Fat, inactivity: fatal combo

Obesity: A new study says unhealthful eating and lack of exercise are overtaking tobacco as the top cause of U.S. deaths.

March 10, 2004|By David Kohn | David Kohn,SUN STAFF

As she does most weekday mornings, Western High School senior Faye McCray ate breakfast yesterday at the McDonald's across the street from school. She had her usual fare: a steak, egg and cheese bagel; hash browns; a cinnamon bun and a strawberry soda.

The meal contains about 1,320 calories and 54 grams of fat. Before her first class, McCray, who rarely exercises, had consumed 60 percent of her recommended daily calories and three-quarters of her recommended daily fat.

The 18-year-old, who also eats McDonald's for dinner several times a week ("double cheeseburger or Big Mac, french fries, a soda"), knows her diet isn't a nutritionist's dream. "But healthy food doesn't taste as good," she said. "It doesn't fill you up. Who wants to eat yogurt for breakfast?"

Though not overweight, McCray is part of a worrisome trend, researchers say, one that has become more and more deadly.

Poor diet and lack of physical activity will soon surpass smoking as the leading cause of premature death among Americans, according to a study released yesterday in the Journal of the American Medical Association.

Together, the two factors caused 400,000 premature deaths in 2000, the study found, almost 17 percent of all deaths. Smoking killed 435,000, just 1 percentage point more.

While tobacco deaths increased only slightly since 1990, deaths blamed on diet and lack of exercise rose by 100,000.

"I would expect it to surpass smoking soon," said the study's lead author, Ali Mokdad. An epidemiologist at the U.S. Centers for Disease Control and Prevention in Atlanta, Mokdad called the findings "striking" and said they should be a "call to action."

"This is an epidemic," said CDC Director Dr. Julie L. Gerberding, who was one of the study's co-authors. Speaking after a Washington news conference at which officials unveiled an anti-obesity ad campaign, she called the trend "alarming."

The public service ads attempt to sway habits with humor, showing typical Americans finding love handles and other excess body parts "lost" by neighbors who are exercising more.

"Americans need to understand that overweight and obesity are literally killing us," Health and Human Services Secretary Tommy G. Thompson said.

Who's responsible

Some researchers have criticized the government's approach, saying it focused too much on individual responsibility and too little on the wider social causes of obesity.

But all sides praised the new study. "It's well-designed work," said Dr. J. Michael McGinnis, an epidemiologist at the Robert Wood Johnson Foundation. An expert on American health trends, McGinnis wrote an editorial accompanying the report.

To come up with what they called the "actual causes of death," the CDC researchers compared data from 2000 on causes of death for the U.S. population with known risk factors for those causes.

Childhood obesity

Using a slightly different calculation technique than Mokdad, McGinnis estimated that inactivity and poor diet already have overtaken tobacco as the leading killer. Noting that children are more than twice as likely to be obese as they were two decades ago, he said the new results indicate that the country faces a "crisis in the making."

"We may be raising the first generation of children who grow up to be sicker than, and die younger than, their parents," he said.

Almost 130 million Americans - 64 percent - are overweight, according to government calculations, up from 47 percent in 1980. A third of the population is obese, an even heavier subcategory. Being overweight increases the risk for a range of ailments, including heart disease, diabetes, arthritis and certain cancers. The annual direct medical cost of obesity is $117 billion, according to the CDC.

Mokdad and other researchers blame the obesity increase mainly on the growing ease and automation of modern life and the availability of cheap, high-calorie, high-fat food.

"We have automatic everything now," said Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center. "But we're not compensating for decreased physical activity by eating less. If anything, we're eating more."

Some researchers argue that increasing suburbanization and sprawl have also fueled the trend, forcing Americans to drive more and walk less.

Other factors

Tobacco and obesity are not the only dangers Americans face. Alcohol consumption caused an estimated 85,000 premature deaths, while microbial diseases killed 75,000. An additional 55,000 died after exposure to toxic chemicals, and 43,000 more from car accidents.

Mokdad noted that almost 40 percent of deaths were caused by the top three, all of which are preventable.

Researchers expressed surprise that tobacco-related mortality hasn't declined, though some suggested that rates won't drop immediately because smoking takes years or decades to seriously impair health.

But smoking hazards took a back seat yesterday as researchers and officials focused on the swift rise in deaths as a result of poor diet and inactivity.

`Startling impact'

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