Posts Tagged ‘CDC’
“She likes to eat,” the mother said. She didn’t have to spell it out. It was obvious that her child at the age of nine was well on her way to become obese. I counseled clients like her before. They keep coming to my practice on a regular basis. Children as young as three or four years old are being diagnosed with multiple health problems caused by overweight. Sadly, they will have to cope with the consequences for the rest of their lives. They are cut off from their future in so many ways, and so unnecessarily.
There are the physical aspects. Too much fat in a growing body wreaks havoc all around, from bones and muscles to vital organs. Overweight and obese children and teenagers are at an immediate risk of heart disease due to high cholesterol levels and high blood pressure. Most are pre-diabetic, meaning they are likely to develop full-blown type 2 diabetes before they reach adulthood. Their bones and joints, unable to carry the extra weight, will weaken and in many cases deform. The list of potentially catastrophic outcomes goes on.
Many of the health issues they are facing early on will only worsen as they grow older. Most will continue to struggle with weight management and related diseases for as long as they live. The long-term effects can become ever more severe, and at some point acutely life-threatening. Premature death from heart failure, stroke or cancer is a real possibility.
For children, the psychological impact of being overweight is equally as menacing. Many suffer from a poor body image and low self-esteem. Depression and suicidal thoughts are not uncommon among older kids and adolescents who struggle with their appearance. Some develop eating disorders and engage in other dysfunctional and detrimental behavior, like under-age smoking, drinking and drug use.
For parents, it can be hard to acknowledge that their offspring is having weight issues. They may hesitate to address the subject because they don’t want to hurt their child’s feelings and make things worse. If they are themselves on the heavy side, they may not see a ‘little chubbiness’ as such a big deal. Or they blame it on their family’s genetic makeup. Or they hope their kid will eventually outgrow it all.
That may be the case for some, but unfortunately, not for most. Childhood obesity is real and it has taken on epidemic proportions. According to the Centers for Disease Control and Prevention (CDC), weight problems plague twice as many children and four times as many adolescents than just a generation ago. One in three is now diagnosed as overweight or obese before the age of 18.
We are not helpless in the face of this crisis. Enough information on how to address the underlying problems is available. We know what to do. What we need is to be clear-sighted and determined to take the necessary steps that can reverse these trends.
There are multiple obvious culprits we know contribute to childhood obesity. Poor diets consisting of fast food and sugary drinks are among them. So is lack of exercise and physical education (PE) in schools. None of these issues are isolated or occur in a vacuum, and I have written plenty about many of them and how they connect with one another.
But foremost – and this cannot be overemphasized – it is the parents who must act as gatekeepers. They are the ones who ultimately control what goes into their children’s mouths. If there is junk food in the house, the kids will eat it. If there are sodas, they will gulp them down. If these things are not brought home, the kids will not even develop a taste for them, let alone overindulge.
This is a choice all parents can make. Yes, healthy food can be more expensive and may not even be readily available everywhere. Yes, not all communities have parks, bike paths or swimming pools. Some may not even be safe enough for kids to play outside without supervision. But alternatives can be found and investments can be made if we only care enough.
The risks are too high and the damages too serious to ignore what’s at stake here. The children who fall prey to these diseases will never live their lives to the fullest and will probably succumb far too soon. For them this is nothing short of a nightmare. It doesn’t have to be this way. It must not.
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®. For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.”
Despite plenty of encouragement from the government and health experts to move more, Americans still find it hard to adopt a less sedentary lifestyle. Merely 20 percent are in compliance with the government’s recommendations for physical activity, which advise getting at least two and a half hours per week of moderately intense aerobic exercise like brisk walking as well as some strength training such as lifting weights or doing pushups.
The Physical Activity Guidelines for Americans, issued by the U.S. Department of Health and Human Services (HHS), call being physically active “one of the most important steps that Americans of all ages can take to improve their health.”
The Physical Activity Guidelines are meant to complement the Dietary Guidelines for Americans, a joint effort of the HHS and the U.S. Department of Agriculture (USDA). They are directed towards policy makers and health care professionals as well as the public at large.
According to a recent survey conducted by the Centers for Disease Control and Prevention (CDC) and published in the May 2013 issue of the journal Morbidity and Mortality Weekly Report, 52 percent of respondents to phone interviews reported meeting the recommended guidelines for aerobics, and 29 percent said they did with muscle-strength training.
