Can small changes make a big difference?

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Today in the UK, the news is awash with a story about how we appear to be sleep-walking into an obesity epidemic. The recently-completed largest ever study into the obesity in the UK, compiled by 250 experts in the field, has concluded that obesity is not rooted in individual gluttony and laziness, but in our ‘obesogenic’ society. Basically, the fact that we are surrounded with cheap, calorie-laden foods and live in environment which is simply not conducive to activity and exercise means that we are essentially set-up for a life of creeping weight gain and the ills that come with it.

So what are we going to do about it?

I read this morning that the public health minister was unsure about how we’re going to proceed though ‘shock’ tactics (like those employed in anti-smoking campaigns) and taxes of fatty foods (inevitably) have been mooted.

A fat tax though is unlikely to work because, the evidence suggests, that fat is not necessarily fattening. And also, low-fat dieting is thoroughly ineffective for the purposes of weight loss. One other thing to bear in mind, even if fat was fattening, is that just because of a food is low in fat does not make it healthy. Plenty of foods low in fat may lead to fatty accumulation in the body by, for instance, causing gluts of insulin in the body. Sugar-charged foods as well as bread, potato, rice, pasta and breakfast cereals all spring to mind in this respect.

While my belief is that industrially-produced (e.g. partially hydrogenated and ‘interesterified’ fats) are worth avoiding, the evidence suggests that targeting fat is unlikely to have the desired effect. And I wouldn’t hold my breath waiting for the food industry to come up with the solution to our problem in the form of chemically-manipulated, highly processed foods, thoroughly unsuitable foods.

I would suggest that if we want to take some personal responsibility for our health and weight, we might concentrate of eating a diet replete with foods that are as natural and unprocessed as possible. Such a diet will not only be relatively close to the foods we evolved on, but will also help us to eat less without necessarily going hungry: the lower GI and higher protein nature of a ‘primal’ diet can help to put a natural and effective break on our appetite.

My experience in practice is that often relatively small changes in lifestyle can reap big dividends. And in addition to concentrating on eating a largely natural, unprocessed diet, taking a few steps (quite literally) in the right direction is also likely to help.

With this in mind, I was very interested to read this week a study published in the journal Pediatrics which assessed the effect of very small lifestyle changes on weight [1].

In this study about 100 American families were enrolled in the ‘America On The Move’ programme which, essentially, asked them to do just two things:

1. Cut out 100 calories worth of sugary soft drink each day

2. Take 2000 steps each day in addition to their ‘baseline’

A further 92 families were issued with pedometers and asked simply to record their level of activity. They were not asked to change their diet in any way.

All the families in this study had at least one child aged 7-14 who was either overweight or was believed to be at risk of becoming overweight. The study lasted 6 months.

Now, neither of these interventions are particularly hard core. Yet, in both groups, there was a significant reduction in the weight (body mass index) of the children in the study. Two thirds of the children on the American on the Move programme saw a drop in their BMI, and about half of those in the ‘self-monitoring’ group saw a drop in their BMI too. The study found that the adults in the study did no experience the weight gain that one would normally anticipate during the course of the study.

Bearing in mind the relatively low-key and manageable nature of the approaches here, I think we should be encouraged by the results of this study. Look, if you wanting to drop a dress size or two in a couple of months or lose your belly before your imminent summer holiday then very minor changes are unlikely to work. However, for those who are looking to the long haul, there results of this study suggest that small changes may make a big difference in time.

On Friday, my plan is to focus on some of the small dietary changes that can reap real dividends in terms of our weight and wellbeing n the long term.


1. Rodearmel SJ, et al. Small Changes in Dietary Sugar and Physical Activity as an Approach to Preventing Excessive Weight Gain: The America on the Move Family Study. Pediatrics 2007; 120: e869-e879

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