Yesterday brought to my attention some distressing material on the obesity epidemic.
First, the Trust for America's Health and the Robert Wood Johnson Foundation issued a report entitled "F as in Fat: How Obesity Threatens America's Future 2011." The report reviews staggering increases in obesity rates in the United States. A person is considered obese if his or her body mass index (BMI) -- a calculation based on height/weight ratios -- is 30 or greater.
Here is the beginning of the press release accompanying the report:
Adult obesity rates increased in 16 states in the past year and did not decline in any state. ... Twelve states now have obesity rates above 30 percent. Four years ago, only one state was above 30 percent.The obesity epidemic continues to be most dramatic in the South, which includes nine of the 10 states with the highest adult obesity rates. States in the Northeast and West tend to have lower rates. Mississippi maintained the highest adult obesity rate for the seventh year in a row, and Colorado has the lowest obesity rate and is the only state with a rate under 20 percent. This year, for the first time, the report examined how the obesity epidemic has grown over the past two decades. Twenty years ago, no state had an obesity rate above 15 percent. Today, more than two out of three states, 38 total, have obesity rates over 25 percent, and just one has a rate lower than 20 percent. Since 1995, when data was available for every state, obesity rates have doubled in seven states and increased by at least 90 percent in 10 others. Obesity rates have grown fastest in Oklahoma, Alabama, and Tennessee, and slowest in Washington, D.C., Colorado, and Connecticut.
As noted, the states with the highest obesity rates are overwhelmingly located in the South. But some Northern states fare poorly as well. For instance, Michigan is 10th, with an obesity rate of 30.5%. And get this: The highest state obesity rate in 1995 (Mississippi at 19.4%) is lower than the lowest state obesity rate today (Colorado at 19.8%).
The report also discusses the relationship between obesity and serious diseases, such as diabetes and high blood pressure:
Obesity contributes to a range of chronic diseases, including diabetes and hypertension. Of the 10 states with the highest rates of diabetes, eight are also in the top 10 for obesity; of the 10 states with the highest rates of hypertension, nine also rank in the top 10 for obesity. Between 1995 and 2010, obesity, diabetes, and hypertension also all rose significantly in almost every state and in Washington, D.C.
The Report goes on to address the particular challenges posed by massive increases in childhood obesity and discusses a wide array of current and potential government policies to curb obesity. Read the entire press release, the full report, and a Washington Post story on the report.
The report's discussion of government policy targetting obesity brings me to a second topic: laws aimed at reducing obesity by requiring disclosure of the calorie content of restaurant food. Over the past decade, localities, such as New York City, Philadelphia, and Montgomery County, Maryland, began to require calorie disclosures at chain restaurants. And, beginning next year, FDA calorie disclosure regulations will apply nationwide. This blog has covered that issue in some depth and expressed optimism that menu labeling would cause people to eat more healthily.
But, according to this story in yesterday's Washington Post, calorie disclosures have made little or no difference, particularly to the people who are meant to benefit from them:
Evidence is mounting that calorie labels — promoted by some nutritionists and the restaurant industry to help stem the obesity crisis — do not steer most people to lower-calorie foods. Eating habits rarely change, according to several studies. Perversely, some diners see the labels yet consume more calories than usual. People who use the labels often don’t need to. (Meaning: They are thin.)
There is little data so far, and it is going to be difficult to isolate the effects of calorie disclosure on eating behavior from other effects that may push in the same or the opposite direction. But we have noted on several occasions -- go here, for instance -- that disclosure laws do not always achieve their intended goals. Calorie disclosure is one tool among many, and, as with the long fight against tobacco addiction, disclosures, warnings, and other forms of public education may take a long time and considerable retooling before they begin to work.
With respect to the second point, on calorie disclosures, I think it's important to note that some of this retooling is hopefully going on. Although not in the context of menu labeling, the FDA's announcement in October 2009 that the agency is considering different forms of front-of-package labeling gives some hope that we may see more effective forms of calorie disclosures in grocery stores and elsewhere (http://www.fda.gov/downloads/NewsEvents/Newsroom/MediaTranscripts/UCM187809.pdf).
One promising model is the "traffic light" system, using the familial colors of the a traffic light to express relative levels of fats, sugar, and sodium. Sadly, while the British Food Standards Agency advised the use of the traffic light system, the EU recently rejected making the system mandatory. A less consumer-friendly model is the Grocery Manufacturer Association's "Nutrition Keys" model, which fails to utilize any effective signals for calorie information (and would only require information on saturated fat, not overall fat), and has been criticized as an attempt to circumvent more effective government regulation.
Posted by: Colin H | Friday, July 08, 2011 at 01:45 PM