Obesity, Land Use, Transportation and Healthcare Reform

A few weeks ago on a family vacation I made a pit stop along one of I-95’s fast-food dominated rest areas. I stood in horror at the sheer size of the people ambling out of their SUVs to load up on burgers, soda and fries. They were beyond just overweight or “fat”. I would say about half were morbidly obese. It was the intersection of our nation’s problems with automobiles, industrial food system and poor land use policies, all of which produced people that could barely manage to walk across the parking lot to load up on more empty calories.

As America suburbanized and sprawled in areas that were more dependent on automobiles, it became fatter along the way. Take a look at this CDC animated Obesity map to see how our obesity rates have evolved over time in the US.

Over the last few months there has been a concerted effort at reforming the healthcare sector to be more equitable and efficient. There is bi-partisan (if not universal) agreement that over the long haul, the most important issue is tackling the rate of inflation in healthcare costs. It is also nearly universally accepted that prevention is the best way to avoid future medical expenses. And one of the largest medical cost drivers is the rampant increase in obesity.

A recent Streetsblog DC post made the bold statement that “Transportation Reform is Healthcare Reform”. It cited a Forbes.com article about one of the many links between obesity, land use policies and transportation policy in this country

The link between walkable, bikeable, denser communities and public health is explored in depth by reporter Christopher Steiner, whose new book cites research by University of North Carolina economist Charles Courtemanche that found a causal relationship between the price of gas and U.S. obesity.

For every long-term $1 increase in gas prices, the national obesity rate drops by 10 percent, according to Courtemanche. That relationship goes a long way towards explaining why the House and Senate health care bills include "community transformation" grants to entice cities and towns into building bike paths, playgrounds, and other pedestrian-friendly improvements.

As a result many Americans are just not getting daily exercise. Only 26 percent of U.S. adults engage in vigorous leisure-time physical activity three or more times per week (defined as periods of vigorous physical activity lasting 10 minutes or more). About 59 percent of adults do no vigorous physical activity at all in their leisure time. About 25 percent of young people (age 12 to 21) participate in light-to-moderate activity (e.g., walking, bicycling) nearly every day. About 50 percent regularly engage in vigorous physical activity. Approximately 25 percent report no vigorous physical activity, and 14 percent report no recent vigorous or light-to-moderate physical activity. It seems the most exercise some people get is the short steps to and from their cars in parking areas.

A recent study reported on by the Washington Post concluded that automobile dependent Sprawl induces this lack of physical activity that causes obesity.

People who live in neighborhoods where they must drive to get anywhere are significantly more likely to be obese than those who can easily walk to their destinations, according to the first study to directly demonstrate that long-suspected link.
The study of nearly 11,000 people in the Atlanta area found that people living in highly residential areas tend to weigh significantly more than those in places where homes and businesses are close together.
The effect appeared to be largely the result of the amount of time people spend driving or walking. Each hour spent in a car was associated with a 6 percent increase in the likelihood of obesity and each half-mile walked per day reduced those odds by nearly 5 percent, the researchers found.
"The kind of neighborhood where a person lives clearly has an effect on their health," said Lawrence D. Frank, an associate professor of community and regional planning at the University of British Columbia, who led the study.

And while this is not necessarily a surprising finding, it does show the cognitive dissonance when it comes to the intersection of health policy and transportation / land use policy. Right now while the US Highway fund needs a $7 Billion cash injection because gas taxes revenue has not kept pace with inflation and the nation's obesity rate remains very high, the mere idea of raising the gas tax as a solution is considered a non-starter politically.

But this doesn't need to wait for a heavy political lift at the national level. Each locality can do its part to make its population healthier and more active by encouraging walking, biking and other regular physical activities and discouraging automobile dependent growth & development.

As a contrast to my I-95 pit stop, I recently took the Amtrak from Baltimore to NY Penn Station and found there to be a few older slightly overweight folks, but most folks were not only somewhat fit, they sprinted down the platform upon exiting carrying 20-30 lbs of luggage with them with little effort.

Is high fructose corn syrup a weapon of mass destruction?

That and transfats;

http://www.fi.edu/learn/brain/fats.html

Studies show that the trans fatty acids we eat do get incorporated into brain cell membranes, including the myelin sheath that insulates neurons. They replace the natural DHA (Omega 3) in the membrane, which affects the electrical activity of the neuron.

Trans fatty acid molecules disrupt communication, setting the stage for cellular degeneration and diminished mental performance.

Human settlement patterns need to be refactored to walkable carfree communities, no doubt about it. J.H. Crawford has been leading this charge for many years with the Carfree Cities approach. It is evident in many European city districts, and boldly so in new cities such as Masdar.

Klagenfurter, Austria

high fructose corn syrup is a weapon of mass distension

The Seven Deadly Sins of Obesity: By Jane Dixon and Dorothy Broom
How the modern world is making us fat.

• Consumption obsession
• Time pressure
• Parenting pressures
• Technology
• Car reliance
• Marketing of unhealthy food
• Confusing advice

I read all the various comments to this thread, and am now sure that part of why we are unable to drive effective change as a society is because we are better blogging about the changes we should make than we are at implementing them! Change is dependent upon action - and action requires more than postulating on the causes of our ill health and sloth.
Interestingly, everyone's opinions bear some truth, so what are the actions needed to take us to a new place?
I'd advocate for changing what we eat to more of what we can grow at home, then supplementing it with what we can obtain from sources we trust to be 100% organic. We are, in fact, what we eat, on so many levels. Once we make that single basic change, we will have at least changed the fuel we put in our bodies, which are the one and only system we do in fact have nearly total control over. This fundamental change affects our economy, our community, our nation,our families and our health and psyche. Think about it.
Next,stop typing on the computer. The discussions ARE fascinating, but just how much communication and infomation do we REALLY need? Substitute 30 minutes outside, walk or run or just meander for starters. Small changes are good beginnings. Let nature and fresh air do their simple magic - you'll want more. Then you can appreciate that you can step it up a notch, and enjoy it even more. Things begin to happen in your body and your head. You'll decide that maybe the reduced stress is preferable to some erudite string of conversation, and perhaps opt instead to take a friend on your walk so you can have both!
Don't get me wrong, I am not saying we shoudl stop the momentum , or go deeper into denial about the harm and waste and outright ignorance we have engaged in as a nation - but let's actually make changes in our OWN spaces, so we can remodel the world where we live, beginning at home in our own environments first.Then once we are walking and eating smart, and maybe driving less in smaller, more fuel efficient cars, and using less energy powering up our PC's, and spending time in our gardens whre we grow healthy stuff without chemicals so bees can have a seciond chance at happy hive lives, THEN we can have a sense of how to fix the rest of what needs to be fixed...and we will have some life experiences to share with those who are just trying to get started on this path. I'm going for a walk - catch you all later. P.

This is fairly good additional evidence that the "military industrial complex" is just one child of big business in a large family of business circles. We can add the "food" and "healthcare" industrial complexes, and while we're at it the "government" and "big finance" industrial complexes. Each and every one start by bringing more and more service to people and end up being driven to excess. I think the main "feedback loop" is the very profitable pairing of forever multiplying investment capital with hired scientific genius and marketing. I think that's the pump that blows up all our bubbles. Anything pumped up enough will overshoot and collapse is the general complex systems principle... The question is not whether "unleashing the creative power of self-interest" was a good idea. Of course it was a good idea. The question is how do you get it to stop? (i.e. - of the thousand possible places, where is it safe and effective to cut the loop)

"... The question is not whether "unleashing the creative power of self-interest" was a good idea. ..."

Um, depends on what kind of "self-interest" you're talking about. If you mean the common, garden-variety form of self-interest otherwise known as "getting ahead," I couldn't disagree more. But if you mean "enlightened" self-interest, wherein one recognizes that his own self-interest is inevitably damaged when it lessens the common good, that's a different story.

Right, but then there's the problem that people tend to make good on their promises to "be enlightened" when it's easy, and tend not to when it's hard.

In my view people are driven to turn the good kind of self-interest into the bad kind when the struggle for personal achievement is continually intensified by the way capitalist economies work. The profits of whatever business you are is are always going to be used the banks and financial markets to invest in the next more competitive businesses, stimulating ever more intense competition. I think it brings about unenlighetned self-interest automatically, and calamity with it.

It one way to look at the dilemma from a whole system analysis of normal market economies. It seems that even using the most optimistic possible assumptions about the intelligence and good will of people and plentiful resources, the complexity of the relationships between people still multiply till the competition becomes destructive.

-I don't think you need to 'cut the loop' just introduce sufficient negative feedback to reverse any positive feedback that has created the expansion...

An example is taxes on fuel. Without taxes people are free to go get the biggest, least economic car they want. With taxes they think of the running costs and go for something more modest (but still OK).

Using this thinking perhaps Health Care insurance should be proportional to a persons level of obesity? This would incentivise (provide a positive feedback loop) lower levels.

I think the issue here though -at least in the US- would be one of use of taxation and its impact on 'freedom of choice'.

People clearly choose to die young, potentially horrible deaths by stuffing themselves with all manner of crap -and who is Obama or anyone else to tell them to stop? Ergo, the system will probably eat itself to a collapse...

Nick.

There is a difference between the 2 examples that you cite.
The fuel tax is an example of punish first and make people minimize the damage by economizing so it is all negative.
The health care example is better because it actually rewards people for improving rather than creating artificial negative conditions.
Also any additional taxes are nothing but inverse Robin Hood and allow even more control by the criminals that actually run the country.
I am all for collapse because I don't think there is any other way at this late stage of failure.

I think a fat tax on junk food would work better. Soda, chips, candy are all called "food" in my state and not subject to the sales tax. A hard sell politically or impossible for some strange reason while new tax after new tax on tobacco is politically easy. Would be a good source for health care money too.

You can't legislate responsibility or good behavior.

Taxing junk food will do nothing to promote better eating habits.

Look at cigarette taxes. They are so high but so many people still smoke.

Doesn't work.

My hunch is that your argument contradicts itself. I believe that in fact smoking rates drop as a direct result of the cost of cigarettes. I will never forget going to a party in Tanzania, where a single cigarette was passed around, because, truly, it was all anyone could afford!!

My state already taxes candy, soda, etc. even at grocery stores and it hasn't made any appreciable dent in obesity rates here. That kind of thing just doesn't work.

Ahavah B.
So, what would be more effective if incentives and punishments are not going to control the overwhelming effectiveness of ever growing investment in marketing and science to get people to earn more, consume more, commute further, and get really agitated having to eat fast food on the run all the time?

What has "worked" at my house has been to instill a deep and probably neurotic distrust of marketing. I take the time to point out to my grown and nearly grown kids (who are all healthy weights) what they DON'T say in commercials, ads and labels. But it take someone with an interest in the subject do that, and most people have enough on their plates, pun intended, as it is. I also discuss articles with them about the exploitative nature of giant agribusiness, etc., but seriously - how many other teens/20s would sit still for that? We began our "anti-indoctrination" at an early age - for most generation x-ers and y-ers it's just too late. I don't know what would work large-scale. I wish I did. "Health and Nutrition" classes at the high school level make the kids eyes glaze over, nor have "veggies are good" campaigns in elementary schools worked. I took one of my high schoolers and a few of his friends out to a local restaurant which specializes, in addition to great low fat grilled chicken, etc. in lots of fresh local veggies cooked "home-style." I was privately appalled when one of the girls ordered a "veggie" platter and the four items she chose (from a list of about 15) were french fries, mashed potatoes, mac and cheese and corn. That's her idea of eating vegetables, and this is a girl from an upscale neighborhood in a good school whose parents are mostly what we used to call yuppies. How can you reach kids like her? It seems they are addicted to starch and grease (and they probably are).

Noutram,
Yes, that's the main way the leading no-growth and sustainable economics models do it, but that fails badly on both the "safety" and "effectiveness" requirements.

What happens if you do that is the same thing that happens if you run into resource limits or other natural prohibitive resistance to using more and more of the earth. The economic multiplier keeps multiplying the share of the most powerful competitors, as we now are experiencing with the "jobless recovery" phenomenon, and the escalation of world food prices so 100 million more people have to live on subsistence food aid or starve.

What people have been very negligent in considering is the entirely non-benign effects of natural limits to growth if the growth pump keeps pumping.

Yes,the obesity epidemic is scary and it is just one of the many self inflicted conditions which plague Western society.

The basic problem is diet.Why do some people eat garbage and far too much of it?Psychosis plays a part in my opinion.And once the fat goes on there is little desire for exercise and it gets to the stage where the individual literally can't exercise.

