Don’t Wait Until It’s Too Late

Type 2 diabetes
Hypertension
Heart disease
Stroke
Breast cancer
Colon cancer
Gallbladder disease
Arthritis
Disability
Sleep disturbances
Breathing problems


Walking around the local mall or driving by a busy  fast food restaurant, it is hard to miss......we have  gotten big! It can happen easily. Life is busy. For  many reasons, it is quite simple to not have the  time to eat healthy meals or to be active on a  daily basis. Work, school, homework, computer work,  family time, chores, errands the list goes on.  Preparing healthy meals takes precious time and  finding the minutes and effort to sweat out those  extra calories is just too demanding or is it?

The Crisis
It is no surprise that over the past two decades  obesity rates have doubled in adults. About 60  million adults, or 30% of the adult population in  the US are now obese. Even worse, in Tennessee over  60% of adults are currently either overweight or  obese. Similarly, the percentage of children and  adolescents who are above their normal weight has  doubled and tripled during the same period to well  over 30-40% in some local areas. Tennessee has the  nation’s 3rd highest ranking of overweight adults,  and East Tennessee is experiencing rates of  unhealthy weight higher than both the state of  Tennessee and the United States as a whole.  Obesity causes many thousands of deaths in adults  and is an important risk factor for serious diseases  like diabetes, heart disease, and some cancers. In  the United States, obesity is related to about:  Two-thirds of Type 2 diabetes, two-thirds of heart  disease, 15% of cancer in men and 20% of cancer in  women.
Adults who are overweight are not necessarily "over fat,"  but increased fat is the reason obese adults are at  such greater risk for a whole range of negative  health conditions and diseases. This epidemic has devastating impacts on health,  quality of life, and health care costs.  Most people still do not practice healthy behaviors  that can prevent obesity. The primary behaviors  causing the obesity epidemic are well known and  preventable: unhealthy diet and physical inactivity.  Despite this knowledge: Less than 25% of Tennessee adults eat the  recommended five or more servings of fruits and  vegetables each day for children and adolescents,  it’s more like 20%. More than 60% of Tennessee adults do not get the  recommended amount of physical activity to provide  health benefits. More than a third of young people in grades 9-12 do  not regularly engage in vigorous physical activity.
Physical activity trends in Tennessee pre-school and  elementary-aged children have followed the national  trends of dramatically declining.

The Economic Burden
Obesity-related costs place a huge burden on the  U.S. economy. The Center for Disease Control and  Prevention has estimated that the total economic  costs attributed to overweight and obesity in the  United States amounted to an estimated $117 billion  in 2000: $61 billion for direct medical costs (e.g.,  costs of diagnostic and treatment services). An  additional $56 billion for indirect expenditures  (e.g., costs of absenteeism and lost productivity).  Among children and adolescents, annual hospital  costs related to overweight and obesity more than  tripled over the past two decades – rising to $127  million during 1997-1999, up from $35 million during  1979 -1981.  In East Tennessee, the economic cost of inactivity  alone has been estimated to be as high as almost  $650 million annually. And this doesn’t even include  the costs of poor nutritional habits.

The Promise of Prevention
Starting Early:
Breast feeding has been shown to potentially reduce  the risk of overweight and obesity later in life (in  addition to breast feeding's countless additional  health and disease prevention benefits). New moms  are advised to breast feed exclusively for the  baby’s first six months of life, and to continue  throughout the first year and beyond as long as is  mutually desired by mother and child.

Children and Adolescents:
Preventing overweight in  childhood and adolescence helps keep blood pressure  and cholesterol at desirable levels and helps  optimize the body’s metabolism of glucose – thus  reducing the major risk factors for diabetes, heart  disease, and stroke. Good nutrition practices and  physical activity established in childhood and  continued into adult life offer better lifelong  health and reduced risk of many of the major chronic  diseases. Parent and familial involvement and role  modeling are critical in establishing these healthy  habits.

Adults:
For overweight and obese adults, losing weight  through a combination of improved diet and increased  physical activity reduces the risk of onset and/or  progression of many of the major chronic diseases.  It has been shown that changes in lifestyle,  including weight control and moderate physical  activity, can reduce the risk of diabetes by nearly  60% among overweight adults with pre-diabetes.  Additionally, just a 10% weight loss = 20 pounds if  you weigh 200 pounds can dramatically improve  immediate health outcomes and also reduce an  overweight persons yearly medical costs.