The survey also came up with some other noticeable statistics. Less than a third of 18 to 24 year-olds met both aerobic and strength-training recommendations. Only 16 percent of over 65 year-olds came close. Hispanics did worse than other ethnicities. Education also seemed a contributing factor. Those with college degrees did on average better than those without. Normal-weight persons were more active than the overweight and obese. Americans living in the Northeast and the West outperformed Southerners. Colorado beat all other states. West Virginia and Tennessee came in last.
Similarly to the Dietary Guidelines, the Physical Activity Guidelines have been criticized as unrealistic and unattainable for many Americans, especially for low-income earners and those living in unwalkable and unsafe neighborhoods.
Multiple studies have shown that walkability in residential areas has a significant impact on people’s health. One study found that residents of neighborhoods with sidewalks, bike paths and public parks had a much lower risk of becoming overweight or obese than those who lived in areas without such amenities.
But unfortunately, issues of walkability and bikeability are still not included in the planning processes of many cities around the country. Walk Score, a Seattle-based company that evaluates major cities and midsized towns in the U.S., releases annual rankings of the most, and least, walkable places and rates them on a scale from 0 (= “car-dependent”) to 100 (= “walker’s paradise”). While New York City and San Francisco routinely qualify as most pedestrian-friendly and are lauded for their extensive public transportation system, smaller towns, especially in rural areas, still make it hard to get around other than by driving your own vehicle.
Physical fitness – like weight control – is considered by many as a matter of personal choice and responsibility. And to a certain extent that is true. However, other factors such as income, residence, access to grocery outlets and opportunities to be physically active within reasonable distance have all been shown to be decisive. If too many of these elements are missing, no appeal to behavioral change will suffice.
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com. For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).
Less salt in our food supply could save at least half a million Americans from dying prematurely over the next ten years, according to separate studies conducted at three universities, two American and one Canadian. If the average daily salt intake were to drop to 1,500 milligrams, as recommended by the Dietary Guidelines for Americans, the number of lives saved could more than double. All study results were published in the medical journal Hypertension, a publication of the American Heart Association (AHA).
Americans currently consume on average 3,600 milligrams of salt daily, mostly in form of sodium, widely used as an ingredient in processed foods. Sodium is considered a significant contributor to high blood pressure, which can lead to heart disease, heart attack and stroke, all leading causes of death in the U.S. today.
About a third of American adults, or 68 million, suffer from high blood pressure, a.k.a. hypertension, according to the Centers for Disease Control and Prevention (CDC). The condition was identified as a primary or contributing cause of nearly 350,000 deaths in the U.S. in 2008, the last time the CDC has updated its research on the subject.
Despite of these alarming statistics, there are currently no signs of improvement. Even better treatment has only shown mixed results. Less than half (46 percent) of high blood pressure patients have their condition under control, according to the CDC.
Because the salt content in processed food is already added before it reaches the consumer, there is little opportunity to make changes on an individual basis other than limiting one’s choices to fresh items like produce. This would also exclude many options in restaurants.
“Individuals can’t make this choice easily,” said Dr. Kirstin Bibbins-Domingo, professor of medicine and epidemiology at the University of California, San Francisco (UCSF), to ABC News. “So maybe we should find ways to work with the food industry,” she suggested.
The National Salt Reduction Initiative, a partnership started by the New York City Health Department that has expanded to nearly 100 city and state health organizations across the country, has been trying to get food manufacturers and restaurant operators to cut salt by 25 percent or more since 2008, the year of the organization’s inception. The current goal is to achieve a reduction of 20 percent by 2014.
Critics say that such measures are impractical and would make little difference. Public health advocates have been focusing on hypertension as if no other health threats existed, said Morton Satin, Vice President of science and research at the Salt Institute, a trade association for the salt industry, in response to the recent studies to ABC News. The association warns that low salt intake could produce its own set of health problems, especially for the elderly.
While most experts would agree that multiple factors can be responsible for the development of high blood pressure, including genetic predisposition, gender, age and other non-modifiable components, poor diet and lifestyle choices, which are modifiable and therefore preventable risk factors, usually play a much greater role. In a milestone conference on the connections between sodium intake and blood pressure, sponsored by the National Heart, Lung and Blood Institute (NHLBI), the participating scientists concluded that “an abundance of scientific evidence indicates that higher sodium consumption is associated with higher levels of blood pressure, [as demonstrated in] animal studies, observational epidemiologic studies, and clinical studies and trials.” They were also hopeful that more effective strategies could be developed to improve diet and lifestyles patterns that benefit the larger population.
If you liked this article, you may also enjoy reading: “Too Much Salt in Our Food Creates Serious Health Hazards.”
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com. For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.
