Fat Nation, Here We Are!


This series of maps on obesity is absolutely devastating. There's a flash version here, but for your viewing (dis)pleasure:

Let's skip to 2001 (the full series is worth looking at though).

The color scheme is different in this last picture, but yes, it's worse:

Now, normally, this is where I'd tell you why I think it's happening. But, for once, I'm mostly flabergasted.

Is it food? People are eating much worse? Is it exercise, that people are getting less of it? I guess it has to be, bottom line. And my guess is that if you were to turn that stuff into a graph, then chart it with the incidence of diabetes those two would track very well.

And I'm also guessing that if you were to do obesity charts by generation, you'd find each generation is fatter than the last. They learn eating and exercise habits as kids and don't change them much.

And probably you could also find a strong correlation between the number of people living in communities without sidewalks which also aren't rural, and obesity.

But still... why did it take off so much starting in the 80's? What changed then? Is it the change that we often talk about, that that's just a few years after the middle class started disappearing and people started having to work longer hours, send their spouses to work (and thus ate a lot worse) and started buying even more cheap but high carb, high caolorie foods? Is it because at that time the mantra that fat and meat were bad but simple carbs were ok came into play?

I don't know. Maybe it's a perfect storm of "all of the above" plus "some other stuff".

But, well, wow.


Ian Welsh November 8, 2007 - 9:00am

In the days of GM grain, corporate agriculture and governmental farm subsidy programs, it's less expensive and much easier to eat crap food.

That is, until you factor in the consequences of eating this way.

And nobody walks in LA. Or anywhere else, it appears.

Per LJ, read The Omnivore's Dilemma

I did inhale.

Don November 8, 2007 - 9:12am

Older people tend to put on more weight, so as our population ages there's going to be more fatbodies. Child obesity percentages might be a better index...

Don's right, too, in that the way our cities are planned that there isn't as much opportunity for necessary physical activity. We have to take a car to go to the post office or the grocery store, where in Europe there is more integration (thus allowing one to bike or walk wherever). If I had to guess, the zoning and spreading out of our cities has only intensified since 1985.

And poor people have to eat unhealthy, so as we get more poor people...

Mr. Flibble November 8, 2007 - 9:26am

the aging of the population is to collect this same data for Europe, since they're going grey even faster than we are. I'm willing to bet that most places over there are not experiencing as much weight gain (though I believe they are still having some problems with it).

Bolo November 8, 2007 - 11:13am

and increased used of growth regulators (hormones) residue in food that is still active when a human eats it? Does growth hormones stay active after the plant or animal eats it?

"There are two types of folk music:
quiet folk music and loud folk music.
I play both."

Dave Alvin

Peter C November 8, 2007 - 9:36am

Word to the wise...

"The BMI is meant to broadly categorize populations for purely statistical purposes. As noted, its accuracy in relation to actual levels of body fat is easily distorted by such factors as fitness level, muscle mass, bone structure, gender, and ethnicity. People who are mesomorphic tend to have higher BMI numbers than people who are endomorphic, because they have greater bone mass and greater muscle mass than do endomorphic individuals.

Similarly, ectomorphic individuals could conceivably receive a reading below the normal range, when in fact their body type makes it healthy for them to be thin. In fact, ectomorphs could obtain healthy readings even when their body fat percentage is higher than is healthy, as their low lean mass will lower the BMI.

People with short stature tend to have lower BMI. Therefore they should use a lower cut-off value for obesity diagnosis.The same applies to older people, whose reduced muscle mass can hide additional body fat without increasing BMI."

JackNYC November 8, 2007 - 9:43am

the BMI is a statistical tool designed for just this sort of analysis. It's not really for individuals, but for large groups.

Bolo November 8, 2007 - 10:41am

...uses height2, which is wrong. Volume increases as the cube. So it is thrown off (even statistically) if a population is getting taller (BMI is artificially high for tall people, because it's weight / height2).

Gordon November 8, 2007 - 11:55am

...but Americans are growing shorter as well as fatter.

http://observer.guardian.co.uk/international/story/0,6903,1185387,00.html

leox November 8, 2007 - 12:24pm

dismiss immigration as a factor, though the article does. We are absorbing a lot of small people.

If inner city blacks were growing shorter, I'd get worried about it.

http://mauberly.blogspot.com/

mauberly November 8, 2007 - 12:57pm

A middle school kid should be able to spot the problem with BMI using the square of height as a scaler, when body weight scales as the cube of height. The fact is that doctors with way more than enough education to know better still buy into this BS.

