American
Obesity Ballooning
Government
health officials fret about expanding waistlines, even in kids
The
US government's latest health and nutrition survey is in, and the results
are huge. Literally.
More
than 30 percent of American adults, or 59 million people, were obese
in 2000, far more than the 23 percent who made their scales wince just
six years earlier.
Weight
problems among the nation's children have also continued to surge, with
15 percent, or nearly 9 million, considered overweight or obese in 1999
and 2000, triple the rate in 1980. Ten percent of pre-schoolers are
now overweight, compared with 7 percent in the early 1990s.
The
Problem Keeps Getting Worse
"The
problem keeps getting worse," Tommy Thompson, secretary of the US
Department of Health and Human Services, said in a statement.
"We've seen virtually a doubling in the number of obese persons over
the past two decades and this has profound health implications. Obesity
increases a person's risk for a number of serious conditions, including
diabetes, heart disease, stroke, high blood pressure and some types
of cancer."
Morgan
Downey, executive director of the American Obesity Association,
called obesity "the most prevalent public health problem of the 21st
century." Heaviness is behind 300,000 to 500,000 deaths a year, says
Downey, who criticized the government for not doing enough to help the
nation stay fit.
"We
think the government needs to do more than just exhort people to live
better," Downey says. His group is calling for more research dollars
devoted to studying obesity, better insurance coverage of weight-loss
treatments, and more attention to physical activity and nutrition in
the nation's schools.
The
survey results appear in two studies published in the Journal
of the American Medical Association (JAMA). Both use data from
the National Health and Nutrition Examination Survey (NHANES). They
included information on 4,115 men and women over age 20, and 4,722 children
from birth through age 19.
Using
Body Mass Index (BMI) As Disease Predictor
Since
obesity is weight in the context of height, scientists use a term called
"body mass index," or BMI, to relate a person's north-south to their
east-west. A man who is 6 feet tall, for example, has a body mass index
of 30 if he weighs 221 pounds. A woman who is 5-foot-5 has a BMI of
30 if she weighs 180 pounds. A BMI of 25 or more for both sexes is considered
overweight, while a BMI in excess of 29 is considered obese.
Between
1988 and 1994, roughly 23 percent of adults surveyed had a BMI of 30
or higher, and 56 percent were overweight but not yet obese. By 1999-2000,
however, those numbers had risen to 30.5 percent and 64.5 percent, respectively.
One-third of women and 28 percent of men were obese by the end of the
last decade.
The
number of "extremely obese" Americans—those with a BMI of 40 or
more—jumped from 2.9 percent to 4.7 percent in the years between
the two surveys. [A third study in the journal found somewhat lower
rates of severe obesity. However, that work relied on self-assessments
of weight, which are usually not reliable.]
People
with extreme obesity have twice the risk of premature death as those
with BMIs between 30 and 39—who themselves are at much greater
risk of dying early than their thinner peers. The extremely obese are
so heavy that they may qualify for stomach-shrinking surgery.
The
surveys found that waistlines bulged for both sexes and in every age
group. However, the scientists were surprised to see an 11 percent to
12 percent surge in obesity in women and men between the ages of 60
and 74, says Cynthia Ogden, an epidemiologist at the National
Center for Health Statistics and a member of the research team.
Although
men in the various racial and ethnic groups surveyed had roughly the
same rates of overweight and obesity, African-American and Mexican-American
women had the most trouble with their waistlines. More than one in two
African-American women over age 40 were obese in 2000, and more than
eight in 10 were overweight. Extreme obesity was also highest among
African-American women, rising from 7.9 percent to just over 15 percent
by 2000.
Overweight
Teens Become Overweight Adults
For
the youth survey, children aged 2 and older were considered overweight
if their BMI was in the top 5 percent for their gender.
It
found that more than 15 percent of children between the ages of 6 and
19 were overweight in 1999-2000, about 50 percent more than in the previous
NHANES review. The problem was slightly better among the very young,
10.4 percent of whom were overweight, compared with 7.2 percent in 1988-1994.
Being
overweight was more common among African-American and Mexican-American
boys and girls than it was among Caucasians.
