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Cultural Causes for Obesity in the U.S.

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Posted Wednesday, Oct. 25th, 2017

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We hear about obesity issues so frequently here in America that, quite honestly, it’s starting to fall on deaf ears. After all, how many times can we be told that we eat too much and don’t exercise enough?

But what if we changed the conversation? What if we stopped looking at what we eat and instead focused on why and when and how we eat?

What if we looked at other developed countries such as France and noted that while the French eat as much (if not more) saturated fat and desserts as Americans, their obesity rates are significantly different with 26 percent of French adults qualifying as obese in France, compared with 35 percent in the U.S. And the obesity rates in children are even more pronounces, with 17 percent of American kids clinically obese, compared to just 3-8 percent of French children.1-2

And, yes, while we do have a few notable differences when it comes to fruit and vegetable consumption, sugary drinks, and exercise patterns, researchers have found that those are NOT the key when it comes weight and health.

Cultural Culinary Challenges

A French psychologist studying eating behaviors has identified four significant differences in attitudes about food between the French and Americans.3 In a nutshell, all four compromise a culture around food and eating in France that simply doesn’t exist (at least to this extent) here in the U.S. The four behaviors include:

  • Meal and snack patterns
  • Eating as an event
  • Palatability
  • Hunger tolerance

In France, there is a distinct pattern of meals and snacks that are followed by most people in the country. In fact, according to surveys by the French National Institute of Statistics (INSEE), the idea of a three-meal day is well ingrained in the French mindset, with 70 percent of all French adults eating three defined meals every day.4

There is also an afternoon snack (called goûter) that is more like a small meal than a snack, and is eaten by both children and adults alike to bridge the gap between lunch and dinner. This goûter makes up about nine percent of total daily calories in adults and 16 percent of daily calories in children.4 Compare that with snacking in America, which comprises more than 24 percent of daily calories in our children, and 27 percent in adults.5

Another meal difference worth noting is the importance of lunch versus dinner in France. Here in the states, we eat progressively more as the day goes on, with breakfast often a small meal (if at all), lunch moderate sized, and dinner being our largest meal. In France, lunch is typically the largest meal of the day and is eaten by virtually everyone in the country between noon and 2 p.m., with dinner not being eaten until 7 p.m., as a rule. Several studies have shown that this simple difference (eating your main meal midday versus in the evening) can have significant weight benefits.6-7

This idea of regular mealtimes feeds into the second key difference—eating as an event. In the U.S., we spend about five percent of our waking hours eating (about 50 minutes). In France, they spend 11 percent of their waking hours eating.8 That’s more than double the time the French spend focusing on eating as the focal point.

One of two things are likely occurring here. Not only do Americans tend to eat faster, but we also to eat distracted, meaning that we aren’t focused on what we are eating and the company we are keeping, but we are doing something else while we are eating. Both of these issues (eating quickly and distracted eating) have also been associated with overeating and weight gain.9-10

A large factor in this idea of distracted, fast eating has to do with the third difference between our two countries—palatability. In France, palatable has been hard-wired for centuries (and from a very early age) to represent fresh, high-quality, “real” food, such as fruits, vegetables, local meats and cheeses, wine, and homemade bread.

Here in the U.S., we look at palatability more in terms of “edible.” Our food tends to be highly processed and purchased in a grocery store versus directly from a farmers’ stand, butcher, baker, or other specialty market.

Given this, it’s not surprising that portion sizes are smaller in France than they are in the U.S., as the French tend to value quality, while Americans focus more on quantity.11-12

This idea of edible versus palatable is like the reason for the fourth key difference in eating culture. It’s the idea of hunger tolerance.

The study author gives a great example to lecturing at universities in the U.S. versus in France. In the U.S., it is common to see students (or audience members of any age) bring their obligatory coffee cup and snack with them to the class or lecture. In France, students don’t bring food or drink with them. At all.3

Clearly the French students may experience hunger during the lecture in the same way their American counterparts may, but the difference is “French audiences allow themselves to experience hunger, while Americans take action to suppress it.”3 More directly, the French have a much higher hunger tolerance than we do in America.

A French Road Map for the U.S.

While these four eating behaviors highlight significant cultural differences around food in France and the U.S., they also provide a road map to changing and improving our relationship with food here in the states.

  • Establish regular mealtimes and adhere to them daily. They should include breakfast, lunch, dinner, and a mid-afternoon mini-meal.
  • Aim to make lunch your largest meal of the day, with a smaller meal at dinnertime.
  • Make mealtimes an event unto themselves. Don’t eat in the car, standing up, at your desk, while watching TV, etc. Make your food and your company your focus at each meal.
  • Eat real Skip the boxed, bagged, processed food and opt instead for fresh produce, local protein sources, whole grains, and homemade versus store-bought products.
  • Be mindful about what and when you are eating. Aim to eat only during your prescribed mealtimes.
  • Get comfortable with mild hunger. After all, no one died from hunger after three hours.

References

1. WHO Global Health Observatory Data Repository. World Health Organization: Geneva, Switzerland. http://apps.who.int/gho/data/view.main.

2. Scherdel P, Botton J, Rolland-CacheraMF, et al. Should the WHO Growth Charts be used in France? PlosOn 2015;10(3):e0120806.

3. Bellisle F. Cultural Resistance to an Obesogenic World: Infrequently Examined Differences in Lifestyle Between France and America. Nutrition Today. 2017 Jan/Feb;52(1):5-9.

4. Agence Franc¸aise de Se´curite´ des Aliments (Lafay J and Volatier JL, Coords). Etude Individuelle Nationale des Consommations Alimentaires 2 (INCA 2) 2006Y2007, rapport version 2, 2009. http://www.anses.fr/Documents/PASER-Ra-INCA2.pdf.

5. Popkin BM, Duffey KJ. Does hunger and satiety drive eating anymore? Increasing eating occasions and decreasing time between eating occasions in the United States. Am J Clin Nutr. 2010;91:1342-7.

6. Wang JB, et al. Timing of energy intake during the day is associated with the risk of obesity in adults. J Hum Nutr Diet. 2013;27(suppl 2):255-62.

7. Garaulet M and Gomez-Abellan P. Timing of food intake and obesity: a novel association. Physiol Behav. 2014;134:44-50.

8. Krueger AB, et al. Time use and subjective well-being in France and the U.S. Soc Indic Res. 2009;93:7Y18.

9. Ferriday D, et al. Effects of eating rate on satiety: a role for episodic memory? Physiol Behav. 2015;152:389-96.

10. Higgs S and Donohoe JE. Focusing on food during lunch enhances lunch memory and decreases later snack intake. Appetite. 2011;57:202-6.

11. Rozin P, et al. Broad themes of difference between French and Americans in attitudes to food and other life domains: personal versus communal values, quantity versus quality, and comforts versus joys. Front Psychol. 2011;2:177.

12. Rozin P, et al. The ecology of eating: smaller portion sizes in France than in the United States help explain the French paradox. Psychol Sci. 2003;14:450-4.

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