Obesity rates are surging globally, with associated health problems such as infertility, liver failure and knee osteoarthritis, leading to an increase in knee replacement surgeries.1 In 1975, an estimated 6.4% of women and 3.2% of men were considered obese,2 But this has risen sharply.
In 2017, the prevalence of obesity in the United States reached 41.9%, of which severe obesity reached 9.2%.3 Heart disease, stroke, type 2 diabetes and certain types of cancer are all thought to be associated with obesity,4 Knee osteoarthritis, a common cause of pain and disability, is also associated with obesity.
Now, as people become obese at a young age, knee replacement surgery — a problematic medical procedure — is also becoming more popular at a young age.5
Growing obesity leads to knee surgery at a young age
In Australia, nearly one-third of adults are obese.6 In a study that compared data from the Australian Bureau of Statistics’ 2017-2018 National Health Survey with data from the National Joint Replacement Registry, researchers found obesity was associated with an increased risk of undergoing knee replacement surgery.
Of the 56,217 patients in the study who underwent knee replacement for osteoarthritis, 31.9% were overweight and 57.7% were obese. The risk of knee replacement increases with increasing body mass index (BMI) category, so obese women 55 to 64 years of age with grade 1, 2, or 1 are 4.7, 8.4, and 4.7 more likely to have a knee replacement. 17.3 times 3 were obese compared with normal-weight women.
What’s more, those in the most severe obesity category (level 3) were also more likely to have knee replacement surgery at a younger age — 7.2 years earlier than normal-weight women. The average age of normal-weight women undergoing knee replacement surgery was 71.3 years, while the average age of women with grade 3 obesity undergoing surgery was 64.1 years.
Men with grade 3 obesity were also 5.8 times more likely to have knee replacement surgery than normal-weight men and had had surgery 7.3 years earlier.7 Overall, the researchers noted that nearly 90 per cent of people undergoing primary knee replacements in Australia are overweight or obese. As for why obesity increases the risk of knee osteoarthritis (OA), they explain:8
“The impact of obesity on the development of knee OA is multifaceted. Not only does obesity lead to overloading of the joint surface, but dyslipidemia and adipose tissue inflammation increase cytokine production, which also contributes to the etiology of OA.”
Knee surgery no better than placebo
Addressing the underlying obesity problem that contributes to the rising incidence of osteoarthritis is critical to protecting the knee. However, surgery is the commonly recommended solution in traditional medicine. However, you should know that multiple studies show that knee surgery may not be any better than a placebo.
The meniscus inside the knee is a thin, crescent-shaped disc of cartilage that acts as a cushion between the femur and tibia and helps stabilize the knee.
Tears can develop in your meniscus over time, especially if you have arthritis. The standard orthopaedic intervention for meniscal tears is arthroscopic partial meniscectomy. In fact, meniscal arthroscopic surgery is the most common orthopaedic surgery in the United States,9 But a study in Finland found that arthroscopic knee surgery for degenerative meniscus tears was no more beneficial than “sham surgery.”10
A landmark study in 2002 also looked at arthroscopic surgery for knee osteoarthritis and found no benefit from real surgery compared to sham surgery.11 While the procedure was no better than a placebo, the study found that arthroscopic knee surgery with meniscectomy tripled the risk of future knee replacement surgery.12
On the other hand, exercise and rehabilitation of middle-aged patients with knee injuries have been found to be as effective as meniscus surgery.13 Unfortunately, obesity is pushing knee replacements to occur at a younger age, as your weight is also an important factor in determining the potential success of surgical repair.
For example, studies have found that the curvature of the knee joint changes significantly with weight gain during the first three months after injury. It found that with a higher body mass index, the knees of those who underwent surgery were more likely to have flattened knees than those who underwent rehabilitation without surgical intervention.14
Obesity affecting male infertility
Male fertility has been declining for at least 40 years, with global sperm quality declining by 50% from 1938 to 2011.15 The book, “Countdown,” by Shanna Swan, a reproductive epidemiologist at the Icahn School of Medicine at Mount Sinai, is based on a 2017 study she co-authored that also found that from 1973 to 2011, sperm counts A drop of 59.3%.16
The most dramatic declines were found in samples of men from North America, Europe, Australia and New Zealand, many of whom had sperm concentrations below 40 million per milliliter, which is considered a tipping point for men to be difficult to fertilize. Overall, men in these countries saw a 52.4% drop in sperm concentration and a 59.3% drop in total sperm count (sperm concentration multiplied by total ejaculate).
