No other human condition combines obesity's prevalence and prejudice; sickness and stigma; death and discrimination.

Posts Tagged ‘adults’

Nation’s Obesity Strategy a Failure

October 7th, 2011

The Department of Health and Human Services has issued its 10 year review of the nation’s health care goals, set in 2000. For obesity the picture is not pretty. By direct measurement between 1988-94 and 2005-8, adults over 20 with obesity increased by nearly 47.8%. The target for 2010 was 15%. Children and adolescent rates increased by 63.5% from 11% to 18%. The 2010 target was 5%. The report also not little to no progress on increasing the proportion of adults or adolescents engaged in regular vigorous physical activity. Finally, the proportion of adults 20 and over at a healthy weight, directly measured, decreased by 26%; in 2008 only 31% of American adults were at a health weight, the Healthy People goal was 60%. The proportion of persons with healthy eating habits showed no change, still below targets.

CDC – National Center for Health Statistics Homepage

It has to be recognized that during this period millions of dollars have been spent in the public and private sector on educating the public on obesity and the message to ‘eat less and exercise more’ (ELEM). One would think that this dismal outcome would encourage a critical reappraisal of the nation’s anti-obesity strategy. Alas, I wish it were so. I suspect that we will see merely a call to shout ELEM louder.

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Posted in DAILY DOWNEY, Featured, Federal Government, NEWS

Tags: adolescents adults children Department Health and Human Servics obesity prevalence Physical Activity

AHRQ Looking at Comparative Effectiveness for Prevention Wt. Gain in Adults

September 5th, 2011

The Agency for Healthcare Research and Quality is undertaking a comparative effectiveness review of approaches to weight maintenance in adults. Information is available at Approaches to Weight Maintenance in Adults: A Comparative Effectiveness Review | AHRQ Effective Health Care Program The paper cites a recent Cochrane review of workplace diet and physical activity which found a rather minimal decrease in weight of 2.8 pounds or .5 BMI unit at 6-12 months.

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Posted in DAILY DOWNEY, Federal Government, Prevention

Tags: adults AHRQ Prevention weight gain

Is obesity leveling off and what does it matter?

January 23rd, 2010

Ten days ago, the media was touting new reports from the CDC that the obesity epidemic was ‘leveling off’ or ‘reaching a plateau.’ The news was taken in some quarters with a sense of relief:”Whew, I’m glad that’s over.” Well, don’t get too comfortable. The reports have a lot more to say and overall, this is not a time for complacency.

What the reports actually say.

First, regarding adults, (Prevalence and trends in obesity among US adults, … [JAMA. 2010] – PubMed result), the authors note that the prevalence of obesity is high, exceeding 30% in most age and sex groups except for men 20-39 years old. Strong racial and ethnic differences persist with very high rates among African-American and Hispanic Americans compared to white Americans. Prevalence of severe or morbid obesity, called class 3, (a BMI of 40 or more) was 5.7% overall, with 4.2% for mean and 7.2% for women, including a rate of 14.2% among non-Hispanic black women. What their analyses found was that the earlier rates of increase were on the order of 6 to 7 percentage points. In the this analysis, over the past ten years, the rate of increase is 4.7 percent. Bottom line: rates are still going up.

Second, regarding children, (Prevalence of high body mass index in US children … [JAMA. 2010] – PubMed result) the authors found no statistically significant increases over the last 10 years among girls. Among boys, there is a different picture. Heavy boys between 6 and 19 years of age are getting heavier. Bottom line: the prevalence of obesity has tripled among school-age children and adolescents if you go back to the 1980s. It is high – 17%- and remains high.

So, is the epidemic leveling off? Answer: we don’t know yet. These analyses look at the last ten year trends and they are less than the peak periods of increase. Is this a pause on an upward track or the start of a decline?

Experts I talked with are not too optimistic. First, there is the perennial question of relying on the BMI. A recent paper indicates that more precise tools, like skinfold tests, would have predicted the obesity epidemic by 10-20 years. The timing of the rise in U.S. obesity varies with… [Econ Hum Biol. 2009] – PubMed result. Second, there isn’t a clear explanation of why the rates should be leveling off. We’d like to think people are changing their behavior but the evidence is there is less compliance with recommended dietary and physical activity standards than ever. Adherence to healthy lifestyle habits in US adults… [Am J Med. 2009] – PubMed result Compliance with the DASH diet among persons with hypertension has slipped. Deteriorating dietary habits among adults with hyp… [Arch Intern Med. 2008] – PubMed result

The recession may be causing people to forgo buying more expensive but healthier foods Recession Weighs on Waistlines – chicagotribune.com. Many clinicians running medical weight management programs I have talked with report their volume is down 20-30%.

Hopefully, this is the beginning of a levelling or downard trend in obesity but we will not know for sure until more information comes in. In the meantime, we should consider that we don’t to be having phenomenal increases in obesity to justify more programs for treatment and prevention. An editorial by J Michael Graziano on the two reports from CDC, states, “Even if these trends can be maintained, 68% of US adults are overweight or obese, and almost 32% of school-aged US children and adolescents are at or above the 85^th percentile of BMI for age. Given the risk of obesity-related major health problems, a massive public health campaign to raise awareness about the effects of overweight and obese is necessary..Major research initiatives are needed to identify better management and treatment options. The longer the delay is taking aggressive action, the higher the likelihood that the significant progress achieved in decreasing chronic disease rates during the last 40 years will be negated, possibly even with a decrease in life expectancy.” Amen.

