This just begs the next "why". Why are people eating more now?

Such a significant behavior change across a large population is not well explained by "we just did".

I'm not sure fast food consumption or huge portion sizes is a great explanation. If fast food is the problem, why does that matter if it just comes down to calories? As for larger portion sizes, would even larger portions make us continue eating? Would tiny portion sizes make us all deadly malnourished?

I wonder if it's correlated with cars.

We do know that walking rates, across the country, have fallen significantly. In 1969, approximately 50% of children walked or bicycled to school, with approximately 87% of children living within one mile of school walking or bicycling. Today, fewer than 15% of schoolchildren walk or bicycle to school. And we see this generally across the board, where for the most part driving to work alone dominates commute habits. If the only walking you do is from the door to the car, you are not getting much routine physical activity.

This would also actually well correlate with the rate of fast food consumption, since it's primarily car-centric, and is more car-centric than other types of eating out.

https://www.saferoutespartnership.org/sites/default/files/pd...

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I also don't think it's really any sort of secret that fast food companies like return customers and engineer the types of food that become addictive. There is a book called the Dorito Effect which theorizes that not only has artificial food become more flavorful over time, but that our industrial scale food production has made the base products less flavorful in favor of prettier or hardier varietals.

https://foodcrumbles.com/the-dorito-effect-book-review/

I’ve read that Dorito book and it was excellent.

Food got way, way cheaper, including and especially convenient (ready to eat) food. Plus a race between companies selling that food to optimize flavor and marketing strategies for maximum sales, which, at some point, had to start meaning “more eating”, not “more eating this instead of something else” otherwise line could not go up.

With this in mind, is the real cause "calories in, calories out" or "optimized flavor and marketing strategies"?

The reason a person gains weight is CICO.

The reason a population gains weight is way more complicated and probably best short-handed as “social”. Moving to America typically makes people gain weight. Leaving it leads to weight loss. If you’re trying to fix an overweight population, you need to look at lots and lots of things and, demonstrably (as in: the science is pretty clear), telling people to simply eat less and even very expensive high-touch interventions aimed at diet correction don’t work. Wrong tree to bark up, your solution lies elsewhere—or, probably, several elsewheres.

(But drugs might work!)

Potato, potato. CICO is just physics, but "optimized flavor and marketing strategies" has had impact on the "CI" side of the equation.

It seems very different and critically important. Would we have a current obesity epidemic without "optimized flavor and marketing strategies"? Because if we would not, then that is the true cause and of fundamental public health importance.

If we would have an obesity epidemic even without "optimized flavor and marketing strategies", then it is totally irrelevant.

Yes and no. I think there are two levers on the CI side of the equation and only one of them is hyper-palatability (optimized flavor); the other is simply cost. Food costs have fallen sharply, and that contributes to over-feeding. Hyper-palatability also contributes. It's not irrelevant, but not the only factor.

> This just begs the next "why". Why are people eating more now?

Have you been in a US supermarket? It's absolutely nuts and I don't think many Americans realise it.

To be bombarded with monumentally huge portions of everything is just a recipe for...well....the situation the US is in. Theres not many other countries that have whole food groups focused on cramming in as much peanut butter, jelly, marshmallow, chocolate, or whatever other high fructose corn syrup crap is being used.

Massive slices of cake prepackaged and ready to eat? Yeah why not. 50 different coffee syrup flavors? Yeah go for it. How about a lovely massive bottle of sugary drink to wash it down? Just one? No no have a crate of 20 of the things.

Just for a comparison, look up candy on the Walmart site. Now do it on Tesco UK. Next, try the bakery, or hell even the meat isle, somehow the exact same product ends up being significantly worse for you in the US.

The orthodox reason for why people are overweight is calories in, calories out. Does it matter if those calories are a prepackaged cake or candy? In the end it is just calories.

Would gratuitously large steaks in the meat section and huge rotisserie turkeys instead of chicken at Costco produce the same result?

It seems strange to pick on certain types of foods unless believe those foods are the cause of obesity instead of just eating too many calories of any kind.

If you think cookies and candy are bad but other things are not, why? Is it that they are easier to over-eat? If so, how does that compound over time, given humans are trying to maintain homeostasis which includes a healthy set weight via satiety. Exercise induces more calorie consumption later. Over calorie consumption also induces lower consumption later. This seem like relevant factors.