By all means build all sorts of facilities for exercise.They will certainly get used by the fitter (and wiser)part of the population.

A good place to start to mitigate this problem would be to identify families and individuals who are at risk early on - from birth and beyond through the education system.I don't see any alternative to some rather intrusive social controls.Also,the supply side junk food would be at least easier to attack through regulation.

People who can not diet should get gastric surgery.
It is probably also much cheaper then the future medical costs of the obesity.

It is probably also much cheaper then the future medical costs of the obesity

So is euthanasia...

You say it as if it's a BAD thing. lol

I strongly Disagree.

Strongly disagree. Anybody can change the way they eat and at least get some exercise. I'm a spine injury patient and cannot walk for more than one block, drive for more than 30 minutes or ride a bicycle but I have figured out how to eat properly and even exercise in some way to keep my weight from increasing.

It's less problem and more bad decisions that causes these people to become morbidly obese.

Having a wife that has had this surgery has given me insight into the Gastric Bypass Racket. It's so easy for people to fall into. Sounds so easy and Oh, the risks, well "their are risks for all surgeries".

I watched helplessly as my wife dug in her heels because she "had to have this surgery because I cannot lose weight". She had it done despite my repeated STRONG objections and even though I gave her a fitness club membership and the fact that the doctor DEMANDS that potential patients attend MANDATORY classes on exercise and proper eating. She even lied on the paperwork that asked what you eat so it looked better for her. I know because I watched WHAT she ate and HOW MUCH.

I know another woman who went through the exact same scenario, also lying about what and how much she ate just to get into the surgical schedule.

Afterward she (my wife) gained most of it back. I learned that this is typical for these patients. They do not exercise enough (or at all) and do not eat right to begin with so they continue this behavior after the surgery. Nothing changes for many of these people. A small percentage change but most do not.

Please note that there are some patients who do keep off some or much of the weight. However, these people are NOT the norm. Most of them gain back much of the weight.

I've watched this type of surgery literally explode in demand. I've been very outspoken about this because it is a potential attempt at a REMEDY, not a PREVENTIVE measure. There are serious risks (death) and complications (vomiting due to simply eating too much or eating the wrong things, among others) from this surgery. I could go on about all the things that I've watched my wife try to eat but could not but the list would take me all afternoon.

If people would simply exercise and eat right (and less of it) they would not need this surgery. Unfortunately many hospitals advertise these surgeries just like cosmetic surgeries (implants) and they would reduce their gross sales if they stopped doing so many.

* - I acknowledge that some people simply cannot, for whatever reason, lose weight or keep their weight down. However, the numbers are such a small percentage of the population.

The straight medical opinion is that people who are obese are simply very unlikely to ever lose weight, and that their best chance lies in gastric bypass surgery.

It must be very hard to watch someone you love go through the pain of being obese, hopeless and helpless about it, and subject themselves to radical surgery, improve and then relapse again. One nurse I used to work with told me about the emotional pain of having everyone stare at you for being morbidly obese, not to mention the physical pain of carrying all that weight around every day. Gastric surgery worked very well for her (and another co-worker) in the short term anyways. One of my patients had several crushed thoracic vertebra (presumably from his own weight, 450 lbs+). Gastric bypass surgery seemed urgent for him, but oh, well, no insurance.

As to the matter of choice, it turns out that the wheat that is grown in 2008 is of much inferior quality to that which was grown in 1920. It contains less than half the protein, for example. So now white bread, pasta, sweetbreads, etc, etc, are a problem that they were never in the past. I am sure this is the case for everything we eat, as everything has relentlessly been bred for yield and nothing else. Number 1 corn has been bred for sweetness. I am sure this does nothing for its nutritional content. What of the gigantic tasteless apples, tomatoes? Add to that factory farmed animals, high fructose corn syrup and trans fats, hundreds of channels on TV and the everpresent internet, and you have a very rapid epidemic, like nothing ever seen before.

An article in the Journal of the American Association outlined the consequences of this: obesity leads not only to diabetes, heart disease, stroke and cancer, but also to chronic pain, sleep apnea and depression. The impact on the economy would be just like that of any plague. Oh and yes, if you believe in vitamin D, turns out that it gets sequestered in adipose tissue, lowering serum levels.

Paranoid,

I am familiar with the gist of your comments redarding the nutritional shortcomings of modern crops and unfortunately I am afraid you are correct.The fact that yields are up as concentrations of protein are down ,etc, is the fault of the big biz marketing system rather than the farmer actually growing the stuff.

My family sawed down whole orchards of apple trees in the fifties,sixties,and seventies-trees that produced damn good tasteing apples that were easy to store,easy to grow,and economical to produce.

We couldn't sell them anymore,because all the women's magazines were full of pictures of fairy tale apples.

So now we raise mostly the crappy kinds you refer too-and we have a hard time getting rid of the surplus from the few trees of the old time varieties we still raise for our own use.

I like to think of them as barbie doll apples-impossibly good looking,totally worthless eccept as eye candy.

mac -

"... The fact that yields are up as concentrations of protein are down ,etc, is the fault of the big biz marketing system rather than the farmer actually growing the stuff. ..."

A lot of it has to do with the quality of the soil, too. Industrial agricultural practice treats the soil as nothing more than a mechanical substrate on and in which to "grow" its products (products engineered for appearance, shelf life, handling, and transport) with the support of chemical fertilizers, pesticides, and herbicides. Within a few short years, even fine, fertile soil indeed becomes a dead substrate - and there's nothing in any plant grown anywhere that didn't come either from or through the soil it was grown in.

If you're buying your food from some 6,000-acre "operation" in the Imperial Valley or the Iowa countryside, as most of us who shop at Kroger or Walmart do, about all you're getting for your money is calories - and a rich assortment of residues from the various chemicals used to "grow" it.

Hard head,you hava a point.

The crop can't put into itself what's not in the soil,excepting co2 and h2o.

But the proportions of various nutrients are more a function of variety than yield.The old time wheat with more protein produced fewer bushels.Total protein is generally up,or about the same,and carbs are way up,per acre basis.

And everything you hear about dead soil is not true,although there is an ugly germ of truth in it. I don't want to go there right now.It's a very involved subject.

Despite the comments to the contrary from people who have, um, shared my bed, I will admit that I am overweight. However, here is my personal opinion as to one of the main reasons for the rate of obesity here.

We don't really WORK. Oh, we may go into an office, and type a little on a keyboard, talk on the phone, and attend meetings, but we don't WORK. We don't produce anything, whether a product, or any end result from physical labor. You will see overweight guys working construction, lifting heavy things, etc, but you won't see obese people doing it.

I've been digging "drainage ditches" around the perimeter of my property, not using a Ditch Witch, but a good old fashioned shovel. I'm pretty sure when I'm done going around all 20 acres of my property, I'll have a few less pounds on my frame, or at least my percentage of body fat will be less.

~Durandal (http://www.wtdwtshtf.com)

I am overweight myself and will be obese in about 10-15 years.
This means that I got to start a few good habits to reverse the trend.

Liquid calories are a sneaker, our internal calorie calculator has a hard time figuring out we've ingested calories if its liquid so we still eat the same amount of solids.

Why do they eat garbage? Because all the stuff made with bleached white flour, white sugar, trans-fats, a chemical feast of additives that interact who-knows-how with each other and your physiology are still cheaper than buying quality products - way cheaper. Which is less expensive, a box of hamburger helper and a pound of hormone-steriod-antibiotic filled ground beef, or a package of whole grain noodles, fresh tomatoes, onions, peppers and garlic, and a pound of organic or at least ASH ground beef? (ASH stands for antiobiotic, steriod and hormone free, btw.) The cheap crappy quality hamburger helper wins hands down on cost. If you want to tax something that will actually make a difference, tax processed foods. Hamburger helper has probably killed more people than an organic dark chocolate bar made with evaporated cane ever will.

I agree that the obesity epidemic is a form of neurosis or psychosis. We always hear in obesity news reports that junk food appeals to peoples' hunger for fats and sugars that were rare in formative primitive environments. I think that is BS. What about getting sick to your stomach or feeling bad from eating bad food? Then there are whole countries, Japan, Italy, France where almost everyone eats real food. I even saw in England, a country not famous for cuisine, that their groceries sell mostly food and lacked the mountains of garbage that Americans buy. (I'd be interested in hearing non-American visitors impressions of this vile crap sold in America.) 70% of Americans are blubber infested. It is a sign of a crazy country--just like you can make the argument that Germans went berserk in the 30's. The graphs showing obesity growth from 1960 coincide with television, suburbia and rock 'n' roll growth. Is there a connection? Did rock n' roll make 70% of the Americans fat? All the other cultural phenomena have in common alienation from nature--i.e. things like walking, hanging out with people instead of TV watching, cooking on a fire, etc. I just heard Michael Pollan say TV cooking shows are more popular than ever while cooking is less popular because humans are filling a void for the ancient custom of cooking.

Michael Pollan also advises that we do most of our shopping around the outer periphery of the supermarket. That is where the fresh produce, fresh meat & fish, and dairy products are. Add an occasional stocking up of whole wheat flour, whole grains, and beans, and a few other staples, and you've got the makings for a reasonably good diet - IF you can cook. This is pretty much what I do, buying organic when available, but not being overly obsessed or fastidious about it. I absolutely do not buy meat or dairy products unless they are free of antibiotics and hormones.

The thing is, this is pretty much the way people used to eat, even back in my childhood. Except for soda pop and candy, the newer breakfast cereals being pitched to kids over TV, and those horrible "TV dinners", there just were not all that many highly processed foods on the supermarket shelves or in shoppers carts. Go back another fifty years before that (a century before the present), and there wasn't much of anything in the stores that we would consider a processed food, except maybe the Uneeda cracker.

It would be nice if one political jurisdiction in the USA went for bikes/walking and a mass transit system which easily accommodated bikes/segways in a big way. Some jurisdictions (like Chicago) have nibbled at making cities less beholden to cars, but they've only just nibbled.

I think Portland OR might be one of the best in the US for biking on a large scale, but even that is only a few % of all travel trips. Some international cities like Bogata, Copenhagen, Amsterdam and many others have gone much further. It's totally possible to get 10-20% of commuters on bikes, you just need the right incentives (i.e. make driving too expensive, allocate space for bikes, etc), which very few local decision-makers are willing to undertake.

Yup. Portland is a good one. Ever been to Pedalpalooza? That looks like a fun time.

A couple of problems with trying to promote bicycling in the city; many drivers think that bicyclists are simply a nuisance, and you need to get the CITY and the PEOPLE to agree on the change. Tough to do. So many people are stubborn and nobody wants to sweat a little.

You would need to make MAJOR changes to roadways to separate the cars from the bikes. Mingling them is a recipe for disaster. Bike lanes, while a good thing, simply get driven over by cars too much in my opinion. Especially at corners. Drivers are supposed to stay out of the bike lane until closer than 200' from the corner, but if they don't see a bike they drive right on through it. I see it all the time.

On the other hand, many bikers ride on the wrong side of the road, run stop signs and lights, etc.

Nobody (ok, I'm over-generalizing here) wants to cooperate when it comes to getting around town. Everyone is late and drives a like a bat out of hell.

Boulder's physical setup is wonderful for biking. There are lots of bike paths, a website that functions like Mapquest for bikers (GoBikeBoulder), a ton of superfit triathletes, and a large number of students who can't afford a car.

I have noticed that my "just-in-time" lifestyle is affecting my ability to bike places. I would have to PLAN for it, allow a little extra time perhaps, and solve the logistic problem of where to put my three kids.

Just step outside of town, however and oh... well...

I did worse than stop at a rest area. I went to WaterWorld. The 30% overweight children (some of them morbidly obese, yes), and their parents, almost none of them normal weight, were on display in bikinis, as this turns out to be the fashion of the moment.

I was prepared for all this, but not for the sight of people streaming out at closing time, with one last large plate of some kind of disgusting fritter dusted in confectioner's sugar.

For full disclosure, I must say that I apparently just recently crossed over into overweight (BMI 25.2), while my spouse is somewhat ahead at 25.8 (more actually, because he doesn't quite measure 6 feet tall).
Our kids, however, tortured daily by my stubborn refusal to buy burgers, sodas, candy bars, and whatnot, were easily the skinniest kids at WaterWorld. I think for the first time, they GOT IT that there was a clear and present danger, not just Bad Mommy.'

