Los Angeles Times
The rates of both obesity and diabetes in the United States have grown by 50 percent or more over the last decade, and the increase seems to be accelerating, according to new figures from the Centers for Disease Control and Prevention.
According to the study, the proportion of Americans who are obese — 30 to 50 pounds overweight, depending on height — rose from 12 percent in 1991 to 19.8 percent in 2000. Over the same period, the proportion who are diabetic increased from 4.9 percent to 7.3 percent.
Between 1999 and 2000 alone, the proportion of obese Americans increased from 18.9 percent to 19.8 percent and the incidence of diabetes rose from 6.9 percent to 7.3 percent, indicating that the growth rate of both problems is accelerating, the researchers said.
The findings are being published in today’s edition of the Journal of the American Medical Association.
The trend is particularly disturbing in children, researchers noted. Two decades ago, the incidence of Type 2 diabetes in children was only 3 percent to 5 percent. Now it’s 25 percent to 30 percent, said Dr. Dan Cooper of the University of California at Irvine School of Medicine.
Some of those factors leading to the increase include growing consumption of fast food, the increased prevalence of video games and other indoor activities, and the inability of many children to play safely outdoors in their neighborhoods.
Already, health care costs associated with diabetes are estimated to be more than $100 billion per year. About 9.4 percent of national health care expenditures are directly related to obesity and physical inactivity, the researchers said.
"If we continue on this course for the next decade, the public health implications of both disease and health care costs will be staggering," said CDC director Dr. Jeffrey Koplan.
Diabetes is a major contributor to blindness, kidney disease and lower limb amputations, as well as heart attacks and strokes. The majority of patients with Type 2 diabetes die of heart attacks and strokes.
The increases in obesity and diabetes go hand in hand. As many as 95 percent of all diabetics have Type 2 diabetes — often known as adult-onset diabetes — and the primary risk factor for Type 2 diabetes is obesity.
"When you gain weight, the body becomes more resistant to the effects of insulin," which regulates blood sugar levels, said Dr. Mohammad Saad of the University of California at Los Angeles. "The more obese you are, the more likely you are to become insulin resistant," he noted.
In fact, 80 percent of Type 2 diabetics are obese.
The diabetes and obesity rates "have more to do with lifestyle than with genetic makeup," said Dr. Frank Vinicor, director of CDC’s diabetes programs.
The new study found, for example, that 27.3 percent of Americans did not engage in any physical activity during the 1990s and only about a quarter of Americans consumed the recommended five or more servings of fruit and vegetables per day.
Only 17.5 percent of Americans are following the recommended guidelines of at least 30 minutes of moderate physical activity most days of the week, the researchers said.
But researchers cautioned that all the figures were very conservative. The data were based on self-reports of height and weight in a large telephone questionnaire conducted by CDC called the Behavioral Risk Factor Surveillance System. But several previous studies have shown that, in such surveys, overweight people tend to underestimate their weight and virtually everyone overestimates their height.
The tragedy of the findings, Saad said, is that diabetes is readily preventable. A major recent study, he noted, found that only a 10-pound weight loss and a modest increase in physical activity decreases the risk of diabetes by 58 percent.
"Our findings were striking," said CDC epidemiologist Ali Mokdad, the lead author of the JAMA article.
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