Health & Fitness
 
Americans just cannot stop eating, and it's affecting our country's overall health
BY COLETTE BANCROFT St. Petersburg Times
Posted July 14, 2003

Americans have become the fattest people in the world, and it's killing us.

What made us so fat so fast?

What can we do about it?

The reasons for our national bulge are the subject of two recent books, "The Hungry Gene: The Science of Fat and the Future of Thin" by Ellen Ruppel Shell (Atlantic Monthly Press, $25) and "Fat Land: How Americans Became the Fattest People in the World" by Greg Critser (Houghton Mifflin, $24).

Both books were written in the wake of an ominous report by Surgeon General David Satcher declaring overweight and obesity a national epidemic, poised to bump tobacco out of first place as a threat to public health.

Overweight and obesity can cause or contribute to myriad health problems: heart disease, type 2 diabetes, high blood pressure, high cholesterol, stroke, osteoarthritis, asthma and many types of cancer. Doctors are seeing unprecedented growth in the number of children with type 2 diabetes, which only 20 years ago was almost never found in kids.

Perhaps most alarming is how quickly the numbers have grown. According to the Centers for Disease Control and Prevention, only four states had obesity rates above 15 percent in 1991. By 2000, 49 states did. The increases cut across age, gender, race and income lines.

How did this happen, and so quickly? There have always been fat people, but so many people becoming overweight in such a short time is unprecedented in human history.

As Shell and Critser make clear, fast food is only part of the reason Americans have become the fattest people on Earth.

The short version is we eat much more and exercise much less than we did 20 - even 10 - years ago, a sure-fire formula for weight gain.

But there are medical, educational, corporate, cultural and even political forces fattening us up.

Shell focuses on research into the scientific mechanisms of weight gain and potential ways to reverse it.

As a species, we evolved to survive in cycles of feast and famine, mostly the latter. For most of human history, the people who got fat the quickest had a survival advantage, so they passed their genes along to us.

Researchers call it the thrifty gene, although there is no single gene that controls weight. In fact, the body's systems for controlling weight are so amazingly complex that scientists are just beginning to figure them out and are a long way from being able to manipulate them.

For millennia, the thrifty genotype served our ancestors well.

But for the past few decades times have been so good they're killing a lot of us. Instead of storing fat during brief periods of plenty and burning it off in longer, leaner times, we just keep storing.

The thrifty genotype has become a liability because of the way we live. Critser quotes James O. Hill, a physiologist who studies obesity and says it's "a normal response to the American environment."

"If obesity is left unchecked," Hill says, "almost all Americans will be overweight by 2050."

Not everything making us fat is in our kitchens. Critser points out three interrelated trends: "One, that most Americans are sedentary; two, that many feel they do not have the time to exercise; and three, that the average adult watches about four hours of television a day."

Not only does TV keep us sitting and inactive, it has also "merged parent and child into one seamless inactivity bubble - a bubble filled with billion-dollar cues to eat, even when one was not hungry."

As screen time has increased, physical education programs in schools have withered. Budget cuts have reduced or eliminated organized PE, and many schools have even gotten rid of recess.

Those kinds of cuts have hit hardest in the poorest school districts, and that is part of another factor Critser addresses: obesity as a class problem.

Although increases in overweight affect every level of society, minorities and the poor are more likely to be obese.

The main reason, Critser says, is that fat-larded, sugar-charged, supersized fast food and convenience food are relatively cheap and easy. Fresh fruits and vegetables, whole grains and lean meats are more expensive and perishable and take more time to prepare.

But two factors related to education cut across class lines, Critser writes.

Most of us are confused about how and how much we should exercise, and about what and how much we should eat.

Critser and Shell condemn in no uncertain terms the invasion of school cafeterias by soft drink companies and fast food chains.

Even more insidious is junk food advertising in the form of "sponsored educational materials" such as a nutrition curriculum published by McDonald's, math lessons using Domino's Pizza graphics and reading texts that teach first-graders to recognize M&Ms logos.

All of this translates to not much real nutrition information and a lot of advertising. Shell adds up the federal government's total annual expenditures for education about healthful eating and obesity prevention and comes up with $9 million. The initial phase of a new ad campaign for Milky Way bars had a budget of $25 million.

Another part of the puzzle is an offshoot of cultural politics.

As Critser writes, as a result of the sensitivity politics born in the '70s, particularly feminism's focus on attitudes toward body image, it has become much less acceptable to stigmatize overweight people.

That's particularly true of overweight children. Many parents and teachers hesitate to limit what kids eat or press them to exercise for fear it will damage their self-esteem.

Certainly it can be harmful to push unrealistically thin body images on children. But, Critser points out, eating disorders such as anorexia and bulimia affect only a fraction of the number of people whose health is threatened by overweight.

Even parents who try to control what their kids eat might not know just how bad some foods are. Some of the ingredients in tiny type in those long lists on the package label pack more punch to the paunch than we're aware of.

But Shell and Critser conclude that everyone is selling us all these diet drugs and baggy-fit jeans because someone else is selling us too much food. And they conclude that the fast food industry is a major villain.

"The fast food industry has managed to disassociate food from its primary purpose," Shell writes. "The food it sells is meant to divert us. That many of these foods offer little in the way of actual nutrition seems to matter not a whit."

What's more, she says, "Fast food creations have indelibly changed our concept of portion size," and larger portions make larger Americans.

In proposing solutions, Shell and Critser focus most urgently on children, emphasizing that schools and parents must take back control of what kids eat and encourage them to be active.

For adults, too, taking back control is key. It's a battle not only against our appetites, but against a food industry that cares about our wallets, not our waistlines, and spends billions to get us to spend more billions on food that might be killing us.

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