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Yes, we’re getting fatter — but how do we reverse the trend?

CC/Flickr/BurgerAustin
Americans have come to see access to plentiful, ever cheaper and ever less healthy foods as proof of the American promise.

This week brought yet another report on how Americans are continuing to pack on the pounds, with dire health consequences.

Earlier this year, the U.S. Centers for Disease Control (CDC) reported that 35.7 percent of American adults — 25.7 percent of Minnesotans — are currently obese. It also projected that more than 42 percent of Americans would be obese by 2030.

On Monday, researchers with Trust for America’s Health and the Robert Wood Johnson Foundation reported that their analysis of the data pointed to an even fatter future for Americans.  They found that, if current trends hold, half of U.S. adults — including 54.7 percent of Minnesotans — could be obese by 2030. In fact, in 13 states, the rate of obesity could top 60 percent by that date.

Because obesity is associated with so many chronic diseases, these projections mean that an increasing number of Americans will be struggling with serious health problems. Here in Minnesota, the report notes, “obesity could contribute to 609,902 new cases of type 2 diabetes, 1,365,612 new cases of coronary heart disease and stroke, 1,312,110 new cases of hypertension, 844,916 new cases of arthritis, and 194,660 new cases of obesity-related cancer” over the next two decades.

Those added health problems have an economic as well as a personal price tag, of course. The report projects that Minnesota’s annual obesity-related medical costs could climb by 15.7 percent by 2030. Nationally, the rise in the rate of obesity would add an estimated $66 billion to our annual health care bill.

Recommendations for change

We know we’re getting fatter. That trajectory has been clear for at least two decades. We also know that obesity exacts a huge personal and financial cost.

What we don’t seem to know — or agree upon — is how to reverse this unhealthy trend.

The new report offers several recommendations, including “increase investments in effective, evidence-based obesity-prevention programs,” “make physical education and physical activity a priority” in schools, and “fully support healthy nutrition in federal food programs.”

None of that sounds particularly new. In fact, it isn’t all that new, as agricultural historian Martin Bruegel points out in an essay published Tuesday in the New York Times.

“While the alarm over obesity is fairly recent,” he writes, “the notion of using ‘scientific’ knowledge to guide the dietary habits of ordinary people — particularly the less well off — is not.”

Calorie counting began in France in the late 19th century, Bruegal reports, and eventually crossed the Atlantic.

“By 1920, Americans were so calorie conscious that a romance novel, Ethel M. Kelley’s ‘Outside Inn,’ featured calories as a prominent theme,” writes Bruegel. “In 1924, the Restaurant Owners’ Association toyed with providing diners with printed advice on well-balanced meals ‘from the point of view of calories.’

Childs Restaurant, which Bruegel calls “an ancestor of today’s global fast-food chains,” actually took that step, offering all sorts of nutritional information to its patrons, including calorie counts of its foods.

Sound familiar?

“None of these initiatives lasted,” notes Bruegel. “For European and American consumers, hearty and palatable meals outweighed scientific formulas every time.”

So what will work? Bruegel offers a provocative and structural suggestion, one that looks to society rather than to individuals for a solution. As I’ve pointed out in Second Opinion before, such approaches to solving the obesity epidemic are not welcomed by Big Food or even much of the American public.

Writes Bruegel:

The history of “scientific eating” offers several lessons. Nutritional campaigns can succeed in influencing consumer behavior only if they take into account the sensual joys of eating. The French continued to eat their red meat and drink their red wine because rich meals gave them a sense of belonging to a community. Similarly, American consumers after World War II saw access to plentiful, ever cheaper and ever less healthy foods as proof of the American promise — even if the impact on their waistlines, and well-being, has been disastrous.

In an era of stagnant wages, dystopian politics and cultural anomie, eating indulgent if unhealthful food has become a last redoubt of enjoyment for Americans who don’t feel they have much control in their lives. Higher incomes and better educations — in the classroom, not on the menu board — will do more to solve the obesity epidemic than mandating the disclosure of calorie counts.

Before we blame the poor and the overweight for their inability to manage their budgets or control their appetites, we might want to think not only about the foods they encounter in the supermarket and on television but about a culture that relies ever more on unhealthy foods to breathe meaning and purpose into everyday life.

You can read Bruegel’s essay at the New York Times website. You can read the Trust for America’s Future/Robert Wood Johnson “F is for Fat” report online as well.

Comments (6)

  1. Submitted by Ann Spencer on 09/20/2012 - 01:31 pm.

    A question and a personal observation

    I’m not being snarky, I genuinely want to know: is there such a thing as an “effective, evidence-based obesity-prevention program”? My understanding is that almost all such programs are dismal failures, at least over the long term.

    I think Martin Bruegel is onto something, too. When I was in college, a friend of mine used to refer jokingly to “EJE”—“the ephemeral joy of eating”—and it’s magical feel-good properties. As she also said, “When all else fails, your tastebuds never let you down.” Too true!

    All kidding aside, though, losing weight and maintaining it is very tough. I’ve lost quite a bit of weight (I did it over three and a half years) and I can tell you that keeping it off requires constant awareness and a never-ending focus on what and how much I’m choosing to eat. I feel great, I know I look better, and I’m certainly healthier—but there is no getting around the fact that it’s a colossal drag. And I am lucky—I have access to great supermarkets with a wide array of fresh fruits and vegetables. I love cooking and I have the time to do it. I have the luxury of being able to afford good quality food. I refuse to sit in judgment on those for whom the battle is much, much harder.

  2. Submitted by Rick Prescott on 09/20/2012 - 03:21 pm.

    Evidence?

