What's It Going to Take America?!

The latest statistics on obesity in America are frightening. While just 13% of the population was
obese in the 1960s, today one in three are obese, an almost 26% increase since 2007 alone. That is 2.4 million more Americans tumbling into the obese category in the past two years. Almost 45% have abdominal obesity, defined as a waist size of 35 inches or more in women and 40 inches or more in men. According to the Centers for Disease Control and Prevention, the number of US States where at least 30% of the adult population is obese has tripled to nine. Ten years ago, no state had an obesity prevalence this high. CDC Director, Dr. Thomas R. Frieden says, “Over the past several decades, obesity has increased faster than anyone could have imagined it would.”

Americans also are in serious denial about the problem. Being fat has become normal, so many
people don’t even realize there are overweight. In a Harris Survey, people gave their heights and
weights, which then were calculated to obtain body mass index (BMI) scores. A third of those in the overweight category thought they were normal size, while 70% of those classified as obese thought they were simply overweight. Among the morbidly obese, almost 60% toned down their opinion of how dangerously fat they were, while another 39% considered themselves merely overweight. Interestingly, about half of obese people don’t think they are eating the wrong foods and only 27% of morbidly obese people think they eat more than they should. (In case you are doubtful of what constitutes obesity it is a BMI of 30 or more. For example, a 5’4” woman weighing at least 174 pounds, or a 5’10” man who weighs at least 209 pounds would fit this description.)

Being overweight undermines mental and physical health and life quality in general. Even a few
extra pounds hinders function of cells that line blood vessels, increasing the risk for hypertension
and atherosclerosis. Serious weight problems are a time bomb for disaster, increasing a person’s risk for heart disease, stroke, diabetes, high blood pressure, sleep apnea, dementia, arthritis, vision loss, depression, infertility, suppressed immunity, shortened life expectancy, cancer, and much more. Chubby little girls begin puberty as early as age 7- or 8-years-old, increasing their risk for breast cancer down the road. In addition, as weight has increased, the number of healthy days each year that Americans lose because of weight has doubled, with many overweight people adding an additional 24 days of sick time to their already illness-prone lives.

At this rate, obesity will break the back of the healthcare system with its enormous burden of
disease and disability, lost work time, and strain on almost every industry. More people are working fewer years and need more social support. Public facilities and transportation must be redesigned to accommodate heavier people with more health problems who also can’t walk or climb stairs, let alone fit into airplane seats or public toilet stalls. What’s it going to take America to put down the doughnuts and pick up the gym membership?! The obesity issue is no longer just an individual matter. It is a social issue that will require the same efforts as were taken with tobacco. Taxes on junk food, public service announcements, increased social incentives to walk, more recess and P.E. time in schools, insurance companies that pay for prevention, as well as increased deductibles for people with high BMIs are all being considered.
Elizabeth Somer, M.A.,R.D.

Drowning In Junk

By Elizabeth Somer

Hundreds, if not thousands, of studies are published each month attempting to identify why Americans are fatter than ever. It can’t be genetics, since this phenomenon has escalated far faster than our genes can evolve. The obesity epidemic, distilled to its essence, is basically a result of eating too much and moving too little. Researchers at the RAND Corporation found that what we are eating is too much junk. They conducted a survey in 228 urban areas around Los Angeles and Southern Louisiana to estimate calories consumed from fruit, vegetables, cookies, candy, salty snacks, sweetened soft drinks, and alcohol in 2,767 people. They found that most people in Los Angeles averaged 60% more, while folks in Louisiana averaged 120% more, than the maximum recommended allotment for “extra” calories from sugary or fatty junk foods, yet consumed far too few nutritious foods, such as vegetables and fruit. The researchers conclude that “...unless the excessive consumption of salty snacks, cookies, candy, and sugar-sweetened beverages is curtailed, other interventions focusing on increasing physical activity and fruit and vegetable consumption will have a limited impact on obesity control.”

Cohen D, Sturm R, Scott M, et al: Not enough fruit and vegetables or too many cookies, candies, salty snacks and soft drinks? Public Health Report 2010;125:88-95.

Why Should I Avoid Sugary Beverages?

The link between sugary beverage consumption and obesity in children is so strong, that researchers at Pennsylvania State University say just knowing a child drinks one or more of these beverages is enough to predict future weight gain. Those same beverages - whether they are soft drinks or bottled energy, coffee, sports, or tea drinks - raise blood pressure, while the fructose in these beverages plays a role in the development of obesity and diabetes, according to a study from the University of Colorado. These are just two additions to an ocean of studies prompting some nutrition and obesity experts to call for a tax on sugary beverages. (New England Journal of Medicine 2009;September 16th) Consumption of beverages that contain high fructose corn syrup, fruit juice concentrates, or sucrose is linked to escalating risks of obesity in a variety of studies, especially when the studies are not funded by the beverage industry. Those links are found in all age groups, genders, and ethnicities. One study that looked at middle-school students over the course of two years found the risk of becoming obese increased by 60% for every additional serving of sugary beverage consumed in a day. Women gain weight in direct proportion to how many soft drinks they consume and lose weight as they cut back. Even replacing sugary beverages with more nutritious beverages, such as milk, results in significant weight loss. Repeatedly, studies show that diabetes and heart disease risk increases with increasing intake of sugary beverages. In the Nurses’ Health Study, an ongoing study at Harvard, the risk for diabetes in women who consumed one or more servings of sugary beverages each day was nearly double the risk among women who consumed less than one serving a month (about half the excess was due to greater body weight). In the same study, heart disease risk increased by 23% for women consuming one and 35% for those consuming two soft drinks a day. While weight gain is the most obvious result of consuming these junk drinks, other mechanisms elevating disease risk also play a role. For example, sugar raises blood triglyceride levels and blood pressure, while lowering the good cholesterol - HDLs, thus raising heart disease risk. Some studies also show that sugar-sweetened beverages increase markers for insulin resistance, a risk factor for diabetes. Liquid calories do not register on the body’s satiation gauge, so they become calories added to rather than calories replacing other energy-containing foods, which leads to overconsumption and weight gain. Sugary beverages may alter taste preferences and food acceptance, are used to quench thirst or for social reasons other than nourishment, and replace more nutritious foods in the diet, such as vegetables, legumes, and fruits, which contributes to malnutrition in the face of overnutrition. Taxation is being proposed by a growing body of nutrition experts as a means of reducing the intake of these beverages and thus, lowering health care costs, much in the same way that legislation taxes tobacco. Revenues generated from this income could be allocated for use in health or obesity-prevention programs. Currently, 33 states have sales taxes on soft drinks (averaging about 5.2%), but the taxes are too small to affect consumption and the revenues are not earmarked for programs related to health. Experts are calling for a change, one that could have a profound influence on this nation’s outof-
control obesity epidemic.

-Elizabeth Somer, M.A.,R.D.