BMI says Shaquille O'Neal is not merely overweight, but "obese". And insurance companies still treat it like it has a basis in reality.

chalo November 8, 2007 - 3:30pm

I don't see how that would solve the problems with BMI. The cut-offs for the categories of underweight, normal weight, and overweight are all determined arbitrarily. All you'd be doing is dividing by height one more time to get kg/m^3. That does make more sense as a unit, since we're looking for a measure of deviation from normal weight and we'd want to use weight per volume rather than weight per area--but I don't see how that fixes anything. You'd still have the same problems, just scaled by 1/height again.

BMI is supposed to be used for statistical purposes over large populations, not on a case-by-case basis (as with Shaq, for example).

Bolo November 8, 2007 - 4:38pm

The cut-offs for the categories of underweight, normal weight, and overweight are all determined arbitrarily.

So we might as well use IQ / shoe size?

It's not "scaling" by 1/height. Scaling is done with scalars, not variables.

Gordon November 8, 2007 - 8:26pm

why 25.0 and 30.0 are used as major dividing numbers between categories--why is it that 25-30 is overweight and >30 is obese? Why are those numbers the ones that were settled upon? Where did that definition come from?

It's not "scaling" by 1/height. Scaling is done with scalars, not variables.

True, I need to get more sleep. ;)

Bolo November 9, 2007 - 11:18am

Wikipedia also doesn't say how the categories were derived. So... yeah, if you could say more about that I'd appreciate it!

Bolo November 9, 2007 - 12:15pm

I do know about another very widely used measurement which is invested with great importance: wind-chill.

Most humans have enough fuzz on their bodies to hold about 1/8" of air, which warms up and insulates the body. Wind, of course, depletes the layer of warm air roughly linearly with wind speed.

So every weather forecaster on any day the temp gets down towards freezing tells us with great solemnity just how cold we would feel if we were stupid enough to stand outside stark fucking naked.

Gordon November 9, 2007 - 12:31pm

is important to consider for exposed body parts--especially ears, face, hands, etc.

If it's 10F outside with no wind I know I can walk around without anything covering my ears for a little while. But if the wind's blowing hard and the wind chill is -20F then I know I can only stand out there for maybe 30 seconds before my ears start to really hurt and I need to cover them up--so, I need a hood or ear muffs.

It's still useful for gauging how cold you'll feel outside and has nothing to do with assuming you're naked (imho).

Edit: Now I'm all nostalgic for winter weather. It's still 90F down here in Arizona. Sucks. Big time.

Bolo November 9, 2007 - 4:36pm

last night. I would be happy to send it to you...as long as I can send the idiot drivers with it. :D

Tina November 9, 2007 - 7:14pm

in the last two decades? Has average height gone up enough to account for the massive BMI increase?

Bolo November 8, 2007 - 4:49pm

Only the number and/or and size of tall people has to increase for it to have an effect on rates of "obesity" as defined by BMI.

chalo November 8, 2007 - 7:00pm

Wednesday, October 17, 2007
Harkin combats childhood obesity with bill to promote physical education in schools

Obesity rates have doubled in kids 2-5 years and 12-19 years; rates have tripled in kids 6-11 years

WASHINGTON, D.C.– Continuing his efforts to lower the rising rates of childhood obesity, Senator Tom Harkin (D-IA) today introduced legislation encouraging schools to provide kids with quality physical education that can help them lead healthier lives. The Fitness Integrated with Teaching Kids Act (FIT Kids Act) would amend the No Child Left Behind Act (NCLB) to support physical education for all public school children through grade 12 and ensure they receive important health and nutritional information. Harkin is a senior member of the Senate Health, Education, Labor and Pensions Committee which is tasked with overseeing NCLB.

Since the 1970s, the percentage rate of obesity has more than doubled for preschool children aged 2-5 years and adolescents aged 12-19 years, and has more than tripled for children aged 6-11 years. Researchers have found that physical inactivity is a contributing factor to the development of childhood obesity.

“As Congress prepares to reauthorize the No Child Left Behind Act, our goal is to support a challenging and diverse education system for all kids that includes rigorous physical education. We must take action to combat rising rates of childhood obesity and diabetes, a public health crisis that we cannot ignore,” Harkin said. “As every parent knows, engaging children in physical activity throughout the day improves fitness, burns off excess energy and boosts concentration in the classroom. I hope this bill will empower our schools and parents to help improve our kids’ health.”

