InTouch Magazine - Spring/Summer 2001

Weighing-In on the Obesity Epidemic

The Minneapolis Heart Institute Foundation (MHIF) is committed to advancing the cardiovascular health of those communities it serves through the promotion of healthy lifestyles and effective disease management strategies. Through our regular and frequent interactions with audiences throughout the state and region, we have been very successful in helping people reduce individual risk for disease and improve their personal well-being. As we look to continue this important work in the 21st century, we find ourselves faced with one of our greatest challenges - an epidemic of obesity.

The major risk factors, which promote heart disease development, are well known. Smoking, high blood pressure and high blood cholesterol top the list of recognized and significant precursors to disease. During the past decade, two additional causal influences were elevated to this level: physical inactivity (1992) and obesity (1997). More than half of all Americans are overweight or obese. Obesity has recently been described as one of the greatest public health problems facing this country, contributing to more than 300,000 deaths each year - deaths that could be avoided. Almost 80% of obese adults have diabetes, high cholesterol, hypertension, coronary artery disease, gallbladder disease or osteoarthritis. The recent sudden rise in obesity rates in the U.S. has been likened to past experiences involving the spread of communicable disease.

Public health professionals define an epidemic as "a greater than usual presence of a disease or health condition." According to recent published findings of the Centers for Disease Control (CDC), the prevalence of obesity in the U.S. has increased from 12% in 1991 to approximately 22% in 2000 (estimated). The prevalence maps on the right highlight this trend of increasing national obesity rates based on actual data through 1998:

Prevalence of Obesity* Among U.S. Adults (*Approximately 30 pounds overweight) Source: Mokdad AH, et al. J Am Med Assoc 1999, 282:16.

So who is at greatest risk for this health problem? Although all segments of the population have been affected, no group has been as hard hit as our children. One of four children today is obese, and obese kids who remain heavy through adolescence tend to stay that way as they progress into adulthood. Also, obese children and adults are less likely to exercise and reap the many health benefits associated with regular physical activity. The following bar graphs represent current physical activity levels of Minnesota youth:

Percentage Kids "Insufficiently Active"
Minnesota Student Survey, 1998


Percentage Kids "Not Active at All"
Minnesota Student Survey, 1998

We know the epidemic is caused not by biological and genetic factors but environmental and societal ones. Simply said, it is a matter of what we are doing (or not doing) not who we are. With an abundant and inexpensive food supply and a largely sedentary population, we are realizing that our behavior is most likely the most significant influence on the obesity epidemic. Specific behavioral guidelines recommend a combination of fewer calories and more physical activity to assist people in achieving their ideal weight and improved health. As a society, we have seen a significant increase in our dependence on the automobile, less physically active jobs, use of labor saving devices and television viewing and computer use, all of which have contributed to the current problem.

In looking beyond the individual, Dr. William Dietz of the CDC believes small, community-based efforts will be instrumental in slowing the obesity epidemic. These efforts may include:

• Encouraging doctors to advise their patients to lose weight and become more physically active;
• Giving kids access to healthy foods and incentives to be healthy;
• Involving children in daily, structured physical education in the schools;
• Encouraging corporations to provide opportunities for onsite fitness activities and/or facilities for employees; and
• Promoting community walking programs.

Walk and Bike Trips
1977-1995


Automobile Trips
1977-1995

According to Dr. Dietz, "These types of strategies work, both in terms of getting people more active as well as changing patterns of food consumption." In addition, it is important to develop and implement broader population strategies such as public awareness campaigns recognizing that awareness of a problem is the first step toward change.

By utilizing a variety of approaches we have a chance to effectively slow or prevent the looming obesity crisis. Minnesota is not immune to the obesity epidemic with prevalence rates consistent with national levels. At present, 76% of Minnesota adults are insufficiently active (moderately active less than 5 times/week). Of those, 24% are not active at all (Minnesota Behavior Risk Factor Surveillance Survey, 1996). In an effort to address this problem locally, the Minneapolis Heart Institute Foundation has recently partnered with the Minnesota Department of Health and the Minnesota Council on Physical Activity and Sports to begin discussions toward the development of a statewide initiative to promote physical activity.

Initial funding for the Minnesota Physical Activity Initiative has been secured through the Team Heart project, a pledge-based, cross-country bicycle race held in June 2000. Thanks to the efforts of an inspirational team of physician riders from Abbott Northwestern Hospital, more than $50,000 in net proceeds were realized for dedicated use in the planning and advancement of the initiative. We have also begun soliciting other groups for financial support. MHIF is very excited about the potential for this effort to play a significant role in improving the health and well-being of Minnesotans. For more information on the obesity epidemic and/or the Minnesota Physical Activity Initiative, please call the Minneapolis Heart Institute Foundation Education Services Division at 612/863-3979.