See Inside
Ever-fatter Americans risk much higher rates of disease and death
| September 24, 2010 | 19
Heavy toll. More Americans than ever are now overweight, and one in three adults is obese. Children are growing fatter even faster. Obesity and diabetes “are the only major health problems that are getting worse in this country, and they are getting worse rapidly,” says Thomas R. Frieden, director of the U.S. Centers for Disease Control and Prevention. The trends add urgency to improving nutrition and exercise at home, schools and workplaces.
See what we're tweeting about
BoraZ ;-) RT @DrPeteEtchells: Came home to find a lovely present... @BenLillie @roseveleth @BoraZ http://t.co/JClXIoWN7L
sciam MT @philipyam: Tech for better tornado predictions, how twisters form video and continuing coverage @SciAm: http://t.co/9Gxd7G7a0M #Oklahoma
dbiello is there a link between climate change and powerful tornadoes? http://t.co/35H2g0bWbT maybe says trenberth of @atmosnews
Deadline: Aug 31 2013
Reward: $100,000 USD
The Geoffrey Beene Foundation Alzheimer’s Initiative (GBFAI) is launching the 2013 Geoffrey Beene Global NeuroDiscovery Challenge whose
Deadline: Jul 15 2013
Reward: $5,000 USD
SciBX: Science-Business eXchange, a joint publication from the makers
Powered By: 
YES! Send me a free issue of Scientific American with no obligation to continue the subscription. If I like it, I will be billed for the one-year subscription.
19 Comments
Add CommentIn my ignorance, I don't know how to calculate my body mass index or, therefore, where I am on this. Did I miss it in the SA magazine?
Reply | Report Abuse | Link to thisThis graph at first seems pretty silly to me, but then it is very useful in presenting the data. It would sure be more informative to have more samples than just 1980 and 2008.
Reply | Report Abuse | Link to thisIn particular, it would be very useful to know whether those adults that are obese today were obese as children.
Since the are so many more obese adults now than there were obese children in 1980 it can't be argued that childhood obesity produces adult obesity - there's some other factors at work.
It is disconcerting that the number of obese children is now so high. It intuitively seems that this must produce more obese adults in the future.
Alternatively, perhaps the factors producing the significant increase in adult obesity in time (even indirectly) also produced the increased childhood obesity. It also seems obvious that a family with an obese adult is likely to produce obese children.
Perhaps it is most critical to understand why such a large number of adults recently became obese. I presume this data represents only only the American population. It's be interesting to know if obesity has increased in other economies and cultures.
Here's a link: http://lmgtfy.com/?q=body+mass+index
Reply | Report Abuse | Link to thisThanks - This might be more direct:
Reply | Report Abuse | Link to thishttp://www.nhlbisupport.com/bmi/
Don't believe the BMI measurement. The old weight tables based on body type are much more accurate than BMI. At my best weight as a Green Beret, I could run 10 miles easily. At 5"7', 170lbs, I had a 44 inch chest. I've never lifted weights in a body building sense. According to the BMI I was overweight then. The old tables said I was at the right weight for someone with my body type. Short fire plug/heavy build, even now carrying around an extra 50lbs I'm described as muscular. I was classed as a endomorph, meaning a fat body and I am. LOL
Reply | Report Abuse | Link to thisThe BMI is a ratio of height to weight and is largely worthless. The American Society of Bariatric Physicians advises against using it, and a moment of thought may convince you to factor in a bit of common sense as well. Are we concerned with being fat or are we concerned with being over the average weight for a particular height? The BMI does not factor the body composition (fat vs muscle, eg) into the evaluation. There may indeed be some appropriate uses of BMI in studies - eg, an evaluation of being overweight as it affects kidney health - but the "obesity epidemic" is not driven by athletes who are "obese" because their muscle mass - and therefore their weight - is above average for their height. Furthermore, genetics (endomorph vs ectomorph = naturally fat vs naturally skinny) and environment play a significant role in the evaluatiuon and the statistics. Common sense, given our history of observation of humans, dictates simply that if you are fatter than you should be, you run a higher risk of the various morbidities mentioned under the "obesity epidemic" column.
