Takeaway food outlets rise by 45% in deprived areas, study finds

pic

creative commons licensed (BY-NC-SA) flickr photo by Stevie Spiers (Photography)

The number of takeaway food outlets has risen by as much as 45% in some of the poorest areas, according to a new study by the University of Cambridge.

Using Yellow Pages telephone directories, researchers were able to collect data on the number and location of takeaway food outlets at various points during 1990 and 2008. The findings were then mapped onto electoral ward boundaries from which a clear pattern emerged linking a rise in fast food outlets with areas of high deprivation.

The highest absolute increase in the number of outlets was seen in the areas of the highest deprivation with an increase from 4.6 outlets to 6.5 outlets per 10,000 residents.  Continue reading

Size Matters: Social Disadvantage, Stress and Chromosomes

Telomere

 

The length of a telomere – a region of repetitive DNA found at the end of a chromosome  – can be up to 19% shorter in children from deprived backgrounds, according to new research conducted by Princeton University, US.

The findings, published in the journal for Proceedings of the National Academy of Sciences, link social environment with health suggesting that disadvantaged backgrounds affect life at a chromosomal level. Continue reading

Counting Calories is Better for Weight Loss – “Little and Often” Can Be Dangerous

apple

 

Counting calories – not adjusting our meals to just “small and often” – is the only important factor in weight loss, according to a new study by the Society for Endocrinology.

The research shows that following a pattern of eating small yet frequent meals will not boost metabolism or encourage weight loss. It is only calories and calories alone, that count.

Conversely, eating single high fat meals can have a negative impact upon health, increasing the risk of developing type-2 diabetes and cardiovascular disease. An increase in endotoxins – fragments of gut bacteria – enter the blood system after eating a single high fat meal, causing a low level inflammation in the body. Continue reading

D is for Discrimination; The Rhetoric of Obesity.

veg

Obesogenic: limited access to fresh fruit and vegetables

Obesity is a threat to global health – the World Health Organisation reports that 2.8 million die each year as a result of obesity. 65% of the world’s population live in a country where overweight kills more than underweight.

According to the Trust for American Health, today’s generation will be the first in US history to live shorter and sicker lives than their parents.

The environment for many is “obesogenic,” by it’s very nature it contributes to obesity as a consequence of it being built up, urban, and offering only limited access to nutrient food and recreational space, yet an abundance of junk food.

In many ways, there is an element of powerlessness for the individual. This has been highlighted in the UK Gov Foresight report; “Tackling Obesities – Future Choices Project”, a UK Government Office of Science study into obesity. One of the main findings by the study is that obesity can no longer be prevented by individual action alone.

Major findings of the Foresight report  include –

  • Modern living ensures that each generation is heavier than the one before
  • The obesity epidemic cannot be prevented by individual action alone
  • Preventing obesity requires a societal challenge, similar to climate change

Despite the research, the modern obesogenic environment that has been created is often ignored — blame set squarely on the lap of the overweight individual for being overweight. Disapproval for obesity is prolific; evident in media, society and individual opinion.

Images of obese individuals are prerequisite of  articles on weight and obesity. The cliché of the typical overweight image in media made number 7 in the Independent Top Ten Visual Clichés, sharing the list of tired clichés along with wedding cake decorations for gay marriage, (number 1) and gas cooker flames for gas bill price hikes, (number 4).

Clichés are easy, and useful. The trouble with a cliché (excuse the one coming….) is that when a cliché is an image, it can speak a thousand words — most of them discriminative when compounding negative views held against a vulnerable group. A study published in PLOS One  found that most people considered overweight people as “lazy, unsuccessful, weak-willed” – an image of a large person at a fast food outlet will only cement the idea of the overweight as defective, less than.

D is for Discrimination

Women and children of low-income or low social economic status have been proven to be consistently more at risk of obesity than any other group, according to research by the Food Research and Action Center (FRAC).

Adult Poverty and Obesity, The Relationship Based on General Trends (excerpt) –

  • Based on a large national study, body mass index (or BMI, an indicator of excess body fat) was higher every year between 1986 and 2002 among adults in the lowest income group and the lowest education group than among those in the highest income and education groups, respectively (Truong & Sturm, 2005).
  • Wages were inversely related to BMI and obesity in a nationally representative sample of more than 6,000 adults – meaning, those with low wages had increased BMI as well as increased chance of being obese (Kim & Leigh, 2010)

With obesity proven to be the shackle of a specific group — low income, uneducated women and children, it is outdated to condemn the individual, to trivialize, or question the validity of obesity as a disease.

