The Obesity/Diabesity Pandemic


Obesity is a major risk factor for the development of  type 2 diabetes mellitus, so much so that the epidemic is often called diabesity. It has been described as one of the most important crises that has invaded our public health system.

Global Statistics,  Source: Lancet

  • Since 1980, the number of adults with diabetes worldwide has quadrupled from 108 million to 422 million in 2014.
  • Diabetes is fast becoming a major problem in low and middle-income countries.
  • From 1980 to 2014, the prevalence of diabetes more than doubles for men in India and China.
  • Half of adults worldwide with diabetes in 2014 lived in five countries: China, India, USA, Brazil and Indonesia.

So what are some solutions?

The standard American diet is in much need of an overhaul and our national food systems need to change if we wish to reverse or at least slow down this trend. Many say that it would take the same determination as the campaigns to change behaviors that were utilized during the campaigns against smoking. .

Prevention awareness should be first on the front lines of treating the people with prediabetes that can often be reversible using lifestyle modifications. There are already some prevention models in the community; however, these should be expanded so that they become more easily accessible to more people. The Diabetes Prevention Program (DPP) uses intensive behavioral therapy to help people lose a little bit of weight (typically 5-10%). When this program is followed, the number of people progressing to have diabetes comes down by more than half. In people over 60, the reduction was 70%.

Nutrition education should be incorporated into the school system in the early years to help young children understand the importance of knowing where our food comes from and why nutritious foods are the best choice. They can be taught about balanced eating, calories, reading labels and grocery shopping. Nutrition education can also be offered at the middle and high schools levels by returning to a revamped and modernized home economics course in the curriculum.

A lingering problem has existed for many primary care physicians for many years in that they say they were never adequately prepared in nutrition principles in medical schools. In a survey of family physicians (2009), two thirds said that dealing with extremely obese patients is “frustrating “and one-half said treatments are often ineffective. This is reflected by a lack off obesity training.

Shockingly, another survey in 2010 of 140 doctors revealed that nearly one-third were not even familiar with the American Diabetes Association (ADA) prediabetes guidelines. Only 6 percent were able to identify all 11 risk factors and on average, the doctors could only identify just eight of the warning signs. Only 17 percent knew the correct laboratory values for blood glucose and only 11 percent said they would refer a patient to a behavioral weight loss program..

There should be an increased access to professional treatments. Medical professionals not trained in obesity management should refer their patients to outside providers such as dietitians, exercise trainers, behavior therapists, psychologists, or a new concept of health coaches. These providers should be trained, certified, and credentialed to protect the public from unscrupulous treatments and to provide quality care. Reimbursement of qualified health professionals needs to be enhanced to keep. Otherwise patient volume high and they lessen out-of-pocket expenses.

We have become a nation of non-cooks and prefer to have our meals prepared by someone else. Encourage home cooking and home kit meals to help to counter using fast foods and packaged highly processed meals loaded with calories, fat, sugar and salt.

Educate the public on food labeling including ingredient lists. Beware of food companies that promote products with a “health halo” meaning exaggerated claims are made that appear to make unhealthy foods seem healthy because of an added nutrient or ingredient. Corporations also mislead consumers with their labeling so they include four different types of sugar to keep sugar from being listed as the first ingredient. This is misleading to the consumer when attempting to make wise food choices.

Stop corporate-government partnerships and diminish lobbying.The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) is funded by myriad food companies such as Coca-Cola, PepsiCo and Kellogg’s. The dairy industry has a long history of influencing the food pyramid and Dietary Guidelines. A good example is the placing of a glass of milk on the MyPlate Logo.

Another health organization guilty of taking in millions from food companies is the American Heart Association. They offer a “Heart – Check logo for a price: $5, 490 to $7,500 that is renewable for another fee annually. The product has to be low in fat, saturated fat and cholesterol to gain this “honor.” However, some products such as Boar’s Head processed meats have the logo and still may still contain high levels of sodium. If the AHA were sincere in their efforts to help consumers choose healthier foods to rein in obesity/diabetes, they would realize that research has shown that a 1.8 oz. daily serving of processed meat raised the risk of diabetes by 19 percent and heart disease by 42 percent. Most current dietary recommendations emphasize a reduction in processed meats (my emphasis).

There is bad news on rising obesity rates – read about them HERE.

It will take a concerted effort from government, politics, industry, communities, and consumers and the perpetrators of our obesigenic culture to begin to change this trend.

In the Beginning: Origins

The Standard American Diet has its beginnings in our early history.  Many food historians refer to the traditional diets of many cultures; however the  traditional American food culture remains elusive and difficult to define.  One thinks of hot dogs,  hamburgers, meat, potatoes that have more recently evolved into fast foods, packaged, processed foods loaded with sugar, salt, and fat along with a list of ingredients that often take up most of the food label.

The following article gives us insights on how it all began especially with gender issues about foods. It’s a fascinating look at the early origins of “feminine” or “masculine” foods and their effects on how we still operate to a degree from these stereotypes.

One important contribution to our food culture has also been the food of the diverse immigration movement early in the 20th century. Thus, the traditional American diet has its  roots primarily from other cultures as well as our own beginnings  – thus, Mexican, Chinese, Italian food primarily.

CLICK HERE.

THE STANDARD AMERICAN DIET (AKA SAD)

A 2010 report from the National Cancer Institute on the status of the American diet found that three out of four Americans don’t eat a single piece of fruit in a given day, and nearly nine out of ten don’t reach the minimum recommended daily intake of vegetables. On a weekly basis, 96 percent of Americans don’t reach the minimum for greens or beans (three servings a week for adults), 98 percent don’t reach the minimum for orange vegetables (two servings a week), and 99 percent don’t reach the minimum for whole grains (about three to four ounces a day). “In conclusion,” the researchers wrote, “nearly the entire U.S. population consumes a diet that is not on par with recommendations. These findings add another piece to the rather disturbing picture that is emerging of a nation’s diet in crisis.”

A dietary quality index was developed reflecting the percentage of calories people derive from nutrient-rich, unprocessed plant foods on a scale of 0 to 100. The higher people score, the more body fat they tend to lose over time and the lower their risk appears to be of abdominal obesity, high blood pressure, high cholesterol, and high triglycerides. Sadly, it appears most Americans hardly make it past a score of ten. The standard American diet reportedly rates 11 out of 100. According to U.S. Department of Agriculture estimates, 32 percent of our calories comes from animal foods, 57 percent from processed plant foods, and only 11 percent from whole grains, beans, fruits, vegetables, and nuts. That means on a scale of one to ten, the American diet would rate about a one.

Adhering to just four simple healthy lifestyle factors may have a strong impact on chronic disease prevention: not smoking, not being obese, getting a daily half hour of exercise, and eating healthier—defined as consuming more fruits, veggies, and whole grains, and less meat. Those four factors alone were found to account for 78 percent of chronic disease risk. If we ticked off all four, we may be able to wipe out more than 90 percent of our risk of developing diabetes, more than 80 percent of our heart attack risk, halve our risk of stroke, and reduce our overall cancer risk by more than one-third.

That is what this blog is about – how the SAD diet affects our food culture positively and negatively. There is much work to do about our lifestyles that can help change the course of the health of our bodies as well as the health of our environment – and the sooner the better. Let’s get started.