Posts Tagged ‘restaurants’

4 in 10 Americans use calorie info on menus

August 22nd, 2013

UPI reports that, according to a Gallup survey,  4 in 10 Americans report using calorie information on menus. While some commentators say this is a low figure, actually it is pretty much in line with other surveys showing about half of adult Americans are dieting at any time.

 

A Diet for the New Administration

September 27th, 2009

December 30, 2008

By Morgan Downey

At this time of year, millions of Americans are hoping the new Administration will solve our seemingly intractable problems at home and abroad. Millions are also hoping to lose weight in the New Year. The two are not unrelated.

Over the past three decades, obesity has increased among all segments of the population, in the United States and abroad. Obesity is now recognized as the fuel behind many major health problems from cancer to diabetes to heart disease, and a significant cause of increasing health care utilization and health care costs.

While this recognition has increased among both Republicans and Democrats (for the first time, both parties recognized obesity in their 2008 party platforms), changing public policy has not caught up with the problem. Under President George W. Bush, Medicare did undo its policy that obesity was not a disease and did expand coverage of surgery for the treatment of obesity. There have been modest increases in the research and prevention budgets at the National Institutes of Health and the Centers for Disease Control and Prevention. But by and large, the efforts of the last eight years have been largely educational: tell people they should lose weight, eat more nutritiously, and exercise more.

Duh! We get it. And it doesn’t work. Frankly, other than bariatric surgery, nothing works very well to lose significant amounts for a long period of time. There simply is not one ‘fix’ that will reverse this disturbing trend.

So here is some advice to the incoming Administration. It should be noted that many appointees named so far have a solid exposure to obesity from a public policy perspective, including former Senator Tom Daschle, nominee for Secretary of Health and Human Services, Peter Orszag, named to head the Office of Management and Budget, Governor Bill Richardson, nominated for Secretary of Commerce, and Melody Barnes, incoming chief of domestic policy at the White House.

Universal health insurance is often put forward as the panacea for all ills. However, Democrats may have to learn that expanding health insurance coverage alone does not translate to a healthier population, especially if obesity continues to increase among children and adolescents. Truth be told, we do not have adequate medical interventions to affect the rates of obesity and its effects. So, if we do not know how to truly prevent obesity or create a long term treatment, what should a new Administration do? Basically, it should focus on how to create the conditions where it is more likely than not that we will find effective strategies for prevention and treatment in the future.