“Ubiquitous chemicals” endocrine disruptors are a key culprit, Swan said: “Chemicals in our environment and the unhealthy lifestyles of the modern world are disrupting our hormonal balance, causing varying degrees of reproductive disruption.”17 Hormonal disturbances can also affect weight, and exposure to environmental chemicals has been linked to worsening the obesity epidemic.18
Research presented at the Endocrine Society’s 2022 Annual Meeting in Atlanta, Georgia, further suggests that maintaining a healthy weight during childhood can help prevent male infertility later in life.19
Children and adolescents who are overweight or obese, or have high levels of insulin or insulin resistance tend to have smaller testes than their normal-weight peers with normal insulin levels. According to the study’s lead investigator, “More careful weight control during childhood and adolescence may help maintain testicular function later in life.”
Fructose, obesity cause liver disease
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in developed countries.20 It is characterized by excess fat accumulation in the liver and is not associated with heavy drinking. Lifestyle factors, such as diet, exercise, weight, and smoking, all play an important role in exacerbating (and reducing) your chances of developing liver disease.
In the United States, 24% of adults have NAFLD, and another study presented at the Endocrine Society’s 2022 Annual Meeting showed that high fructose intake was associated with an increased risk of NAFLD.twenty one Foods high in fructose, including soda and candy, have been linked to obesity and diabetes, which is also linked to NAFLD. Lead author Dr. Theodore Friedman, of Charles Drew University in Los Angeles, California, said in a press release:twenty two
“NAFLD is a serious problem and is increasing in the population. There are racial/ethnic differences in the prevalence of NAFLD. People consume high fructose corn syrup in food, soft drinks and other beverages. Corn syrup has been implicated in the development of NAFLD.”
While fructose intake certainly does not contribute to liver health, increased NAFLD may be associated with increased intake of toxic industrially processed seed oils (commonly referred to as “vegetable oils”).
Examples of seed oils high in omega-6 PUFAs include soybean, cottonseed, sunflower, rapeseed (rapeseed), corn, and safflower.twenty three Omega-6s are considered pro-inflammatory because the most common variety, linoleic acid, radically increases oxidative free radicals and causes mitochondrial dysfunction.twenty four
As the researchers noted in the journal Nutrients, “In addition, several studies have linked omega-6 PUFAs to chronic inflammatory diseases such as obesity, nonalcoholic fatty liver disease, and cardiovascular disease.”25 Reducing your intake of fructose and seed oils while increasing your intake of healthy fats is an effective way to support liver health and a healthy weight.
It is also important to avoid almost all processed and fast foods, as almost all of them contain these toxic oils and/or fructose. The easiest way is to prepare most of your food at home so you know what you’re eating.
Also, be aware that because animals are fed grains that are high in linoleic acid,26 It’s also hidden in “healthy” foods like chicken and pork, making these meats the main source to avoid. Olive oil is another healthy food that can be a hidden source of linoleic acid, since it’s often cut with cheaper seed oils.
Try TRE to lose weight
In addition to avoiding the linoleic acid in seed oils, time-restricted eating (TRE) is a simple and effective intervention that mimics the eating habits of our ancestors and returns your body to a more natural state, resulting in a range of metabolic benefits .27
TRE involves limiting your eating window to 6 to 8 hours a day, rather than the more than 12-hour window that most people use. For example, studies have shown that people who follow a TRE significantly reduce body weight and fat mass while maintaining fat-free mass, while improving blood pressure, fasting blood sugar, and cholesterol levels, compared to those who follow a regular diet.28
Ideally, you’ll want to stop eating a few hours before bedtime and start eating around mid-night after you wake up. TRE, along with a comprehensive lifestyle program that supports a healthy weight, including exercise, daily exercise, and stress reduction, can help you maintain a normal weight and avoid the pitfalls of obesity, including knee problems, infertility, and liver damage.