"Quality physical education will not only give our kids the tools to lead healthy lives, but it will motivate them to learn and boost academic performance, said Daniel W. Jones, M.D., American Heart Association President. "That's why we're pleased Senator Harkin has introduced FIT Kids Act to amend No Child Left Behind in efforts to improve physical education in our schools. With an increasing number of children at risk for cardiovascular diseases as a result of our nation's childhood obesity epidemic, we must teach them the ABC’s of health, physical activity and good nutrition."

Many governmental, scientific, and public health agencies recommend that school-age children and adolescents engage in at least 60 minutes of moderate to vigorous physical activity every day of the week, or 420 minutes per week. The national standard for physical education frequency is 150 minutes per week in elementary school and 225 minutes per week in middle and high school.

Despite these recommendations, the Centers for Disease Control and Prevention reported in 2000 that fewer than ten percent of elementary, junior high and high schools offer daily PE or its equivalent for the entire school year for all students. In addition, a 2002 survey reported that more than 60 percent of children do not participate in any organized physical activity outside of school hours.

more

Tina November 8, 2007 - 9:45am

As global warming heats up, all those kids exercising will sweat the pounds off that much quicker ;)

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Doug Richardson November 8, 2007 - 3:19pm

It takes about 11 calories per day to maintain an extra pound of weight. So, someone who is 30 pounds overweight is eating about 330 extra calories per day. That's roughly the difference between a small and large order of fries at McDonalds, three ounces of peanut butter or cheese, two tablespoons of sugar, or a bit more than a tablespoon of oil.

For a 2000 calorie per day diet, that's a relative 15% increase. I'm willing to bet that restaurant serving sizes have increased by more than that in th e last 30 years.

NateTG November 8, 2007 - 9:58am

Now doctors say it's good to be fat

After years of anti-obesity public health advice, a major new study causes an outcry by concluding that the overweight live longer

By David Usborne in New York
Published: 08 November 2007

A startling new study by medical researchers in the United States has caused consternation among public health professionals by suggesting that, contrary to conventional wisdom, being overweight might actually be beneficial for health.

The study, published yesterday in the respected Journal of the American Medical Association, runs counter to almost all other advice to consumers by saying that carrying a little extra flab – though not too much – might help people to live longer.

Struggling dieters, used to being told that staying thin is the best prescription for longevity, are likely to be confused this morning if not heartily relieved. While being a bit overweight may indeed increase your chances of dying from diabetes and kidney disease – conditions that are often linked with one another – the same is not true for a host of other ailments including cancer and heart disease, the report suggests.

In fact, scanning the whole gamut of diseases that could curtail your life, being over weight is, on balance, a good thing. The bottom line, the scientists say, is that modestly overweight people demonstrate a lower death rate than their peers who are underweight, obese or – most surprisingly – normal weight.

The findings will be hard to dismiss. They are the result of analysis of decades of data by federal researchers at the Centres for Disease Control and Prevention (CDC) in Atlanta, Georgia. This is not a study from a fringe group of scientists or sponsored by a fast-food chain.

Being overweight, the report asserts in its conclusions, "was associated with significantly decreased all-cause mortality overall".

"The take-home message is that the relationship between fat and mortality is more complicated than we tend to think," said Katherine Flegal, the lead researcher. "It's not a cookie-cutter, one-size-fits-all situation where excess weight just increases your mortality risk for any and all causes of death."

That the CDC has even published the report and thus threatened to muffle years of propaganda as to the health benefits of staying slender has enraged some medical experts.

"It's just rubbish," fumed Walter Willett, the professor of epidemiology and nutrition at the Harvard School of Public Health. "It's just ludicrous to say there is no increased risk of mortality from being overweight."

Not that the CDC results are an invitation to throw caution to the winds and take cream with everything. The scientists are careful to stress that the benefits they are describing are limited to those people who are merely overweight – which generally means being no more than 30 pounds heavier than is recommended for your height – and certainly do not carry over to those who fall into the category of obese.

Obesity has been declared one of the main threats to health in the US, including among children. Those considered obese, with a body mass index (BMI) of more than 30, continue to run a higher risk of death, the study says, from a variety of ailments, including numerous cancers and heart disease. It said that being underweight increases the risk of ailments not including heart disease or cancer.

The scientists at the CDC first hinted at the upside of being overweight a few years ago. Since then, however, they have expanded the base of their analysis, with data that includes mortality figures from 2004, the last year for which numbers were available, for no fewer than 2.3 million American adults.