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Posted in Childhood Obesity, DAILY DOWNEY

Tags: adolescents adults CDC children obesity prevalence

Downey Fact Sheet 2 – Quick Facts

September 27th, 2009

The Downey Obesity Report

Printable PDF

ADULT OBESITY

The adult obesity rates have risen dramatically from 1960 to today; rates of overweight (BMI >30) have doubled, rates of obesity (BMI 30-39.9) have nearly tripled and rates of extreme or morbid obesity (BMI >40) have nearly increased seven fold.

ADULT (age 20-74) Prevalence ¹

Overweight (BMI 25-30) Percentage

1960-1962 31.5%

2005-2006 33%

Obese (BMI>30)

1960-1962 13.4%

2005-2006 35.1%

Extreme or Morbid Obese( BMI>40)

1960-1962 0.9%

2005-2006 6.2%

The rates of obesity only tell half the story. During this period, the total US population has also increased. Therefore, the raw numbers of Americans affected have also increased. Looking at the numbers of people affected, the overweight population has doubled, the obese population has increased 5 fold and the population with extreme or morbid obesity as increased by a factor of nearly 12!

Number of Americans Overweight in 1960: 56.5 million

Number of Americans Overweight in 2006: 94.5 million

Number of Americans Obese in 1960: 24 million

Number of Americans Obese in 2006:
40 million

Number of American with extreme or morbid obesity in 1960:
1.6 million

Number of Americans with extreme or morbid obesity in 2006: 18.6 million

Since 1960-61 to 2006, the number of American adults who became obese or extremely obese*: 61.1 million

Average number per year: 1.3 million

Average number per month: 110,779

Average number per day: 3,693

Average number per hour: 153

Average increase per minute: 2.5

Since 1960-61 to 2006, the number of American adults who became extremely obese*: 11 million

Average number per year: 240,217

Average number per month: 20,018

Average number per day: 667

Average number per hour: 27

Adolescents Obesity age 12-19 ³

Percent overweight/obese 2005-2006 18%

Young adult Obesity
Ages 18-29

Percent obese 1971-1974 8%

Percent obese 2005 24%

Childhood ²

Ages 6-11 15%

Ages 2-5 11%

Year at which each group will reach 80% obesity ⁴

All 2072

Men 2077

Women
2058

African American Women 2035

African American Men 2079

Mexican American Women 2073

Mexican American Men 20 91

White Women 2082

White Men
2073

Adipose Tissue (Fat Cells) ⁵

Age at which typical body has acquired its full number of fat cells: 13

Number of fat cells in average American Adult: 23-65 billion

Number of fat cells in persons with morbid obesity: 37-237 billion

Number of fat cells lost in weight-loss efforts: 0

By Julie Snider for the Downey Obesity Report

Daily Calories Needed and Available ⁶

Recommended calories per day by typical American adult:

Men 2,400 to 2,800

Women 2,000 to 2,200

Mean (meaning half were above and half below) adult daily calorie intake per day ⁷:

Men

1971 2,450

2001-2004 2,593

Women

1971 1,542

2001-2004 1,886

Percent increase in food available for consumption per person from
1970 to 2003: 16%

Amount of food available for each person increase from
1.67 pounds in 1970 to 1.95 pounds in 2003

Daily caloric intake has grown by 523 calories from 1970 to 2003. Leading the way were fats, oils, grains, vegetables and sugars and sweeteners.

U.S. Government Biomedical Research ⁸

2008 Budget of National Institutes of Health $29.6 billion

NIH Spending 2008 on selected diseases:

Cancer
$5.6 billion

HIV/AIDS funding $2.9 billion

Cardiovascular Disease
$2.0 billion

Heart Disease $1.2 billion

Obesity
$664 million

U. S. Government Infrastructure on Combating Obesity

Name of coordinator of U.S. global anti-obesity efforts:

(Trick question: no such position exists)

Name of White House coordinator of federal anti-obesity efforts:

(Another trick question: no such position exists)

Name of coordinator of Department of Health and Human Services***anti-obesity efforts:

(No such position exists)

*Calculations were made by taking the CDC prevalence figures for 1960-1962 and 2005-2006and multiplying them against US census data for 1960 and census data for 2006,respectively. See Census Bureau Home Page

**Available in this context means the total US calories available for consumption, less spoilage and waste. See ERS/USDA Data – Food Availability (Per Capita) Data System)

*** Department of Health and Human Services includes the National Institutes of Health, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Food and Drug Administration, Office of the Surgeon General, the Agency for Healthcare Research and Quality among others.)

Notes

1. N C H S – Health E Stats – Prevalence of overweight, obesity and exreme obesity among adults: United States, trends 1960-62 through 2005-2006

2. FASTSTATS – Overweight Prevalence

3. http://www.cdc.gov/nchs/data/hus/hus08.pdf

4. Studies of human adipose tissue. Adipose cell size…[J Clin Invest. 1973] – PubMed Result

5. Will all Americans become overweight or obese? est…[Obesity (Silver Spring). 2008] – PubMed Result. In this estimate, by 2030, 86.3% of adults will be overweight or obese and 51% obese; black women at a level of 96.9% will be the most effected, followed by Mexican-American men (91.1%). By 2048, all American adults would be overweight or obese but black women would reach that milestone by 2034. In children, the authors estimate, rates will nearly double by 2030.

6. http://www.mypyramid.gov/downloads/MyPyramid_Food_Intake_Patterns.pdf

7. http://www.ers.usda.gov/AmberWaves/November05/pdf/FindingsDHNovember2005.pdf

8. NIH Research Portfolio Online Reporting Tool (RePORT) – Estimates of Funding for Various Research, Condition, and Disease Categories (RCDC)