    ‘The new report offers several recommendations, including “increase investments in effective, evidence-based obesity-prevention programs,” “make physical education and physical activity a priority” in schools, and “fully support healthy nutrition in federal food programs.”’

    There are some pretty big assumptions hiding in those recommendations.

    The first is that we already know how to prevent obesity, and could actually design some sort of “obesity-prevention programs.”

    The second is two-fold: A) That modifying “physical education and physical activity” would be an actual solution, and, B) that it is somehow deficient now.

    The third is also two-fold: A) That “healthy nutrition” is not currently sufficiently supported in “federal food programs”, and, B) the we know what constitutes “healthy nutrition”.

    My point is that no one yet knows definitively what is causing the obesity epidemic. The assumptions in this report all seem to be based on the “calories in, calories out” model of weight gain, which hardly has experimental results to back it up and has been called into question by many researchers in recent years. Some consider that model to have already been debunked.

    How about this for a recommendation: Outlaw BPA. It is a chemical used in plastic manufacturing, and widely known to be a carcinogen which disrupts the body’s metabolism causing weight gain. You can find it in almost every piece of plastic you touch, and you don’t have to ingest it to be harmed by it. It’s most likely to enter your system in large quantities through register receipts!

    Or how about this: Reduce our dependance on wheat, present in so many foods that we eat, which has been shown experimentally to have highly-detrimental effects on the health of many (including causing significant weight gain).

    Dare we discuss sugars? Antibiotics in farming? Pesticides and herbicides? The economics of processed foods? The stresses people face from income disparity?

    Too radical? Maybe. But at least each of these potential sources of the epidemic is already supported by experimental evidence, while the assumptions in this report generally must be considered “common knowledge” — which, it turns out, may have little basis in actual science.

  3. Submitted by Lance Groth on 09/20/2012 - 03:30 pm.

    Not just eating

    I don’t think food choices is the whole story. Certainly it is true that eating the typical western diet, high in high-glycemic carbs coupled with fats, both high energy sources, combined with a mostly sedentary lifestyle, is a large part of the problem. However, there are environmental factors that I think work very much against weight control.

    An obvious one is that most processed foods are spiked with corn syrup. This is not only unnecessary, but dangerous to peoples’ health, and the practice should be banned. It won’t be, mostly because of lobbyists, but when everything you eat is spiked with simple sugars, you are going to gain weight. Back in the days when most people worked on farms or in blue collar, physical jobs, they were able to burn off the calories they consumed, but for most of us, this is simply no longer true.

    Another, I’m convinced, is the chemical load that is embedded in most foods, some of which act as endocrine disruptors. BHA & BHT, used as a preservative for foods containing fats, mimic the action of estrogen, and have been demonstrated to be carcinogens in lab animals. BPA, another endocrine disruptor, is used in plastic bottles & containers and cans. It has been associated with childhood obesity, and obesity & coronary artery disease in adults. Yet these chemicals continue to be used because they are cheaper than alternatives which are safer. Commercial crops are sprayed with all kinds of pesticides, herbicides, fungicides & preservatives, and god only knows what affect this cocktail of toxins has on people.

    While it is certainly healthier to eat local/organic/non-processed foods, it is also expensive, and many people simply can’t afford it.

    So yes, counseling people on healthy diets and exercise programs, etc., is a good thing to do, but the deck will still be stacked against them as long as we fail to deal with the environmental factors over which individuals have no control. Most such factors are caused by the decisions that we make collectively, and therefore can & should be changed.

  4. Submitted by David Frenkel on 09/20/2012 - 03:55 pm.

    Food industry

    Many of the giants of corporate American make junk food, Coke, Pepsi, General Mills, Nestle, Kraft, etc.
    They are not going to want to loose market share and profits just to keep Americans healthy. It took 30 years to get us to this point and it will take 30 years or longer to break our depence on sugar, fat and salt.

  5. Submitted by Eric Carrig on 09/20/2012 - 06:35 pm.

    Minnpost Obesity Challenge

    Most programs to reduce obesity boil down to some combination changes to nutrition, exercise, and engagement with a coach or group of people to support you. Obesity has gotten so out of hand that the argument now involves potential changes to policy.

    The problem is how to get a reasonably-sized movement to support one strategy to reduce the prevalence of obesity — and likely go toe-to-toe with the medical and food establishment.

    Minnpost should find five to seven people who could write a business case — or a legal argument — for different approaches to weight loss. There are 10 or so common elements that could be used to make it easy to compare strategies. Then invite your readers to vote on each aspect of the solutions, Think of it as a 10-question multiple-choice quiz.

    You would identify the aspects of a strategy on which to build and be able to drill into the most contentious parts of the debate. Imagine taking a viable strategy supported by the community to agribusiness and politicians instead of simply reporting about how obesity imposes this social and financial cost on the United States.

    There is a group that has developed the technology to manage a debate in this manner. http://www.at10us.com

    Since we lack an approach to devise a solution to obesity — and other significant problems — it seems like an audience like Minnpost’s would think something like that was pretty cool.

  6. Submitted by Ray Marshall on 09/20/2012 - 07:07 pm.

    Eating is becoming a very dangerous activity

    It is becoming very obvious that eating is becoming a very dangerous human activity. People eat too much, and some throw away too much. Some food is not good for us and just this morning I read that there is too much arsenic in our rice. I like rice!

    It seems to me that the storage and preparation of food in the home can no longer be entrusted to amateur cooks. We need to set up dining halls for the entire population so that people will eat well balanced meals and keep their body weight in proper proportion to their height.

    Of course millions of jobs will be lost in the grocery and restaurant business, but they could be given priority applications for employment in the government dining halls.

    With government handling food preparation and serving, everybody will be healthier, happier and skinnier. What more could one ask for out of life?

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