Enjoying delicious food is at the center of nearly all holiday celebrations, regardless of social, cultural or religious background. Festive banquets, sumptuous buffets and overflowing dinner tables invite to indulge. However, with so much food put out, there is also a heightened danger of contamination that can result in sometimes serious, even fatal food-borne illness. Whether you eat out in a restaurant, partake in a catered office party or cook up a storm at home, chances are you encounter items that are not agreeable with your digestive system.
Fortunately, most food-borne infections only cause stomach cramps, vomiting and a day or two of diarrhea – but nothing more serious. Still, out of the nearly 50 million Americans who on average fall sick from spoiled food every year, 128,000 were hospitalized and 5,000 died in 2011, according to the Centers for Disease Control and Prevention (CDC).
Treating cases of acute food poisoning costs the United States a whopping $152 billion per year in healthcare, missed work and other economic losses, says a report by the Produce Safety Project (PSP), an initiative of the Pew Charitable Trust.
According to the CDC, food-borne illness, also known as “food poisoning,” is a common but largely preventable public health problem. There can be many different kinds of infections caused by a wide range of pathogens that contaminate food. In addition, there are poisonous chemicals and other harmful substances that can do equal damage. Currently, over 250 different food-borne diseases have been identified by the agency. Besides through food, infections can spread through unsafe drinking water, water people swim in, and even person-to-person contact.
Raw animal food products spoil the easiest and fastest. Raw meat, seafood (especially shellfish), poultry, eggs and unpasteurized milk are prime candidates for contamination. The risks multiply when items consist of parts from many individual animals such as ground beef or raw milk that often come from hundreds of different sources.
Fruits and vegetables are also of concern when they are consumed uncooked, unpeeled, unwashed or washed in unclean water. Exposure to fertilizers, especially manure, can result in E. coli and salmonella, to name just two of the most common illnesses. If there are pathogens in or on fruit used for fruit juices, even those can be contaminated if they are not pasteurized.
Contamination can also occur when the people who handle the food don’t take the necessary precautions. Dirty kitchens and unsound cooking techniques are often a cause for food spoilage. And so is improper refrigeration.
While you can only hope for the best when eating out, you can reasonably safeguard your food at home, especially when you are in charge of the kitchen. Here are a few rules you should always observe, according to the CDC:
Cook meats and seafood thoroughly. Even if you like your steak less than well done, make sure it gets exposed to heat high enough to kill bacteria on the outside and avoid contamination of the center from improper handling.
Wash lettuce and all salad ingredients you consume raw in clean water and peel fruits whenever possible.
Always clean hands, utensils, cutting boards, plates and kitchen counter surfaces after they’ve come in touch with raw meat or fish.
Refrigerate perishables as soon as possible and don’t keep them unnecessarily exposed to room temperature during preparation.
If you get sick and have symptoms of food poisoning, see your doctor.
Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.
A study by the Centers for Disease Control and Prevention (CDC) predicts that obesity rates in the United States will reach up to 42 percent of the population by the year 2030. More than 10 percent will be classified as “morbidly obese,” which is 100 pounds plus over a healthy weight range. If these predictions come true, health care costs in the U.S. will increase by well over half a trillion dollars.
The study report was presented at a conference sponsored by the CDC, titled “Weight of the Nation” (May 7 to 8, 2012) in Washington D.C. and simultaneously published in the American Journal for Preventive Medicine.
While it is difficult to make these kinds of forecasts, it is clear that obesity trends that started in the 1980s and 1990s continue on their paths. Currently, over 60 percent of Americans have weight problems and over 30 percent are diagnosed as obese. Even more worrisome are the growing rates among young people. Over 20 percent of children and adolescents are obese today.
Obesity can cause a host of chronic health problems such as cardiovascular disease, diabetes and also certain forms of cancer. Many people who develop weight-related illnesses during childhood are likely to face at least some of the consequences throughout their adult-lives.
“The prospect of such increasing rates, particularly those of severely obese Americans, is alarming, especially since efforts aimed at helping people to lose weight have so far proven relatively ineffective,” said Dr. Eric Finkelstein, one of the authors of the CDC report.
For a long time, the causes of obesity have been in dispute. One popular explanation is that people just eat too much and exercise too little. Some health experts say it’s not that simple. In a separate report on America’s obesity epidemic that was also released at the “Weight of the Nation” conference, the Institute of Medicine (IOM) concluded that the crisis is deeply rooted in the environment we live in, which is, as the report called it, “obesogenic.” According to the IOM, it is not so much people’s behavior that has changed over the past few decades but rather a number of factors that are beyond any individual’s control, including agricultural policies and food manufacturing.
