In another study confirming the obvious, the CDC has determined that being obese causes diabetes. The researchers claim this study is important because it is the first one to use a representative sample of the American population.
While other factors play some role in the rapidly increasing number of people with diabetes, obesity is the major factor in the trend, said Linda S. Geiss, lead author of the study, published in the May issue of the American Journal of Preventive Medicine.
The study, based on concrete numbers drawn from the entire country, backs up what experts have long believed, said Geiss, a statistician with the CDC's Division of Diabetes Translation.
"Most incidence studies [of diabetes] have been done on samples that aren't representative of the United States," she said. "These [new] data are nationally representative. And these data certainly help make the case that obesity is a major factor in the diabetes epidemic. I think it adds to the evidence."
Geiss and her research team looked at statistics from the National Health Interview Survey, an ongoing nationwide in-person survey of about 40,000 households. They zeroed in on the years 1997 to 2003 to look for trends in the incidence of diagnosed diabetes in adults aged 18 to 79. Each year, about 31,000 adults were asked whether a health professional had told them they had diabetes. Not included was gestational diabetes, a type that occurs during pregnancy.
Participants were asked how old they were when their diabetes was diagnosed. The researchers had access to information about height and weight so they could compute the participants' body mass index (BMI, a ratio of height to weight). A BMI of 25 and above is termed overweight; 30 and higher is considered obese.
Excess weight and inactivity are risk factors for type 2 diabetes, in which the body doesn't properly use the hormone insulin, which is crucial for converting sugars and starches in the blood into fuel for the body.
The incidence of diagnosed diabetes rose 41 percent from 1997 to 2003 among the study participants, Geiss found.
About 20 million Americans have diabetes, although many do not yet know it, according to the American Diabetes Association.
About two-thirds of American adults are now overweight or obese, according to the National Institutes of Health. In 1960, 13 percent of adults were obese, but by 2000, nearly 31 percent were.
Geiss wanted to determine, however, if the rise in diabetes might be due at least partially to better detection methods allowing for earlier diagnosis. "If we were doing a better job, we would be detecting it earlier and when people are healthier."
But from 1997 to 2003, those diagnosed with diabetes were not healthier or younger. Increased detection of diabetes "could be part of the answer," she said, "but not the whole answer. It doesn't seem to be a major factor. Most of the increase in diabetes occurred in those with a BMI of 30 or above. In 2003, 59 percent of the newly diagnosed were at a BMI of 30 or above. Another 30 percent were overweight, with a BMI of 25 to under 30. All together, 89 percent of the [new] cases were either overweight or obese."
The researchers recommend the obvious: get some regular exercise, eat healthy foods, keep your weight at a healthy level.
"Gee, Wally."
"What, Beav?"
"That seems mighty easy. Why would anyone be obese?"
"Well, Beav, it just isn't as easy as it sounds."
"But why, Wally?"
"I don't know, Beav, I just don't know."
The truth, and I see it every day, is that it isn't that easy. For a million different reasons, people seem unwilling and/or unable to eat a healthy diet that will prevent diabetes and obesity.
Despite what some people might say, it is economic. A loaf of white bread is less than half the cost of a loaf of high fiber wheat bread. Extra-lean ground beef is more than twice as expensive as regular ground beef. Whole wheat tortilla shells are much more expensive than white flour shells. Instant white rice is much cheaper and easier to cook that whole grain rice. The list goes on and on.
More so, however, it is emotional. People have an emotional connection to eating, especially comfort foods. Eating healthy to most people means eating bland foods that don't taste good. We have become a culture that equates quality of life with being able to eat anything we want. How did this happen? If you say anything other than "the marketing media" you haven't seen a television or a magazine in 50 years or so.
We need an integral approach. Right now, every option must be on the table. We risk national bankruptcy over obesity and its related illnesses if nothing is done soon. We are spending 20 percent of the GNP on medical care already. It will only get worse -- today's young people will develop diabetes at a rate of one in three.
Think about that for a while.
When people talk about obesity, I'm always interested in where they place the crux of the problem. Poverty, you say? Or emotional eating? I would put both of those things (manifestations of the same thing) under the heading: "cultural." Those same poor people manage outrageous car notes, cell phone bills, and sport the latest fashions, but where they choose to cut corners is in the area of food. That's an American style choice, in my opinion (as in, when choosing between organic whole foods and a materialistically gorgeous presentation, guess which wins?). Somehow, as a culture, we're inculcated in believing crap food is acceptable, even a treat!!! There can't be many other places in the world where so many adults would prefer #3 at McDonalds to a well prepared homemade meal. That strikes me as deeply creepy, and indicative of a deeper cultural sickness I don't like to dwell on too much.
ReplyDeleteI realize I'm drifting dangerously into paranoid-sounding territory, but I truly think that a capitalist drive which is fundamental amoral in its pursuit of profits has hijacked American culture and managed to lull a majority into beliefs counter to their own best interests: to have to walk, or exercise in any fashion is terrible and burdensome (drive! drive a SUV!); cooking healthful foods at home is an unspeakable imposition, and nasty anyway (you deserve a break!); taking a pill (or many pills, an infinity of pills) will handle any and all problems faster and more tidily than any self-responsible, informed, agentic choices an individual can make. Whew, I've gotten long-winded! The heart of my argument, anyway, is that no substantial change will happen (and now that I think on it, not just where obesity is concerned ..) until corporate interests are not the paramount ones in American culture. I have spoken. lol
Kai in NYC
But surely, Marty, there can be capitalism without money-making at the expense of the citizens well being? The Netherlands just outlawed transfats for example: is that so terrible? But you make excellent, eye-opening points about insurance incentives. That seems imminently workable.
ReplyDeleteKai in NYC
Kai said: "But surely, Marty, there can be capitalism without money-making at the expense of the citizens well being?"
ReplyDeleteYes, I agree.