  1. Being a role model is not enough. It’s been noted that George Bush and Barack Obama share a passion for physical activity. Unfortunately, the habits of the chief executive do not translate to population changes. And then there is the smoking thing. Being a role model is not an excuse for inadequate policies.
  2. Make someone responsible for obesity policy development. Right now there is no one tasked at the upper levels of the U.S. Government with dealing with obesity. True, periodically the heads of different agencies give a speech, start a new website or create a new task force but little happens because so many do so little with scant coordination.
  3. Prepare to spend some money. For one of the most significant health problems in the country, the federal government spends vastly less than on obesity than other conditions. Research, prevention and treatment costs for diabetes and heart disease, to name but two, swamp comparable figures for obesity. The federal government is spending more on getting TV converters boxes in US homes than the entire NIH research budget on obesity.
  4. Do not just focus on childhood obesity. While childhood obesity is critical, remember that the population between 7 and 16 spans only 9 years out of a lifetime. Look at obesity over the lifetime and look for relevant interventions. Support childhood prevention programs but require that they have a competent evaluation method so we will know what is working and what is not.
  5. Do focus on research. Perhaps 90% of what we know about obesity has been learned since the discovery of leptin in 1994. Too many people believe that we know everything we need to know about obesity and do not need any more research. That’s not true. A great deal is known but there are many more questions than answers. Scientific credibility on issues around body weight is sorely needed. Every hour on television another weight loss program or product is hyped as being based on doctor’s advice or scientific study. What can help on both fronts is for the Administration to create a National Institute of Obesity Research at the National Institutes of Health. A new entity like this can reenergize researchers on obesity, can more closely coordinate the many disparate programs across NIH, provide leadership to other federal agencies, states and local governments and provide much needed focus on the social and economic impacts of obesity. Furthermore, a director who is articulate can help lead policymakers and the public away from harmful and dangerous products and keep a focus on developing effective interventions. The NIH bureaucracy will oppose “disease specific” research but their interests should not trump the public health needs and the best use of taxpayer dollars.
  6. As part of your health care reform package, remove the bias against drugs for weight loss in the Medicaid statute and change the exclusion of these drugs under Medicare Part D. Then have the Food and Drug Administration revisit its risk/benefit views of drugs to treat obesity. There are few fans of pharmaceutical companies in a Democratic Congress and Administration and there are even fewer who favor drugs to treat obesity. Nonetheless, there is a huge treatment gap. We have more and more effective surgical options, one over-the-counter FDA approved pill, a couple of tried medicines, commercial plans and self-help. What we do not have are the drug treatment options we have for high cholesterol, hypertension or diabetes. Recently, major pharmaceutical companies such as Merck, Pfizer, Solvay and Sanofi-Aventis have dropped or cut back on their programs to develop drugs for obesity. There are two reasons. First, insurance companies will not reimburse for most obesity treatments, including counseling, drugs and surgery. For the pharmaceutical industry, it just did not make economic sense to invest in drugs which were not going to be reimbursed. This is where leadership by Medicaid and Medicare is critical. If these programs support obesity products, private insurance may follow. This is in the government’s long term interest because insurers can avoid treating or preventing obesity knowing that the big effects, like diabetes and heart disease will not be seen until later in life, when Medicare will become the payor. Second, many involved in obesity drug development feel, rightly or wrongly, that the Food and Drug Administration is so risk-averse that they simply cannot afford the long and expensive trials necessary to meet the rising bar of safety. A National Institute of Obesity Research can help shape clinical trials needed by the FDA and speed the process along.
  7. Look to multiply your opportunities. For example, you can use the public works part of the economic stimulus package to construct new gyms in schools, sidewalks, playgrounds, green spaces and biking/walking trails to encourage more physical activity.
  8. Let the states experiment with taxes and proposals like displaying caloric content in restaurants. Vending machines, non-diet soft drinks, high-fat foods have all come under fire in recent years for contributing to the obesity epidemic. The problem is that these products still only contribute a fraction to an individual’s total caloric intake. But no one is sure that they won’t be replaced by other calories. Likewise, there will be voices to restrict food advertising to children through the federal government’s regulatory powers. Use your National Institute of Obesity Research to design evaluation studies so that there is an objective review to see if these policies will work.
  9. Take some leadership internationally. The United States has a long history of involvement in global health issues, such as HIV/AIDs. However, very little is done on the federal level to learn from other countries’ experiences and to help shape global patterns of eating and physical activity.
  10. Avoid the single fix ideas. The obesity field is full of good advice and scant evidence. Focusing on a single fix, such a TV advertising, agricultural subsidies or sweetened beverage may consume a great amount of political resources without producing the outcome you seek.

The obesity epidemic is more likely than not to continue to grow over the next four to eight years. However, the new Administration can position the United States for meaningful change if it takes its time and devotes attention to organizing the effort. With any luck, we can make future New Year’s resolutions more likely to be successful.

Archives

September 27th, 2009

APRIL 2009

April 24, 2009

After planting garden, Michelle Obama skips out to Five Guys for a burger.

First lady says she sneaks off to fun restaurants – washingtonpost.com

MARCH 2009

March 31, 2009

Kansas Governor Kathleen Sebelius lead off her testimony to the Senate Health, Education, Labor, and Pensions Committee stating, “Yet, at the beginning of the 21st century, we face new and equally daunting challenges.

We face an obesity epidemic that threatens to make our children the first generation of Americanchildren to face life expectancies shorter than our own.”

March 30, 2009

Review of new drugs for obesity Obesity Drug by Arena Has an Effect, but a Limited One – NYTimes.com

March 27, 2009

New York Times reports on walking school buses in Italy fighting obesity and climate change

Students Give Up Wheels for Their Own Two Feet – NYTimes.com

March 18, 2009

Another study shows obesity increases risk of death

Obesity Takes Years Off Your Life – Forbes.com

March 13, 2009

Mississippi to cover state workers’ bariatric surgery

Surgery: Long-term care is more expensive | clarionledger.com | The Clarion-Ledger

March 9, 2009

Obama sets out Administration policy on use of science The White House – Press Office – Memorandum for the Heads of Executive Departments and Agencies 3-9-09

March 6, 2009

Abdominal obesity adversely affects lung function Belly Fat Bad for Your Lungs?