Yet, it happens, frequently and publicly. Obesity has made recent headlines in national media and the world has seen the best and the worst of  journalist puns on weight; “The Big Fat Lie,” “The Big Fat Truth,” “Fat Profits,” “Heavy Burden,” and even “F is for Fat,” — the title of an official study into obesity by the Robert Wood Johnston Foundation.

Obesity can cause obesity related cancers, Type 2 diabetes, cardiovascular disease. It is difficult to imagine any other disease so open to puns and play on words.

Is obesity, the last form of socially acceptable discrimination? Joseph Nadglowski of the President of the Obesity Action Coalition, thinks yes –

Obesity carries with it one of the last forms of socially acceptable discrimination. We, as a society, need to make every possible effort to eradicate it from our culture.” Joseph Nadglowski, President and CEO,  Obesity Action Coalition

The Consequence of Weight Bias

In a study by Florida State University College of Medicine, researchers proved that perceived weight discrimination leads to longitudinal changes in obesity.

Published on PLOS One, “Perceived Weight Discrimination and Obesity,” researched by Angelina R. Sutin Ph.D.,  and Antonio Terracciano Ph.D studied  6157 patients over a 4 year period, tracking BMI’s and individual experiences of  perceived weight discrimination.

Participants rated  experiences of everyday discrimination in a psychosocial survey,   attributing perceived discrimination to weight, ancestry, sex, race, age, physical disability, any other aspects of their physical appearance, and/or their sexual orientation.

4,193 of the 6157 were at baseline BMI at the beginning of the study — 1,964 were clinically obese.

Of the 4,193 participants who were not obese at baseline, 357 (5.8%) became obese by follow-up, and of the 1,964 participants who were obese at baseline, 1,618 (26.3%) remained obese at follow-up.

Participants who reported experiencing a perceived weight discrimination were 2.5 times more likely to become obese, and obese participants 3 times more likely to remain obese than those who had did not report experience weight discrimination.

These effects held even when BMIs were used as  a variable to predict outcomes, and despite ethnic and other bias affecting results.

Why Weight Bias?

According to a Rudd Center for Food Policy and Obesity report, weight bias exists because as a society, we share a belief that individuals are responsible for their own weight and refuse to consider the environmental conditions that cause obesity. Culturally, we value thinness, and, anything that strays from the acceptable idea of body image is considered a flaw, a failure even, belonging to the individual. Negative views are further compounded by negative portrayal of obese individuals, coupled with a media obsession with the body and its appearance.

According to researchers, discrimination against obese Americans is pervasive in society. Such biased and negative attitudes are thought to lead to depression,  a negative effect on employment opportunities, salary disparities, healthcare access.

The Rudd Center found in a recent study that even mental health workers working specifically with patients with eating disorders were “not immune to weight bias.”

At its worst, discrimination against people with excess weight can lead to the very behaviors that exasperate obesity; avoiding physical exercise and binge eating, and, as the study by the Florida State University College of Medicine proves, a longitudinal weight increase.

The measure of a society has long been judged by how it treats its weakest –

Any society, any nation, is judged on the basis of how it treats its weakest members — the last, the least, the littlest.” ~Cardinal Roger Mahony, In a 1998 letter, Creating a Culture of Life

An inability for us to foster compassion for those who suffer the consequence of health and economic inequity, makes us all small.

Notes:

The Independent, Top Ten: Visual cliches
http://www.independent.co.uk/news/media/tv-radio/the-top-ten-visual-clichs-8665467.html

Foresight Report – Tackling Obesities – Future Choices (2007)
http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publichealth/Healthimprovement/Obesity/DH_079713

FRAC: Relationship between Poverty and Obesity
http://frac.org/initiatives/hunger-and-obesity/are-low-income-people-at-greater-risk-for-overweight-or-obesity/

Perceived Weight Discrimination
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070048

Consequences of Obesity (FRAC)
http://frac.org/initiatives/hunger-and-obesity/what-are-the-consequences-of-adult-overweight-and-obesity/

Rudd Center for Food Policy & Obesity
http://www.yaleruddcenter.org/mental-health-professionals-treating-eating-disorders-are-not-immune-to-weight-bias

Image credit: RGB Free Stock
Thanks to photographer tacluda

D is for Discrimination; The Rhetoric of Obesity.

veg

Obesogenic: limited access to fresh fruit and vegetables

Obesity is a threat to global health – the World Health Organisation reports that 2.8 million die each year as a result of obesity. 65% of the world’s population live in a country where overweight kills more than underweight.

According to the Trust for American Health, today’s generation will be the first in US history to live shorter and sicker lives than their parents.

The environment for many is “obesogenic,” by it’s very nature it contributes to obesity as a consequence of it being built up, urban, and offering only limited access to nutrient food and recreational space, yet an abundance of junk food.

