Currently browsing posts about: Obesity

Good news (sort of): Overall obesity rates in children seem to be stabilizing.  Rates rose from 1998-2003 but did not change much from 2003-2007, with one exception: rates are still rising among American Indian/Alaskan Native children.  Here’s a map of childhood obesity rates by state (thanks to the Wall Street Journal).  Rates are decreasing in a few states!  Oregon has the lowest rates (less than 10%).  Mississippi has the highest (21%).

Overweight children are more influenced by advertisements for branded products than are average weight children, according to a pilot (preliminary) study in Appetite.  Evidence for restrictions on advertising?  I think so.

The CDC has produced a policy-wonkish list of 22 Recommended Community Strategies and Measurements to Prevent Obesity in the United States.  These are suggestions for what communities should do to make it easier for people to eat less (or better) and move more.  Examples: “Communities Should Provide Incentives to Food Retailers to Locate in and/or Offer Healthier Food and Beverage Choices in Underserved Areas,” and “Communities Should Improve Availability of Mechanisms for Purchasing Foods from Farms.”  These are all good “shoulds.”   The report gives ideas for measuring the success of such initiatives but does not discuss how to implement them, alas.

[Posted from New Delhi]

The latest estimate from CDC on the annual cost of obesity: $147 billion.  Ordinarily, I don’t take such numbers too seriously because they are based on assumptions that may or may not  be correct.  But this number has been challenged by so personal an attack on the new head of the CDC, Tom Friedan, that I’m thinking it should be taken seriously.

The attacker is the supposedly independent – but thoroughly industry-sponsored –  American Council on Science and Health (ACSH).  Here’s the quote from its latest online newsletter:

Frieden’s Crusade Moves to Washington

A study presented on Monday at a CDC obesity meeting determined that obesity-related diseases account for nearly 10 percent of all medical spending in the United States – an estimated $147 billion per year. The study was sanctioned by CDC director Dr. Thomas Frieden, whose partiality to government-interventionist responses to public health concerns is epitomized by his quote: “Reversing obesity is not going to be done successfully with individual effort. It will be done successfully as a society.”

“The reason he hyped this study was to promote more proactive government interventions, including a three cent soda tax,” says ACSH’s Jeff Stier. Dr. Ross adds, “Whenever I see numbers like this – especially when they are being promoted by someone we know is a fan of big government – I suspect that they have been altered or manipulated. Obesity is definitely a health threat, and it will definitely be a burden on our health care system. How much of a burden, we don’t know. But I don’t trust these numbers.”

Well, I don’t trust ACSH.  For one thing, just try to figure out who funds them.  For another, note the way ACSH invokes science to make its political agenda seem authoritative.

Whatever the real cost of obesity, its consequences will place a considerable burden on our health care system.    And it will take societal responsibility as much as – or more than – individual responsibility to deal with the problem.

[Posted from London]

I am always indebted to Joel Moskowitz of the University of California School of Public Health’s Center for Family and Community Health for his almost daily forwarding of research on obesity.  His recent postings include data from the Centers for Disease Control (CDC).  The CDC has just released preliminary results of the 2008 National Health Interview Survey.  These include, among other measures, data charts and tables on obesity (rates still rising steadily since 1997), physical activity (no measurable change), and diabetes (rising in parallel with obesity).

Interpretation: if physical activity rates have not changed, then the reason obesity rates are going up is because people are eating more calories.

Plenty of evidence backs up this idea.  All you need to do to see why people are eating more is to take a look at Time magazine’s discussion of the implications of calorie labeling: “Would you like 1,000 calories with that?”

I’ve just received the latest cancer statistics from CA–A Cancer Journal for Clinicians. The good news is that overall cancer death rates are down from their peak in the 1990s and rates of specific cancers are stable or decreasing.  None seems to be increasing.

Look at what is happening with heart disease (page 15).   Its rates have fallen by half since the mid-1970s for people under age 85.  Even for people over 85, heart disease death rates are falling rapidly.

