Obesity case study.htm

What is the cause of obesity in the United

States?

Jennifer HolderKate Herman

Christina JanushevichLindy Paul

Approach

To complete this project our group used a Google Document to gather our information into one place. We

used resources from online and Anne Belk Library. To coordinate meetings

we sent texts and emails to each other.

Introduction: What is Obesity?

Definitions:Obesity refers to an increase in body fat; “overweight” is an increase in body weight relative to some standard and has become a surrogate for “obesity” both clinically and epidemiologically (Ripper).

Obesity is an “abnormal or excessive fat accumulation that presents a risk to health” but this is not very specific (WHO, Obesity and Overweight).

BMI is the most common way to measure overweight and obesity but it does not take into account body composition (Rossen) (Stern) (Cawley).

“‘Overweight’ is defined as having body weight than is considered normal or healthy for one’s age or build. The term ‘obese’ is used for very overweight people who have a high percentage of body fat.” (Stern)

“Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health.  Population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in meters). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight.” (WHO, Obesity)

Background

CausesEffectsFacts

Causes

Flaws in nutritional education, resources, and healthcare:• Doctors are not educated enough in nutrition (Chen, 2010)• Asking for a doctor’s advice isn’t always the best idea; consulting a

dietician or nutritionist would be more beneficial (Chen, 2010)• American healthcare is based off of treatment and not prevention (Fromke,

2012)• Doctors paid based on number of patients seen, operations, surgeries not

on success of treatment or prevention; quantity over quality (Fromke, 2012)

• Food Pyramid has major flaws and isn’t based in research (Willett, 2001)• "The thing to keep in mind about the USDA Pyramid is that it comes from

the [U.S.] Department of Agriculture, the agency responsible for promoting American agriculture, not from agencies established to monitor and protect our health, like the Department of Health and Human Services, or the National Institutes of Health, or the Institute of Medicine.” (Willett, 2001)

• Food labels based on faulty Food Pyramid system

Causes (con’t)

Genes• “Obesity usually results from interaction of certain gene polymorphisms

with environment. Moreover, only a small number of cases of obesity (5%) result from mutations in specific genes (monogenic obesity), causing in some cases Mendelian syndromes with a very low incidence in the population. One hundred and thirty genes related to obesity have been reported, some of which are involved in coding of peptide transmitting hunger and satiety signals, while others are involved in adipocyte growth and differentiation processes, and still others are involved in regulation of energy expenditure. In addition, obesity is a chronic inflammatory state. In this regard, altered expression of genes related to insulin metabolism and adipose tissue inflammation is a basic process which may explain the etiology of obesity” (González Jiménez, 2011)

Socioeconomic rank• “Many studies have shown an overall socio-economic gradient in obesity in

modern industrialized societies. Rates tend to decrease progressively with increasing socio-economic status.” (Perez, 2013)

Causes (con’t)

Bad habits in childhood• Feeding Infants and Toddlers Study (FITS) in North America: “higher than generally

recommended energy, protein, and saturated fat intakes. The majority of infants are bottle fed at some point in their first year of life, and their weaning diet often includes low intakes of fruits and vegetables, with high starchy, rather than green or yellow, vegetables. Early introduction of solids, use of cow's milk prior to 1 year of age, and high juice intake in the first 2 years - all less desirable diet practices - are improving, but are still prevalent. More preschoolers are likely to get sweets or sweetened beverages than a serving of fruit or a vegetable on a given day” (Savedra, 2013)

• “These food intake patterns mimic the adult American diet and are associated with an increased risk of obesity in childhood and later life.” (Savedra, 2013) 

• “Obesity prevention needs to include specific targets in terms of breastfeeding and adequate formula feeding, as well as appropriate introduction of weaning foods with goals of changing the inadequate patterns documented in the FITS. These interventions will also require addressing parent and caregiver behaviors, including attending to hunger satiety cues (responsive feeding), and shaping early food preferences. This needs to be done starting at birth, in the first months of life. Early intervention offers a unique and potentially efficacious opportunity to shape the future dietary patterns of the next generation.” (Savedra, 2013)

Causes (con’t)Food deserts• “A “food desert” is defined as a populated area with deficient access to the most well-

stocked outlets, the large stores or supermarkets that usually provide abundant, good quality, low-priced food choices” (Hubley,2011)

• “food deserts—low-income communities without ready access to healthy and affordable food—by developing and equipping grocery stores, small retailers, corner stores, and farmers markets with fresh and healthy food” ("USDA defines food," 2010) 

• “Low access to supermarkets in the United States has been linked with poor quality diets” (Hubley, 2011)

• “predominately lower income neighborhoods and communities” (Hubley, 2011)

Cheapest food lacks quality and nutritionSedentary lifestylesEmotional issues, binge eating, food addiction Portion sizes“Portion distortion”: “Food portions in America's restaurants have doubled or tripled over the last 20 years, a key factor that is contributing to a potentially devastating increase in obesity among children and adults.” ("Portion distortion" 2013)American portion size can feed 2 or 3 peopleHuge in comparison to most other countries

Effects• diabetes• cancer• respiratory functions: alters the

relationship between the lungs, chest wall, and diaphragm (Ray).

