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

Let's Cook: Cooking as life skill

 Image from Let's Move website

Just heard about "Let's Cook" a new White House video series hosted by Michelle Obama's Let's Move campaign, which is set to launch today Tuesday 7/13/10 at 10am via webcast. There is a preview here at the Obama Foodorama Blog. Such a great idea. From the start, I've been hoping that the Let's Move campaign would take a broad view of health and combine its message to be about both staying active and eating right. Teaching kids, and adults, how to cook healthy foods and empowering them to actually cook for themselves and their families is an important step.

I read something recently that listed all the things you would expect a 20-something independent adult to do, such as making simple meals, doing laundry, pretty standard stuff.  The punch line was that these are the things we are supposed to be teaching our older kids and teens to do now so that they will, in fact, become the independent 20-somethings that we hope they will be. I have to admit that I haven’t done too well in making my reluctant teenage son do these daily-living household chores. My nagging usually runs towards homework first and then to “please stop playing that video game and/or get off the computer.”

Nonetheless, cooking basic meals is an essential life skill.  I know my experience cooking for my family as a teen (my mom worked in a restaurant on the night shift) was instrumental in giving me life skills in the kitchen and beyond. My son does like to make breakfast and will often make himself or his crew of friends that slept over a big breakfast of eggs and whatever else he can scrounge up. It’s a start.

Cooking doesn't have to be set up as a chore (that goes for parents and kids), even though it's something to "get done." Find some joy in learning a new skill or just getting a dish to the table, be it something new or an old standard.  Bon appetit!

The Bronx Paradox and other new food policy research

Many articles and issues about food security popping up lately: here's a quick look a few.

The Obesity-Hunger Paradox, NYT 3.12.10
A fascinating article in the Times about the co-mordibity of hunger and obesity, dubbed here "the Bronx Paradox." It's an issue I've long suspected but never saw the data put side-by-side. Some of the highest rates of food hardship are in the South Bronx and Central Brooklyn; right where there are high percentages of food-related illness. This is another example about how socioeconomic problems are often a complex web with very few easy prescriptions. As quoted in the article,

“If you look at rates of obesity, diabetes, poor access to grocery stores, poverty rates, unemployment and hunger measures, the Bronx lights up on all of those,” said Triada Stampas of the Food Bank for New York City. “They’re all very much interconnected.”

Multi-pronged solutions of income support, nutritional support and education, improved access to better food choices in schools, in local stores and in neighborhood supermarkets, and improved spaces for recreation are all needed to combat the twin problems of hunger and obesity.

Rise in Soda Price Linked to Better Health, NYT 3.15.10

New research provides evidence that a proposed soda tax could reduce soda consumption and help young people make healthier choices. In nearly a one-to-one ratio, a 10% increase in price led to a 7% decrease in soda consumption, and less calories consumed overall. Full study is in the March 8 edition of the Archives of Internal Medicine.

Michelle Obama's Let's Move Campaign wants ideas:
A new White House directive has created the interagency Childhood Obesity Task Force which is developing an action plan for how federal, state, and local governments, along with the private and nonprofit sectors, can come together to fight childhood obesity. In a call for ideas, you can submit suggestions here. The regulations.gov form is a little daunting, but you can use the comments button to write in your suggestions. They say whatever ideas you have are welcome, and they want ideas from parents and educators as well as from professionals. The deadline for submitting comments is March 26, 2010.