Oh, and we are in Colorado, the best state in the country from the obesity standpoint.

"Mingling them is a recipe for disaster."

That is a gross over-generalisation. I bicycle to and from work on roads every day, and have for a couple of decades. This is in Melbourne, Victoria, in which the car is king as in big cities in the USA. I also drive a car (say once a week), and cross the roads as a pedestrian.

I use some off-road paths and on-road bike lanes, but much of my riding is in the normal traffic lane. This can be quite safe, depending on:
- Riding style
- Skills and experience
- Traffic conditions
- Road conditions

Most of the time, the cars are moving from one traffic light queue to the next. Sometimes they are overtaking me, sometimes I am passing them on the curb-side (the left side here), and sometimes I am riding in line with them as a queue.

For an idea of how I ride, check out this document:
http://www.bikexprt.com/streetsmarts/usa/index.htm

I accept that I have a higher risk of injury per kilometer than a car driver (but lower than a motor bike rider) My commute (12k one-way) is a lot shorter than most motorists, so my overall injury risk may be similar to many drivers.

However, outweighing the injury risk is my reduction in health risks. Several studies have found that cyclists have longer life expectancies than non-cyclists (even ones who exercise).

So which is the real "recipe for disaster"? My commute or that of the non-exercising motorist?

On-road bike lanes are useful on straight stretches of road, but they don't help at intersections, which are the main danger areas. They are good for enticing new cyclists onto the roads, but do not remove the need for skills and experience.

From my observations the motorists where I live are a bit more civilised than what I've seen in the USA. I've never had a real "road rage" incident, and aggressive driving is very rare. Maybe part of the reason, apart from my riding style, is that I wear shirt and pants, not lycra/spandex.

We've discussed this before, repeatedly. Failing to mingle them is usually the bigger disaster. Out of sight, out of mind. Entering the street is not optional anyhow, it has to be done at every single corner, else one is confined solely to one's own block. Sometimes a reasonably safe path can be created along a creek, lakeshore, railroad line, or freeway that is blocking off most of the potential cross traffic anyhow, but that's about it.

Sidewalks masquerading as paths often force bicyclists to enter the street at points and/or in directions from which they are not expected or seen, which is too often how they get killed or seriously hurt where I live. Normally, a motor-vehicle driver suddenly makes a turn and simply fails to look for the cyclist popping out of "nowhere", i.e. in a direction opposite to the traffic. In much the same way, driveway users also often fail to notice cyclists on sidewalks. It can happen to skaters and joggers too, or to anyone else who for any reason can't jump backward out of the way on a dime.

The "feeling of being safe" and actually being safe are two different things. This is why the unsettling practice in some parts of Europe of removing all traffic signs, markings, etc. often works when it's done thoroughly in an appropriate area. It's also why having enough cyclists on the road is well-known to counter-intuitively reduce car-bike crashes. Road users of all types ought not to "feel safe" because whenever they do they become oblivious and start daydreaming and yakking about nothing on their phones instead of attending to where they are going. They should instead feel unsettled, insecure, and alert, and put the damned phones away - as if lives are stake, because they unavoidably are.

Serious car accidents are fairly rare - people can drive for many years between them - so one's intuition is not well-trained. Occasionally, as in this case, it is a poor guide to avoiding them.

You sort of mentioned it in passing, but I think the for profit industrialized food industry is a bit part of the problem. Packaged food is engineered to make us crave want more of it. Ingredients are carefully market tested, not for nutritional value, but for taste, and for addicting the consumer. So a lot of the problem is that as consumers it is hard to avoid food addiction -or near addiction. Then you add in the ease with which we can avoid exercise in modern society, i.e. for most of us, it is time we must take away from other activities that society requires us to do.

Just as in healthcare, food provision, when it is for profit will tend to seek to maximize profits. This usually translates into attempts to increase the demand for the product.

While the lack of physical activity is touted as the causal factor in the obesity increase, it is in reality only one of them. The saturated fat and cholesterol hysteria that came out of the do-gooder 1960s prompted politicians to adopt laws and policies in the 70s that were prime contributing factors to the increase in obesity and early onset type II diabetes starting from the early 80s. None of the "bad cholesterol" studies using powdered eggs on rabbits has any scientific merit: oxidized cholesterol is bad but you don't get it from non-powdered eggs. But we were brainwashed that eggs are bad (although now there is a lot of back pedaling). Thanks to the "saturated fats will kill you" myth, places like McDonald's started using polyunsaturated oils for deep frying. These oils are easily oxidized and also converted to trans fats by heating. On top of this fats were replaced by starch in processed food. Eating more carbohydrates is not particularly healthy for people with a genetic predisposition to type II diabetes (insulin resistance).

The correlation between traffic congestion and obesity should be investigated from the perspective of NOx inhalation. Free radical damage of the arterial wall is a prime candidate for atherosclerotic plaque formation and build up.

"The Scientific Method" depends on repeatable experimentation to conclusively proove a theory. Unfortunatley in the case of many of the issues we face the timespans are so long (generasional) that it not possible to repat until absolutley sure.

In the worst cases (I'm thinking Global Warming and Peak Oil) they are one-offs and the experiment is not even 'complete'...

Nick.

Not buying the sprawl causes obesity hypothesis. Exercise is a relatively new concept, and was at one time thought to provoke weight because it works up an appetite. Taubes makes this argument here:

http://www.guardian.co.uk/lifeandstyle/2007/oct/28/healthandwellbeing.fe...

Industrialized diets, specifically those high in fructose, glucose, and omega-6 linoleic acid, are more likely behind the obesity epidemic.

We'll just have to agree to disagree on the exercise part, but I think you need to expand the boundaries a bit to appreciate the point I'm making. IMO lack of exercise is not the only contributor - sprawl also encourages an unhealthy "food environment". From later in the WaPo article:

But Frank said the amount of activity that people got did not completely explain the findings. He speculated that in some neighborhoods it is easier for people to eat a more healthful diet because there are grocery stores instead of convenience stores and good-quality restaurants instead of fast-food outlets.

"I think the food environment also plays an important role," Frank said.

The automobile not only robs us of physical activity that used to be commonplace, but places us in a unhealthy food environment, similar to the experience at the rest stop on I-95 that I mentioned

Fair 'nough about the exercise. I'm on the fence about it myself, but thought an alternative view might be thought provoking. Problem is that most people confuse exercise and physical activity. Walking around the neighborhood is not exercise. Biking to work/school is not exercise.

Here is my question: do you really believe.. "it is easier for people to eat a more healthful diet because there are grocery stores instead of convenience stores and good-quality restaurants instead of fast-food outlets." This argument usually appears when the subjects live in poor parts of Brooklyn or LA (folks do not have cars and there are few grocery stores). Weird how its the opposite in this here WaPo article. Nearly anyone who is part of the automobile sprawl has the option of driving to a grocery store that can provide them with all the healthy choices required - and the cost is usually cheaper than most of the restaurant choices (Chili's, Ruby Tuesday, Olive Garden ect).

But back to your main point: Sprawl makes it easy to make poor choices. Whether it be driving instead of walking or McDonald's instead of chicken & broccoli. This is true. But even if there weren't sprawl there would still be plenty of people making the same poor decisions. Heck you live on the UES, I live on the UWS. Within 1 block I can binge on McDonald's, Chipotle, Haagen Daaz, Gray's Papaya (recession special?) ect. I can be just as inactive. I can sit in my apartment watching TV or take the subway/bus to work just like the suburban-sprawler.

On a side note I love mixed use development like we have here uptown. I just don't think it provides any weight-loss benefits, particularly when it comes to walking vs driving. Also happy to see you post again.

Last paragraph from WaPo was classic though..

People were less likely to drive and more likely to walk if they lived close to businesses, but most of the people in the study walked very little, regardless of where they lived. More than 90 percent said they did not walk at all, and the average respondent spent more than one hour per day in a car.

"... Problem is that most people confuse exercise and physical activity. Walking around the neighborhood is not exercise. Biking to work/school is not exercise. ..."

Not sure what distinction you're trying to make. Do you mean that "exercise" is more rigorous or strenuous or formal or of longer duration than "physical activity?"

Whatever, it's pretty clear than even a little "physical activity" is better than none, in terms of weight and general health.

Actually, I moved to Morningside Heights last year. Much better access to parks and bike paths over here and the student culture around Columbia University is nice.

I probably walk 3-4 miles a day and without that I know that I'd be at least 20-30 lbs heavier.

I think mixed use urban areas also encourage a certain healthy level of concern about your appearance.

I also don't understand your distinction between exercise and physical activity, they seem more or less the same thing to me. I have cycled to work, 7 miles each way including several hills, for some years now, the last year every day, and I could describe the activity as either. I am a lot fitter and feel a lot better, I am certainly ill less, but I have not lost any weight as the Taubes article implies. But then again I don't feel the need to eat when I reach work. Maybe a lifestyle incorporating physical activity helps to regulate dietary intake.

IMHO, you are absolutely right. Only a small percentage of people are devoting their leisure time to "exercise" on any consistent basis. The reasons are numerous, I am sure, but the bottom line is that, for one reason or another, the exercise doesn't get done.

The answer has to be to build more physical activity into routine daily life. Maybe that is not enough to get a person into tip-top physical condition, but maybe it will just have to be good enough.

Commuting on bike or on foot is definitely one good way to do this. I have been commuting on foot 1.7 miles each way for over a year now. One of my reasons for doing this is that I just was not able to fit an exercise routine into my "leisure time" on a consistent basis. Having gotten into the walking commute routine, though, I now do this consistently.

What about for those who live too far from work to walk or bike? There may be other options. For example, they might be within walking or bicycling distance of a mass transit node. Or maybe they could get off one stop farther away from work and walk the rest of the way. Or maybe they could walk to a car-pool rendezvous point on days they are not the driver.

People could also get in the habit of parking as far away from the front door as they can (a habit I've tried to practice) rather than circling around like vultures waiting for a parking space right by the front door. One could also take the stairs rather than the elevator, and so forth.

Another beef: I see far too many overweight people on lawn tractors. If one's lawn is too big to mow with even a self-propelled push mower, then one's lawn is too big!

We've talked about gardening a lot here. One more advantage of growing some of one's own food is the physical activity that goes with it. I would suggest really trying to garden without the use of a rotary cultivator if one can possibly manage it. There are tools like an azada one can use to work a lot of soil without breaking your back.

Even cooking one's own meals is good for a little physical activity. At least one is on one's own feet and moving about, rather than sitting in a restaurant chowing down.

I'm not advocating anything here I am not doing myself. I'm still overweight and far from being what you would really call fit, but I hate to think what I would be like if I did none of the above.

You are both right.

Pickitupsnake is correct in this way. I have studied diets for over 20 years and experimented with many different foods over those 20 years and what I have discovered is this. Excercise can help those who eat a poor diet and are overweight to reduce their weight, and exercise is desirable for many reasons those who eat a healthy diet. But if one eats a diet primarily composed of raw fruits and vegetables and nuts (virtually void of cooked foods), you will not be overweight regardless of the amount of exercise you get. I eat such a raw food diet and I exercise to PUT ON WEIGHT, to keep my muscle mass up. If I stop exercising, I lose weight. If everyone in America ate like I do, health care costs in the US would drop by probably 60 to 70 percent.

Of course, I doubt that we can expect America to shift to a diet like mine, so in this case, Glenn is also correct. Exercise will be needed for Americans to control their weight because they will continue to eat a lot of processed foods, if for no other reason than because restaurants and the food industry which sell such crap advertise like crazy about how sexy it is to eat it. We live among a lot of brainwashed people. Exercise is necessary for people on processed food diets to maintain a proper weight.

Retsel

Retsel,

You've added a bit of confirmation to my own suspicion about diet and weight, albeit one constructed from a single anecdotal sample. A friend of mine, when I first met her, was quite overweight, borderline obese. About a year after we met, she went on a raw food diet. Her stated reasons for it were for energy and vitality, not weight reduction, but the results were dramatic, and seriously challenged my opinion that consistent exercise was absolutely necessary along with a healthy diet for permanent weight loss.

My friend's diet consisted of only raw foods. In addition to lots of vegetables and fruits, she ate large amounts of nuts and avocados. Her salads were bathed in homemade dressings of olive oil and balsamic. This was by no means a low fat diet.

She started shedding pounds dramatically. I would guesstimate that she dropped eighty to a hundred pounds in about four to five months (5'-6"). The thing that startled me most was that she hadn't purposely increased her level of physical activity at all - no exercise program. As she became ever thinner though, she did become more active, but it was clear that was an effect of the weight loss, not a contributing factor to it.

