The Pima Indians and the Obesity Epidemic

The Pima Indians went from being prosperous and thin to being poor and fat; this poses a paradox for the dominant theory about what has caused the obesity epidemic.

The Pima have occupied land in Arizona for centuries. As Gary Taubes details in Chapter 14 of Good Calories Bad Calories, these people lived a hunter-gatherer existence and enjoyed both prosperity and good health.

Shortly after the Pima Indians encountered the Anglos and Mexicans, however, they suffered a great famine. Over the course of just a decade or two, the Pima went from being rich and healthy to being poor and unhealthy. Forced to subsist on government rations -- which included lots of refined carbohydrates and sugars -- many became overweight and diabetic.

What can this observation tell us?

...

Most of blame the obesity epidemic on prosperity. If we didn't have supermarkets and convenience stores allowing us access to so many calories; and if we didn't have video games, the internet and TV to keep us locked inside, then maybe we would eat fewer calories and maybe we would get more exercise. And if we ate less and exercised more, then we'd all be thinner for it.

1. But Taubes' point is that -- at least with the Pima Indians -- prosperity and obesity can be inversely correlated. The Pima enjoyed a copious supply of food and an abundance of leisure. Then the Anglos entered the picture. The Pima suffered. They were forced onto reservations and starved. And in this environment -- not exactly replete with video games and fast food -- they became extremely obese and diabetic.[1]

It's a paradox. Poor people should not be more obese than rich people. But that's just what we see -- and not only with the Pima Indians.

2. Here's a report from the National Statistics Office:

"The data show quite clearly that lower income families... are far more at risk from becoming obese than the middle and upper classes... Obesity is linked to social class, being more common among those in the routine or semi-routine occupational groups than the managerial and professional groups."[2]

We're told that inactivity causes weight gain. But here is evidence from the National Statistics Office that poor people who do 'occupational' work -- that is, physically active labor -- are more obese than people who work in managerial positions. Does that make sense? Do office managers really burn more calories a day than farm laborers or agricultural workers?

3. Even public health authorities acknowledge the paradox. Consider this article: 'Poverty, obesity, and malnutrition: an international perspective regarding the paradox.'

Here is a quote from the abstract:

"Our greatest responsibility as nutritional professionals is to understand the ramifications of poverty, chronic hunger, and food insecurity. Food insecurity is complex, and the paradox is that not only can it lead to under nutrition and recurring hunger, but also to over nutrition, which can lead to overweight and obesity."[3]

The reason why these public health experts -- dietitians, doctors, nutritionists, you name it -- cannot resolve this paradox is because they only look through the lens of the Caloric Balance Hypothesis. Think about obesity only in terms of "Calories In" and "Calories Out," and you're bound to run into logical dead ends, such as we have discussed here regarding the unusual case of the Pima Indians.

The Lipophilia Hypothesis gets rid of the paradox. Think about obesity in terms of chronic hyperinsulinemia, on the other hand, and the evidence all makes sense.

Of course the Pima Indians got fat: they went from eating a diet low in carbohydrates to a diet comprised of very insulinogenic carbohydrates (e.g. refined flour, sugar, etc). A diet high in refined carbs can cause obesity. Refined carbs are cheap. Hence, people living on subsistence wages will eat more refined carbs. Hence, poor people will become fatter and more diabetic than wealthier people. All the puzzle pieces fit. There is no paradox.

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References


1. Taubes, Gary. "Good Calories, Bad Calories." pp 235-239. New York: Knopf (2007).

2. Marsh, Peter. Poverty and obesity Social Issues Research Centre (listed Mar 15 2004).

3. Tanumihardjo SA, Anderson C, Kaufer-Horwitz M, Bode L, Emenaker NJ, Haqq AM, Satia JA, Silver HJ, Stadler DD. Poverty, obesity, and malnutrition: an international perspective regarding the paradox J Am Diet Assoc. 2007 Nov;107(11):1966-72.

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