Ogden,
who also co-wrote the journal article on the youth survey, says being
overweight even early in life is linked to high blood pressure, high
cholesterol, and the first stages of diabetes. "Overweight teens are
more likely to become overweight adults," she adds.
In
an unrelated survey released last week, the National Association
for Sport and Physical Education found that most Americans
greatly overestimate the amount of exercise they get each week. The
Centers for Disease Control and Prevention (CDC)
advises 30 minutes of physical activity every day.
Always
consult your physician for more information.
Online
Resources
American
Association of Diabetes Educators
American
Diabetes Association
American
Obesity Association
Centers
for Disease Control and Prevention (CDC)
Journal
of the American Medical Association (JAMA)
National
Association for Sport and Physical Education
National
Center for Health Statistics
National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
US
Department of Health and Human Services
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November
2002
The
Problem Keeps Getting Worse
Using
Body Mass Index (BMI) As Disease Predictor
Overweight
Teens Become Overweight Adults
Diabetes:
The Silent Killer
Online
Resources
Diabetes
Services at St. John's Mercy
Find
a St. John's Mercy Physician
Diabetes:
The Silent Killer
Millions
of Americans have a potentially deadly disease and do not even know
it.
The
disease: Diabetes, which can cause blindness, kidney failure, heart
attacks, and strokes. More than 16 million Americans have diabetes,
but more than five million of them are not aware of their condition.
"It
is truly a huge national problem," says Dr. Francine Kaufman, president-elect
of the American Diabetes Association. "And
it is an epidemic in the adolescent population."
Diabetes
is increasing at a startling rate. In the last decade, there has
been a 33 percent jump in people with type 2 diabetes, often called
"lifestyle diabetes."
Type
2 diabetes used to be known as "adult-onset diabetes," because it
usually occurred in mature adults. But that term has been dropped
as the disease increasingly strikes children in their teens or younger.
At
the heart of the problem: Too much food and not enough exercise.
"We're
getting heavier. We're not as active," says Dr. Frank Vinicor, head
of diabetes programs for the federal Centers for Disease
Control and Prevention (CDC).
"We're
not only eating more calories, but maybe not the best foods, either,"
he adds.
Diabetes
is caused by an imbalance of insulin, a substance that helps the
body process sugar to produce energy.
Type
1 diabetes, usually first seen in children, is caused by the body's
failure to produce insulin. People with type 1 diabetes have
to take daily injections of insulin.
But
type 1 diabetes accounts for only 5 percent to 10 percent of
all diabetes cases. Type 2 diabetes is much more common—and
more preventable.
Drastic
improvements in your risk for diabetes can be made with only modest
changes in behavior.
Recent
studies show that a brisk 30-minute walk five times a week and the
loss of 10 pounds can cut the risk of type 2 diabetes in half.
"That's
hot stuff," says Vinicor. "You can cut the risk in half if you exercise
and eat better.
"Those
can be tough things to do," he acknowledges. "It's tough to exercise
and to push away from the table. Food tastes good."
With
more and more children developing diabetes, Vinicor and Kaufman
say the schools are a good place to start changing habits.
"It's
important that the schools are a healthy environment," says Kaufman.
"It has deviated from that. You can eat junk food and sugary sodas
whenever you want, and meanwhile, they've taken away physical education."
"That's
not a good switch," she says.
Vinicor
says school districts need to say "no" to lucrative contracts with
soft-drink companies, which often pay schools millions of dollars
for exclusive sales rights. Schools also need to reinstate physical-education
requirements, he says.
"Somebody's
got to step in and say, 'The risks are too great,' " Vinicor says.
"We're not only harming the kids today, but also harming them later
as adults."
While
those with type 1 diabetes have no choice but to inject insulin,
an array of newly developed drugs is available to treat type 2
diabetes. Some make the body more sensitive to its own insulin.
Others slow down the body's absorption of sugar or reduce the addition
of sugar from the liver.
Possible
symptoms of type 2 diabetes include excessive thirst, frequent
urination, sudden weight loss, fatigue, blurred vision or tingling
and numbness in the hands or feet.
Consult
your physician if you have any of these symptoms and/or for more
information on preventing diabetes, particularly if you are overweight.
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