, obesity would not be rampant.
The Neolithic Era began around 10, B. Neolithic humans discovered agriculture and animal husbandry, which allowed them to settle down in one area . This was the first change in sourcing food.
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The revolution changed the dynamics of the society from small clusters of hunter-gatherers to a large community of farmers . The change also brought about abundance of food, even though seasonal. Crop production led to increases in carbohydrate-rich diets and changes in dental microbiota . The changes in dental microbiota reflect historical dietary changes . Furthermore, Bogaard et al. In illustration of the Neolithic era obesity, a female Greek figurine made of clay estimated from 5 th Millennium B.
The figurine had visible characteristics of female obesity, protrusion of the abdomen in a broad convexity, legs full, nearly round in section and the size of thighs almost the same as the upper body. It may be that obesity became more common as agricultural settlements began to take over from hunter-gatherer tribes . The process would need manpower and hence facilitation of large communities to work on the farms and herd animals . The change from exercising all the time hunt and gather to periodic work on the farms and sedentary lifestyle and having more food would lead to energy imbalance with built up of positive energy leading to overweight and eventually obesity.
The Neolithic revolution would have led to widening the gap in sociocultural groups- the less well-off working for the rich. The Greco-Roman period is from B. Another source state that the Byzantine Empire ended in when it was conquered by the Ottoman Turks . Papavramidou et al. They reported on the writings of Aulus Cornelius Celsus circa 25 B. It is interesting to note that all selected writers were addressing etiology, manifestations, and treatment of obesity. They all postulated that a healthy body is a balanced one with moderate thin and fat, balanced temperament and retentive and natural faculties.
With regards to obesity, there has to be imbalance i. These points address the cause of obesity and point to possible cure by trying to restore the imbalances. Furthermore, the authors addressed the treatment of obesity by suggesting shifting the ill temperament of the patient to a healthy one and reestablishing the balance of the humors .
The treatment options they suggested were all focused on weight loss and include diet, medications, and change in lifestyle among others. Since the Byzantine world is around the Mediterranean, then the diet suggested is thought to be a Mediterranean diet. Mediterranean diet has been shown to reduce the incidence of obesity . In this section, we have shown that obesity and its management were considered by physicians of the time. It was a period characterized by religious, social and political changes. It was a period when the globalization of the economy and the exchange of foods across continents occurred .
We can deduce that it might have been about excess eating leading to obesity or corpulence. An example of obesity during the Reformation era includes the Protestant reformer, Martin Luther [24,25]. Portraits of the time also depict obesity, e. Industrialisation led to a shift towards added sugars and high-fat diet in a heterogeneous pattern depending on the region and culture. Simultaneously, the occupations required less energy to be expended and the new technologies allowed those in each occupation to engage in increasingly sedentary work . The technologies included packaging, refrigeration, cookers, fire, and electricity among others i.
Transportation changed from walking and horse-drawn vehicles to trains, cars, electric scooters, and buses for rapid access. Transportation of goods involved the use of trucks and lorries and most notably rail networks . These changes would lead to energy preservation which in turn would be converted to fat and lead to obesity. Urbanization described as a shift from rural to urban dwelling also had an impact on weight.
Having stated that, efforts to reduce overweight and hypertension and their health sequelae should address the dietary changes and reductions in physical activity that have occurred in both urban and rural populations . In China for an example, there has been a rapid growth of population dwelling in urban areas. The economic opportunities are a strong pull factor stimulating migration and the effect is to provide a large labour pool for productive activities in urban areas .
According to Popkin, , the rapid decline in energy expenditure of the population, linked with the enormous shift towards a diet with more energy density from edible oils and animal source foods, have resulted in a rapid increase in the distribution of the body mass index BMI of the Chinese population, particularly adults.
The consequence of this would be increased weight. Chinese diet like other Asian countries has shifted from more traditional plant-based diet to westernized, highly processed diet . The money elasticity for the demand for edible oil rose significantly between and and was positive at all income values . Guldan , reported that Asian childhood overweight dietary patterns include snacking and eating out; consumption of fast food, sweetened beverages, and excessive meat; unhealthy macronutrient energy proportions; and a preference for refined grains.
Furthermore, overweight or obese adolescents tended to view TV programs and become less physically active . Using data from China Health and Nutrition Survey, a longitudinal survey from to , Luo et al.
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Changes in social status have resulted in a rapid increase in the distribution of the body mass index BMI of the Chinese population, with adult male overweight status tripling and female overweight status doubling between and . Furthermore, Popkin , reported that more than 1. In Africa, with special reference to sub-Saharan Africa, social epidemiology reveals that females sex and women gender regard plumpness as a sign of beauty, fertility, and well-being [37,38].
This social depiction is more on ethnic lineages . When a female is due to get married is fattening to prepare her for pregnancy, breastfeeding and social status as a married woman in the community . Culture as a changing phenomenon is influenced by national and international media, occupations, psychosocial factors and importantly the advent of modeling industry that might have led to double effect malnutrition- thinness and fatness in the same communities.
Holdsworth et al, . Overweight and obesity are on the rise in sub-Saharan Africa with women being disproportionately affected compared to men . Stewart et al. Early humans had to endure famines and shortages of food, so their bodies were equipped to survive long periods without eating.
Researchers believe these people possessed what's known as a "thrifty gene," which helped their bodies store fat for endurance.
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Since the ability to outlast a famine would have been a useful skill, evolution would have favored those who possessed this gene, and it would have been passed down to humans living today. For many people in the developed world, food is rarely in short supply, so we eat more often. If that thrifty gene is present, though, the body holds onto that food as fat, even if the person has no risk of starving.
And it's only in recent years, when humans started living much longer, that we've realized just how many health problems wait down the line for someone with the inability to get rid of excess fat.
Whether humans will continue to evolve and rid themselves of the thrifty gene remains to be seen. How the Obesity Paradox Works.
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