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Obesity, Diabetes on the Rise

Preventive measures ignored, says study

TUESDAY, Sept. 10, 2001 (HealthDayNews) -- The dual epidemics of obesity and diabetes continue unabated in the United States as Americans ignore life-saving advice about diet and physical activity, federal epidemiologists report.

The results of the latest survey are an unpleasant surprise, since so many people are aware of guidelines about eating and exercise and their health benefits -- and are ignoring them, says Ali H. Mokdad, senior epidemiologist at the Centers for Disease Control and Prevention (CDC).

"The rate of increase is surprising," says Mokdad, the lead author of the study. "Since we have been putting out the message for a long time, we expected a decrease. But when we examined the behavior of Americans, we were surprised that even those who are trying to maintain or lose weight are not following the guidelines."

The data come from the Behavioral Risk Factor Surveillance System, a telephone survey conducted by the CDC and state health departments in 2000. Of 184,450 adults in the survey, 19.8 were classified as obese, 7.3 percent had diabetes and 2.9 percent were both obese and had diabetes, says a report in the Journal of the American Medical Association.

That translates to 38.8 million obese Americans, a 61 percent increase since 1991. And the incidence of diagnosed diabetes was up 49 percent since 1990.

The health effects are significant. An estimated 300,000 Americans die each year from diabetes and other causes related to obesity. That puts obesity not far behind smoking, which kills an estimated 400,000 Americans annually. Health costs of diabetes alone were estimated at $97 billion in 1997, and overall costs of obesity and inactivity account for almost 10 percent of national health spending.

"We are saying that obesity is not a cosmetic issue any more. It's not the way you look, but something that puts you at risk of chronic diseases such as diabetes and cardiovascular disease," Mokdad says.

The message just isn't getting through to the people who need it most, Mokdad says. While more than 42 percent of obese adults were told by their doctors to lose weight, only 17.5 percent were following the recommendation to cut back calorie intake and engage in some physical activity for more than 150 minutes a week, he says.

Overall, 27 percent of American adults did not engage in any physical activity, and another 28.2 percent were not regularly active, the survey found. And only 24.4 percent consumed fruits and vegetables five times a day as recommended.

Simple measures -- cutting back on fatty foods, eating more fruits and vegetables, walking briskly for a half hour every day -- have been shown to have clear benefits, Mokdad says.

"Two trials, one in the United States, one in Europe, show that if you make behavioral changes, you can prevent diabetes," he says. "People who followed the recommendations lowered their risk."

The report is no surprise to Dr. Christopher Saudek, professor of medicine at Johns Hopkins University and president of the American Diabetes Association.

"There has been data coming out over the last several years, all of which is alarming. They all point in the same direction, that people are gaining too much weight," says Saudek.

The problem has to be attacked on multiple fronts, Saudek says: "We need more public awareness, better school programs for diet and physical activity, more healthy food and people knowing where they get their calories."

What To Do

Push yourself away from the table and start moving. Whatever your weight, stay away from fatty foods, eat more fruits and vegetables and start walking.

But if you absolutely can't give up your Whopper habit, here's a site from the U.S. Department of Agriculture that will tell you the horrifying details about what you're eating. And here's a little help from the food pyramid and tips on losing weight.

The American Heart Association has a section on healthy exercise.

SOURCES: Interviews with Ali H. Mokdad, Ph.D., senior CDC epidemiologist, Atlanta, Ga.; Christopher Saudek, M.D., professor of medicine, Johns Hopkins University, Baltimore, Md.; Sept. 12, 2001, Journal of the American Medical Association
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