“When you see the increase in obesity, you ask, what changed? The answer is, the environment,” said Dr. Shiriki Kumanyika, a professor at the University of Pennsylvania of Medicine and IOM committee member in an interview with Reuters. “The average person cannot maintain a healthy weight in this obesity-promoting environment.”
Instead of appealing to “personal responsibility,” the report suggests for policy makers to pursue structural changes like shifting subsidies from corn and wheat farms to fruit and vegetable growers, creating more pedestrian-friendly infrastructure, and limiting the number of fast food outlets near schools and residential areas and so on. The hot-button-issue of imposing surtaxes on sodas to curb consumption was also mentioned.
The Center for Consumer Freedom, an advocacy group for the food manufacturing and restaurant industry, rejected the IOM report and argued that Americans should be free in making their own food choices but should act responsibly. It accused the IOM of joining forces with the nation’s “food nannies,” according to a Reuters report (5/8/2012).
By contrast, the IOM panel said that blaming obesity on a failure of personal responsibility and individual willpower has long been used by the industry as the basis for resisting legislative and regulatory efforts to address the problem.
The costs for treating obesity and obesity-related diseases are responsible for about 20 percent of all spending on healthcare today, about $190 billion annually, not counting rising insurance premiums, lost productivity and missed work days due to illness. The IOM urges employers and insurance companies to participate more aggressively in the fight against obesity, if for no other reason than their own bottom line.
Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.
The highest amount of salt Americans eat comes from bread, according to a study by the Centers for Disease Control and Prevention (CDC). Nearly 50 percent of the salt consumed in the U.S. is linked to popular foods such as baked goods, cold cuts, cured meats, pizza, poultry, soups, sandwiches, cheese, pasta and snacks like pretzels and potato chips. Many items loaded with salt don’t even taste salty.
The study, which involved over 7,000 participants, found that bread accounted for an average of seven percent of daily sodium intake, more than any other individual food item. Bread may not contain the highest amount of salt per serving, but the fact that people eat it more often and in larger quantities than most other foods makes it a leading contributor to high blood pressure, heart disease and stroke.
The average American consumes about 3,250 milligrams of salt per day, far more than what’s recommended by the government’s Dietary Guidelines, which is 2,300 milligrams for healthy adults and 1,500 milligrams for high blood pressure and heart disease patients. Over 30 percent of the adult population suffer from high blood pressure, according to the CDC.
Most consumers are not aware that they are getting too much salt. What makes matters worse is that they could not easily change that even if they wanted to. “Most sodium comes from common grocery store and restaurant items and only a very small portion from the shaker at the table,” Dr. Thomas R. Frieden, the Director of the CDC, told reporters. “People can choose how much salt they add to their food at the table,” he said, “but they can’t take it out once it’s there.”
In fact, over 60 percent of the salt consumed by Americans is found in processed foods, about 25 percent in restaurant meals and the remainder from other sources such as vending machines and extra salt added at home, according to CDC statistics.
Dr. Frieden called for food manufacturers and restaurant owners to reduce the amount of salt they apply to their products. It is estimated that a 25 percent reduction in salt content in the most popular food items could save tens of thousands of lives every year.
Food industry representatives have responded by saying that reducing sodium would adversely affect taste and may also violate food safety standards because salt is commonly used as a preservative.
The CDC study report was released in the February edition of the journal “Vital Signs,” just in time to coincide with “Heart Health Month.” Sodium is well known to raise blood pressure, which is a major risk factor for heart disease and stroke. More than 800,000 Americans die each year from these diseases.
Health experts have long advised that people with heart problems should avoid processed and packaged foods as much as possible and eat more fresh produce instead. With regards to bread, it is important to read the Nutrition Facts labels. Sodium content in different breads can considerably vary between 80 and well over 200 milligrams. Other items like canned soups can have a wide sodium range from 100 to well over 900 milligrams, depending on the brand. Many fast food choices and TV dinners contain astronomical amounts of salt, often more than the recommended daily values in just one serving.
Asking food manufacturers and restaurants to voluntarily change the ways they use salt has not been very effective, although there are exceptions. Other than through legislation, the only promising approach would be consumer demand. If grocery store owners found that customers prefer low-sodium products and restaurant patrons asked to have salt reduced or eliminated in their dishes, we could see some positive changes over time.
Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.
Sodas add hundreds of calories a day to the typical American diet, according to a new government investigation. Over half of all Americans drink varying amounts of sugary beverages on most days. Adults consume daily an average of 336 calories from sodas and kids are not far behind.
