Posts Tagged ‘CDC’
February 21st, 2013
New data released by the Centers for Disease Control and Prevention, National Center for health statistics finds a modest drop in calories consumed by adults eating at fast food outlets (and, somewhat ambiguously, “pizza”). An earlier report by the U.S. Department of Agriculture found that the percentage of adults eating fast food increased from the early 1990s to the mid-1990s. Moreover, previous studies have reported that more frequent fast-food consumption is associated with higher energy and fat intake and lower intake of healthful nutrients. This report indicates that for 2007–2010, on average, adults consumed just over one-tenth of their percentage of calories from fast food, which represents a decrease from 2003–2006 when approximately 13% of calories were consumed from fast food. During 2007–2010, the highest percentage of calories from fast food was consumed among adults who were aged 20–39 or non-Hispanic black or obese. Among young non-Hispanic black adults, more than one-fifth of their calories were consumed from fast food.
October 17th, 2012
If you follow developments in obesity at all, you are familiar with the CDC maps showing the increases in obesity across the nation. Likewise, it is clear from these maps, the obesity is a major problem in the South.
Unfortunately, and tragically for many obese poor persons, the governors of Florida, Louisiana, Georgia, South Carolina and Texas have now been joined by the governor of Mississippi in rejecting the expansion of Medicaid in their states. The expansion is authorized under the Affordable Care Act (Obamacare). St.LouisPostDispatch_Mississippi Decides Medicaid Dollars not Worth Cost
Under the Affordable Care Act, the federal government will pay 100% of the cost of expanding Medicaid from 2014 to 2016. Between 2017 and 2020, the federal share drops to 90% and the states’ contribution gradually rises. The Kaiser Family Foundation projected that Mississippi would receive $23 dollars from Washington for every $1 from the state.
While state budgets are clearly under pressure, many see politics at work as all of the Governors in these states are Republicans and are opposed to Obamacare. Regardless, Mississippi has the highest rate of childhood obesity in the nation with nearly 40% of children up to age 17 meeting the obesity criteria. In all of these states, the lower income groups, who would be covered by the expansion of Medicaid, have major health problems. Refusing to participate in the Medicaid expansion only perpetuates these issues.
October 9th, 2012
What is the Weight of the Nations? Earlier in the year, the CDC hosted a conference, the Weight of the Nation. Now come researchers Sarah Catherine Walpole and colleagues from the London School of Hygiene and Tropical Medicine who have assessed global human biomass, its distribution by regions and by proportions attributable to overweight and obesity. Their findings are, well, a ‘gut-check,’ (if you don’t mind the metaphor.) The numbers are staggering.
They note that more than a billion adults are overweight and, in all regions of the world, the entire population distribution is moving upwards.
So, they calculated that, in 2005, the global human biomass was approximately 287 million tons, of which 15 million tons was attributable to overweight. Biomass due to obesity was 3.5 million tons, equal to 56 million people of average body mass. North America has 6% of the world population but 34% of the biomass due to obesity. Asia has 61% of the world population but 13% of the biomass due to obesity.
One ton of human biomass equates to approximately 12 adults in North America, 17 adults in Asia. According to the authors, “The average BMI in USA in 2005 was 28.7. If all countries had the same age-sex BMI distribution as the USA, total human biomass would increase by 58 million tonnes, a 20% increase in global biomass and the equivalent of 935 million people of world average body mass in 2005. This increase in biomass would increase energy requirements by 261 kcal/day/adult, which is equivalent to the energy requirement of 473 million adults. Biomass due to obesity would increase by 434%”. In contrast, they note that if all countries had the same BMI distribution as Japan, total biomass would fall by 14.6 million tons, a 5% reduction in global biomass or the mass equivalent of 235 million people of world average body mass. This would decrease energy requirements by an average of 59 kcal/day per adult, equivalent to the energy requirement of 107 million adults. Biomass due to obesity would be reduced by 93%.
The authors conclude that, “Increasing population fatness could have the same implication for world food energy demands as an extra half a billion people living on the earth.” See PubMed: The weight of nations: an estimation of adult human biomass
August 15th, 2012
The Centers for Disease Control and Prevention (CDC) has released new state level prevalence data on adult obesity. By my count, only 11 states have obesity rates below 25%. Not one state has reached Healthy People objective for adult obesity. CDC: State Adult Obesity Rates.
June 10th, 2012
The June 10th Washington Post has an insightful article on the federally-funded food desert initiative in Philadelphia. The article describes how an hypothesis (lack of access to healthy foods leads to eating unhealthy foods which leads to obesity) becomes a large experiment before research is done to determine if it is going to work. WaPo: Will Philadepphia’s experiment in eradicating food deserts
Last month, at the Weight of the Nation conference, Department of Health and Human Services Secretary Kathleen Sebelius took the hypothesis one step further elevating food deserts into a cause of obesity. She said, “Obesity can be caused by any combination of factors. For some it’s an addiction like smoking. For others it’s a lack of fresh fruits or vegetables near their home. “ This is pretty sloppy work for a conference so highly organized by the CDC and HHS. An addiction? Still being researched I believe. People are looking at whether certain foods may be “addictive” not whether excess adipose tissue itself is addictive. When a national health leader elevates putative causes like addiction and food deserts to actual causes, a disservice is done and real progress is delayed.
November 3rd, 2011
The New York Times reports on conflicts of interest on three panels writing clinical guidelines for the National Institutes of Health, including cholesterol, hypertension and obesity. The article notes “At least eight of the 19 members of the obesity panel have financial ties to a phalanx of private business interests.” The companies listed include GlaxoSmithKline which makes Alli (over-the-counter version of Xenical), Allergan (maker of Lap-Band), Nestle and Weight Watchers. “One (panel member, not identified), is paid to speak or advise 11 companies with obesity products.” Potential Conflicts on U.S. Health Guideline Panels – NYTimes.com
In my opinion, the latter point here is important. The people picked for these guideline writing groups are often clinical researchers. Usually they are at academic centers with clinical facilities which attract patients who companies need to be included in a valid clinical trial of their product. The fact is that, in the obesity field, there is not a large pool of such clinical researchers. Few can exist on NIH funding alone, or on clinic fees alone, for that matter. So, it is natural that companies with products under development come to these centers for clinical trials.
Some years ago, a case could have been made that too many researchers on such panels were working for a few pharmaceutical companies. Now, many pharmaceutical companies have disbanded their research and development activities. The companies left in the market are too small to exert much influence.
As a result, many of these researchers have worked for multiple companies who are competitors. The companies are not monolithic interests. Device companies compete with drug companies who compete with behavioral care providers; medical providers compete with non-medical providers. (Another point is that many also do work for food and beverage companies.) So it would a real surprise if one of these conflicted researchers were to, in effect, burn their reputation and prospects for future research, to shill for one of many companies in a complex market. Might happen, can’t say it won’t. But then again, this would be evident not only to the other 18 members of the panel but the staff of NIH as well. Oh, did I mention the staff are often involved in funding these researchers? It would have been interesting for the writer to ask how many were funded by NIH, CDC, Robert Wood Johnson Foundation and other, non-commercial interests.
As mentioned in an earlier post, the medical device makers looking at the obesity market are taking their research OUS, outside the United States to avoid the extra costs and time in the US regulatory schema.
The public and other health professionals have a right to expect that clinical guidelines are free of undue influence which would change the recommendations from that as indicated by the scientific literature. But they also have a right to expect guidance from leading experts whose range of experience, even in the commercial sector, gives them invaluable information. The NIH and FDA will, no doubt, continue to grapple with this problem.