A recent article (https://aeon.co/essays/blaming-individuals-for-obesity-may-be-altogether-wrong) by David Berreby in Aeon magazine dubs this "the obesity era" in America. As we are all aware, a high percentage of US citizens are overweight. This is an especially important topic for myeloma patients because several studies (https://academic.oup.com/aje/article/177/8/776/133932) have linked excess body weight or high BMI (body mass index greater than 25 kg/m2 body surface area) to an increased risk of myeloma.  

 

Interestingly, not only are people getting fatter, but so are animals in the wild, laboratory animals, and even pets. A study (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922741/pdf/ijerph-07-02988.pdf) by David Allison and colleagues (from the University of Alabama and other research centers) notes a particular weight increase among research colonies of primates, including the very cute marmoset monkeys!  So why is that?  The laboratory conditions are tightly controlled, especially with regard to calorie intake.  The answer is not the calories which are unchanged, but "global hidden factors."  Hidden factors are things that can alter or trick the body's fat metabolism toward weight gain.  

 

Top of the list of possible factors are chemicals, leading to the new concept that "all calories are not equal."  I have discussed suspect obesogenic chemicals before, including compounds such as BPA (bisphenol-A) present in many household plastics--"in everything from children's sippy cups to the aluminum in fizzy drink cans," Berreby writes. Marmosets can pick up chemicals from their food and drink containers as well as their environment.  Persistent environmental organic pollutants are being linked to obesity, diabetes, plus multiple myeloma as well as other hematologic cancers, such as lymphoma.  

 

Other ideas about possible hidden factors include a lipid-triggering virus called Adenovirus-36 (linked to higher body mass); a hormone called leptin, linked to stress and sleep; plus a whole range of other chemicals, such as artificial sweeteners.  Researchers at Cedars Sinai (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922741/pdf/ijerph-07-02988.pdf)right here in Los Angeles have noted increased numbers of gut microorganisms called methanobrevibacter smithii (!) pointing to yet another type of factor in our complex modern environment.

 

So how can we connect the dots here?  Clearly, we need to learn more.  The recurring theme, however, is to protect yourself against chemicals as best as possible, and stay tuned to see how research proceeds to further clarify "hidden factors" contributing to both obesity and cancer.