Thursday, February 10, 2011

Not Just a U.S. Problem: Thoughts on the Global Obesity Crisis

The U.S. has an obesity problem, no doubt about it. It is a large and growing problem that some are taking very seriously (thank you Michelle Obama and Let's Move) and others are ignoring or downplaying. What may be surprising, though, is that the U.S. is not alone. According to a recently released Lancet, worldwide obesity has doubled since the 1980s and now 1 in 9  people worldwide are obese.

In fact, the largest rates of increase in obesity (that is, the highest rate of change not the total number) is in countries where rapid changes in economic development and industrialization are happening, like the Middle East, Latin America, and parts of Asia.  The reasons behind this are complex, and not dissimilar to issues in the U.S.: increased access to low-cost, low-nutrient processed foods, less time at home for traditional meals, more TV and computer use and less physical activity, both at work and for leisure.
"A 2004 [World Health Organization] study shows that obesity rates in China, Brazil, Morocco, Thailand, and Mexico are all increasing at a faster pace than rates in the U.S." Benjamin Caballero of the Center for Human Nutrition at Johns Hopkins Bloomberg School of Public Health, "Obesity—A Global Perspective," presented at the NYAS 12.10.10.
Widespread changes in food availability, food quality and cost greatly influence eating behaviors. Food Econ 101 says that cheap prices lead to high consumption. Throughout the world there has been a rapid decrease in the cost of carbonated, non-alcoholic beverages and of vegetable oils (a key ingredient to processed foods),  while there has been an increased cost of fresh fruits and vegetables. The result is high calorie intake that way out-balances high nutrient intake in the average diet. With high rates of obesity come high rates of disease-related illness. The highest worldwide prevalence of diabetes is in India and China, with the U.S. third. (NYAS, Super-Sized World Conference Report) 

Some of the poorest nations are actually facing twin-crises of hunger and obesity, where children are hungry and under-nourished but adults are obese (and perhaps hungry too.) This is also a problem in the U.S. where families that are "food insecure" struggle both with hunger and health problems due to poor food choices and food availability, as I have posted previously here.

What does this have to do with family dinner? Well, it is evidence that the challenges are great and the tools are few. One tool that is often overlooked is family dinner. It is overlooked by policymakers and public health researchers and it is overlooked by families. Family dinner has been shown to help families eat better and be less at risk for obesity, as well as a myriad of other social and health problems, like depression and underage drinking. It is not the only solution, but it is one of those "small steps" that you, as an individual, can change right now. And to policymakers and others, I say, support families with food and economic policies that can make healthy family meals and food choices easier. Guilt and blame will not be effective to spur long-standing health changes. Globally and nationally, we have a lot of work to do, but at home, it can be as simple as making a commitment to family dinner.

References and more reading:
First Lady Taking Health Work Global, NYT 02.08.11
GOOD Feast Your Eyes:  Visualization of BMI by country using data from Lancet. 02.09.11
The Obesity-Hunger Paradox, NYT 03.12 11
Super-Sized World Conference Report, New York Academy of Science, 12.10.10 (some data may be members only)
The 30 Project by Ellen Gustafson


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