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Obesity a Heavy Burden

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CHICAGO, Dec 23, 2003 (United Press International via COMTEX) -- There's no hiding a 3-year-old child who weighs 100 pounds or a 15-year-old who tips the scales at more than 400 pounds.

The U.S. Centers for Disease Control considers obesity a national epidemic with health consequences on par with smoking.

More than 1 in 5 people -- some 44 million Americans -- fit the definition for obesity.

Being at least 30 to 40 pounds overweight can lead to a host of health problems from diabetes, cancer and arthritis, to sleep and breathing problems, high blood pressure, heart disease and stroke, driving up healthcare costs and shortening lives.

At least 60 pounds overweight? You're severely obese. One hundred pounds of fat: morbidly obese; 200 pounds: super obese.

Fat is a killer. U.S. Surgeon General Richard Carmona and the CDC estimate obesity contributes to 300,000 preventable deaths a year.

"The obesity problem is spiraling out of control, posing serious health risks to millions of overweight Americas -- young and old," said Sen. Peter Fitzgerald, R-Ill., sponsor of an obesity prevention bill passed this month.

The measure would promote nutrition and fitness programs in schools, day-care centers and senior centers and provide block grants to train health professionals in identifying, preventing and treating obesity-related conditions.

"While many factors contribute to this growing health crisis, the problem, in part, may be attributed to a lack of nutrition and fitness information available to the public, especially among low-income groups," said Fitzgerald.

The U.S. Preventive Services Task Force recommends doctors screen all adults for obesity and refer obese patients to counseling.

The American Medical Association offers a primer, "Assessment and Management of Adult Obesity: A Primer for Physicians," with case studies tackling issues of weight control from drugs to surgical options such as stomach-shrinking gastric bypass.

"The numbers on obesity are staggering," said AMA President Donald J. Palmisano. "It makes perfect sense to have physicians address the underlying cause and encourage healthy eating and physical activity."

Researchers at the University of Denver discovered a biochemical connection between obesity and Type 2 diabetes, which afflicts about 16 million people. The study appears in December's Journal of Endocrinology.

One highly regarded test for obesity is body mass index, calculated either as weight in pounds divided by height in inches squared multiplied by 703, or as weight in kilograms divided by height in meters squared.

A person with a BMI between 25 and 29.9 is considered overweight. A BMI of 30 or more is obesity.

Hardest hit are poor African-Americans and Hispanics, with obesity rates of 24 percent and 31 percent, respectively. The rate for whites was 19 percent. More than a quarter of people living below the poverty line are obese. The obesity rate for the college educated is 16 percent, an indication it may take more than education efforts to significantly change eating habits.

Since 1963, obesity among adults in the United States increased from 13 percent to 27 percent while the overweight population rose from 31 percent to 34 percent.

Scientists and nutritionists blame America's love of junk food -- sugared soda, double cheeseburgers and fries and sweets often sold in schools -- for the growing problem.

"We need to stem the rising epidemic of obesity in this nation," said Health and Human Services Secretary Tommy G. Thompson. "These findings show that clinicians can have a significant impact on the health of their adult patients by screening for obesity and offering or referring patients to intensive counseling and behavioral interventions."

McDonald's, target of several lawsuits on behalf of obese patrons, has been selling premium salads since March. Kraft plans to introduce reduced-fat Lunchables packaged meals in February.

Hardees, known for serving up 1,200-calorie Monster Thickburger sandwiches, introduced a "low-carb" Thickburger with no bun. The lettuce-wrapped beef patties, cheese and bacon strips still have nearly 34 grams of saturated fat, according to the Center for Science in the Public Interest.

A backlash against fast food is growing, with the popularity of no- and low-carbohydrate diets. Five years after winning Food and Drug Administration approval the no-calorie sugar substitute Splenda -- a sucralose sweetener in a yellow package -- is in 3,000 products from syrup to flavored canned skim milk.

Splenda had sales exceeding $105 million in 2003. Last year the FDA approved Neotame, the NutraSweet Company's no-calorie sweetener 13,000 times sweeter than sugar. Other sugar substitutes are under development or are being tested.

No-sugar ice cream is available, but so far science has not figured out how to make it taste good without fat and calories.

A nutrition expert critical of the chemistry lab approach to satisfying America's sweet tooth calls Splenda "a gateway drug to Snackwell's."

J. Hugh McEvoy, president of the Chicago Nutrition Association, explained his position on "nutraceuticals" -- artificially derived chemicals that have a meaningful effect on the body's metabolism. He helped develop light and reduced-fat food products for Sara Lee and other major corporations during the 1970s as a certified research chef.

"If you feed an infant Diet Coke in baby bottles the child develops a taste for sweets," he said. "If you feed that same child a diet of fruits, vegetables and fresh water for 18 years they tend to form good eating habits.

Eating and exercise habits are learned, he said, sugar substitutes lead to "a lazy, bad lifestyle."

McEvoy said the problem goes beyond fast food. When he eats at McDonald's he orders two plain hamburgers, apple dips without the sugar sauce and low-fat milk, not your typical super-size meal.

The value of sugar substitutes is sparking debate.

"I definitely think using a (sugar) substitute if someone is going to sweeten their food is helpful," Anastasia McGee, director of the Chicago Partnership for Health Promotion, told United Press International. "If somebody is a sweet craver and they eat the extra doughnut or chocolate, then that's not necessarily going to help reduce their calories."

The partnership, funded by the U.S. Department of Agriculture, targets low-income minorities, many food stamp eligible, and has reached more than 50,000 people with nutritional and health information in its two years of existence.

"A lot of it (obesity) has to do with poor choices, reliance on fast food," said McGee, an expert in diabetes education.

The University of Illinois at Chicago's nutrition program has many elements encouraged by the Fitzgerald bill.

Peer educators take obese people grocery shopping to show them the best foods to purchase. The group offers classes on budgeting, food safety and food handling, hosts health fairs and uses beauty salons and barber shops for on-site education to increase diet and malnutrition awareness in the communities.

It's ironic there's hunger in a nation facing an epidemic of obesity. According to the USDA nearly 12 million America families were worried about putting food on the table in 2002, up 5 percent from 2001.

"Often, having to stretch their food dollar, people tend to buy the most food for their money, rather than the healthiest," said nutritionist Amy Lopez of the North Texas Food Bank in Dallas. Calorie-dense foods like macaroni and cheese are cheap and filling.

The food bank has compiled a list of healthy items that can be donated to feed the needy during the holiday season.

The Top Ten list includes, protein (fresh, frozen or canned beef, chicken, pork of fish), vegetables (fresh or canned), fruit (fresh or canned), soups, beans (dried or canned), nuts (canned or jar), cereal (hot or dry, oatmeal, cereal bars), milk (evaporated or powdered), baby food and healthy snacks like pretzels, multi-grain crackers and pudding.

Copyright 2003 by United Press International.

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