By 2030 50% of American adults will be obese, and 25% will be severely obese

by Diana R. H. Winters

If the predictions from a recent New England Journal of Medicine article (pay-walled, but 3 free articles a month available with account creation) come true, the implications–for our nation’s health, for our health care system, and for our economy–are vast.  The study shows that by 2030, almost half of American adults will be obese and a quarter will be severely obese.  The study authors were meticulous in their methods to increase the reliability of their projections.

The study found that there is great variation among states, with over 29 states projected to have higher than 50% obesity, and a large variation in the prevalence of obesity according to income.  Severe obesity will be much more common among low-income adults than higher income adults.

The study also notes that the health consequences of this magnitude of obesity in the population are enormous, and will likely increase socioeconomic disparities.

Although the researchers are light on policy suggestions, the authors do write that, “a range of sustained approaches to maintain a healthy weight over the life course, including policy and environmental interventions at the community level that address upstream social and cultural determinants of obesity, will probably be needed to prevent further weight gain across the BMI distribution.”

In the New York Times, Jane E. Brody notes in covering this study that the United States has done very little to address the food environment that has led to such a marked increase in obesity (since 1990, obesity in the United States has doubled).  Policy interventions such as taxes on sugar-sweetened beverages, portion control, and partnering with restaurants and food manufacturers to reformulate food to be more healthy would be a start.

In fact, another article published today in the New York Times shows that multifaceted policy intervention can have a huge effect on consumption.  It is four years since Chile passed a series of sweeping laws to combat obesity including raising taxes on sugar-sweetened beverages, and “advertising restrictions on unhealthy foods, bold front-of-package warning labels and a ban on junk food in schools,” and there has been a marked drop in the consumption of sugar-sweetened beverages.  That article cited a public health policy professor from Harvard University who said “the early results suggested that a raft of food policies, not just stand-alone measures like soda taxes, were needed to address a growing obesity crisis that is affecting nations rich and poor.”

As the study and these articles note, time is short.  The costs of obesity at this magnitude are enormous – on quality of life, on health care spending, on the economy, on socioeconomic disparities.  We need these policies, and we need them now.

 

 

Once again, scientists say not to give children juice

by Diana R. H. Winters

In my house, I frown on recreational juice drinking by my children.  My kids get juice on their birthdays, sometimes.

I am happy to say that a panel of scientists has issued new nutritional guidelines for children supporting my draconian approach.  Kids under five should drink milk and water, and every once in a while, a half of a cup of 100% fruit juice.

And although I am delighted to have these recommendations to hand to my poor kids when they ask for juice, I do wish this wasn’t news, because as coverage of this study explains, “[r]ecommendations to limit juice are not new.”

Dr. Richard Besser, president and chief executive of the Robert Wood Johnson Foundation says, “When we talk about empty calories that are consumed through beverages and the number of calories people get from sugar-sweetened drinks, we’re not just talking about soda . . . Juice is another source of calories that nutritionally aren’t terrific.”

 

From The Economist: Death of the Calorie

by Diana R. H. Winters

“What we…know, however, suggests that counting calories is very crude and often misleading…. a  growing body of research shows that when different people consume the same meal, the impact on each person’s blood sugar and fat formation will vary according to their genes, lifestyles and unique mix of gut bacteria…[and] the amount of energy we absorb from food depends on how we prepare it..”                                                                    -Peter Wilson, “Death of the Calorie”

Today I taught a segment of a pre-written nutrition curriculum to my son’s fourth grade class on serving sizes.  Imagine my dismay when I picked up the script twenty minutes (oops) before I was to teach the class and found that it wanted me to teach the kids that serving sizes were recommended portions, not a reflection of what Americans actually eat (which they are, by law).  The fundamental lesson, however, contained some decent guidance–people should eat less protein (although the lesson didn’t recognize any protein but animal) and processed foods, and eat more fruits,vegetables, and other whole foods.  This simple prescription, also taught by Michael Pollan (“Eat food, not too much, mostly plants”), is more effective by far than teaching people to rely on serving sizes and calorie counting to eat healthy and maintain body weight.

This article in The Economist’s 1843 magazine on our misguided reliance on calories to measure our food intake addresses this concept, and is a fascinating and important read.

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