I recently saw this headline: Obesity-related illness could cost Utah billions by 2018
You may be wondering why this matters to anyone outside of Utah? Let me explain. First off, I was surprised by how obese my fellow Utahans have become. We are generally very outdoorsy, agriculture and mining are big industries and our natural resources of mountains, rivers and snow are what brings many people to live here. However, obesity is an all encompassing health problem nation-wide. Outdoorsy or not, obese we have become.
You may still be asking how Utah's obesity crisis matters to the other 49 states? Take a look at the chart below.
You may be wondering why this matters to anyone outside of Utah? Let me explain. First off, I was surprised by how obese my fellow Utahans have become. We are generally very outdoorsy, agriculture and mining are big industries and our natural resources of mountains, rivers and snow are what brings many people to live here. However, obesity is an all encompassing health problem nation-wide. Outdoorsy or not, obese we have become.
You may still be asking how Utah's obesity crisis matters to the other 49 states? Take a look at the chart below.
| 2010 State Obesity Rates | |||||||
|---|---|---|---|---|---|---|---|
| State | % | State | % | State | % | State | % |
| Alabama | 32.2 | Illinois | 28.2 | Montana | 23.0 | Rhode Island | 25.5 |
| Alaska | 24.5 | Indiana | 29.6 | Nebraska | 26.9 | South Carolina | 31.5 |
| Arizona | 24.3 | Iowa | 28.4 | Nevada | 22.4 | South Dakota | 27.3 |
| Arkansas | 30.1 | Kansas | 29.4 | New Hampshire | 25.0 | Tennessee | 30.8 |
| California | 24.0 | Kentucky | 31.3 | New Jersey | 23.8 | Texas | 31.0 |
| Colorado | 21.0 | Louisiana | 31.0 | New Mexico | 25.1 | Utah | 22.5 |
| Connecticut | 22.5 | Maine | 26.8 | New York | 23.9 | Vermont | 23.2 |
| Delaware | 28.0 | Maryland | 27.1 | North Carolina | 27.8 | Virginia | 26.0 |
| District of Columbia | 22.2 | Massachusetts | 23.0 | North Dakota | 27.2 | Washington | 25.5 |
| Florida | 26.6 | Michigan | 30.9 | Ohio | 29.2 | West Virginia | 32.5 |
| Georgia | 29.6 | Minnesota | 24.8 | Oklahoma | 30.4 | Wisconsin | 26.3 |
| Hawaii | 22.7 | Mississippi | 34.0 | Oregon | 26.8 | Wyoming | 25.1 |
| Idaho | 26.5 | Missouri | 30.5 | Pennsylvania | 28.6 | ||
The chart taken from the CDC shows each state's adult obesity rate as of 2010. By 2008 Utah was already spending hundreds of millions of dollars (estimates show $485 million) to treat obesity-related illnesses. Estimates show if Utahans don't slim down, that number could rise into the billions in just a few years. Considering that Utah's rate of 22.5% is comparatively low, the costs for many other states, and as a nation, must be mind-boggling!
Obesity in Utah
- Adults - 22.5%
- Public elementary school students - 9.7%
- Public high school students - 8.6%
Obesity in the United States
- Adults - 35.7%
- Public elementary and high school students - 17%
Relative medical costs of the obese are estimated to be up to 100 percent higher than for Americans of healthy weight. Based on data from the U.S. Medical Expenditure Panel Survey, per capita medical spending for obese individuals was an additional $1,429 (42 percent higher) compared to individuals of normal weight. In middle-age men, treatment of five common obesity-related conditions (stroke, coronary artery disease, diabetes, hypertension, and elevated cholesterol) resulted in roughly $9,000 to $17,000 higher costs compared to normal-weight adults. Looking ahead, researchers have estimated that by 2030, if obesity trends continue unchecked, obesity-related medical costs alone could rise by $48 to $66 billion a year in the U.S.
Left unchecked, obesity’s effects on health, health care costs, and our productivity as a nation could become catastrophic. To put it mildly, if we do not begin to reverse the obesity epidemic it will crush us. We will not be able to compete on the global market place.
The staggering human toll of obesity-related chronic disease and disability, and an annual cost of $190.2 billion for treating obesity-related illness, underscore the urgent need to strengthen prevention efforts in the United States. The Robert Wood Johnson Foundation asked the IOM to identify catalysts that could speed progress in obesity prevention.
The staggering human toll of obesity-related chronic disease and disability, and an annual cost of $190.2 billion for treating obesity-related illness, underscore the urgent need to strengthen prevention efforts in the United States. The Robert Wood Johnson Foundation asked the IOM to identify catalysts that could speed progress in obesity prevention.
A Report
A new report by the Institute of Medicine warns these social and economic costs will increase in the coming years unless we do more to prevent people from becoming overweight -- especially young people. And researchers say a real solution will require leadership from educators to employers to the president.
A new report by the Institute of Medicine warns these social and economic costs will increase in the coming years unless we do more to prevent people from becoming overweight -- especially young people. And researchers say a real solution will require leadership from educators to employers to the president.
