Diets: The making of an obesogenic society

United Press International surveyed 84 specialists for a 15-part series weighing in on the causes, consequences and costs of a global gain in girth and measures to curtail the corpulence. Part 9 chews the fat on the obese and the overweight.

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SAN FRANCISCO (UPI) Stoked by evolution and steamed by economics, the pandemic of extra poundage spreading across the globe has become a hot-topic issue, igniting controversy, circumspection and concern.

Critics, angered over what they deem as unfair milking by the food industry of humans' ancestrally acquired taste for fat and sweets, threaten to employ the courts to try to make toast of nutritionally deficient fare. Their detractors, soured over what they see as a stale argument against personal responsibility, instead urge use of behavior modification to just say, "No!" to endangering eating practices and "Yes!" to empowering exercise habits.

Still others, questioning the pragmatism of either proposal, note today's fast-feasting, slow-moving society was made to order for putting on the pounds and must switch course to break away from the oversized mold that shapes two-thirds of the adult population -- or 129.6 million men and women.

"Calories come really cheap these days," said Gail Woodward-Lopez, associate director of the Center for Weight and Health at the University of California, Berkeley. "Food with sugar used to be a rare treat, far less accessible than produce; now, it's cheaper and far more common to eat candy than fruits and vegetables."

Riskier as well.

A draft report by experts, commissioned by the World Health Organization and the Food and Agriculture Organization of the United Nations, fingered unhealthy diets and insufficient exercise as leading causes of the world's major, non-communicable disorders, which account for nearly 60 percent of the 56.5 million annual deaths around the planet and 47 percent of all illnesses.

The scientists deemed excessive weight and cholesterol major risk factors for disease and decreed fat-, sugar- and salt-laden foods health hazards. That covers some of the most common and popular items on the store shelf.

In "Fat Land" (Houghton Mifflin, 2003), writer Greg Critser spiced up the national diet debate by following the sugar trail from the 1970s premiere of cheap corn syrup sweetener to the plumping of America. Some scientists have taken exception to the assessment, but few can deny the swelling in number -- from about 250 to 2,000 -- and popularity of snacks since then.

A new UC Berkeley study shows a greater appetite for sugary treats and sodas than for healthier, nature-made options, with sweets, desserts, soft drinks and alcoholic beverages accounting for nearly a quarter of all calories Americans consume. In the survey of 4,760 adults, Gladys Block, professor of epidemiology and public health nutrition, also found salty snacks and fruit-flavored libations make up another 5 percent of calorie intake.

"We know people are eating a lot of junk food, but to have almost one-third of Americans' calories coming from those categories is a shocker," she said. "It's no wonder there's an obesity epidemic in this country."

The sweet smell of success from soaring snack sales may turn sour as the winds of litigation shift from big tobacco to big food. Despite the recent, failed lawsuit by three obese teenagers blaming McDonald's for their plumped-up plight, lawyers are sitting up and smelling the cheeseburgers in anticipation of future court action.

"It is hard to single out specific 'culprits' -- there are too many, and they are all linked together in our culture," said Leon Rappoport, emeritus professor of psychology at Kansas State University in Manhattan. "So the food industry generates tasty products, the marketing industry promotes them, the supermarkets and fast-food outlets sell them ... and all collaborate to foster our culture of sensory gratification because they all profit -- and the pharmaceutical-medical industry profits from the consequences."

Whatever its true triggers, overweight is soaring to surpass tobacco as America's No. 1 avoidable killer. The U.S. ranks of the corpulent have ballooned since the 1960s, with no signs of abating. Severe overweight affects one-third of the adult population, or 61.3 million men and women, exacting a heavy cost in lives -- more than 400,000 each year -- and expenditures -- $117 billion annually, report the U.S. Surgeon General's office in Washington, D.C., and the Centers for Disease Control and Prevention in Atlanta.

"There's a growing public realization that obesity (typically 30 or more excess pounds) is a killer disease," said Judith Stern, a University of California, Davis, leader of a newly formed international team charged with evaluating the sometimes confusing and contradictory published research on obesity.

"Everyone -- moms making dinner, chefs choosing ingredients, reporters writing articles about obesity and policymakers writing laws -- wants to do the right thing, but there are many food myths, and it is almost impossible even for trained scientists to decipher just what the research is telling us."

The story told by the numbers is clearer.