When she hit thin, I started to worry. She had been shrinking so quickly that I had visions of a skeletal anorexic friend dying of malnutrition in the near future. No need to be concerned though, when she hit what is apparently her healthy body weight, she just simply stopped losing pounds. That was three years ago or so, and she is still thin, although she does eat some cooked foods now.

I recently traveled to Paris France, my third trip there in ten years. I speak no French, but I love the place. I love the food. I love the people. I love the culture. I love the metro - it is like magic. After just a little over two weeks there, I returned to the U.S. and was simply shocked at how obese we Americans are. When you have the kind of obesity rates that the U.S. does, and especially the rate of increase in obesity over the last twenty five years, it is clear that it isn't just a problem of will power, or appetite control. It is systemic. There is something wrong with the system. There is something wrong with our food.

And in regards to health care, of which I have none. I'm a bit dubious about the prospects of reform in the U.S. We could have the French take over our system and replicate theirs entirely, and I'm certain the costs would be significantly higher and the outcomes worse than for the French within the French system. We are much less healthy.

Now I'm totally jonesing for a foret noir pastry and a double espresso.

Vegetarian and non dairy eaters state that exercise is not necessary for healthy weight. Meat and diary products are healthy. They are the petroleums of foods. They are potent concentrated energy. Meat/ dairy are so potent that if you do not exercise and eat them you will get fat. If you keep on filling up the tank and never use the gas it has to go somewhere. IMO exercise is part of a healthy life--is an idle raw food eater with atrophied muscles as healthy as meat eater who runs 3 miles a day? Perhaps genetics is a factor, but I eat meat and dairy products, I have always exercised and I have never been overweight. Your friend was certainly better off with raw foods -- but in a way it is a form of starvation. Without exercise perhaps she had skinny flabby muscles instead of fat flabby muscles.

Physical activity is of course crucial to health. I didn't mean to imply that it isn't necessary. My paradigm, which was that healthy permanent weight loss can't happen without both a dietary change and a lot of exercise, was challenged by observing my friends experience and I wanted to relate that. I question your use of the term starvation in this context though. Her diet was neither low calorie, or low protein. I have no way of quantifying what her calorie consumption was, or how it compared with her diet before, as she wasn't calorie counting at all. Like you, I was worried about her diet being "starvation", but then her weight stabilized at what I would consider a healthy body weight, mesomorphic, not emaciated like a runway model.

I probably didn't emphasize this enough, but as she lost weight, she did become more active over time. She married a very close friend of mine who is an avid cyclist, and they mountain bike almost daily, and ride fixed gear bikes around their city for transportation much of the time. In the winter they are avid snowboarders. She is very strong, very fit now. All of this activity came after the weight loss however.

One thing about very heavy or obese people is that if they move around much at all, they have a lot of muscle. They would not be able to move that much bulk around if they didn't. If the fat can be lost but the muscle tissue maintained, they will be strong and thin at the end. Obviously I have zero expertise in this area, I'm only relating my conjectures, it isn't informed, but my understanding of how the body works is that when it encounters calorie deprivation, regardless of its on board stores, it goes into famine mode and starts to metabolize muscle. Why would it metabolize muscle? Don't we need that muscle to go out and hunt and gather during a famine? My guess is that since muscle increases your base metabolism, that in a famine, the faster your body can power that down, the longer it can make the fat stores last.

If that is the case, the worst thing you can do to lose weight is to throw your body into famine response mode by going on a calorie restricted diet. Muscle mass will be reduced, along with metabolic rate, and the body will try its best to hold onto stored energy as long as possible while the famine lasts.

Perhaps a raw food diet bypasses this, as it isn't low calorie, but is nutrient dense.

I've never researched a raw food diet, and I certainly don't eat that way. I do everything wrong depending on your point of view. I don't eat vegetables and fruit much, maybe a serving of each per day. My diet is mostly whole grain breads, eggs, whole milk, cream, yogurt, and cheese. I cook with olive oil and butter, and use only olive oil when I make my whole wheat pancakes and waffles. In other words, lots of fats, and saturated ones, yet I'm skinny. I usually only eat twice a day, then I stuff myself, but I really only eat when I start to power down because I need energy. I don't eat much meat, only at restaurants, and then usually chicken. My thinness may have a significant genetic component, but my siblings (which are legion) who eat a more usual American diet struggle with their weight.

I'm suspicious of the genetic predisposition to fatness hypothesis. Did our genes suddenly change in 1980?

What did change around that time is the advent of the big gulp. At one time Coke's were eight ounces, and you might have a few a week. Now, a small drink at a fast food shop is twice that, and a large is monstrous. And people drink several a day. I don't drink soda pop.

I'm suspicious of the genetic predisposition to fatness hypothesis. Did our genes suddenly change in 1980?

That's always been my question. I think the best book on American obesity is Greg Critser's Fatland: How Americans Became the Fattest People in the World. He analyzes multiple causes - including social and agricultural policy, HFCS, exploitation by agribusiness of traits we've evolved - e.g. a predisposition to eat a variety of food, but the food variety introduced yearly is dozens of new cookies, cakes, etc. Multiple causes of decrease in exercise. And much more. Best summation: Quote from physiologist James O. Hill: "Becoming obese is a normal response to the American environment."

Incidentally, I used to teach sociology, and used Critser's book in my Soc of Health class. College students loved it, but a campus psychologist got wind of it and contacted me. She was irate; claimed it would make overweight students feel bad about themselves, when they were already suffering. I asked her to read the book and join our class one day.

She did, but she never "got it." Couldn't see that the author was analyzing social causes and kept focusing on the pain of the overweight students she counseled and what she saw as the author's "cruelty" - even though his focus was never on the individual. I just had to use it as a "teaching moment" to illustrate the difference between a psychological and sociological perspective...

lilith

Riban, I find all your comments fascinating. Thanks for posting. Regarding this:

If that is the case, the worst thing you can do to lose weight is to throw your body into famine response mode by going on a calorie restricted diet. Muscle mass will be reduced, along with metabolic rate, and the body will try its best to hold onto stored energy as long as possible while the famine lasts.

My experience tells me that the energy balance really is what matters. Calories in minus calories expended = net energy gain. It cannot be otherwise. You simply cannot lose weight without decreasing calories in or increasing calories expended. No doubt a lot of people have different experiences, as we all have different genetic makeups and habits and attitudes, but what worked for me was precisely the "calorie restricted diet" you're warning about. I basically cut my intake from something in the neighbourhood of 4000 calories per day (I'm very tall and somewhat active) to 1500 calories per day, and maintained that for about two months. I dropped 20 kg/44 pounds.

I had never done anything like that before, but while I was losing weight I was still regularly playing soccer and doing long distance running (about 40 km per month, I think). I figured if I didn't feel tired and I had the energy to do that, then... carry on, right?

It had taken me 20 years to put on an extra 30 kg/66 pounds or so. It took me a couple of years to lose 10 kg/22 pounds through exercise. It took me two months to lose twice as much through diet (while continuing exercise). So, I am totally not surprised by the story of your friend who lost weight simply by eating differently, though I think that exercising typically helps a lot because (I think) it regulates your appetite.

Now, bringing this back to the topic of this posting: it seems obvious that there are links between obesity and "urban sprawl" and its attendant car dependency. I would lean towards saying it has more to do with diet than with lack of exercise, however, it's not that simple as I think the two are inextricably linked. Sedentary people eat more. Well, I did, anyway.

My experience tells me that the energy balance really is what matters. Calories in minus calories expended = net energy gain. It cannot be otherwise. You simply cannot lose weight without decreasing calories in or increasing calories expended. No doubt a lot of people have different experiences, as we all have different genetic makeups and habits and attitudes, but what worked for me was precisely the "calorie restricted diet" you're warning about. I basically cut my intake from something in the neighbourhood of 4000 calories per day (I'm very tall and somewhat active) to 1500 calories per day, and maintained that for about two months. I dropped 20 kg/44 pounds.

Its far better to just become a bodybuilder. Then you're rebuilding your body to have a higher base metabolic rate, lower body fat, and you have the added bonus of being stronger and better looking. Of course the downside is you'll always be overweight by whatever indices the BMI is calculated on, even at under 10% body fat. And its a hell of a lot more difficult to put on muscle mass than it is to just lose weight. But it lasts a lot longer.

Meat and dairy are NOT healthy.

Starting with dairy. People have taken pasturized dairy and fed it to calves and the calves died. Once the milk has been pasturized, it is no longer fit for consumption for the very creature it was designed to nurture. One guy who wrote a simple nutritional booklet entitled Stale Food versus Fresh Food found a very large difference between using raw dairy versus pasturized dairy. But even considering raw dairy, it is not compatible for human consumption as it contains way too much fat. Then once calves reach a larger weight, they stop consuming that food. Yet humans consume the cooked (thus no longer health) milk of another species even as adults. No dairy is NOT healthy, particularly because it is pasturized.

Now with meat. Consumption of meat causes a body's pH to go acidic and because calcium is used to buffer high pH, meat causes osteoporosis. Meat contains cholesterol which becomomes oxidized upon heating. It is oxidized cholesterol which damages the inside walls of arteries which, over many meals over many years, results in atherosclorosis. Ground meat is particularly bad with respect to oxidized cholesterol. If you want to eat a meat diet but not be so unhealthy, then don't eat ground meat and do cook the meat in a stew where the meat is boiled and not cooked at high temperatures.

Another problem with meat is that the cows from which the meat comes accumulate dioxin (even those which are pastured and eat only grass). Thus all cows have a high concentration of dioxin. When we eat meat and all that dioxin, our T-cells are supressed and this severly limits our immune system's ability to fight cancer and viruses as well as other diseases.

If we are eating meat we are displacing vegetables and fruit which contain phytochemicals that prevent cancer, thus meat eaters are eating a high cancer diet. In fact, a book called the China Syndrome summarized scientific data which proved that eating meat causes cancer. By eating meat you are at risk from mad cow disease. Finally, eating meat contributes to global warming not just because rain forest is being cut down to make room for grazing cattle, but because of the methane emmissions.

If you want to be healthy, eat raw fruits and vegetables.

Retsel

I prefer my vegetables cooked.

Alan

Except meat, egg, and dairy proteins are far more bioavaliable. You are going to have a real hard time putting on muscle mass on a vegan diet, which means your base metabolic rate is going to be lower.

to bad Obama's electric grant money announced today did not give any to electric assist pedal machines ....

http://farm4.static.flickr.com/3443/3740029949_c471af79c2_o.jpg

In evolutionary terms,food has generally been scarce,especially the highest quality food-fats,meat proteins,and sugar from nice sweet fruits.

Under natural conditions living as hunters/foragers/primitive farmers it is very unlikely that more than an isolated individual here and there managed to eat enough to become sufficiently obese to reduce his /her reproductive fitness.

On the other hand,a few pounds of stored fat could easily be the difference between making it thru the winter,or a dry spell,or an accident, in good health,ready to go,capable of making babies and finding food for them.

A good greasy piece of meat loaded with salt- a SCARCE nutrient-and high in protein and fat is the best possible food,excepting mothers milk,that a happy healthy horny young hominid can eat.Next comes nice sweet fruit loaded with sugar-another excellent nutrient-if you are physically extremely active and doomed to die fairly young.

We would have starved eating any likely-to-be-available combination of plant foods,excepting possibly if there were lots of oil and protein rich nuts available on a regular basis.

Wild grains and other hard to digest plant based foods were not of much use to us anyway,given our teeth and our digestive systems,until the advent of controlled fire.

So the Blind Watchmaker TUNED or ADJUSTED-whatever word you like- our metabolism to work BEST when consuming a high fat high protien high sugar high salt diet.

Our metabolism is also programmed to RETAIN as much fat and salt as possible due to the high survival value of doing so -under NATURAL conditions.

And of course we enjoy this very fine diet because it enables us SURVIVE AND THRIVE under NATURAL CONDITIONS.

Pigging out on protein, fat, sugar, and salt feels so good for the same reason sex feels so good-it's highly adaptive behavior.Pleasure is the tool evolution uses to drive us to eat and drink and be merry-and make a little whoopee too, once we retire to our beds,be they a pile of grass or a canopied four poster with a big overhead morror.

But there are a couple of catches.

We don't live under natural conditions anymore-

And evolution does not waste resources constructing defense mechanisms against hazards that do not exist.There is no built in defense against obesity because none has ever been needed until VERY recently.

