Healthier, not healthy

Jan 2014, by C.H. | NEW YORK

THE overweight American, slurping a bucket of soda in his car, is an international stereotype. Thankfully, fewer Americans fit the mould. Obesity rates among adults were flat from 2011 to 2012 in every state but Arkansas. And obesity rates among poor young children declined in 18 states from 2008 to 2011. This month brought new data that may help explain why.

On January 8th 16 top food companies announced that they had fulfilled their promise to sell 1 trillion fewer calories in 2012 than they had in 2007. Indeed the companies surpassed their goal, reducing the number of calories by 6.4 trillion, according to an independent review funded by the Robert Wood Johnson Foundation, a respected health philanthropy. And on January 16th America’s agriculture department published a report showing that Americans are eating slightly more healthily. In 2010 American adults ate an average of 78 fewer calories each day than they had in 2005.

All this is promising news. The food companies’ announcement brought praise from the White House: “We are thrilled,” declared Sam Kass, the director of Michelle Obama’s “Let’s Move!” anti-obesity campaign.

But there are a few clouds darkening this sunny picture. First, the detailed review of food companies’ pledge, conducted by Barry Popkin of the University of North Carolina, has yet to be published in a peer-reviewed journal. Second, Americans’ health is still abysmal.

In 1980 no state had an obesity rate higher than 15%, with obesity defined as a body-mass index of 30 or higher, 203 pounds for 5’9” man. Now every state has an obesity rate above 20%, and 13 have rates of 30% or higher. Meanwhile rates of extreme obesity, with a BMI of 40 or more, have risen for both adults and children. This matters. Those who are obese are more likely to develop diabetes, heart disease and other chronic ailments.

Worryingly, obesity rates are highest among the poor and uneducated, according to a towering stack of research. In the most recent addition to the pile, researchers from Harvard and INSEAD, writing in the Proceedings of the National Academy of Sciences, show that obesity rates declined among teenagers with college-educated parents, from 14% in 2003-4 to about 7% in 2009-10. Among teens with parents with only a high-school degree, obesity rates rose from 20% to 25%.

There remains the question of what to do about it. It is easy to cast food companies as villains. Much of what they sell is rubbish. Taxing sugary soda, which has no nutritional value, seems sensible. But food companies, and fast-food companies in particular, are only partly responsible. In a new study published in the American Journal of Clinical Nutrition, Dr Popkin shows that unhealthy meals outside fast-food chains play a greater role in boosting obesity rates. The researchers at Harvard and INSEAD found that the main difference between the rich and poorer teens was not how much they ate but how much they exercised.

All this serves as a reminder of an important fact, well known but worth highlighting once more. Millions of Americans are ill thanks to factors that have nothing to do with the health system, from poverty to food marketing to poor urban planning to strapped school athletic programmes. Obamacare helps previously uninsured Americans afford treatment. Improving Americans’ health will take much more.

Date: 2015-02-28; view: 1530