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Symposium deals with obesity causes, solutions

About one-third of Americans are considered obese, and if the trend isn’t reversed quickly, related health concerns could cripple the health care system, an expert said at an obesity symposium last week.

William H. Dietz, director of the Division of Nutrition and Physical Activity for the Centers for Disease Control and Prevention (CDC), gave the keynote address at the School of Public Health symposium on obesity Sept. 30. His talk served as a call to arms for public health professionals to address the myriad root causes of obesity.

Dietz said doctors are treating more obesity-related problems—including diabetes, cancer and cardiovascular disease—but what they really need to do is help patients lose the extra pounds that put them at risk in the first place.

“This is beyond the capacity of our disease care system,” he said.

Dietz demonstrated the intensity of the problem by displaying a map of the United States with obesity rates in 1991, then showing the progression through 2000. In 1991, three states—including Michigan—reported the worst overweight percentages, with 15–19 percent of the population considered overweight by body mass index evaluation. By 2000, only Colorado hadn’t hit the 15–19 percent range, and nearly half of the states tipped the scales with 20 percent or more of residents considered obese.

There are many causes, Dietz said, including shifts in American eating habits, and both decreased physical activity and increased inactivity, which Dietz said are similar but separate factors affecting people’s waistlines.

People eat more fast food, with some 40 percent of family food budgets going toward fast food, he said. In addition, fewer families eat meals together, which affects what and how people eat. Consumption of soft drinks soared from 27 gallons a year on average in 1972 to 44 gallons in 1992.

Decreased physical activity is in part a consequence of new community structure, Dietz said. Old-style neighborhoods had schools and shopping centers at the heart of the community, often within walking distance. Many of today’s subdivisions don’t have sidewalks and are isolated from the destinations that would cause people to walk.

As a result, according to a recent CDC study, just 19 percent of households with children 5–18 years old reported their children walked to school at least once a week and 6 percent said their children biked to school once a week.

Dietz recommended a number of possible approaches to arrest the obesity problem, including:

* Allying with fast food chains to help develop healthier choices. The fast food industry knows how to deliver tasty, appealing and cheap meals, and public health professionals don’t, so teaming up to figure out how to give price- and time-conscious consumers choices with less fat, fewer calories and more fiber makes sense, he said.

* Working with the government and groups such as the American Heart Association and the American Cancer Society to encourage them to see obesity treatment and prevention as a vital way of attacking cancer, cardiovascular disease and other health concerns.

* Boosting breastfeeding. Studies show breastfeeding leads to a reduction in obesity in children, though Dietz said it’s unclear what the relationship is.

* Examining community planning and zoning. Attractive sidewalks that go to destinations can make walking more appealing, and locating schools within walking distance instead of the periphery of a community makes it more practical for kids to walk to school, he said.

* Integrating physical activity into daily routine. For example, Dietz suggested posting signs encouraging office workers to use stairs instead of elevators, and making the stairs more aesthetically pleasing.

* Increasing the number of students enrolled in regular physical education classes, particularly in high school, where the vast majority of students do not participate in a gym class.

* Decreasing television viewing, especially in children and adolescents. Dietz showed studies demonstrating that children today watch more TV than in years past, as well as a study showing that the more TV children watch, the more likely they are to be obese.

* Communicating with the public about obesity instead of just issuing dictates.

For more information on the obesity symposium, visit http://www.sph.umich.edu/symposium/2002/index.html








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