The IOM evaluated prior obesity prevention strategies and identified recommendations to meet the following goals and accelerate progress:
- *Integrate physical activity every day in every way
- *Market what matters for a healthy life
- *Make healthy foods and beverages available everywhere
- *Activate employers and health care professionals
- *Strengthen schools as the heart of health
Related:
Report: Schools key to fighting America's obesityFighting obesity will require changes everywhere Americans live, work, play and learn, says a major new report that outlines dozens of options – from building more walkable neighborhoods to zoning limits on fast-food restaurants to selling healthier snacks in sports arenas.
The obesity epidemic is about much more than the burden it places on us financially. It's a moral crisis. This is something that we have brought upon ourselves and now we are bringing it upon our children. We have to ask ourselves what kind of society we want to pass on. This could be called the obesity era. Similar to how the industrial revolution changed society as a whole, obesity at its current rates will do the same.
What answers will we give our children when they ask us why we didn't do something about it sooner?
The obesity epidemic began in the 1980s
What has happened in the last 30 years to cause this dramatic change in our health? It's a complex answer to that question but much of it is due to the industrialization of food. In the early 1900's we began to use technology to grow large amounts of food and ship it not only across the United States, but also across the world. This ability began a trend of mechanizing the agricultural industry and producing cheaper and cheaper food.
The desire to grow large amounts of food and process and then sell it cheaply was a great advantage to the growing economy of the United States. Small farms could make more money, families could use more of their income for other things and we could sell the surplus to other countries to make more money for both farmers and the federal economy. Efforts to maintain stable prices on these crops eventually led to federal subsidy programs for farmers. That has led us to our current predicament. Farm subsidy programs support our major commodity crops of corn, soy, wheat, and dairy while neglecting fruits and vegetables. This program has unnaturally influenced the prices of food, mainly manufactured foods, against fresh produce.
Here's an example; since 1985 the percent increase of costs from inflation for sugar-sweetened drinks has held steady at 20%, it has gone up 46% for sugar and sweets and it has gone up 117% for fruits and vegetables! This has caused a dramatic shift in our agricultural system. Only 3% of US farm land is planted with fruits and vegetables. We currently do not grow enough fruits and vegetables to meet our own dietary recommendations!
Why is that? Corn, which is nearly 50% of all crops grown in the US, is used to make HFCS (High Fructose Corn Syrup) which is used in sweetened drinks and nearly every manufactured food in the US. It would go against farm policy to allow the costs of corn to increase when the federal government is subsidizing its production. This unnatural price control makes it cheaper to grow corn to be turned into a sweetener than it is to grow fruits or vegetables!
These abundant and cheap ingredients have stimulated the growth of a food industry with a financial incentive to use corn and soy products (such as high fructose corn syrup, hydrogenated oils, modified corn starches, etc.) to produce a huge quantity and variety of highly processed foods. The result is a range of inexpensive foods that enable Americans to eat more. Unfortunately, as corn and soy production has increased so have obesity rates.
In the modern world, sugar and fat-rich processed foods are readily available, convenient, inexpensive, and good-tasting, so people are more likely to buy and eat them. Since the 1970s, the amount food available per person increased by 16%, making more calories available in the U.S. food supply than we need.
Many people live in areas known as "food deserts" where supermarkets are not readily available to buy things like fresh fruits and vegetables. Many others, especially individuals with low-incomes and minorities, live in areas considered "food swamps," where there is a high density and variety of fast food restaurants and convenience stores selling large quantities of calorie-dense snack foods and sugar sweetened beverages.
Living in an area with a high concentration of fast food restaurants is associated with eating more fast food, which, in turn, is associated with obesity risk.
Cheap food is only part of it
I said earlier that the answer is complex when looking at the roots of this obesity epidemic. Besides the inequality in our agricultural system, we have engineered work out of our lives. In the last 50 years jobs requiring moderate physical exertion have dropped from 50% to 20%. Along with more sedentary work more than 75% of Americans drive to get to work. That is a 300% increase since 1960! Our societies have become car dependent.
In 1969 42% of children walked to school. More than 80% are driven to school today by parents rushing off to sit in front their computer at work. A consequence of this dependence on cars and lack of physical exertion at work is that less than 5% of adults meet the minimum activity guidelines for physical activity. 1 in 4 adults get NO physical activity at all. The consequences of this? Obesity is a significant contributing risk factor to 5 of 10 leading causes of death today. Those five are *heart disease, cancer, *stroke, *diabetes, and kidney disease. Diabetes has been to shown to contribute to more than 40 % of deaths in the US each year, 36% of American adults have *cardiovascular disease and as many 25% have excess fat in their livers. The main cause of liver transplants is quickly changing from hepatitis to fatty liver disease!
What about our kids?
While we've seen just how sedentary adults in America have become, our children are following right in our footsteps. In the last decade the federal government began cutting spending on physical education. In 2006 alone, the government cut $19 million on spending to train physical education teachers.
The results of this drain on our childrens' fitness education is that only 4% of elementary schools, 8% of middle schools, and 2% of high schools provide daily physical education. Only 1 out of 6 states require it three days per week!