Highlighting how a bit of bulge might help you, the scientists said that in 2004 there were 100,000 fewer deaths among the overweight in the US than would have been expected if they were all considered to be of normal weight. Put slightly differently, those Americans who were merely overweight were up to about 40 per cent less likely than normal-weight people to die from a whole range of diseases and risks including emphysema, pneumonia, Alzheimer's, injuries and various infections.

Aside from escaping diseases, tipping the scales a little further may also help people recover from serious surgery, injuries and infections, Dr Flegal suggested. Such patients may simply have deeper bodily reserves to draw on in times of medical crisis.

Not everyone in the medical profession was surprised or angry about the study. "What this tells us is the hazards have been very much exaggerated," said Steven Blair, a professor of exercise science and biostatistics at the University of South Carolina, who has long argued that the case for dietary restraint has been taken too far.

"I believe the data," added Elizabeth Barrett-Connor, a professor of family and preventive medicine at the University of California, San Diego, who believes that a BMI of 25 to 30 – roughly the the so-called overweight range – "may be optimal".

Critics, however, were quick to point out that the study was concerned with mortality data only and did not take account of the quality of life benefits of keeping your weight down. The study "is not about health and sickness", noted the obesity researcher Barry Popkin of the University of North Carolina.

The report "definitely won't be the last word", said Dr Michael Thun of the American Cancer Society, who pointed out, in a report released last week by the World Cancer Research Fund and the American Institute for Cancer Research, that staying slim was the main recommendation for avoiding cancer.

Others in the American medical community, while a little bemused, were withholding judgement. "This is a very puzzling disconnect," said Dr JoAnn Manson, the chief of preventive medicine at Harvard's Brigham and Women's Hospital.

The suggestion that a bit of extra weight may assist patients recovering from an infection or surgery was of no surprise to Dr Flegal. "You may also have more lean mass – more bone and muscle," she said. "If you are in an adverse situation, that could be good for you."

In their conclusions, the authors of the study note: "Overweight... may be associated with improved survival during recovery from adverse conditions, such as infections or medical procedures, and with improved prognosis for some diseases. Such findings may be due to greater nutritional reserves or higher lean body mass associated with overweight."

Those of us mostly likely to benefit from a little bulge beneath the belt, the study adds, are between 25 and 59 years old, although there were also some advantages for people over 60.

Tina November 8, 2007 - 10:33am

"Overweight... may be associated with improved survival during recovery from adverse conditions, such as infections or medical procedures, and with improved prognosis for some diseases.

This is true, from personal experience. Being a little overweight made my recovery from major surgery go well. I spent 10 days in the hospital and wasn't allowed to eat anything for most of that time--ended up losing 20 pounds and going down to 225. No big deal for me, and I'm actively trying to get back down to that weight now!

On the other hand, my co-worker would face serious problems if she lost even 5 more lbs off her tiny frame--if she ever went in for major surgery she would be in a lot of trouble.

And of course, being very overweight is just as bad as being very underweight. I was told several times that I was a good weight for the surgery, since if I were a lot fatter there would be complications and less chance of success.

Bolo November 8, 2007 - 11:07am

...discussed here, on scienceblogs.

Seems we know how to medicate for the most common overweight associated ailments, and thin / normal people are more at risk for injury (couch's are usually pretty safe).

Gordon November 9, 2007 - 9:42am

...which is when ketchup was declared a vegetable.

Gordon November 8, 2007 - 11:49am

High fructose corn syrup is in almost everything. Read ingredients, cut it out of your diet, and a lot of the pronlem goes away.

It's like crack to your blood sugar levels, and ought to be banned from our food.

“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change.”

Charles Darwin

darwin November 8, 2007 - 12:14pm

Processed food is all one type of starch, and all one type of sugar. Our bodies evolved expected a wide variety of each. The body may be keyed to sense one type, and release a variety of chemicals to deal with a whole spectrum of types. So part of the reaction is overwhelmed, and the rest finds nothing useful to do, and may end up doing harmful things.

