Poor Diet Kills More Than Smoking & Firearms

(From a 2004 article) Poor diet and physical inactivity are overtaking smoking as the No. 1 cause of preventable deaths in the United States, federal officials reported Tuesday.

The study by the U.S. Centers for Disease Control and Prevention found that about 400,000 deaths in the United States in 2000 could be attributed to poor eating and exercise habits, coming close to tying tobacco as the leading cause of avoidable deaths.

Smoking deaths have essentially leveled out, and deaths tied to such culprits as alcohol, illicit drug use, sexual behavior and firearms have declined over the past decade. But against that backdrop, the obesity problem is strikingly different.

“This is tragic,” Dr. Julie Gerberding, CDC‘s director and an author of the study at the time, told reporters. “Our worst fears were confirmed.” She was joined by Tommy Thompson, secretary of health and human services, at a Washington, D.C., news briefing to call attention to the new cause-of-death study.

In response to the findings, Thompson revealed a new public-health ad campaign to heighten awareness of the health benefits of walking, while the National Institutes of Health proposed a new research agenda to tackle the obesity problem.

Many experts, however, said tougher measures might be needed to turn the grim numbers around.

About half of all deaths in 2000 were tied to “largely preventable behaviors and exposures,” the CDC analysis concluded. Technically, smoking remained the No. 1 preventable killer in 2000, the “actual cause” of about 435, 000 deaths, up from 400,000 in 1990.

The toll from poor diet and physical inactivity increased by about a third — to 400,000 deaths in 2000 from 300,000 deaths in 1990. But the figure might be even worse than the study suggests.

Although the statisticians said they chose a more conservative approach for their published findings, they said diet deficiencies and sedentary lifestyles could be causing as many as 500,000 deaths each year, or about the same as the annual cancer toll.

The new study appears in the latest Journal of the American Medical Association. A commentary in the medical journal demands a stronger “social commitment” to put the nation on a slimmer path.

“Sometime within the last 10 or 15 years the obesity epidemic has really started to take full flight,” said Dr. J. Michael McGinnis of the Robert Wood Johnson Foundation, co-author of the commentary as well as the original 1990 analysis upon which the latest study was modeled.

“Our policies haven’t caught up,” he said. “It isn’t enough anymore just to say, ‘This is the problem. People need to eat better and exercise better.’ We need to address the environmental influences and everything that goes into social behavior.”

Smoking rates have peaked and even begun declining in some population groups. Experts attribute the trend to such factors as higher cigarette taxes, indoor smoking bans — soon to extend to the area outside the CDC’s own headquarters in Atlanta — and relentless anti-smoking ad campaigns.

While obesity has been getting more attention lately as a public health issue, perceptions may lag the body counts. Some analysts, including McGinnis, have called for more potent measures to tackle the problem, such as tough nutrition labeling rules and insurance premiums with incentives to lose weight.

The Bush administration has resisted some of the more sweeping proposals, and Tuesday’s announcements did little to change the perception that nothing far-reaching was in the works.

Even though more is being done to get the obesity health message across, it’s proving to be a tough sell. Some specialists in analyzing risk-taking behavior say this is only to be expected given the different ways people perceive dangers.

“Chronic deaths don’t scare us as much as deaths that happen catastrophically, all at once, like in a plane crash,” said David Ropeik, a spokesman for the Center for Risk Analysis at the Harvard School of Public Health.

People are also skilled at tuning out what they don’t want to hear about behaviors from which they derive immediate gratification, even if it means being at greater risk for disease in years ahead.

“We get a benefit from being obese,” Ropeik noted. “All those fries we get to have, taking a nap and watching a ballgame on the weekend instead of working outside in the garden, the extra dessert, the burgers, the beer — we are certainly getting a benefit, and so we play down the risk in our mind if we get a benefit.”

Local health officials said they were well aware of the scale of the problem.

“The statistics here don’t surprise me at all,” said Dr. Mitch Katz, director of the San Francisco Department of Public Health. “We’ve known for some time that physical inactivity has a tremendous burden of disease in this country. Our society has evolved to the point that you don’t even have to get up anymore to switch TV channels.”

The big challenge raised by the new findings is “getting people to be responsible for their own health,” Katz said. The interventions may be as simple as walking instead of taking the elevator at work — as signs exhort people to do in the San Francisco Health Department lobby.

Katz said policies need to change to encourage a leaner society, including tax and other incentives for walking or bicycling. “Right now,” Katz noted, “we subsidize driving.”

February 14, 2013 В· Reality В· No Comments
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