While exercise has dipped, screen time has increased. Children now consume over 7.5 hours of media every day! This only further increases the sedentary lifestyles of our children.
Video Link --> HBO's The Weight of the Nation: Children in Crisis
On top of the lack of physical education and extended media use, the misinformation about "healthy foods" contributes to childhood obesity. We all know that soda has ABSOLUTELY NO NUTRITIONAL VALUE, but what about juice? While juice does have nutritional value, mainly in the form of vitamins and minerals, it also has a lot of sugar. To illustrate this: 12 oz of Coke has 10 teaspoons of sugar. 12 oz of apple juice and/or grape juice has 10 teaspoons of sugar and 12 oz of orange juice has 8 teaspoons of sugar! There is not much of a difference between drinking soda and drinking juice. 1/5 of all teens drink 3 or more sugar-sweetened drinks each day-that is the equivalent of an extra meal! It's no wonder that sugar-sweetened drinks have been classified as the single biggest contributor to childhood obesity rates.
Specifically, the last minute provisions were to:
- Block the Agriculture Department from limiting starchy vegetables, including corn and peas, to two servings a week. The rule was intended to cut down on french fries, which some schools serve daily.
- Allow USDA to count two tablespoons of tomato paste as a vegetable, as it does now. The department had attempted to require that only a half-cup of tomato paste could be considered a vegetable — too much to put on a pizza. Federally subsidized lunches must have a certain number of vegetables to be served.
- Require further study on long-term sodium reduction requirements set forth by the USDA guidelines.
- Require USDA to define "whole grains" before they regulate them. The rules would require schools to use more whole grains.
Another issue is that increasingly, children who eat a majority of processed foods don't even know what fruits and vegetables are!
Video Link -->Potato or Tomato?
Serving Sizes
Over the past few decades, portion sizes of everything from muffins to sandwiches have grown considerably.
These portion comparisons, adapted from the National Heart, Lung, and Blood Institute’s (NHLBI) Portion Distortion Quiz, give a visual representation of what sizes used to be compared to what they are today.
Two Slices of Pizza
Twenty years ago Today
500 calories 850 calories
500 calories 850 calories
Those extra 350 calories, if eaten a two times a month, would put on two extra pounds a year, or forty pounds in the next two decades.
Plates
Studies have also found that children consume almost twice as many calories when eating at a restaurant as they do at home. That is attributed to the fact that most restaurant portions are 2-5 times what they should be eating!
With these oversized portions, Americans are eating about 600 more calories per day than in 1970. That equals 5-10 pounds of weight gain per year!
It seems rather daunting when faced with all of these problems to ask what we can do to fix them. While some fixes are easy and can be implemented at home others are only going to change at the highest levels of our government.
We need to step back and realize that while our DNA has not changed, our world around us has. We are still programmed for scarcity. Our ancient ancestors valued sugary, fatty foods for the high caloric impact they had. Meals that were hard to come by needed to give us as much energy in the form of calories as possible. While we are programmed to eat in that way, our calorie-rich, cheap food system works against us.
One of the first things we can do is to limit processed foods and sugar-sweetened drinks. EAT REAL FOOD! I have written many posts discussing the reasons behind this statement. We are meant to eat a variety fruits, vegetables, and lean proteins. Fresh produce may cost more than a bag of chips but you will not have to eat continuously to feel full. Also, eat at home. I stated that restaurant portions are 2-5 times more than we need. Cook real food with your children explaining to them what the ingredients are. Educate them. Then sit down and eat together. Making the effort will pay off when they know what their fruits and vegetables are and actually eat them.
Stop drinking sugar-sweetened drinks. Juice is slightly better than soda but you're better off eating your fruit than drinking it. Instead, drink water. Lots of it.
We need to exercise. We all know it but few of us do it. Here are the recommendations for physical activity: Physical Activity Guidelines.
*Children: Children and adolescents should do 60 minutes (1 hour) or more of physical activity each day.
*Adults: 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
This can be made harder by the fact that half of American kids don't have a park, community center, or sidewalk in their neighborhood. Without physical education or access to places to play outside our children are truly suffering. Go for walks or ride bikes with them. Make the effort to help them get outside and play on the weekends. For that matter, go play with them. Most adults don't get outside enough either.
Limiting screen time goes hand in hand with getting outside and exercising. Our children are mercilessly marketed by food companies. A set of international principles on marketing food to children recommends that all countries establish legal measures to protect children and support their rights. While I agree that the marketing should be regulated to protect our kids, the easier alternative is to turn off the tv. In our house, our kids only watch shows we have scheduled to be recorded. That way we can control what they watch AND they have to skip through the commercials.
As far as taking action to limit obesity, HBO's The Weight of the Nation has opportunities on their website. I have included this link for those interested: Take Action
It has opportunities to learn about many of the problems contributing to obesity, what you can do, and how to reach out to others for help.
And one last thing is to become more educated about obesity and obesity-related illnesses. If is not affecting you it is probably affecting someone you know. Prevention costs less (financially, physically and mentally) for all of us. Talk to your children about what obesity is. The more they know about it the better health decisions they can make.
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