Pa. needs to go on a diet
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After 20 years of rising obesity rates, the Keystone State has become the 19th most obese state in the country.
The eighth annual "F as in Fat" report by the Trust for America's Health and Robert Wood Johnson Foundation shows that 28.5 percent of Pennsylvanian adults are obese. That's more than double the obesity rate for the state in the late 1980s, which was 13.7 percent.
There is a bright spot in "F as in Fat," however: The number of states showing what the study's authors called statistically significant increases in their obesity rates dropped to 16 this year from 28 in 2009. Pennsylvania's own obesity rate increased by half a percent over the past year, which the study authors did not consider statistically significant.
If obesity rates are slowing, it could be due in part to an outpouring of public interest in preventing obesity -- particularly in children, said Jim Marks, senior vice president of the Robert Wood Johnson Foundation.
"Policies at the state and local levels may be beginning to have an effect," Dr. Marks said. "But it is a small victory, and it does not mean we can ease off the gas pedal."
An obese individual, as defined in "F as in Fat," is a person whose body mass index -- the person's self-reported weight, in kilograms, divided by the square of that person's self-reported height, in meters -- exceeds 30. Obesity can cause a litany of health problems, including hypertension and diabetes.
Diabetes rates in Pennsylvania reached 9.4 percent last year, according to the study. Twenty years ago, that rate was 6.1 percent. The condition has grown so prevalent in some regions that researchers have been able to identify a "diabetes belt" composed of 644 counties in 15 states in Appalachia and the southern United States. Several Pennsylvania counties are included in the belt, which was first published in the American Journal of Preventive Medicine in March.
Jeff Levi, executive director of Trust for America's Health and a study author, said Americans were developing diabetes at a younger age as obesity rates increase. In turn, he said, the disease becomes harder to manage over the course of a person's life.
"It is through diabetes that we see some of the most dramatic increases in negative health outcomes and health-care costs," Mr. Levi said.
The University of Pittsburgh's Diabetes Prevention Support Center has trained more than 800 health professionals to deliver community-based diabetes prevention education since 2002. The educational program, called Group Lifestyle Balance, is based on a massive clinical study of Pitt's diabetes care center and 25 others like it, center director Mary Kaye Kramer said. Group Lifestyle Balance principles have lowered diabetes in at-risk participants by 58 percent by encouraging healthy eating and exercise.
Though Ms. Kramer's center focuses on preventing diabetes in middle-age people, she said anecdotal evidence suggested that the program impacts the rest of a person's family as well.
"Making healthy lifestyle changes certainly trickles down to kids," Ms. Kramer said.
Pennsylvania, like many states, has tried to stem obesity starting in schools, where children eat about half of their daily calories, according to "F as in Fat."
With the School Nutrition Incentive Program, established in 2007, the state began to offer financial benefits to schools that served children healthier meals. Compliant schools earn an additional 3 to 4 cents in reimbursement from the state for their food expenses. Pennsylvania also established a farm-to-school program in 2010 that uses federal funds to send fresh produce from independent farms to school kitchens.
Tim Eller, press secretary for the Pennsylvania Department of Education, said state funding for the incentive program increased this year by 16 percent, or about $451,000, and that federal funding for the farm-to-school program faced no cuts.
Mr. Eller said good nutrition is a high priority for the Department of Education because it contributes to higher academic achievement.
Efforts to prevent childhood obesity are not confined to the cafeteria. In an effort to prevent hypertension -- which now affects 28.9 percent of Pennsylvanians -- the National Hypertension Association created an educational program for school-age children with funding from philanthropic foundations. The obesity prevention program, called Values Initiative Teaching About Lifestyle, or VITAL, has taught about 35,000 kids about the importance of good nutrition and outfitted them with pedometers to encourage them to exercise more.
The National Hypertension Association's internal review of VITAL's impact at elementary schools in the Catholic Diocese of Pittsburgh in 2007 found that VITAL students had a better chance of avoiding excessive weight gain than peers who didn't participate, putting the youngsters on track for better health down the road.
"If people are obese when they're older, it's very difficult to turn back the clock," said William Manger, chairman of the National Hypertension Association. "Some people can lose weight on programs, but there is a very high recidivism rate, and people often go back."
Dr. Manger said he didn't think the association could determine whether VITAL specifically had positive health outcomes for the parents of its young participants.
Still, Mr. Levi said obesity prevention efforts for children often "have dual use" and can discourage obesity among parents as well.
"One of the most effective ways of reaching adults is through their kids," Mr. Levi said.
First Published July 8, 2011 12:00 am