So we are up agianst a drive as powerful as the sex drive and one that is ,if you choose to view it as an adversary,tougher by far.Good hot do-anything-for-it sex is an evolutionary gift denied to children and the grayhaired.

Hot young blossoms,as Twain put it,still catch my eye but they don't cause me to drool any more.
But a good steak has about the same chance with me as it would have with my coon dog.
Any day of the week.Tired or not.

Ps Of course I understand that dieticians have prov...blah blah blah.Most ag majors get the fundamentals of nutrition.When you die at thirty or thirty five ,IF you are LUCKY,you need not worry about your arteries or your triglycerides.

oldfarmermac

Your arguments sound very plausible until you go to Europe and find out that everyone is slim. So something is different in America and I don't think it's the species.

TW

It is the limitless-growth-and-endless-consumption religion of America made flesh.

Watcher,

I agree with you.The comment that you respond to is only the background information,so to speak.

I didn't have time to write the whole book,and I knew that others would amply cover the cultural aspects of this issue.

I have already posted another comment touching on the costs of produce(farm talk for fruits and veggies for those from exotic locales and the marketing of junk food.

Time permitting I will add more.

I can comment on that. There is growing evidence that humans were locally adapted before the great mixing in the last 500 to 1000 years or so. As a result there appears to be a number of genes associated with what is being called "metabolic syndrome" (obesity, hypertension, high cholesterol, type II diabetes) that show frequency differences that make sense given the climate. People of sub Saharan African descent are much more inclined to retain salt and suffer hypertension than are those of northern latitude descent, people descended from cold climates appear to have more cholesterol problems, and possibly obesity. However, I think the Europe/US comparison clearly shows that modern environment has a huge amount to do with it, so genes can be only part of the answer.

My own opinion is that we all need something to control our behavior. For most of human history it has been lack of resources, but for the wealthy it has probably always had to be something else. What I mean is that for most of our history we probably did not get enough to eat because the food was not available , we walked because that was the only option. These days, for most Americans money is not limiting for getting calories, and driving is always available, and an easy option. Those that are within a generation or less of this release in wealth have few controls on their behavior. On the other hand, "old wealth" has found other ways of controlling their behavior, such as social controls on obesity, or developing a culture of leisure exercise. I know that for me every day I have to wheel my bike past my car. I know that I can jump in my car, drive to work, and there will be a good parking place for me. A day doesn't go by that I don't question whether or not I am too "tired" to bike to work, or it might rain, or, or, or. The car is a huge temptation that I simply have to resist. What I am trying to say is that the important aspect of our behavior is finding means of controlling our behavior that is consistent with modern society, and provides us a means of reacting to our bodies needs, rather than to the "feeding stimulants" and convenience factors that big business has gotten so good at manipulating.

Europe does count as old wealth, and they have the culture of leisure exercise and social controls on obesity. However, they were much poorer than us in the 50s when they were rebuilding from WWII. That culture of thrift and frugality lasted for at least a generation, but their obesity rates are rising too. You could also say we had a decade or two headstart on Europe in abundance.

For most of human history it has been lack of resources, but for the wealthy it has probably always had to be something else.

I could be wrong, but for most of human history being very heavy was a sign of wealth! Exercise, perhaps even extreme amounts of exercise, was something that the vast majority of humanity could not avoid. It is somewhat ironic that it is the opposite way around today; obesity is more a problem with the "lower" class, whereas many of those with leisure time can choose to devote that time to physical fitness.

I'm not so sure that the unhealthy American diet can be totally blamed on the modern food industry. I think some of it is a carryover from America's rural past.

I used to do a fair amount of business travel, and one thing I couldn't help but notice is that once you get away from both coasts and away from the large cities, you find that many people routinely pack on the fat and carbs as part of their daily diet. There are many people in these parts who eat breakfasts consisting of sausage, bacon, pan cakes, fried eggs, home fries and sticky buns seven days a week. I suspect that some of this is a throwback to the days when farming involved long days of back-breaking manual labor. Somebody burning 5,000 calories a day might get away with eating like that, but not someone sitting in front of a computer monitor all day.

The other thing I have noticed is that in rural areas many people don't appear to be ashamed of being obese. I was once in central Illinois having breakfast at one of these faux cozy country family restaurants when in walks a party of about six people, ranging in age from over sixty to early teens, evidently an extended family passing through on some kind of trip. Even single one of them, including the teens was not just very fat but dangerously obese.

But that didn't seem to bother any of them in the least. The place had a breakfast buffet, and this family descended upon it like a swarm of locusts. They were piling their plates with all sausage, bacon, eggs, home fries, french toast, and pancakes that could fit without falling off. By the time they made one pass there wasn't much left. Then when they got done, they went back for more. A celebration of unabashed gluttony!

So, I think some of the problem (at least in the rural US) is partly a cultural thing carried over from when people did hard physical work. It's also a class thing: the more deeply working-class you are, the more likely you are going eat in an unhealthy manner.

let's all try to hold on to our basic human compassion here and not be too quick to pile on with the pop media analyses...fat people don't walk enough, they've been unwittingly poisoned by tasty fast food, portion sizes have crept up, etc...heck, why not blame women, they all want careers nowadays so instead of having to eat mom's crappy home-cooked meals we can all eat yummy prepared foods all the time!
Look, a lot of people go through very stressful periods in their life where they just don't have the time, energy or resources to monitor their health, or they go through periods of moderate depression and before you know it, their weight is out of the healthful range...then they are hosed. Losing that weight is just a Sisyphean task that those of us smug in the aristocracy of the fit cannot imagine.
My point is that we are the true aristocracy- those of us who are blessed with the ability to ride bikes, hike National Parks, and travel easily on trains, planes and mass transit.
We should have a sense of noblesse oblige when we see a friend or family member starting to put on weight, knowing that a tipping point will be reached, and try to communicate what is at stake.
At a human, personal level this is the most effective thing we can do.
To encourage localities to pass legislation to require more physical exertion such as parking restrictions or forbidding drive-thrus just kicks the can down the road and ends up encouraging more sprawl.

One problem with us humans is we will often take the path of least resistance. So whilst not becoming fat is at one level a personal choice and responsibility it can certainly be made easier or harder depending upon the environment. In the same way that someone with gambling tendencies is more likely to lose money if there's a bookies down the road or if they still have access to online accounts.

Also there is a cultural acceptance thing. If obesity goes past a certain level of the population then it probably becomes more socially acceptable - a fat person is less likely to stand out in the crowd and thus won't feel quite so bad. A relevent recent analogy is debt, if you are heavily in debt and all around you are solvent you feel worse than if your neighbours/friends are also in debt. I don't know what the tipping point for social tolerance is but America must be close to it or past it wrt obesity.

So IMO changing the environment to make it that bit harder to become fat is a step in the right direction

TW

IMHO - while I am a huge fan of exercise- it is likely to be less than half of the solution.

I think it is no coincidence that obesity rates begin their inexorable rise in 1976-80. Our secretary of agriculture, Earl Butz, was at the helm from 1971-76, and clearly did all he could to set up the system we suffer under today. So for me, health care reform begins at the department of Agriculture, then perhaps as soon as possible should spread to the department of Transportation.

It is also possible that exercise took a nosedive in 1975, and that driving took off at that time. I don't find much evidence of that, though. Here (http://www.its.ucdavis.edu/publications/2002/UCD-ITS-RR-02-05.pdf) I found one VMT graph (page 33) that goes back to 1966. It does not appear that there is a direct correlation between the obesity curve and the VMT curve.

Yes we find that people who live in areas with poor walkability are more overweight. And yes, there is data to support that moderate exercise, about 1 hour per day (3 miles?), prevents weight gain with age. It turns out that biking to work, walking to school ARE indeed exercise. Biking up a mountain and digging for 8 hours a day constitute excessive physical activity that (Day-in, day-out) will result in physical damage to joints (well, nowadays, anyway).

But I won't draw conclusions. This is a multifaceted problem. Back in the 1990's it was apparent that obesity rates were climbing fastest in college-educated men in their 20's. My hunch was that the internet was playing a huge role. Well in retrospect that would also be a car ownership demographic.

It is also likely that obese people drive more because they have to carry so much. Can you imagine strapping on a 100 lbs backpack to go to the corner store? Hoisting yourself in and out of your car is enough strenuous effort. You'll require an additional 1000 calories just to get yourself to the bathroom a few times a day, and you won't get that from carrots and celery - back to the fries, then. It's just reality - I'm not trying to be harsh...

Then of course, a few days ago we had a discussion in the DB about depression being a common diagnosis in the US. Food, especially fatty food, not salad, is a way to numb unpleasant feelings. It is one place people who feel terrible can experience abundance. People who know they don't really count in the eyes of TPTB, can literally choose to take up more physical space.

I'll be working on a post that takes as many influences as possible into account. Either at www.ecoyear.net, or at www.ediblefrontrange.com.

Make sure you announce it here when you do.
(on a current thread, of course..)

Bob

Paranoid,

I believe you have put your finger on a major point.Once obese,exercise becomes painful and as you say,even a normal activity such as walking becomes strenous.

Positive feedback loops are real killers sometimes.

Every thing I have read that seems credible to me is consistent with your comments about self medicating with food.

This is a subject I have recent real world experience with. After having a heart catheterization, I was told I had some artery blockage, and needed to work on some lifestyle changes. My blood sugar was also considered high, not diabetic, but getting there. I have a long running hereditary condition of extremely high blood pressure (shared by most of fathers relatives) I a 50 year old male, about 5 foot 5. At the time of my cath (about a year ago) I weighed 172 pounds. The doctor gave me no instructions concerning weight, but simply said the sugar, flour and fatty foods needed to come down.

I stopped all sugar intake. This was easier than you may think, because I was getting 1600 calories per day in sweet tea alone (note that sweet tea is very common in the most obese areas of the U.S. south). I switched to diet drinks and Truvia, the artificial sweetener made from the Stevia plant. I stopped eating white bread for the most part and went to vegetable fiber bread. I stopped the eggs, beef and other fatty foods for the most part, but the biggest change was the ommission of white flour and sugar.

The Japanese have used sweetener from the Stevia plant since 1971, about 37 years, and seen no ill side effects. Some have argued that the only reason it was outlawed in the U.S. until recently is due to the power of the sugar cane and corn sweetener lobbies.

With no set goal of weight loss, I have gone from 172 to 125 pounds. I have not changed anything else concerning lifestyle, exercise, etc.

There is no doubt in my mind that the automobile and the fossil fueled transportation system have many faults. However one can easily come across as a crank in attempting to tie America's fat to the automobile. It is usually the logic of the anti-automobile ascetic who would blame crabgrass in the yard on the automobile if the opportunity presented itself. There are easy causal relationships that are much more direct between sugar, corn syrup and the food producers who make it very difficult to find real alternatives to the fattening options, even when the do exist.

RC

It is also worth noting that the environmental and energy impacts of sugar (and corn syrup) consumption are immense. I suspect that the average American could more easily lower their energy/environment footprint by reducing sugar consumption than by making changes in their transportation methods. The same goes for meat and processed foods.

I have never understood why people shout that ethanol is murder, but think nothing of sucking down some 13 teaspoons of sugar in a soda. I'm not a huge ethanol proponent and certainly think corn as a source is a fraud. But sugar and corn syrup still seem like a better candidate for murderer then the use of those same crops for fuel.

"I have never understood why people shout that ethanol is murder, but think nothing of sucking down some 13 teaspoons of sugar in a soda."

Maybe because it took somewhere well north of 700 teaspoons of sugar to make the gallon of E85 they might have burned to run to the convenience store to get the six-pack of soda. Sometimes sheer magnitude does count for something.

As long as the trip used less than 78/700 of a gallon magnitude isn't relevant in this case. And the consumer likely spread the gallon of gas over a lot of shopping. It would also be difficult for the consumer to completely replace his/her car and alternatives would in most cases just reduce the impact. Soda on the other hand is pure waste.

According to this article, the average American uses 142 pounds of sugar and 61 pounds of corn syrup per year.

http://health.usnews.com/usnews/health/articles/050328/28sugar.b.htm

This may account for somewhat less energy than per capita fuel use, but it, again, is pure waste. Americans could cut that in half tomorrow and be no worse off.

I would wager that a similar cut in transportation related energy would be a lot more painful.