In many ways, there is an element of powerlessness for the individual. This has been highlighted in the UK Gov Foresight report; “Tackling Obesities – Future Choices Project”, a UK Government Office of Science study into obesity. One of the main findings by the study is that obesity can no longer be prevented by individual action alone.

Major findings of the Foresight report  include –

  • Modern living ensures that each generation is heavier than the one before
  • The obesity epidemic cannot be prevented by individual action alone
  • Preventing obesity requires a societal challenge, similar to climate change

Despite the research, the modern obesogenic environment that has been created is often ignored — blame set squarely on the lap of the overweight individual for being overweight. Disapproval for obesity is prolific; evident in media, society and individual opinion.

Images of obese individuals are prerequisite of  articles on weight and obesity. The cliché of the typical overweight image in media made number 7 in the Independent Top Ten Visual Clichés, sharing the list of tired clichés along with wedding cake decorations for gay marriage, (number 1) and gas cooker flames for gas bill price hikes, (number 4).

Clichés are easy, and useful. The trouble with a cliché (excuse the one coming….) is that when a cliché is an image, it can speak a thousand words — most of them discriminative when compounding negative views held against a vulnerable group. A study published in PLOS One  found that most people considered overweight people as “lazy, unsuccessful, weak-willed” – an image of a large person at a fast food outlet will only cement the idea of the overweight as defective, less than.

D is for Discrimination

Women and children of low-income or low social economic status have been proven to be consistently more at risk of obesity than any other group, according to research by the Food Research and Action Center (FRAC).

Adult Poverty and Obesity, The Relationship Based on General Trends (excerpt) –

  • Based on a large national study, body mass index (or BMI, an indicator of excess body fat) was higher every year between 1986 and 2002 among adults in the lowest income group and the lowest education group than among those in the highest income and education groups, respectively (Truong & Sturm, 2005).
  • Wages were inversely related to BMI and obesity in a nationally representative sample of more than 6,000 adults – meaning, those with low wages had increased BMI as well as increased chance of being obese (Kim & Leigh, 2010)

With obesity proven to be the shackle of a specific group — low income, uneducated women and children, it is outdated to condemn the individual, to trivialize, or question the validity of obesity as a disease.

Yet, it happens, frequently and publicly. Obesity has made recent headlines in national media and the world has seen the best and the worst of  journalist puns on weight; “The Big Fat Lie,” “The Big Fat Truth,” “Fat Profits,” “Heavy Burden,” and even “F is for Fat,” — the title of an official study into obesity by the Robert Wood Johnston Foundation.

Obesity can cause obesity related cancers, Type 2 diabetes, cardiovascular disease. It is difficult to imagine any other disease so open to puns and play on words.

Is obesity, the last form of socially acceptable discrimination? Joseph Nadglowski of the President of the Obesity Action Coalition, thinks yes –

Obesity carries with it one of the last forms of socially acceptable discrimination. We, as a society, need to make every possible effort to eradicate it from our culture.” Joseph Nadglowski, President and CEO,  Obesity Action Coalition

The Consequence of Weight Bias

In a study by Florida State University College of Medicine, researchers proved that perceived weight discrimination leads to longitudinal changes in obesity.

Published on PLOS One, “Perceived Weight Discrimination and Obesity,” researched by Angelina R. Sutin Ph.D.,  and Antonio Terracciano Ph.D studied  6157 patients over a 4 year period, tracking BMI’s and individual experiences of  perceived weight discrimination.

Participants rated  experiences of everyday discrimination in a psychosocial survey,   attributing perceived discrimination to weight, ancestry, sex, race, age, physical disability, any other aspects of their physical appearance, and/or their sexual orientation.

4,193 of the 6157 were at baseline BMI at the beginning of the study — 1,964 were clinically obese.

Of the 4,193 participants who were not obese at baseline, 357 (5.8%) became obese by follow-up, and of the 1,964 participants who were obese at baseline, 1,618 (26.3%) remained obese at follow-up.

Participants who reported experiencing a perceived weight discrimination were 2.5 times more likely to become obese, and obese participants 3 times more likely to remain obese than those who had did not report experience weight discrimination.

These effects held even when BMIs were used as  a variable to predict outcomes, and despite ethnic and other bias affecting results.

Why Weight Bias?

According to a Rudd Center for Food Policy and Obesity report, weight bias exists because as a society, we share a belief that individuals are responsible for their own weight and refuse to consider the environmental conditions that cause obesity. Culturally, we value thinness, and, anything that strays from the acceptable idea of body image is considered a flaw, a failure even, belonging to the individual. Negative views are further compounded by negative portrayal of obese individuals, coupled with a media obsession with the body and its appearance.