From 1991 to 2002, the number of states with obesity rates at or above 20 percent piled up from zero to 30 and, of those in the 15 percent to 19 percent range, from four to 20. Among cities, San Antonio, with a 31.1 percent obesity incidence, carries the most weight, and Denver, at 14.1 percent, the least.

SizeUSA, a body-measure survey of 10,000 Americans, showed a whopping gain in girth since the last study was conducted in 1941, with the average woman filling out a size 14, significantly up from the previous size 8 average. The analysis indicated 64 percent of women are pear-shaped, another 30 percent are "straight," or columnar, with the tiny remainder retaining the traditional hour-glass shape cinched by a svelte waist. Men have grown in equal proportion over the same period.

Stewing since the second half of the last century, the chronic problem has boiled over into a worldwide health threat of epidemic proportions. Globally, an estimated 1.2 billion people carry more weight than they should, increasing their risk of developing heart disease, hypertension, stroke, diabetes, gallbladder problems, osteoarthritis and other inflammatory conditions, respiratory disorders and certain types of cancer.

The WHO and CDC estimate the incidence of obesity -- which tops 300 million individuals worldwide -- is now doubling every five years. For the first time in history, a plurality is overweight in some societies, including the United States, Russia, United Kingdom and Germany.

Even nations with starving populations have not escaped. Sub-Saharan Africa, an enclave of the world's hungriest, is experiencing growing pains in obesity, especially among urban women. In China, the overweight sector jumped from 9 percent to 15 percent in just three years. In Brazil and Colombia, some 40 percent of adults weigh too much.

The spread of an illness once confined to lands of plenty coincides with increased urbanization as rural residents flee the country in favor of the city, trading in fresh farm produce for processed foods seeped in saturated fats and refined carbohydrates and physically demanding field work for a more couch-bound lifestyle along the way.

"The increase (in overweight is) in the poorer levels of the population," said clinical psychologist Ted Feder of Sao Paulo, Brazil, who has spent a quarter of a century studying the world's obesity epidemic, particularly among children and adolescents.

"In an emergent economy like Brazil's, with an unequal distribution of wealth, products and services, a significant part of the population does not have access to the correct mix of quantity and quality to ensure a healthy development."

In what many see as the most troublesome trend, children, formerly immune to the condition once confined to middle age, are filling the ranks of the overfilled. Increasingly, the world's oldest metabolic disorder -- recorded as early as the Stone Age -- affects ever-younger age groups.

The number of Canadian youngsters who are overweight (33 percent) and obese (12 percent to 14 percent) has tripled in 15 years. At least 15 of every 100 American 6-to-17-year-olds are too heavy, more than double the incidence of 30 years ago.

Brazil has seen a 240 percent bloating in the ranks of its young and overweight, said Vera Lucia Barbosa, a specialist in maternal and child nutrition in Sao Paulo.

In Egypt and Mexico, the rate has bulged to 25 percent, while, worldwide, one in five little ones has put on some big pounds.

"We're losing (the battle of the bulge with) no end in sight," said Dr. Lawrence Cheskin, director of the Weight Management Center at Johns Hopkins University in Baltimore.

The fight seems concentrated where evolution and economics clash, twisting life-enhancing benefits into potentially crippling and even fatal burdens. A society grown obesogenic -- a term coined in 1996 to connote an environment replete with weight-bloating traps -- defies nature's evolutionary intent.

The survival mechanisms that staved off starvation during ancient periods of meager food supplies can bring on weighty troubles in an age of abundant, accessible, affordable fare ready for the feasting at the tap of a microwave button or the click of a drive-up meal selection panel. Metabolic systems shaped by 4 million years of hunting and gathering often make mockery of efforts to shed or stabilize pounds by an overwhelmingly sedentary populace.

"We have been 'programmed' by evolution/natural selection (to like fat)," Rappoport said. "Fat enhances chances of survival in famine conditions and serves as a storehouse of energy; sweet, starchy foods are an all-purpose source of pleasure and easily obtained form of gratification when depressed."

The "let's eat and not run" mentality, however, stands to cause hefty problems, said Craig Stanford, chair of the Department of Anthropology and Biological Sciences at the Jane Goodall Research Center at the University of Southern California in Los Angeles.

"Our environment asks for more self-control than we're capable of," Woodward-Lopez said. "We need to do something to decrease the accessibility to tasty sources of calories."

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Next: Nature-nurture nexus

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UPI Science News welcomes comments on this series. E-mail sciencemail@upi.com