Reply | Report Abuse | Link to thisBMI is calculated by dividing bodyweight in kilograms by height in meters squared. As an example, I am 5'4" tall and I weight 125 lbs. So my BMI is 56.8 (my weight in kg) divided by 1.63 squared. The number is 21.4. But you don't have to do the calculation yourself. There are plenty of BMI calculators on the web. Try this one: http://www.nhlbisupport.com/bmi/bminojs.htm.
Reply | Report Abuse | Link to thisEarlier this week I read something where they were finding a correlation between childhood obesity and having been infected by a particular type of virus and still having antibodies for it. It made some indefensible conclusions about the viral infection triggering the production of extra fat cells. Unfortunately, the numbers in the study were so small as to make it meaningless, and even if the numbers are borne out by broader study, finding a correlation might only indicate that being an obese child makes you more vulnerable to infection at a level that would require antibodies to fend it off. It does offer some hope though. If we could tie this to an actual bug, then the NIH might just be able to actually cure this thing. We all know it is definitely not in big Pharma's interest for us to cure obesity. Most of that 147 billion or whatever from the article goes to them.
Reply | Report Abuse | Link to thisHow about we teachers running or bicycling to work, and teaching in our workout clothes? We'd be showing our students that a person CAN be successful and fit, that success does NOT mean letting one's body go to seed. Oh right, school administrators don't provide anywhere to secure a bicycle, only parking lots for automobiles. And a tank top and shorts on a teacher is "inappropriate" - but it's perfectly okay for fat principals to waddle to their desks looking like pregnant women.
Reply | Report Abuse | Link to thisSuspicious of BMI accuracy since college courses, I submit to you the latest from the American Association of Endocrinologists:
Reply | Report Abuse | Link to this"The scale of the obesity epidemic may be much worse than currently believed, because the usual measure, body mass index (BMI), is a very insensitive measure of excess body fat, researchers said here. . ." by Med page Today's Kristina Fiore.
Article at: http://www.medpagetoday.com/MeetingCoverage/AACE/19756
Source reference:
Braverman E, et al "DEXA more accurately predicts obesity compared to BMI utilizing American Bariatric Society criteria in 1,234 adults in primary care outpatient facility" AACE 2010; Abstract 609.
And, contrary to the claim stated above in comment, it CAN be argued that childhood obesity produces adult obesity:
While not the sole correlation, it has been shown to be an accurate predictor.
Other related causes, such as sedentary lifestyles, poor eating habits, are additional, and not exclusively results of childhood obesity.
DIffering causes can also be lifestyle changes occurring after childhood, and do not negate the exteremly high rate of adult obesity following childhood overweight.
Scientists and others decry fuzzy thinking and inaccuracy of wording. Let us at least attempt concise or accurate use of language in our commentary.
…Urgency to improve nutrition and exercise…
Reply | Report Abuse | Link to this...Such recommendations are too weak!!!
Indeed, we are daily ‘bombarded’ by magazines, newspapers, reviews, television, and Internet with ‘news’ touting “miraculous” products, diets, or sensational scientific discoveries aimed to make us live healthier and become slim in a rush… guaranteed!?
In spite of all this, or more likely just because of all that, obesity rates and the number of people affected by obesity-linked diseases (as the graph shows) continue to grow worldwide… ….even in my home country, Italy: cradle of the healthy Mediterranean diet!
Shamefully, these sensational “discoveries” are questionable and often conflict with each other, generating confusion and uncertainty… even among scientists! In addition, “miraculous products” from such “discoveries” are more likely to be useless or even dangerous to our health! In other terms: science feeds confusion!
By the end of October we will present a book with the title : EATING HEALTHY AND DYING OBESE! This book outspokenly condemns these ways of malpracticing science and of misinformation. Moreover it shows how to counter charlatanry and “half-truths”!
In order to prevent and defeat obesity in a ultimate way, EACH SINGLE PERSON must known its own capacity of burning energy (e. g. CALORIES), e.g. its own metabolic rate, which is very individual, because genetic driven!!
In the book, the human metabolic rate is compared to the engine’s capacity (PS) of a car: the more PS, the more fuel a car needs…even at rest! Consequently, two cars with the same carossery but different PS, will burn a different amount of gasoline even for the same speed and distance covered.