• cardiovascular diseaseso coronary heart diseases: a condition

in which plaque builds up inside the arteries that supply oxygen-rich blood to the heart which narrow or block the coronary arteries and reduce blood flow to the heart muscle which leads to chest pain and heart attack (NHI).

o heart failure: a serious condition where the heart can't pump enough blood to meet the body's needs (NHI).

Facts

• When did obesity emerge in the US?o 1980s-2000so Doubled in childreno Tripled in adolescenceo 60 million adults were considered obese, which is  about 30% of the

population (CDC)• What cause obesity to emerge in the US?

o 25% of Americans eat the recommended 5 servings of fruit and vegetables per day

o More than 50% of Americans do not get the recommended amount of physical activity (CDC)

• Obesity is dramatically on the rise in low- and middle-income countries, particularly in urban settings.

• In 2008, 35% of adults were overweight, 11% were obese.• More people are killed from being over weight than

underweight.• Obesity is preventable. (WHO,

http://www.who.int/topics/obesity/en/)

Factors

Key IssuesKey Stakeholders

Key Issues

• Health (see Effects)• Food (cheapest)

o Subsidieso Seasonalityo Transportationo Processed foods contain many low quality ingredients

• Food marking o Grocery store setupo Focus on children: TV, internet and movie adverts, collectibles (toys in

cereal boxes, fast food meals)o Identifying key buyingo Loyalty programs

Key Stakeholders

• Primary:o Producers/ restaurants

o Marketers

o Endorsers

o Sellers

o Consumers

• Secondaryo Doctors/ plastic surgeons

o Medicare

o Health insurance companies

o Weight loss companies, gyms, trainers

Conclusionand what we learned

Obesity is caused by a number of things that vary from eating large proportions to the way food is marketed. Our group concluded that sources of obesity are preventable and the

cost of stopping them outweighs the cost of letting obesity to continue to harm individuals.

ReferencesCawley, J. (2011). The Oxford Handbook of the Social Science of Obesity. Oxford University Press, Inc.: New York, NY.CDC. (2010). Facts About Obesity in the United States. Retrieved from: http://

www.cdc.gov/pdf/facts_about_obesity_in_the_united_states.pdfChen, P. (2010, September 16). Teaching doctors about nutrition and diet. The New York Times. Retrieved from

http://www.nytimes.com/2010/09/16/health/16chen.html?_r=0Fromke, S. (Director) (2012). Escape fire: The fight to rescue american healthcare [Web]. Retrieved from http://www.escapefiremovie.comGonzález Jiménez, E. (2011). Genes and obesity: A cause and effect relationship. Endocrinología y Nutrición, 58(9), 492–496. Retrieved from

http://dx.doi.org/10.1016/j.endoen.2011.06.005Hubley, T. (2011). Assessing the proximity of healthy food options and food deserts in a rural area in maine. Applied Geography , 31(4), 1224–1231.

Retrieved from http://dx.doi.org/10.1016/j.apgeog.2010.09.00 NHI. (2012, July 13). What Are the Health Risks of Overweight and Obesity? Retrieved From: http://

www.nhlbi.nih.gov/health/health-topics/topics/obe/risks.htmlPérez Rodrigo, C. (2013). Current mapping of obesity. Nutricion Hospitalaria, 2821-31. doi:10.3305/nh.2013.28.sup5.6869Portion distortion and serving size. (2013, February 13). Retrieved from http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/eat-right/

distortion.htmRay C. S., Sue D. Y., Bray G., Hansen J. E., Wasserman K. (1983). The American Review of Respiratory Disease.Rippe, J. M. Angelopoulos, T. J. (2012, May). Obesity : Prevention and Treatment. Retrieved from:

http://appencore.wncln.org/iii/encore/record/C__Rb4659894__SObesity%20%3A%20Prevention%20and%20Treatment.__Orightresult__X4?lang=eng&suite=ncapp

Rossen, L. M., Rossen, E. A. (2012). Obesity 101. Springer Publishing Company, LLC: New York, NY.Saavedra, J. M., Deming, D., Dattilo, A., & Reidy, K. (2013). Lessons from the Feeding Infants and Toddlers Study in North America: What Children Eat, and

Implications for Obesity Prevention. Annals Of Nutrition & Metabolism, 6227-36. doi:10.1159/000351538Stern, J. S., Kazaks, A. (2009). Obesity. ABC-CLIO, LLC: Santa Barbara, CA.USDA defines food deserts. (2010). Retrieved from http://americannutritionassociation.org/newsletter/usda-defines-food-deserts WHO. (2013).

Obesity. Retrieved from: http://www.who.int/topics/obesity/en/WHO. (2013). Obesity and overweight. Retrieved from: http://www.who.int/mediacentre/factsheets/fs311/en/Willett, W. (2001). Eat, drink, and be healthy: The harvard medical school guide to healthy eating. New York, NY: Simon & Schuster, Inc. Retrieved from

http://www.health.harvard.edu/newsweek/Eat_Drink_and_Be_Healthy.htm