I had the opportunity to interview Dr. Eric L. Ding. Dr. Ding completed his undergraduate degree at The Johns Hopkins University with Honors in Public Health and election to Phi Beta Kappa. He earned his dual doctorate in epidemiology and doctorate in nutrition at age 23 from Harvard University. At Harvard, Eric has taught and lectured in more than a dozen graduate and undergraduate courses, for which he received the Derek Bok Distinction in Teaching Award from Harvard College. In addition to teaching, he has published in the New England Journal of Medicine, and the Journal of the American Medical Association, and researches global disease burden and nutritional risk factors for chronic diseases at Harvard. His more than three dozen publications have received over 1500 external citations. He currently also serves as an appointed expert committee member on Nutritional Expert Group of the World Health Organization’s Global Burden of Disease Project.
Dr. Ding answered the following 10 questions.
1. What got you interested in the topic of obesity and nutritional risk factors for diabetes, heart disease, and cancer?
“Nutrition, obesity, and lifestyle are a preventable cause of 80% of heart disease, 90% of diabetes, and 30-50% of cancer.
As a child, I had overcome a battle with a tennis-ball sized tumor, and was originally given less than five years to live. After recovering, I had a new found purpose in life – to find the preventable causes of diseases.”
2. Do you believe people can be obese and healthy?
“No, generally not. Obesity is associated/causally related to dozens upon dozens of diseases. All the previous ‘fat-and-fit’ claims are woefully false. A fit person who is fat may be healthier than a less-fit person who is equally fat, but being fit does not negate the underlying risks of being obese. Moreover, many studies show that being thin and unfit is most often healthier than being fat and fit – but both are independently important for health.
The only exception would be perhaps someone suffering from a wasting disease like advanced AIDS.
The other rare exception is pre-menopausal breast cancer risk – obese women have lower risk of pre-menopausal breast cancer. However, upon menopause, it quickly reverses, and obese women have a higher risk of post-menopausal breast cancer. That said all the other negative effects of obesity overwhelm any marginally lower risk on pre-menopausal breast cancer (a relatively rare disease pre-menopausal).”
3. If you were to give an obese person one piece of advice what would it be?
“Make every effort to lose weight. Not losing weight and staying obese is nearly just as bad for you as smoking every day.”
4. What kind of nutritional program do you put together?
“A dietary pattern based on our Harvard Nutrition department’s Alternative Healthy Eating Index – generally a diet that is filled with fruits and vegetables, high fiber whole grains, legumes, low red meat, low trans-fat, no trans-fat, and no sugar sweetened beverages.”
5. What is the greatest nutritional mistake people make that leads to diabetes, heart disease, and cancer?
“From an overall perspective, over eating. But from a singular perspective, one of the greatest causes of overeating and obesity is sugar-sweetened beverages. The reason is that SSBs are inherently metabolic poison — they are one of the only consumed products that trick your body into thinking it ate fewer calories that you actually did.”
6. Do you suggest that an obese person lose weight before starting an exercise program?
“Depending on their starting obesity level and background exercise I recommend people start slowly – not only to not have immediate high-impact on their already overburdened joints/ligament, but also because sedentary people who immediately exercise hardcore (aka ‘weekend warriors’) have elevated risk of cardiac arrhythmias if they suddenly go from zero to high-strain exercises too quickly. A low and gradually stepped up regimen is the best.”
7. Are there specific foods that your recommend for obese people?
“Because of long-time necessary for sustained weight loss (and the adverse effects of obesity that would continue to accrue during that time), I would recommend certain supplements that can at least reduce/offset the harmful cardiovascular effects of obesity in the interim. Notably, one natural way would be via cocoa flavonoids – which have been clinically demonstrated (in multiple studies) to reduce the risk of cardiovascular disease by lowering blood pressure (an obesity-related effect), lower the bad LDL cholesterol (also obesity related), raise the good HDL cholesterol (also obesity-related), and improve insulin sensitivity which may cause type 2 diabetes (also obesity-related). Thus a cocoa flavonoid supplement in the 400-500mg/day range, such as Cocoawell, which was the dose found to be effective in our studies, and found in supplements may offset negative obesity risks of high blood pressure, high cholesterol, and low insulin sensitivity –all of which would also prevent heart disease. Until sustained weight loss is attained, such an obesity-risk-offset strategy should be considered.”
Obesity is the greatest cause of type 2 diabetes, and an enormously huge cause of heart disease, strokes, and many cancers.”
8. What can people do to prevent their children from becoming obese?
“Don’t feed your children sugary foods and sugary drinks —especially avoid all sugar sweetened beverages. This includes most non-100%fruit juices – so don’t fill up their Sippy cups with too much apple juice!”
9. Do you see any decrease in obesity either because our schools are changing their meal plans or because people are becoming aware of the risks?
“Awareness is not enough – most people know obesity is bad (just like smokers know smoking is bad), but most choose to ignore the risk when faced with their daily lifestyle routines.”
10. What is the greatest risk to our health due to obesity?
“Think of obesity as equally dangerous as smoking. And remember to cut down / stop consuming sugar-sweetened drinks.”
Thank you, Dr. Ding. This has been extremely helpful.
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