This helps us understanding, how two human beings with same carossery (e.g. weight and height) can have different resting metabolic rate and consequently different total caloric requirements!
That is scientifically all about! As nowadays it is very simple and quick to measure the individual resting metabolic rate, the conclusion is that only the broad measurement of the resting metabolic rate (like boold pressure or cholesterol levels) will tell us how ‘improve nutrition and exercise!! All the other recommendations are hocus-pocus!!
And just to confirm this, in this book are also presented the results of two personal studies, demonstrating how to lose weight even while eating only fast-food…and, by contrast, how to fatten up - although not desired – with organic and Mediterranean foods!
Enjoy your meal!
Dr. Leoluca Criscione, Basel, Switzerland
I'm a retired principal with a BMI of under 20. I got up every morning at 0445, so I could do an aerobics class before school and taught t'ai chi two nights a week. One definitely can be fit while working full-time, even if living too far to bike to work (too rainy in winter, anyway). BTW, a tank top and shorts is de rigeur for teachers here (HI)!
Reply | Report Abuse | Link to thisMauims - Do they need biology teachers in Hawaii? 0445 sounds like you were in the military - you certainly have the discipline and you're setting a wonderful example for your students.
Reply | Report Abuse | Link to thisObesity rates took off for the stratosphere beginning in the 1980s, so we have to ask ourselves what changed between then and now. Our genetics have not. Our diet and activity patterns have. We're eating more junk than ever, eating out more (restaurant food is not known for its healthfulness), eating with our families less. And we're spending ever more time in front of the computer and TV, and less time outdoors.
It's really very simple. Calories in > Calories out means you get fat. And let's not peddle feel-good euphemisms; FAT is FAT, as in UGLY.
Your heading 'Dying to Eat' is apt; it points to the fact that Obesity is an addiction disease! It also means it's fatal in the long run: It means,'Eating To Die'.
Reply | Report Abuse | Link to thisTo quote from my book:The YANCHEP DIET (Anti-Cancer/ Heart Disease) DIET(Youthevity.com)
'Obesity ought to be classified as the Number One Modern INDUSTRIAL" Disease:
We have become addicts to modern mass-produced industrial food, laced with food additives which can lead to addiction and result in obesity.
This fact will be adamantly denied by the food industrialists, of course.
But now, modern medicine can provide proof by way of brain scans that the industry is making consumers addicted to its products , which should clearly be certified as health risks, just like cigarettes and alcohol.Merchandise masquerading as 'Fast' Food (a misprint for 'FATS' Food) should especially bear labels warning of the more than likely chance of dying an early death due to Obesity, the new Mother of: Heart Disease, Cancer, Diebetes, Arthritis, etc. What are the Fast Food additives that lead us into temptation to eat this health food risk in the first place, and then eat too much of it? Culprit Number One is the addition of Industrial sugar. harmless though it may seem, it is, in its 99% concentration, a potent poison... Its effects, by sludging vital body metabolism, may be slow at first, just like with any addictive drug...Sugar ( AND salt) are the favored, 'flavored',additives of the Fast Food industry..., because we are meant to come back and buy MORE of their products! they are, after all, not a health industry, so Obesity is then the sole responsibility of the customer - just like, lung cancer is the responsibility of the smoker. Addiction still does not exist in the eye of the producers.
And government revenue coffers burgeon from such consumer addictions!'
Recent research findings have shown that obesity may be like a tumour , that is a natural body response to toxic input which acts like a toxic waste deposit; so, anyone suffering from a tumour, cannot be blamed for it personally, in my opinion. ( And, besides, it would take THREE hours of strenuous physical exercise to 'work off' ONE greasy hamburger!)
The "graph" shown on page 104 of the October 2010 issue of Scientific American is a prime example of how to display data in a confusing and misleading manner. I would strongly recommend that the creator of this "graph" read books by Tufte and Bertin.
Reply | Report Abuse | Link to thisI found it very difficult to gather good information from this graph. I get the idea that the rate of obesity has increased, but how do I carefully interpret the graph. Does each dot count as a certain percentage of the population? Do I consider the area? The graph makes me see more rows but some rows have fewer but larger dots. What does that mean? The temptation is to count the number of rows, but the outer rows, the non-obese people, have more dots. Overall all I would say that the graphical image makes a strong point but does not give me easily grasped information on which to judge the point being made. A different way of presenting the data may be less eye-catching but more helpful for one wanting to understand the actual problem.