It is, of course, not as easy as calories in / calories out, although the "Twinkies experiment" proved that you can in fact lose weight via caloric restriction alone. For any kind of "normal" diet insulin plays a massive role in obesity. And that bag of candy will absolutely send it to the stratosphere, especially if you consume sweets frequently. Buy a continuous glucose monitor (it's now available OTC via Stelo), and see for yourself. That's what I did.

I am aware of this, I am more trying to get those that really believe it is as simple as calories in calories out to break free from that Plato-ey over-simplified explanation.

This is an oversimplification.

>Does it matter if those calories are a prepackaged cake or candy? In the end it is just calories.

In the end it's a complex, poorly understood network of hormones and brain chemistry. Human action is mostly downstream of that.

I agree, however for some reason calories in calories out is generally unquestioned among people I know personally.

I didn’t fully grasp how poorly our US bread approximates the real thing until I visited Europe. It’s weirdly spongy and candy sweet, and that’s the “healthy” bread in the bread aisle. Our food culture is just kind of gross most of the time, and the ersatz health food is some of the worst, as it’s been punched up with loads of organic cane juice or pear juice concentrate. Or celery juice if it’s a product that wants to claim not to have added nitrates. And, it should go without saying, truckloads of salt.

Food designed to circumvent the sensation of cloying or satiation.

Also, eating more in isolation and without talking.

Food design does seem like a higher potential explanation than many others offered.

The proportion of households with a person with time and energy to prepare a healthy home cooked meal has diminished. We have sacrificed domestic life on the altar of profit.

It really doesn't have to take more than 10-15 minutes per day in total, you just have to be aware of what you're doing. I know several examples — including myself — who eat healthy food on a budget and spend very little time doing it. We had our problems with American-style food when it appeared and became popular (I had a BMI of 30.5 for several years and blamed everything but myself), but quickly self corrected before real damage was done.

If healthy home cooked meals are better, why is that? This is a non-answer.

It must be something about the ingredients (invalidating calorie theory) or it must be lower calorie (invalidating ingredient theory).

Why does capitalism not make people fat in Japan, France, Italy and Spain?

Japan's easy: only about 1-in-3 households in Tokyo (and presumably the other large cities, where the majority of people live, are similar) own a car. People walk and take trains to work or to go shopping or eat out. A half hour of walking can burn upwards of 100 calories.

The typical diet is also relatively lower in bread (processed carbohydrates...with unnecessary added sugar in the US) and higher in protein. That combination is typical of any structured diet designed around controlling weight gain, such as Weight Watchers.

Fast food is also different. International menus have different items and different sizes. I've seen people express shock about the existence of things like the Triple Baconator or US soda sizes. Drinking a 32 oz of sugar-filled soda is an easy 350 calories right there, and a disturbing number of Americans "don't like water."

Konbini and ramen/soba shops also exist, so there are even more convenient alternatives to western fast food, which are often healthier in the typical portions.

They have much smaller portions across the board. Their "venti" Starbucks drink is what we call "small" in the US, and our "venti" is simply not available. Might even be smaller than small, it sure seemed like it.

> diet is also relatively lower in bread

I've wondered about about carb substitution. The rice, and the wheat noodles, why are they healthier? (I can understand rice somewhat: it's less processed, by certain definitions.)

> and the wheat noodles

Buckwheat is not wheat, soba noodles are based on buckwheat.

Not sure how large fraction of all noodles they eat are that though. Feels like there is something related to additives and other things that makes people eat more.

> Buckwheat is not wheat, soba noodles are based on buckwheat.

Whilst you're correct about buckwheat, just about all soba noodles that I've seen here in the UK are predominantly wheat based (I'm gluten sensitive, so have read a lot of product labels).

When looking for gluten free noodles in Asian supermarkets, I've only really found ones that are rice based with some rarer sweet potato vermicelli varieties.

Edit: after a brief search, I have found some Clearspring 100% buckwheat noodles which I shall have to find and buy. They also sell the more usual wheat and buckwheat version of Soba noodles.

Probably slower absorption. Bread really peaks blood glucose, and therefore insulin.