Help is Near
What are some things happening in our community to combat the crisis?
The local public health community is well aware of  the obesity epidemic and has many programs available  that are addressing the multi-faceted problem. The  Knox County Health Department, for instance, houses  the East Tennessee 2 Step: Eat Smart, Move More  Initiative, which is addressing issues such as work  site wellness and active living in our area. In  addition, Knox County maintains its own work site  wellness program, called Bright Start, which has  greatly impacted the health of Knox County  employees. The Knox County Health Department also  houses initiatives addressing early childhood  nutrition and physical activity (Fueling & Movin’  for Life’s Childcare Initiative and the Women,  Infants, and Children (WIC) Program); as well as the  East Tennessee Breast feeding Coalition; the Greater  Knoxville Nutrition Council; and partnerships with  Knox County Schools, the Tennessee Healthy Weight  Network, the Governor’s Council on Physical Fitness  and Health, and Emergency Food Helpers, among  others.  Some other groups that are notably aware of the  obesity crisis in our community and actively working  to address it are: Knoxville-Knox County Head Start  Programs Healthy Weight Initiative; Knox County  Schools food service Department (offering SMART  Lunches at all middle and high schools, among other  programs); Knox County Schools Physical Education  Department; all local hospitals; Tennessee On the  Move; the Knoxville District Dietetic Association  and other professional groups; as well as a  multitude of community groups and faith-based  organizations.  In addition to these programs and initiatives, many  other private industries are addressing the problem  through: Corporate/work site wellness programs,  In-service seminars on health and nutrition,  Corporate discounts at health clubs, Nutrition  counseling by Registered Dietitian's ,∑ Healthy  vending and work site food options.  As obesity is a multi-faceted issue, the community  must have a multi-faceted approach to address it.  Many community groups and organizations have drafted  plans with specific policy recommendations to  further combat the problem. The solution to changing  the current trends must involve adequately assessing  the issue, assuring services are appropriately  provided, and instituting policies to help create a  healthier climate in which to live.

Knowledge is Power
What should you do with this information? Regardless  of your body weight, you should continue to pursue a  healthy lifestyle, including getting regular  physical activity, eating a diet rich in fruits,  vegetables, and whole grains, avoiding smoking, and  going for regular visits to the doctor to monitor risk factors. If you have an  obesity-related disease or condition and are trying  to lose weight, be sure to check first with your  doctor. The newly revised 2005 Dietary Guidelines for  Americans include recommendations for physical  activity to promote a healthy body weight and reduce  the risk of chronic disease. Among the  recommendations, we are encouraged to: Engage in at least 30 minutes of  moderate-intensity physical activity (like walking  briskly, mowing the lawn, golfing, scrubbing floors)  above usual activity, at work or home on most days  of the week. Engage in approximately 60 minutes of moderate- to  vigorous-intensity activity (like swimming laps,  running, tennis, circuit training) on most days of  the week. Participate in at least 60 to 90 minutes of daily  moderate-intensity physical activity when attempting  to lose weight. (Some people may need to consult  with a healthcare provider before participating in  this level of activity.)
Achieve physical fitness by including  cardiovascular conditioning, stretching exercises  for flexibility, and resistance exercises or  calisthenics for muscle strength and endurance. Among the specific nutrition recommendations, you  are encouraged to: Consume sufficient amounts of fruits and  vegetables while staying within energy needs. Two  cups of fruit and 21/2 cups of vegetables per day  are recommended. Choose a variety of fruits and vegetables each  day. In particular, select from all five vegetable  subgroups (dark green, orange, legume's, starchy  vegetables, and other vegetables) several times a  week. Consume fiber-rich whole-grain products for at least half of your daily grain  servings. Consume 3 cups per day of fat-free or low-fat milk  or equivalent milk products. Limit intake of fats and oils high in saturated  and/or trans fatty acids, and choose products low in  such fats and oils, cholesterol, added sugars, and  salt. In order to combat the obesity crisis in our  area, individuals and families can balance healthful  eating with regular physical activity to reach and  stay at a healthy weight. Reasonable, long term  eating and exercise goals are most likely to be  successful. Use family time to be active together.  Take advantage of the many opportunities to be  physically active in East Tennessee (mountain trails  and local greenways, fitness clubs and community  centers, organized sports and walking/running  clubs....). Adopt more healthful eating habits,  including eating smaller portion sizes - this can be  done simply, but it must be made a priority in order  to happen. In addition, communities (including  schools, work sites, and places of worship and  recreation) can adopt policies to encourage  healthful eating and physical activity. Generally, gradual and reasonable eating and  exercise goals are most likely to have long-term  success. But you must establish them as habits and  work to make them happen. Talk with your medical  provider for more information about specific  recommendations for you.

Lee Murphy MS-MPH,RD, LDN
Community Nutritionist for
Knox County Health Department