Gordon November 8, 2007 - 1:14pm

The increased weight for large numbers of people is too consistent and dramatic to be the sum of individual choices. Food tasted really good 50 years ago, and yes, there were Twinkies at the snack counter. Transportation exclusively by car was well established by the 70's. I can believe some effects from the desire for bigger portions and decreased exercise, but nothing at the level we're seeing. The notion that people eat not because they're hungry but because they're just greedy is bizarre -- do you exercise when you're tired or spend the day in bed when you're restless? You go to bed when you're sleepy and eat when you're hungry. The model of hunger like the fuel gauge in your car is silly -- you need to fill up when the needle goes to empty. But hunger has a heavy chemical component, so that your stomache can be stuffed, and you can still feel hungry (personal experience here). So what's happened? Just from my reading, some possibilities:

- our food has been laced with substances that chemically unbalance the hunger mechanism. Potential culprits include high fructose and transfats, but may also include growth hormones from livestock.

- Some obesity may be caused by viruses, which act on the body either through the hunger mechanism or through metabolic issues or some combination thereof.

- hunger may be affected by widely spread and increasing changes in lifestyle, such as increased anxiety and exhaustion.

- food may have changed in ways that interact badly with the hunger mechanism (related to first issue above). Our food now has significantly less nutrients than food a generation ago. As various characteristics such as fast growth and attractive shelf appearance have been bred for, bulk has increased while density has decreased. As people who usually drink diet sodas will drink significantly more of them (interaction of full stomach and hunger noted above), we may be eating more because the emptiness of the food eventually affects hunger.

These are all hypotheses that I've gotten out of news articles on obesity over the last five to ten years. I'd like to see more research (I'm convinced by the article Tina cited that overweight is overfeared, though obesity is a problem). And yet, we continue to base our policies on obesity on harranguing individuals to eat less and exercise more, without accounting for the quite extraordinary need of people to eat when they're hungry.

nihil obstet November 8, 2007 - 12:50pm

There are a bunch of contributing factors:

The processed food that people eat is, by and large, insufficiently nutritious. There is plenty of the obvious stuff - fat, protein, carbohydrates, sodium, but not necessarily enough of other nutrients that your body wants or needs. (There's a bunch of stuff about fiber that people talk about, for example.) So people may be eating more to compensate for shortcomings in the food that they're eating.

Serving sizes have gotten bigger. 30 pounds corresponds to an increased daily intake around 300 calories - 15% of the nominal 2000 calorie per day diet. These days, sit-down restaurant entrees frequently hit 1000 calories or more which, basically, won't fit into a 2000 calorie diet. Generally speaking, people will eat what's put in front of them. Moreover, processed and restaurant foods tend to be more calorie-dense than unprocessed and home-made foods.

People aren't planning their food intake. Because the culture has moved to convenience eating rather than one of planned eating people are frequently only eating when they're already feeling very hungry. If we assume, for a moment, that the mechanisms that determine how much is eaten are tied to how hungry one feels, it would make sense that delaying meals leads to more calorie intake. (Of course, this synergizes with large portion sizes.)

NateTG November 8, 2007 - 4:06pm

"Serving sizes have gotten bigger."....This is very important!
We're not JUST talking about the 64 oz "Big Gulp" Coke and the Super Sized fry. (I'm 50, I remember when what we call a 'mini-bagel' today was just a 'bagel', and a shmear of cream cheese wasn't nearly an inch think).......Go back and look at your Granny's best china, the dinner plates were an inch or 2 smaller...we eat off of platters today! To end on a positive note, if you want to lose weight start eating like a diabetic....use a glycemic (or glycaemic) index and create new eating habits for the rest of your life.

http://www.city.londonmet.ac.uk/~stgeorge/method/sorta.html

JackNYC November 8, 2007 - 7:02pm

I'm a huge fan of dieting, at least in the sense of watching what you eat. However, it's not particularly difficult to eat enough 'good' food - for any value of good that you like - to get fat. For example, sumo wrestlers primarily eat chanko nabe which is - from a food content perspective - pretty good stuff. (Of course, they eat mass quantities, one meal a day, sleep after eating and so on.)

The basic idea for weight loss dieting is to eat less than you take in - basically, this amounts to counting calories. The glycemic index stuff may be better for dealing with the diabetes aspect of things, but, for basic weight loss, it's really ancillary. Similarly, eating plenty of fiber or protein has a lot of benefits, and the feeling of fullness and slowed digestion make it easier to eat less, but, at the end of the day the calculus of calories is going to be what determines body weight.

NateTG November 9, 2007 - 10:38am

Moderation in all things, including moderation...............

JackNYC November 10, 2007 - 2:08pm



Turn back to the Constitution - and
READ it.

Rick November 10, 2007 - 6:46pm

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