I've just trained myself to drink my iced and hot tea plain, without any sweetener at all. After a while, you just get used to it and it is just fine. I also just keep a pitcher of plain tap water in the refrigerator, and find that to be more refreshing than soda pop (which I really don't care for now that I've weaned myself off of it). I do still enjoy drinking 100% natural, no sugar added, fruit juices, but try to go easy on those.

I keep several jugs of charcoal-filtered water around the house and it's great stuff as-is. Sometimes a little squeezed lemon into the container. But the jugs I find most useful are the 2-liter soda pop bottles, and every couple months I get a fresh one since algae starts to grow in the old ones (it's the climate and the bright house).

So last week I bought my wife a couple of 2-liter bottles of "Dr. Skipper", a safeway-brand Dr. Pepper knockoff she likes... she's incredibly fit and loves the stuff, and doesn't often get it. But a terrible thing happened; having a very hot and humid spell out here, I was aware that there was cold sweet carbonated ceffeinated soda in the 'fridge when coming into the house sweaty. Danged if I didn't drink more than half of it.

I think next time the containers will be seltzer water. Some stuff has no business in the house.

It's good to see this kind of connecting-the-dots going on. Despite the stupefying availability of "facts" and "data" and "information" - and yes, a great deal of "mis-information" too - nobody much seems very willing, or even able, to draw conclusions from any of it, at least not out loud. But, without some kind of context, all this "information" is useless, just so many isolated fragments of a giant jigsaw puzzle.

Connecting the dots - drawing conclusions - seeing the context - making judgements - putting the puzzle together - these are the faculties we really need to be exercising. Developing and strengthening them could - should - be the highest priority of real education, not the social conditioning and baby-sitting goals that what we call "education" (at all levels) is now committed to.

From the connections made in this particular instance, I think we should be able to draw the conclusion (among many others) that piece-meal solutions are not really solutions at all. Obesity, land use, transportation, and healthcare reform are not isolated, unrelated issues, and to approach them as such is futile and a total waste of time, energy, and resources.

Good post, Glenn.

Connecting the dots - drawing conclusions - seeing the context - making judgements - putting the puzzle together - these are the faculties we really need to be exercising. Developing and strengthening them could - should - be the highest priority of real education, not the social conditioning and baby-sitting goals that what we call "education" (at all levels) is now committed to.

Dream on! I'm afraid that if the average person were able to think critically there would be an attempt to overthrow TPTB in a very bloody revolution. The education system is gamed to turn out brainwashed sheep, which are much easier to herd and then shear.

"Connecting the dots - drawing conclusions - seeing the context - making judgements - putting the puzzle together - these are the faculties we really need to be exercising. Developing and strengthening them could - should - be the highest priority of real education, not the social conditioning and baby-sitting goals that what we call "education" (at all levels) is now committed to."

Nicely put. Almost verbatim what I have stated as my goal as an educator (with, of course, the ancillary goal of the overthrow of TPTB in a very bloody revolution ;-)

Thanks - that's exactly the point here. Taking on healthcare cost inflation alone, without looking head-on obesity, land use policies, transportation modes and food systems is not going to work. We need whole systems approaches to these complex problems. And it's not just government - it's all institutions.

Employers, churches, schools, etc all need to live the values that they preach. If you're preaching healthy mind & body on the pulpit, but serving donuts and coffee cake after the ceremony, you're clearly not living out your values. If you own a business and worry about your healthcare premiums, take a look at what they serve in the cafeteria at lunch and maybe clear out some space for a few treadmills...

Glenn;
Thanks for this topic.

My wife just watched the film 'Two Angry Moms', which was followed by a conversation about the food programs at the Portland Maine Public Schools. Our daughter starts in First Grade next year, and we've learned that the main drink available at lunch is Chocolate Milk. (!!)

Are you sick and tired of packing your kids’ lunch box everyday because the cafeteria food is unfit for human consumption? Do you feel guilty when your kids “buy”? Are you annoyed at all the junk being handed out and sold at school? Are you angry enough to do something about it? We are!

Two Angry Moms is a documentary that asks the question: What happens when two “fed-up” moms try to change the school lunch program?

http://www.angrymoms.org/

One thing the MSM harps on when they talk about obesity...and it is true...is the fact that healthier food simply costs more than the junk. You can easily pay over a dollar for a single apple, for instance, while a dollar will get you a bag of chips or a 44oz soda at the gas station, or some fries at Mickey D's. Thus, you get more bang (bulge?) for the buck with the unhealthy food, and that's why a lot of the rural poor around here (West Virginia) spend so much time at the fast food or buffet joints.

It mystifies me why fresh produce should cost so much more than most processed foods. Are transport costs that much more for produce, do the economics of scale work in processed food's favor, or is it something else?

In your example I fail to understand why these 'rural poor' people can't simply grow apples -the last time I looked growing stuff was cheaper (free) than a 44oz soda or MickeyD fries...

It's down to habit IMO -bad ones. You have to consistently over-stuff your face to get fat. Sure even the healthiest of us has the odd bad or stressful day but not 24/7/365...

Another aspect to explore is "generally agreed societal norms". Its only when you step out of your norm that you realize its not normal. For example I am not overweight but on a recent trip to India felt positively obese with all these thin people walking around me. One well-to-do obese Indian Business man stood out a mile in this crowd.

Nick.

"It mystifies me why fresh produce should cost so much more than most processed foods. Are transport costs that much more for produce, do the economics of scale work in processed food's favor, or is it something else?"

There is a long and complex history behind these prices. Try any of Michael Polan's books. Basically, grains that can easily be stored and traded as commodities, and especially corn, have long been hugely subsidized, originally as a way of helping farmers through hard times, but now as an entrenched system of big agribusiness corporate welfare.

You cost example is typical of a Quickie-Mart, 7-11 type price. A bag of 12 apples cost less than $4.00 in St. Louis.

The main three causes for obesity IMO:

1. lack of exercise/physical activity at home, at work (or going to/from work) and during leisure activities (rather play on X-box than play baseball or go to the park)

2. Proliferation of cheap high carb fast food.

3. Great variety of pre-cooked and packaged food at the grocery store, which imitates fast food.

Growing up in the 60's and early 1970's we had outdoor activities every day, during school and during summer break (I lived in Minnesota). Kids today don't have as much outdoor play, especially with parents dictating nearly every activity, and supplying modern games that require sitting down. The typical grocery stores were much smaller forty years ago because they did not offer so many pre-made foods that today are high in additives, corn sweetener, and preservatives. More food (meat, vegtables, dairy, etc.) was bought fresh or frozen and made into a meal. And lastly, many people accept being fat as "part of who they are and who their friends are".

Produce of all kinds that can be produced in quantity in many parts of the country is very cheap in season at the wholesale or farm level.

But produce is not easy to package and ship compared to junk food.It's heavy, odd shaped,highly perishable compared to the REPUTEDLY immortal TWINKIE.

The supply is highly variable in the sense that matters most as far as day to day business is concerned-at the farms where it is grown,at the processing plants where it is canned or frozen,or just washed and boxed for shipment.zillions of bucks in eqiuipment sit for most of the year in the ag biz.

The harvest season for corn ,wheat, and soybeans is sort,and a 250 grand combine is as useless as a pig saddle the rest of the year.But grains store VERY well.Losses are usually only a miniscule percentage of the harvested crop.

Produce losses begin on the truck coming in from the field and more is lost every foot of the way thru the delivery and sales system.In poor nieghborhoods that still have supermarkets,you can buy four or five pounds of mixed fruit still edible for a dollar lots of times but in more prosperous nieghborhoods,everything that is not COSMETICALLY PERFECT is automatically dumpstered or in a few cases,donated to a charity.

A lot of hand work is inevitably involved at every step of the marketing cain as a result of these factors,and nobody has figured out a way to sell apples the way you can Twinkies.

The next time you watch your Mom or a customer at a buffet take a serving of food from a big pan ,watch her stir and mix and remix and finally ladle up a serving.

Mom would be shocked of course if I were to point out that she is not likely to find what she doesn't realize she is looking for-bugs,sticks,stones,rotten bits and pieces and anything else that might be found in food gathered from the fields.The fact that she prepared the dish herself is no defense against this built in behavior.

Customers won't even BUY produce from a bin that is not reasonably full-OBVIUOSLY it has been PICKED OVER and all the GOOD apples are GONE!

So produce gets rolled and tumbled and squeezed and pinched in the bins until a good bit more is wasted.Or it gets the cardboard and cello treatment,which costs MONEY but reduces waste of PRODUCE.

Otoh you can examine two TWINKIES all day and find no differences,and they move right off the shelf-or sit there,it makes very little difference,excepting the almghty sales per square foot metric.

Nearly everything that falls into the junk food category is well suted to completely mechanized production,packaging, and distribution.Excepting the fast food sold at cheap restaurants,it's all perfectly suited to self service shopping.

It's actually cheaper than produce most of the time,in terms of tummy satisfaction ,because of these large scale economies,than an apple or an orange,purchased individually.

It's not as messy either on the average.

And although it seems to me that we have more than enough people in positions of trust and authority telling us whoppers with a straight face,the well meaning folks trying to tell us that veggies are "nutrient dense" they are just trying to manipulate us -at least thier intentions are good.

Fruits and veggies DO CONTAIN a large number of vitamins ,minerals,and assorted bio-molecules that are either ESSENTIAL to our health ,or at least very very good for us.There are plenty of excellent reasons for eating your veggies and MY apples.

Unfortunately is it a lot easier to "brand" a hamburger than it is an apple.(I am only mildly amused whem folks call me "big mac")

But(and this is CRITICAL if you don't have very much money),beans and bread and rice and cheap meat-chicken leg quarters for example are much cheaper in terms of the two most important nutrients of all-calories and protein.

On top of all these difficulties besetting the poor truck farmer(the wholesale retail chain could care less as long as they have SOMETHING to sell or haul,etc)we must add in the various unfortunate dietary influences pointed out by every one else commenting today.

The fact that we have been TRAINED to eat junk food is the biggest of these.When I have tried to sell VERY GOOD FRESH APPLES off the tailgate of my truck at a local furniture factory parking lot,only a few older women will buy a half a bushel at twenty cents per pound."too high" is a common comment-this from a man drinking a ten ounce sugar water he paid seventy five cents for on his way out the door."don't have time to put 'em up" is another."my boys won't eatem"

Out of five hundred people,only two dozen or so will buy first class apples for tweny cents per pound. And these are people living from check to check for the most part.

Out of that two dozen,recent Mexican immigrants are heavily over represented.

I could go on for days but I'm not getting paid.

Got another minute now.Eating is a pleasure that makes helps compensate for an otherwise dull life.

And eating to excess is thought (believed ) by some experts in medicine /mental health as a form of self medication.

A comment on how people will not buy produce from a mostly-empty bin at the supermarket even if the remaining produce is fine:

People are less likely to buy boxed, manufactured products off shelves if there is only a few left, unless they absolutely need the product. This is what every employee at any big-box retail establishment is told, which is why we have to spend so much time "facing" (making shelves appear full even if they are not). In fact, when the first Home Depot opened, the founders were unable to buy a whole store worth of inventory. They were so concerned with making the store seem full, that when stocking the store for the first time, they saved the empty boxes and put them in the overhead shelving to make the store appear fully stocked.

There's no mystery. Fresh produce is fragile and perishable. This means that produce, if it is to be useful, has to be transported more or less on time, which, as I like to point out with respect to bus service, seems to be an insurmountable problem in the USA, where certain jobs tend to be dispensed politically-correctly as charity sinecures for the stupid and lazy at the bottom of the Darwinian barrel, instead of being filled by those who could actually get the work done properly and on time. It also means produce has to be handled with care, which is more time-consuming and therefore expensive, and requires a little more thought, than just stupidly and indiscriminately heaving nearly indestructible boxes of foodlike objects off the loading dock and slamming them down onto the concrete. That, in turn, gets us right back to the same seemingly unsolvable problem we have with on time.

The obesity epidemic will only end when the cheap energy starts to run out. It's not just that people will be forced to use their cars less & will be more reliant on other forms of transport. It's the staggering amount of energy that is used to produce and transport our cheap, industrially processed food. It's not sustainable. This article - about comments made by the UN chief climate expert - makes for very interesting reading. I quote "It requires four calories of plant protein to make one of chicken protein, while the ratio for pork is 17:1; for lamb, 50:1; and for beef, a staggering 54:1."

http://www.guardian.co.uk/environment/2008/sep/07/food.meat

Good point. And, vegetarian diets protect against both obesity and diabetes.