Reply | Report Abuse | Link to thisThe part of the graph using vertical bars, or the length of the bars, showing male and female disease rates is more straight-forward to interpret.
Like a beautiful pastry in a baker’s window, Mark Fischetti’s mouth-watering graphic in “Dying to Eat” immediately caught my eye. Unfortunately, the analogy doesn’t stop there, because the graphic has some fat and useless calories. The first thing I noticed is that the subhead, “Ever fatter Americans risk much higher rates of disease and death,” is untrue. The risk of death remains the same for everyone: everybody dies. The rate of death from specific causes and the rate of death at given ages do indeed change, but the rate of death remains one per lifetime. In trying to winkle out what risks Fischetti is really talking about, I noticed that the dots for overweight and obese portions of the population are, well, overweight and obese. Each dot may represent 1% of the population, but each obese dot accounts for about 10 times more area than each normal dot. Because the eye consumes area more easily than number, the reader is subtly deceived about the weight of the problem. The bar chart in the upper right also left me hungry for more information, because it contains the even more puzzling statistic that the risk of death triples for both males and females if one is obese at age 50. “More puzzling” because seemingly more specific, it still tells us nothing useful about what risk has been tripled: death at age 50? death from one of the three diseases enumerated? And strangest of all, why is the females’ risk of death the same as males’, even though the rates of coronary artery disease and Type II diabetes are so much higher for females? Oh, I know: because everybody dies.
Reply | Report Abuse | Link to thisOverall, however, SciAm’s new look and format leaves me well satisfied. Great job!
Regina L. Hunter
Albuquerque, New Mexico
I appreciate the graphical presentation of the data; the growth in blue dots is astounding. In the written summary, Mr. Fischetti points out that we need to address exercise and nutrition in our schools, workplaces and homes. I would like to add that is crucial that we think about and change our approach to how we travel to and from school, work and home.
Reply | Report Abuse | Link to thisIf we have human-powered transit, then increased caloric output is a natural outcome on a typical day.
Right now, American towns aren't set up for that. How will we get there?
Well designed, dense neighborhoods that provide privacy and proximity to work, play, grocery stores, and schools are one important factor in a move toward creating a situation where a person can get around by foot/bike/3 wheel scooter rather than car. We need to design for the pedestrian and biker in conjunction with car travel and rapid transit. We need to tie our federal transportation monies to pedestrian way improvements. We need to include sidewalks in all types of developments.
I know there are many times I have opted to drive because either the street lights were out or I was worried we might get hit by a car when the sidewalk suddenly gave way to road.
I suggest that one component of the solution is to advocate for safe walking/ biking/ scootering/ rollerblading paths into towns and cities. Then it's our choice whether we get ourselves and our children out of the car and move. Changes in the way we develop will make it much easier for an individual to shift from reliance on fossil- to personal-fuel.
The 28 square-inch circular display of a mere 24 data points makes me confuse Scientific American with USA Today.
Reply | Report Abuse | Link to thisWith a data density of less than one data point per square inch, you have wasted over half the page.
Obesity is very serious. Why not have a serious display of data?
Are the dots on the left side in proportion to body mass? No. Are the different years on the left side easy to compare? No. Why not have a simple bar graph for Children, and another for Adults?
On the right side, truncated pie sections are notoriously hard to compare. Yes, the 11X Female Type II diabetes blue spike shouts out, but comparing it to the other spikes is much more difficult than if you had used rectangular boxes in a bar graph. There no easy way to compare the overall differences between male and female.
There's no connection between the circular marking on the right graph and the left.
If you have graphs that efficiently, correctly, and beautifully told your data, there would be room to show how that $147 Billion dollars relates to which of the heath problems, there would be room for comparison data among different countries, and even show how nutrition and exercise might improve the situation.
I am offended by the showing of this circular confusing and barely useful data under the heading of Graphic Science. This is a page that could have been displayed by a beginner graphic designer student who just discovered PowerPoint and all the cool tools in it. Read Edward Tufte's The Visual Display of Quantitative Data. Or hire him as a consultant. You can do better than this.