Obesity is a risk factor for both cancer and heart disease.  So ideas about its effects on health need to take these statistics into consideration.  But before dismissing obesity as a risk factor, note that both heart disease and cancer remain leading causes of death, and both disproportionately affect low-income groups.   Groups with low income and education tend to have many risk factors for these diseases, among them high rates of obesity.

Public health still has plenty of work to do.

Investigators at the Harvard School of Public Health estimated the toll of behavioral contributors to early mortality.  Obesity, they say, is the #3 cause of death after cigarette smoking and high blood pressure.

Dutch researchers say smoking is what kills people.  Obesity just leads to disability.

The Robert Wood Johnson Foundation says schools could do something to help prevent obesity if they got their act together.  It provides a guide to doing so.

Adam Drewnowski, my colleague and friend at the University of Washington, says: if you want to understand obesity, take a look at what poverty makes people eat.

And Jeffrey Friedman, an obesity researcher at Rockfeller University tells Nature that obesity is neither an epidemic nor a disease of lifestyle.  It’s all in the genes and in evolution.

I say (see What to Eat): eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food!

According to the latest charts in the New York Times, countries in which people eat more quickly have faster growing economies than countries in which people linger over meals.  The Gross National Product in such countries also suffered less severe declines last year.  On the other hand, they exhibit higher rates of obesity.  Coincidence?  Maybe, but here’s another example of why food is such a powerful tool for examining major societal questions.

First, the cartoons: this week’s question from Eating Liberally’s kat has to do with whether it makes sense to put cartoon characters on eggs or, for that matter, fruits and vegetables.  I vote no, of course, and the illustrations alone explain why.

Next, the scholarship: The latest volume of Annual Reviews of Public Health contains excellent reviews of studies of the influence of the food marketing environment on child and adult health.

Sara Bleich et al explain why obesity has become so common in the developed world.

Kelly Brownell’s group reviews the effects of food marketing on childhood obesity.

David Katz discusses school-based obesity interventions.

Mary Story et al describe policy approaches to creating healthy food environments.

And the American Association of Wine Economists (a group new to me, but interesting) forwards its Working Paper #33:

Janet Currie et al on the effect of fast food restaurants on obesity.

Finally, the action: Perhaps in response to all this, language inserted into the congressional spending bill asks the Federal Trade Commission to set up an interagency committee to set nutritional standards for products allowed to be marketed to children age 17 or under.  According to Advertising Age, the food industry thinks this is not a good idea.

While the new website was in production, I got a bit caught up on my reading.  Here’s what’s been happening on the obesity front.

Middle-age spread: eat less or else! A new study proves what every woman over the age of 50 knows all too well: you just can’t eat the way you used to without putting on the pounds.  Muscle mass declines with age, calorie needs do too.    Activity helps some, but not enough.  I think it’s totally unfair, by the way, but I’m guessing the same thing happens to men (but they have more muscle to begin with).  Alas.

Turn off the TV: Common Sense Media looked at 173 studies of the effects of watching TV on child and adolescent health.  Of 73 studies examining correlations between TV-watching and obesity, 86% found strong associations.  TV-watching was also strongly associated with such unfortunate outcomes as cigarette smoking, drug use, early sexual activity, and poor academic performance.  Conclusion: if you want to encourage kids to be healthier, turn off the TV!

British government launched an anti-obesity campaign: The UK government’s Change4Life campaign is designed to promote healthier lifestyles.  This is causing much discussion, not least because of its food-industry sponsorship (uh oh).  Food companies are said to view the campaign as good for business (uh oh, indeed). The government wants everyone to help with the campaign by putting up posters and such, and its website is cheery.  Buried in all of this is some good advice, but most of it is phrased as eat better, not eat less or avoid.  That, of course, is why the food industry is willing to fund a campaign which, if successful, could hardly be in the food industry’s best interest.