"The 5-unit BMI difference between vegans and nonvegetarians indicates a substantial potential of vegetarianism to protect against obesity," the study authors write.

http://www.medscape.com/viewarticle/702782

It could also reflect that vegans simply cant put on muscle mass.

The amount of calories is one part of the problem. However, it is a now know that dietary free glutamates (MSG, hydrolyzed proteins) that are used as flavor enhancers play a large role in obesity:

http://www.sciencedaily.com/releases/2008/08/080813164638.htm

Just look at all the creative names they give glutamates so they can hide it in your food:
http://www.truthinlabeling.org/hiddensources.html

The glutamate promotes insulin release which tells the body to store calories as fat.

Right. Which is why the Japanese, who have for a long time used soy sauce fairly liberally for its umami flavor that comes largely from glutamates, have a tradition of being obese. I dunno, this looks to me like yet another politically-correct excuse for those who choose to make dysfunctional selections and decisions. Just go to the grocery store, and when the fat indolent slobs waddle by, you will almost invariably see them carting high piles of calorific treats that would make anyone fat in such vast quantities, irrespective of minutiae such as glutamates.

Yes, they use a lot of soy sauce, however, the rest of their diet is free of all the other sources of dietary free glutamates. AND they also eat less. In the US we eat more and more DFGs.

And obesity is rising in Japan as kids eat more of these DFGs;
http://www.nature.com/oby/journal/v12/n2/full/oby200427

And why do you deny the research?
http://www.sciencemag.org/cgi/content/abstract/164/3880/719
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid...
http://www.ncbi.nlm.nih.gov/pubmed/6493048

But hey, I know two people who could not loose weight till they stopped eating DFGs.

AND they also eat less. Bingo, at least until quite recently, and that makes a nit-pick of every other factor but one.

The remaining and really important factor is the abnegation of social control, same as here in the USA and in Europe. This is not and never was a matter of stationing food-police at every supermarket cash register, but a matter of social non-acceptance. Less than two decades ago, even modestly overweight people received negative social "attention" in Japan.

When I saw it, it was always very polite, though often not particularly subtle, but most of the visiting Americans (who tend towards obliviousness to their surroundings) failed to notice. More recently, Western political correctness has been creeping in, and once that happens it should be no surprise at all that dysfunctional behavior increases by leaps and bounds.

I'm not going to bother affirming or denying this "research", as it would be an utter waste of time. Instead I'm going to bin it with "research" into caffeine. That's all over the map from "suppresses cancer" to "causes cancer", apparently pure noise driven by a claque of would-be social engineers who seem to despise coffee with a totally weird and incomprehensible passion coming from I know not where.

In other words, I'm going to take the "research" with a grain of salt - nay, with the whole salt shaker - for as long as the subject matter is charged with political correctness, driven in part by the endless quest for excuses for moronic dysfunctional behavior and in part by a futile hatred for "big business" (which isn't going away with seven billion on the planet.) And as I implied, I'm going to attribute the problem itself mainly to the abnegation of informal social control, carried out in the interest of political correctness, i.e. on behalf of the same old concept that somebody or something else is always responsible for one's poor behavior, entitling one to claim the exalted state of victimhood, in turn entitling one to reach for the real holy grail, cash from someone else's wallet.

I did not say it caused cancer. I said it causes weight gain. My friend who works in biotechnology turned me on to the research. They GIVE the mice MSG to make then obese. Do you discount all research?

And isn't it personal responsibility not only to watch how much you eat but also WHAT you eat? Eating bad food is the same as eating too much. Choice without knowledge, isn't that what got us into this oil mess? You seem to be projecting something onto what I am saying. Eat what you want, suffer the consequences.

Looks like a pretty simplistic analysis to me. There are serious obesity issues within the inner city population, too. And these folks aren't exactly married to SUVs. I believe there are food "addiction" issues as well. It's very hard for people to control their diets by employing self control.

As an aside, I have found it very surprising how little I need to eat as I have gotten older. I work a full time job and lead an active life which includes some pretty strenuous outside work around the house. But I have found (at age 58) that eating any more than two (small) meals per day will just totally pile on the pounds. I have been able to hold my weight down below 150lbs (I'm 5'9" and pretty fit), but it's very difficult to do. Vigorous physical activity will help a lot in controlling appetite, but it has to be regular and pretty intense. Most people don't lead lives where this level of devotion to exercise is practical.

"There are serious obesity issues within the inner city population, too. And these folks aren't exactly married to SUVs. I believe there are food "addiction" issues as well. It's very hard for people to control their diets by employing self control."

This is also fairly simplistic. What kinds of foods are available to people in these neighborhoods? Lots of fresh vegies and fruits and whole-grain foods?

Nope.

These neighborhoods are called food deserts by nutritionists and activists, because the only food available for many miles is highly processed and nutritionally deficient. Check out anything by Van Jones on this.

Your point about age and food/weight is well taken. I've read (can't remember where right now) that if people continue to eat and exercise at the same level, then they will gain one pound every year after 35 (if I remember the age right). Only a reduction in caloric intake or an increase in exercise (or both) will counteract this dynamic.

Yup. That's my whole point. I didn't read anything about "Food Deserts" in the original post.

There are a lot of factors influencing America's weight problem. Let's not just try to dump it all on "suburbia".

Frankly, I think it boils down to an uncontrollable craving for fat and sugar (largely biological programming). And bad habits; we learn at an early age that we "need" three "square meals" per day. Our moms teach us this, and it's WRONG. We don't need three square meals per day, especially as we age. But once we have spent our youth and young adulthood eating this way, we just keep doing it by habit, all the while claiming, "I DON'T eat THAT much!"

jabberwock

You've hit the nail on the head when you say it begins at an early age. But not with the 3 square meals, rather with the snacks given to kids between and after those meals. As a parent it takes a lot of effort nowadays to not give in to the tantrums for sweets, chocolates, crisps etc. And the saddest statistic shown is the one showing childhood obesity trends.

I'm by no means perfect but I do usually, when my kids come to me complaining of extreme inter-meal hunger, offer them some fruit. It's strange how often the extreme hunger evaporates. And on the occasions they really are hungry then lo and behold they actually eat the fruit. Amazing innit!

As for so many things, what we learn as children we carry with us through our adult lives.

TW

I like your point about three square meals. At www.myfootprint.org one question is how many large meals you have per day. Most people only need one at most unless they are engaged in very hard labor. And it is surely true that it's not all merely about suburbanization. But if it's "largely biological" we should expect obesity to be rampant in all countries that have populations living above subsistence level. While there are some problems world wide, the problem is much more severe in the US than in Europe or Japan.

Here as elsewhere, we must ask the Latin question: "Qui bono?" Who benefits? Who is making profit from pushing lots of not very nutritious food on the population?

Yeah, as I said in the comment right above you, most food that is consumed by lower income folks is filled with dietary free glutamates.

There is no amount of exercise that gets rid of fat added by hormonal signaling.

For me the trouble with this is that it's about purely voluntary behavior that, when we get down to brass tacks, is really none of my business, until someone shoves it in my face in the name of political correctness. It's a lot like so many others who dislike suburbs or so-called "sprawl" for abstract and sometimes incomprehensible aesthetic or philosophical reasons. Since no one else needs to care about said preferences (some say to-may-to, some say to-mah-to), the only way to start conversations is to resort to extraneous arguments (after all, Jim Kunstler would still dislike suburbs even if the Earth did have a creamy nougat center of oil, but take away the oil trope and hardly anyone would see a need to care.)

In this respect, phony medical tropes are especially useful. They lend themselves well to arguments for for unjustifiable coercion and meddling, simply because people are already used to doctors having (legitimately and needfully) social license to engage in procedures that would otherwise constitute egregious felony assault, and to make social recommendations that would otherwise be instantly rejected as blatantly objectionable tyranny. Thus any objections may be conveniently self-censored almost before they arise (kneel and bow down before the holy of holies, we're talking public health here, and that trumps all else.)

At the end of the day, I don't even buy the medical trope that obesity is costly; it may well be quite the opposite. People who stay fit and linger on long after their minds are utterly dead risk being far and away the costliest, as they are the ones who will hoover up the most pension money and likely the most nursing-home money as well. Nor do I really buy cause-of-death arguments. The exact cause scarcely matters any longer because today's culture (at least in the USA) insists on providing "care" around the time of death going far beyond what is of any value whatsoever, even far past the point of simple blatant inhumanity. As a result, nearly everyone will die at prodigious and most likely obscene expense and suffering, irrespective of weight or physical fitness.

This seems to leave a choice of focusing on the money - and therefore perhaps being obliged to encourage people to eat in a way that may help them die young - or else minding my own business. So my basic attitude tends to be to leave it that if the fat indolent slobs come whining for free double-wide seats at the theater or on the airplane, they can pay for their own damned seats in full or else stay home - or else they can simply choose to stop shopping and eating like pigs, end of story. And should they come whining with all manner of airy abstract twaddle about how the big ("big" is an ever-handy rhetorical curse-word) wicked food industry is trying make them do themselves in - no doubt by issuing subliminal orders from radio receivers in their teeth in the dead of night - they can jolly well buzz off and heave their gargantuan bulk to a different part of the store that they already shop at. And if they come whining that it's easier for the next guy not to overeat, well, they don't actually know that at all, but they can jolly well take it to the Devil anyway because nowhere is it written that every person shall be guaranteed absolutely equal ease in life.

And if, on the other hand, they're not coming whining, then there's not much of an issue. Yes, there are a tiny, tiny handful with terribly diseased or defective metabolisms, but beyond that, the feckless will always be with us (in our wisdom we've switched off both natural selection and social opprobrium) and I need not make their choices my problem. So in the end I'm inclined to play deaf to the sniveling and whining - and I'm not inclined to enable the crybabies and whiners with special sympathy, monetary handouts, or costly 'accommodations'.

Paul,
I have been following your comments for a little while and generally you seem to have your head on straight.

And I agree with your rant today -until I remember that I have changed my mind about the will power paradigm.Once upon a time I believed all the standard WASP theology about work,industry,second class citizens and races,etc.

It just ain't so ,Joe.

My eyeopener came when I read for the fourth or fifth time the story of Nigger Jim and his deaf little girl in Huck Finn.(Anybody who believes Twain was a racist is ignorant of his work and/or utterly lacking in any understanding of historical context)

A black man(to me when I was a kid) who took life as he found it and made his journey thru this world as painless as possible was OBVIOUSLY WORTHLESS-ELSE WHY WASN'T HE BUSTING ASS like my own Daddy to get ahead?NO WILL POWER,OBVIOUSLY.

It took me some time to figure out that in the local society we lived in at the time,his chances of getting ahead were about as good as mine of becoming a professional athlete-so small as to not be worth bothering.It took no time at all after that to realize that most of the "worthless" people were working thier butts off forever,for next to nothing.

Will power is not the key to obesity.I have known quite a few obese people who have shown that they possess enormous will power-sticking to hard tough nasty jobs,standing by scumbag spouses for the sake of a kid,looking after an invalid relative for years on end without a weekend off.Bearing great pain without complaint in other cases.

Most of them have dieted,unsuccessfully.

You impress me,iirc,as a person with some understanding of science.

The science of the human brain is such that the gray matter is not the boss.If your genes dictate that your hormone balances are such that you will be obese if you over eat,and that you will overeat if food is available,YOU WILL OVEREAT AND BECOME OBESE-if the food is available
and your lifestyle is such that you don't need the extra calories.

Within the last two hundred years,people who were obese in THIS nieghborhood survived a winter with very little food and were still in good health in the spring as the result of military foragers cleaning out the barns.Any personally oriented civil war hstory will fill you in on the details.I don't know for sure that anyone starved ,but it certainly happens regularly in many places in the world. BODY FAT is your friend,in terms of the biochemical computer "operating system". The neocortex cannot override most lower brain functions.This is one that apparently cannot be overridden in most cases.

True enough, but it does NOT explain the startling rise in obesity since 1960 (see CDC graphic in article above).

Alan

Hi, Mac. I'm choosing to partially disregard the "science" here and in another comment elsewhere on the page, because for this purpose that science is like a lot of financial-accounting data - true on its face, calculated to an absurd number of decimals, and of functional use. In the end, genes are only a part of destiny and they simply do not force one to stuff every treat on the supermarket shelf into one's face all in one go. Nor can they force anyone to pile the cart high with cardboard boxes - for precisely the same reason you never heard of the goo-goo bird, which feeds exclusively on railroad ties. Similarly, the history of evolutionarily recent times, i.e. all of recorded history including everything that can be called military, is only a part of destiny and virtually nothing of genetics, so it too is hardly an excuse.