These are the findings of a study conducted by the Centers for Disease Control and Prevention (CDC) as part of its National Health and Nutrition Examination Survey, which is widely acknowledged among experts as the gold standard for evaluating food- and beverage-related consumer habits. The results are based on over 17,000 interviews between 2005 and 2008.
“Sugar-sweetened beverages are the number one single source of calories in the American diet and account for about half of all added sugars that people consume,” said Dr. Rachel Johnson, a nutrition expert at the University of Vermont, speaking on behalf of the American Heart Association (AHA). The association advises that people should consume not more than 36 ounces or about 450 calories from sugary drinks – a week.
The CDC study has been released less than two weeks after the U.S. Department of Agriculture (USDA) withheld its support for a proposal to exclude soda drinks from New York City’s food stamp program, which was championed by Mayor Michael Bloomberg, who is also known for his strong anti-smoking advocacy.
With anti-soda legislation still facing a rough road ahead, consumer advocacy groups like the Center for Science in the Public Interest (CSPI) say it’s time to think of more effective strategies to increase awareness of the health risks from excessive soda consumption. “Reducing the consumption of sodas and other sugary drinks would be a major public health victory and would help reduce health care costs for all levels of government,” the group wrote in a statement. CSPI announced a new campaign called “Life’s Sweeter With Fewer Sugary Drinks.”
What’s required in this ongoing battle against the health hazards from sodas is an involvement of health experts, civic organizations, youth groups, civil rights groups and many others, according to CSPI director Michael F. Jacobson. He pointed out that the worst health problems caused by excessive soda consumption occur among minorities, the poor and the young. “Not since the anti-tobacco campaigns has there been a product so worthy of a national health campaign,” he said.
Despite of New York City’s recent setback, there are signs that the anti-soda movement is catching on in many more parts of the country. In Boston, soda sales have recently been banned from city property. Public schools are no longer allowed to sell sugary beverages on campus. An extensive media campaign against soda consumption that specifically targets parents of young children is in the works. Later this month, the Los Angeles County Health Department plans to implement a host of similar policies.
In the meantime, there has been considerable pushback coming from the beverage industry. Soda makers have sued health departments from New York to California. The industry, which insists that it only defends itself against baseless attacks, has filed numerous requests for scientific proof of the claims made by government agencies.
Anti-soda advocates say that these requests for documentation, which often require hundreds of staff hours from cash-strapped governments on the local and state level, are only made to sabotage new health policies before they can get off the ground. They come directly from the tobacco industry’s playbook, according to Ian McLaughlin, an attorney at the National Policy & Legal Analysis Network to Prevent Childhood Obesity in Oakland, California. “It is, in our opinion, an effort to overwhelm or smother government employees, who already have too much to do,” he said.
Santa Clara County in California received subpoena letters asking for records relating to its “Rethink Your Drink” education program. Similar notifications were sent to Chicago and Seattle county governments for their publications connected to beverage education efforts, according to Reuters (“Soda Makers Escalate Attacks Over Obesity,” 7/29/2011).
The American Beverage Association (ABA) says that food and beverage makers are being unfairly singled out. “Sugar-sweetened beverages are not driving health issues like obesity and diabetes. In fact, recently published data from CDC researchers show that sugar-sweetened beverages play a declining role in the American diet, even as obesity is increasing,” said Christopher Gindlesperger, director of communications for the ABA.
From 2009 to 2010, the ABA, Coke and Pepsi, two of the largest producers of sodas, have collectively spent $60 million on lobbying efforts against raising taxes on sugary beverages to cover obesity-related health care costs, according to data collected by the Center for Responsive Politics (Reuters ibid.).
In going after public health campaigns, the ABA is taking its cues from the tobacco wars of the 1990s. Back then, tobacco companies embarked on a Freedom of Information effort, targeting government agencies for their anti-smoking legislation, according to a report by the National Cancer Institute.
“For beverage manufacturers, the issue of obesity is kind of Armageddon,” said Tom Pirko, an industry consultant. He may have hit the nail on the head. Once the evidence that tobacco use causes cancer became overwhelming, people finally started paying attention and smoking went down dramatically. When the connection between sugary drinks and obesity becomes similarly clear, a large-scale change of consumer behavior will likely follow. In other words, if it’s no longer considered cool to smoke today, it may no longer be cool to guzzle sodas tomorrow. Obviously, there is a long way to go.
Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” ( http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter at http://twitter.com/TimiGustafsonRD