Dr. Phil Fontanarosa, the editor of a Journal of the American Medical Association (JAMA) theme issue on obesity research,1 stated, "During a time when the amount of research activity, knowledge, and interest in obesity among the medical community, as well as the level of public attention to issues of weight, diet, and exercise have never been greater, the epidemic of obesity continues virtually unabated, with no sign of reversal."2
Many of the effects of obesity are well-known, including cardiovascular disease, diabetes and gastrointestinal disease.
What is not as accepted, generally, is the link between obesity and cancer. In a new retrospective study, a subgroup of people were selected from the Cancer Prevention Study II, which was started by the American Cancer Society in 1982. The subgroups selected included 107,000 men and 276,000 women who had never smoked. The authors performed an in-depth statistical analysis to evaluate the potential association between obesity and mortality from cancer. Results showed that deaths from all cancers were 52 percent higher in obese males, and 62 percent higher in obese females, compared to individuals of normal weight. Normal weight, overweight, and obesity designations were calculated using body mass index (BMI) data. (See DC, April 21, "U.S. Food Consumption and Obesity, Part 2" for BMI calculations and explanations.) The authors estimated that the proportion of all deaths from cancer in U.S. adults over age 50 attributable to overweight and obesity were as follows: 14 percent in men and 20 percent in women.4
The recent passing of Dr. Robert Atkins (creator of the Atkins diet, which emphasizes low consumption of carbohydrates and high consumption of protein) highlights the continuing debate between clinicians and researchers as to the optimal diet for weight loss and maintenance.
Research is expanding as fast as our waistlines. Studies targeting the up- or down-regulation of numerous hormones, peptides, neurochemicals, and membrane receptors to biologically modify appetite and satiety, along with metabolic, psychological and genetic factors, are progressing at an ever-increasing rate. To this author, it appears that (triggers aside) Americans simply eat more of everything. I agree with Michael Jacobson, of the Center for Science in the Public Interest, who would like restaurants to be required to publish the true caloric content of their servings of foods and beverages.5 I believe most people have no clue that a typical prime-rib dinner with a baked potato and a Caesar salad amounts to more than 2,000 calories. Add a glass or two of wine, some rolls and butter and the numbers increase to over 2,500 calories. Choose a selection from the dessert cart, and the total calories exceed 3,000, just for this one meal. Even with a light breakfast and a light lunch, the person in our example likely has exceeded 4,000 calories in one day.
The following tables are a continuation of the U.S. Department of Agriculture (USDA) disappearance data reviewed in this series.6
Table 1:Cereal: pounds per person per year.
Table 2:Milk, coffee and bottled water: gallons per person per year.
* With the rise in the coffeehouses, it is likely the declining trend has reversed.
Table 3:Meat, poultry and fish: pounds per person per year.
Table 4:Cheese: pounds per person per year.
Table 5:Nonfat cheese: pounds per person per year.
Fats and Oils
Table 6:Added fats and oils:* pounds per person per year.
Table 7:Fruit: pounds per person per year.
All Other Vegetables
Table 8:Vegetables: pounds per person per year.
Fontanarosa PB, ed. JAMA 2003; 289(14):1729-1880.
Kravets BZ. The Nutrition News #32. www.iaacn.org.
Andersen GD. U.S. food consumption and obesity, part 2. Dynamic Chiropractic 2003;21(9):40.
Calle EE, Rodrigues C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. New England Journal of Medicine 2003;348 (17):1625-1638.
Jacobson MS. Fight belly sprawl. Nutrition Action Health Letter 2003; 30(4):2.
Putnam JJ, Allshouse JE. Food consumption, prices, and expenditures 1970-97. Food and rural economics division, Economics Research Service, United States Department of Agriculture 1990, Statistical Bulletin, no. 965.
G. Douglas Andersen, DC, DACBSP, CCN Brea, California
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