Anyone who can function as a human being has a neocortex, which, unless it's mutant and defective, affords a very considerable range of choice unavailable to a mere animal (which can function merely as rather little more than a preprogrammed motile GI tract.) Among other things, said neocortex is capable of enabling one to realize that stuffed full to bursting is a feeling one need not seek all the time. The problem with the lumbering whales at the rest stop is that they sought that feeling at that rest stop and the one before and so on ad infinitum. Neither the rest stop nor their genes forced that upon them.

So I will agree that the range of choice is not quite infinite; some people will never be svelte, and a tiny handful with seriously mutant metabolisms may be best served by high-risk "treatment". However, the original trope up top, which IMO was being used to call for the wholesale rearrangement of the entire built landscape as a matter of Big Brother Knows Best social engineering, was rather widespread obesity among human vacuum cleaners who made their choices. In the end, I think I'll remain mostly tone-deaf to the political correctness on this matter, to the whining and moaning of irresponsible crybabies who simply don't feel like using their neocortexes because they deem it to be too much effort compared to watching moronic rubbish every day on 'reality' TV while downing 32-oz jumbo sacks of munchies and 64-oz slop-buckets of sugar water. Yes, genes may make it slightly harder for some than for their neighbors - IIRC the typical range of variation might amount to a whole teaspoon of mayo a week. But no one was guaranteed equal ease in this life, so tough noogies.

Paul,the stuff I'm talking about is not pc bullshit.It's hard biology the way it is taught in major universities these days.Kinda like DARWIN was taught a century ago.

Of course a certain percentage of us have the combination of genes and will power to refrain from overeating.

A certain percentage can stuff themselves every day and stay skinny.

I begin to think that you know all the "science" that supports your pov and none that doesn't.

A little self test here for you: how long has it been since you CHANGED your mind on a serious cultural/scientific issue?

But if you think your neocortex can override your lower brain,just try to stop breatheing some day.

I gaurantee it won't kill ya.

The brain is a work in progress .
It has no built in brakes or governer to control overeating because there has never been a time when one was needed-. until now.
Kinda like houses in Key West don't have furnaces and houses in Fairbanks don't have air conditioning.
If we have a new ice age,folks in Key West....
If global warming gets bad enough,folks in Fairbanls.....

The principle involved is Occam's razor.

You just go with the simplest explaination that gives you a good fit with the known facts.

There is no built in tendency to exercise for the fun of it,like sex,because again there has never been a need for it .

The Japanese are getting bigger and fatter fast.
They are eating more,what do you expect?

Evolution does not create unneeded features.

But there is a lot that is still unknown for sure.
The junk food business has managed to discover cracks and chinks in our metabolisms that allow certain foods,and combinations of foods,to respond to them as we do to habit forming drugs.

The extraordinary successful marketing of these products here in the states,combined with our cultural shortcomings-ride never walk,television versus playing outside etc-is sufficient explaination of the difference between European rates and American rates of obesity.

But I could be wrong.

I 'm just a crabby old farmer who knows that the vast majority(all?) of mammalian SPECIES put on wieght whenever food is plentiful.

There is no good reason why we should be an exception to this rule.

Unless perhaps one is of the opinion that we are made of different stuff.

The family resemblence of "God ",as he exists in the minds of Christian theologians, to a chimpanzee is simply astonishing .

This is not to say that any particular person is a fundamentalist ,but rather that the stereotype of who and what we are,in most peoples minds,is still determined by the religion of thr King James Bible era.

There seem to be two arguments presented here:
1) Fossil fuel energy, big agriculture, sprawl, TV, car culture, fast food etc... Causes Obesity
2) Obesity creates higher costs to society

Most of the discussion has revolved around #1

But Id like to understand #2 better. Weve seen some statistics about how much Obesity is costing us in healthcare dollars. Weve also seen how much smokers cost in healthcare dollars.

Folks often fail to see the other side of the healthcare coin though. Smokers and Obese people die in their 50s and 60's. Fit healthy people die in their 80's and 90's. The average life expectancy is about 76. What is the cost (in energy terms as well as financial terms) to society of supporting those fit but old people for an extra 30 years? Then after 30 years they get Alzheimers, or cancer or some other disease simply from being really old, diseases which will cost just as much to treat.

perhaps if the goal is to reduce waste, control healthcare costs, reduce population and reduce total energy consumption we shouldnt be fighting the smokers or the obese? After all they are basically committing mass suicide. We should send them a thankyou card (made on recycled cardboard of course)

I have traditionally been overweight, but with a healthy walking habit and "decent" fitness (3 mile walk would be close to my limit without a break). I lose weight when eating at home, and gain weight when eating out in New Orleans (which I love !).

However, the months with my mother's final illness put "the Fear of God" into me. It was not so much the other patients in the doctors offices in Kentucky, but their family members that scared me.

Since returning home, I go out at dawn, work in the yard for 30 to 90 minutes, break a good sweat & elevated pulse, come in, drink a glass of water then a half glass of orange juice and take a bath. 4 to 5 times/week. Added to my walking I hope that it is enough (plus no eating out). If not, then I will do more.

Better fitness first, then reduced weight are my goals.

Good to see the hundreds of bicycles that pass my place every day :-)

Best Hopes for those that see,

Alan

Good to see you so inclined; I'm already in fair shape, but am doing more each day also. I would suggest, however, the fitness and weight loss would go hand in hand.

Well, I'll likely always be overweight. I'm not sure what overweight means for me given I'm 6 feet and just over 100kg, and likely to stay that way for a long long time. But dropping my bodyfat from 25% to 15 is proving to be a hell of a lot of work.

To further this, I think there should be more restrictions on drive-thrus. Make the person exit their car for their Big Mac or to make their bank deposit. It would help with obesity - if it was just as convenient to get a salad as a cheeseburger, maybe they would opt for the salad every now and then. And it would help with air quality since multiple cars would not be sitting idol for 3-10 minute stretches. Have you ever driven past a fast food drive-thru at breakfast time? Cars are wrapped around the corner, emmiting fumes, polluting the air as they wait to pollute their bodies.
There would have to be some exceptions - the elderly, the disabled, women with small children in the car, etc. But overall I think we would see a large (pun intended) difference by restricting drive-thrus.

There would have to be some exceptions...

Oh, yes, I can see it now, the minimum-wage high-school student at the remaining window peering into the dark recesses of the car that pulls up, trying desperately to administer a complicated set of "exceptions". How small a child is small enough? Do people post child-age tags on the corner of the windshield, or does the poor student have to guess? If they put their strapping teenager on a booster seat just before pulling up, does that qualify? Is the mere presence of a 'disabled' tag excuse enough even when it's blindingly obvious no one actually present has the slightest need of it, as it is with parking spaces? As more and more people both double up on the use of cars and ferry their aging disabled parents around, mightn't most cars still on the road wind up with such tags? Oh, the lawyers must be salivating at the prospect of endless billions in multimillion-dollar "discrimination" lawsuits.

At the end of the day, that sort of thing is the trouble with a lot of social engineering. It tends to become - and quickly - a hodgepodge of unenforceable nonsense that corrupts governance and enriches lawyers while perhaps even backfiring against the stated goals.

At the end of the day, that sort of thing is the trouble with a lot of social engineering. It tends to become - and quickly - a hodgepodge of unenforceable nonsense that corrupts governance and enriches lawyers while perhaps even backfiring against the stated goals.

Many of your comments seem to worry that social engineers will attempt to engineer away suburbia. But suburbia as it exists in the US is largely a product of social engineering in the form of building codes, occupancy and use restrictions, minimum street widths, maximum floor-area ratios, etc.

So long before a "Nanny Government" starts ordering people out of their SUVs, US governments could remove or relax the many regulations that enforce the suburban physical layout. Even here in bike-friendly "green" Boulder, most neighborhoods are mandated to have single-family houses, with off-street parking (whether or not a car is owned). More dense, mixed-use buildings are allowed only a few places. In other US cities the regulatory requirement for suburbia is even more strict.

I’m always a little troubled or dubious when I read mainstream studies or essays on obesity or overweight.

It appears to me that the framework in which the issue is set is purposely too narrow. It is mechanistic, quasi-Victorian, based on the calories in (food) and calories out uniquely in the shape of exercise. Exercise - sport, gym, walking, etc. - represents only a small part of calorie expenditure in any case, and it is on the whole a leisure pastime, so even seen under the light of the paradigm itself it is faulty because incomplete.

Within this frame purposeful activity (eating, working, thinking, running around taking care of kids, doing laundry, chopping wood, etc. etc.) vanishes leaving us with a passive being - with very odd in> and out< arrows.

The only other actors who get a starred mention are the food industry (with agriculture sometimes, but usually just fast food, corn syrup, etc.) and advertisers. Sometimes - the car, driving (vs. walking etc. as here.) All this does is reinforce the narrow paradigm and throw the problem into realms that are in a way intractable - personal responsibility, will, determination; the evilness of the profit motive and ‘empty’ foods, the craziness of suburbia, etc.

Some ex: Social: All the social aspects of eating are left out. From the end part of the chain; how food is bought, transported, stored, cooked, how meals are planned, how they proceed, what is done with waste, etc. etc. Psychological: The idea that obesity is related to unhappiness (stress, abuse, grief, unemployment), mentioned above by sidulin isn’t explored enough. Cultural:....fill it in..

Anyway, so a study showing that those who live in more ‘walkable’ communities weigh less seems a truism, as pointed out in the top post. It might however be an X factor - with the ‘lower weight’ (or whatever..) due to more conversation / less isolation / shopping for smaller amounts more frequently / etc., and not a bit of extra walking.

Stumbling along the correlational path, the best that Nationmaster throws up for obesity (country rate) is the teen age birth rate. (.66)

http://www.nationmaster.com/plot/hea_obe/peo_tee_bir_rat/flag

Size of houses is interesting - look at the top right, US, UK, Aus, NZ, and slightly to the left, Canada and Ireland, the biggest houses and the highest obesity rates....Oh wait! They all speak English, I’ve got it, Americans should just learn Japanese ;)

http://www.nationmaster.com/plot/hea_obe/peo_siz_of_hou/flag

Both of these would seem to indicate very mild extra activity? ;)

sprawl, obesity, Aus. - another study

http://www.planetizen.com/node/36538

paranoid posted: It does not appear that there is a direct correlation between the obesity curve and the VMT curve. see this for a little adjustment.

http://www1.eere.energy.gov/vehiclesandfuels/facts/2007_fcvt_fotw469.html

I suspect that, although politically incorrect and therefore not tested, that obese people have steeper discount rates (less cortical control over sub-cortical behaviors) than non-obese people.

In very real ways, sugar (and refined sugars) are contributing to our collective inaction on the future - I have wanted to write on this for a while but too busy reading, eating cookies and enjoying red wine this summer...

(**Edit -there IS research comparing obese subjects vs controls on delayed discounting.)

Due to a problem with "funding" recently I had three weeks of living from my cache of what if food.
Wholemeal pasta, double concentrated tomato paste, vegetable stock, beans, tuna, olive oil, chilli sauce, milk powder, tea and coffee.
I found my sustained energy levels improved substantially and have deteriorated since adding some high GI foods back into my diet.
I was surprised at how much more cognitive stamina the 'Peak' diet gave me and am cutting back on my over use of smoothies.

In the UK it has been established that obesity is simply caused by over eating. During WWII on average more calories were consumed than today.
A comprehensive scientifically planned rationing system eliminated the gap between exercise and consumption so that people mostly ate when hungry.

How about school lunches?

I remember school lunches in the US (CT, mid 1970s) were horrible---canned ravioli, canned corn, canned green beans.....ugh!!! My mom made cheese and cucumber sandwiches for me.
But most kids didn`t think twice about the lunches at school---they just ate them. My family were immigrants from Europe so our food at home was always fresh and I was horrified by the school cuisine.

I understand that school lunches in other parts of the world are healthier. I read a study somewhere but don`t remember where. Maybe if the US started healthy school lunches that would be a good beginning??

It is really simple don't eat too much, exercise the power of your mind over your environment and cut back on the amount of food you eat.
Your stomach will shrink, which is all stomach stapling does.
Be a full on human being and unleash the power of you mind, it is what makes us the top animal.
If there is a collapse and cannibalism the morbidly obese will be easy to catch and self basting ;¬)))