March 6, 2009

New study finds dietician students prejudiced against persons with obesity Bias Against Obesity Is Found Among Future Dietitians – Forbes.com

March 1, 2009

Obesity increases worker’s comp. Obesity supersizing workers comp costs – Financial Week

March 1, 2009

South Carolina Senator criticized for trying to dump bicycle paths from stimulus bill. DC Bicycle Transportation Examiner: Sen. DeMint’s pro-obesity legislation was the real pork in the stimulus debate

FEBRUARY 2009

February 27, 2009

Obama budget to cut farm subsidies; improve child nutrition Obama wants to cut subsidies to farmers | DesMoinesRegister.com | The Des Moines Register

February 27, 2009

Drug maker buries data on diabetes drug causing weight gain AstraZeneca Documents Released in Seroquel Suit – NYTimes.com

February 20, 2009

North Carolina looks to penalize persons with obesity: Smoking, obesity may cost state employees | CharlotteObserver.com

February 19, 2009

Robert Wood Johnson Foundation announces national effort on childhood obesity Leading Research Funders Launch Collaborative To Accelerate Nation’s Progress in Reducing Childhood Obesity – RWJF

February 19, 2009

Clinton Foundation announces alliance on childhood obesity Alliance for a Healthier Generation Expands Efforts to Combat Childhood Obesity with Launch of Landmark Healthcare Initiative

February 18, 2009

Court of Appeals upholds NYC Calorie Disclosure Ordinance

http://www.citizen.org/documents/NYSRAOpinion.pdf

Court Upholds the City’s Rule Requiring Some Restaurants to Post Calorie Counts – NYTimes.com

CDC: Young Invincibles are obese CDC: ‘Young invincibles’ have significant health concerns – CNN.com

February 16, 2009:

Home recipes increase in calories: ‘Joy of Cooking’ or ‘Joy of Obesity’? – Los Angeles Times

February 12, 2009

CMS Issues decision on using bariatric surgery to treat Type 2 Diabetes; notes effectiveness of bariatric surgery in resolving Type 2 Diabetes. Centers for Medicare & Medicaid Services

Obesity linked to Birth Defects

Obesity During Pregnancy Linked to Infant Birth Defects – NYTimes.com

JAMA paper on birth defect risks with mothers with obesity. JAMA — Maternal Overweight and Obesity and the Risk of Congenital Anomalies: A Systematic Review and Meta-analysis, February 11, 2009, Stothard et al. 301 (6): 636

February 19, 2009

Fast food restaurants predict strokes

More Fast-Food Joints in Neighborhoods Mean More Strokes – US News and World Report

February 12, 2009

How evolution lead to modern obesity

AAAS: Modern obesity epidemic can be traced back two million years – Telegraph

NEJM — Expanding Coverage for Children — The Democrats’ Power and SCHIP Reauthorization

JANUARY 2009

January 24, 2009

Childhood obesity influenced by genetic variations

Science Centric | News | Childhood obesity risk increased by newly-discovered genetic mutations

January 21, 2009

Obesity imperils health care reform

FEATURE-U.S. obesity epidemic shows perils to health reform – Forbes.com

January 20, 2009

Employers try incentives for healthier workforce Firms offer bigger incentives for healthy living – USATODAY.com

January 13, 2009

NIH launches study of how genes and environment affect children’s development National Children’s Study Begins Recruiting Volunteers, January 13, 2009 News Release – National Institutes of Health (NIH)

January 9, 2009

Physical Activity May not be Key to Obesity After All

Physical Activity May Not Be Key To Obesity Epidemic

January 6, 2009

Obesity and Ovarian Cancer Linked

Obesity Linked To Elevated Risk Of Ovarian Cancer

DECEMBER 2008

December 22, 2008

A little overweight and inactive hurts too

Even a Little Overweight, Inactivity Hurts the Heart – washingtonpost.com

December 19, 2008

Limiting snacks in schools can increase fruit, veggie consumption

Limiting School Snacks Boosts Fruit, Veggie Consumption – US News and World Report

December 18, 2008

Childhood Obesity may affect thyroid

Childhood Obesity May Cause Thyroid Problems – washingtonpost.com

December 16, 2008

New York Debates Tax on Soft Drinks

A Tax on Many Soft Drinks Sets Off a Spirited Debate – NYTimes.com

December 12, 2008

Study looks at relationship between obesity, breast cancer and frequency of mammography

Daily Cancer News – CancerConsultants.com

December 3, 2008

Visceral obesity linked to depression in elderly

Depression Linked to Increase in Abdominal Fat – US News and World Report