Too Much Riding and Eating Fuel Obesity Epidemic

WASHINGTON, Aug. 30 -- Plates groaning with food, communities that discourage walking, and long hours of working and commuting are all conspiring to make Americans obese, according to a report released by a non-profit group.

Since 2002, obesity rates have climbed in 31 states, while rates in the remaining states have held fast, said Jeffrey Levi, Ph.D., executive director of the research and policy group Trust for America's Health, in a report titled F as in Fat: 2006.

Mississippi ranked as the fattest state with an obesity rate of 29.5%. Obesity was defined as a body mass index (kg/m2) above 30. In fact, Southern states were the "biggest belts" overall, the report said, with nine of 10 states with obesity rates greater than 25% located in the south:

• Mississippi: 29.5%
• Alabama: 28.7%
• West Virginia: 28.6%
• Louisiana: 27.4%
• Kentucky: 26.7%
• Tennessee: 26.6%
• Arkansas: 26.4%
• Indiana: 26.2%
• South Carolina: 26.2%
• Texas: 25.8%

The slimmest state was Colorado, with an obesity rate of 16.9%. The 10 states with the lowest obesity rates tended to cluster in the northeast and west, according to the report:

• Colorado: 16.9%
• Hawaii: 18.2%
• Massachusetts: 18.6%
• Rhode Island: 19.5%
• Vermont: 19.5%
• Connecticut: 19.6%
• Montana: 19.9%
• Arizona: 20.8%
• Utah: 20.8%
• Nevada: 21%

The report authors analyzed data from two national information surveys conducted by the CDC, the National Health and Nutrition Examination Survey (NHANES), and the Behavioral Risk Factor Surveillance System (BRFSS).

Nearly two-thirds of Americans are either overweight or obese, the report said. From 1980 to 2004, U.S. adult obesity rates have grown from 15% to 32%. At the same time, childhood obesity rates have more than tripled, from 5% to 17%, according to the report.

One factor fueling the obesity epidemic is "portion distortion," or the ever-increasing portion sizes offered by restaurants and grocery store food products, which lead to a higher intake of calories, the report said.

For example, the typical 8-ounce coffee with whole milk and sugar served 20 years ago (45 calories) has been replaced by a 16-ounce mocha with steamed milk and syrup (350 calories), the report said.

Twenty years ago, typical serving of popcorn at a movie theater was five cups (270 calories), but that has increased to an 11-cup serving size today (630 calories). A typical chicken Caesar salad 20 years ago was 1.5 cups, with 390 calories, while the same salad today is likely to be 3.5 cups and rack up 790 calories, according to the report.

In addition, regular exercise is discouraged by communities designed to foster driving rather than walking, poor upkeep of sidewalks, and poor maintenance and security in local parks, the report said.

Adults are working longer hours and spending more time in the car commuting, while kids are spending more time in front of the TV or computer and playing video games, the report said. Both trends reduce the amount of time available for exercise.

At school, physical education requirements are not enforced and exercise programs are not funded. The nutritional value of school lunches is often substandard, and many schools allow an influx of soda and snack machines, the report said.

At work, the typical environment is not designed to foster movement, and there are few opportunities for exercise or recreation during the day but plenty of unhealthy options at the company cafeteria, the authors noted.

The report recommended actions that can be taken not only by state and federal governments but by families, communities, schools, employers, and the food industry to combat overweight and obesity. Key components of the report's action plan included:

• An appropriate set of indicators to measure progress in the fight against obesity. Instead of focusing solely on weight loss, improved nutrition and increased physical activity should also be measured, the authors suggest.
• Community-driven efforts that increase access to healthy foods for low-income areas and improve sidewalks, parks, and bike paths so that the neighborhood is more conducive to physical activity.
• School-based efforts to strengthen physical fitness curricula and improve the nutritional content of all foods and beverages served and sold on school campuses.
• Employer-sponsored programs that offer employees more places and time to work out, subsidize health club memberships, and provide better insurance coverage for preventive for preventive services.
• Food, beverage, and marketing industry initiatives that improve nutritional labeling practices, such as nutritional labels based on product size instead of serving size.

The report was supported by a grant from the Robert Wood Johnson Foundation.