According to researchers, discrimination against obese Americans is pervasive in society. Such biased and negative attitudes are thought to lead to depression,  a negative effect on employment opportunities, salary disparities, healthcare access.

The Rudd Center found in a recent study that even mental health workers working specifically with patients with eating disorders were “not immune to weight bias.”

At its worst, discrimination against people with excess weight can lead to the very behaviors that exasperate obesity; avoiding physical exercise and binge eating, and, as the study by the Florida State University College of Medicine proves, a longitudinal weight increase.

The measure of a society has long been judged by how it treats its weakest –

Any society, any nation, is judged on the basis of how it treats its weakest members — the last, the least, the littlest.” ~Cardinal Roger Mahony, In a 1998 letter, Creating a Culture of Life

An inability for us to foster compassion for those who suffer the consequence of health and economic inequity, makes us all small.

Notes:

The Independent, Top Ten: Visual cliches
http://www.independent.co.uk/news/media/tv-radio/the-top-ten-visual-clichs-8665467.html

Foresight Report – Tackling Obesities – Future Choices (2007)
http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publichealth/Healthimprovement/Obesity/DH_079713

FRAC: Relationship between Poverty and Obesity
http://frac.org/initiatives/hunger-and-obesity/are-low-income-people-at-greater-risk-for-overweight-or-obesity/

Perceived Weight Discrimination
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0070048

Consequences of Obesity (FRAC)
http://frac.org/initiatives/hunger-and-obesity/what-are-the-consequences-of-adult-overweight-and-obesity/

Rudd Center for Food Policy & Obesity
http://www.yaleruddcenter.org/mental-health-professionals-treating-eating-disorders-are-not-immune-to-weight-bias

Image credit: RGB Free Stock
Thanks to photographer tacluda

First generation in US history to live shorter lives than their parents.

Image: credit to wolliballa Today’s US children are destined to be the first generation in American history to live shorter lives than their parents, according to a report by The Trust for American Health.

5 – 11 years is thought to be lost from the current average life span of 75 years. Executive director of The Trust for American Health (TFAH), Jeffrey Levi, claims that children’s lives will not only be shorter, but sicker too if current rates of obesity, cancer, Type 2 diabetes and heart disease continue;

Today’s kids could become the first in American history to live shorter, less healthy lives than their parents.” Jeffrey Levi, PhD, executive director of Trust for American Health

The antidote to the crisis is the Health Prevention Fund; a $14.5 billion US government investment enacted by the Affordable Care Act, 2010, the largest investment ever in prevention care by the US. Before the Affordable Care Act was passed, only 3% of health care funding was allocated to preventative health care. In stark contrast, 75 per cent of the $2.5 trillion spent on U.S. medical care was spent on treatment of chronic and preventable disease such as heart disease and Type 2 diabetes.

Sequestering of government budgets has seen cuts to the Health Prevention Fund of $51 million. Despite this the US government is confident that the Health Prevention Fund can contribute to a preventative health care system to replace the current “sick care” system.

The $14.5 billion dollars, to be attributed over a 10 year period, will lead to a number of investments to include:

  • Vaccinations for Children (+$261.955 million)
  • Chronic Disease Prevention and Health Promotion (+$128.699 million)
  • Affordable Care Act Prevention and Public Health Fund (+$78.210 million)
  • Domestic HIV/AIDS Prevention and Research (+$40.231 million)
  • Health Statistics (+$23.150 million)
  • Food Safety (+$16.735 million)
  • Polio Eradication (+$15.079 million)
  • National Healthcare Safety Network (+$12.628 million)
  • Tobacco cessation (helpline and education) (+$6.040 million)

Community Transformation Grants (CTGs) — ambitious, community-centered grants enabling communities to respond to health inequalities from “within” have 5 year targets to achieve which include –

  • reduce a community’s rate of obesity by 5%
  • reduce death and disability from heart disease and stroke by 5%
  • reduce death and disability due to tobacco use by 5%

The TFAH report documents a number of successful CTG programs that have been in operation including in Akron, Ohio where the CTG fund has helped to reduce the average care cost per month for Type 2 diabetes by more than 10%, saving an estimated $3,185 per person, per year. West Virginia has implemented policies for safety, school nutrition and physical activity and in Iowa, healthy lifestyle accountability is being cultivated through a partnership between health providers and community agencies.

The Tipping Point for US Health

Adult obesity has doubled since 1980 from 15% to 30%. By 2030, more than 60% of adults in 13 US states are predicted to be diagnosed with obesity if current trajectories continue costing $196 billion in lost productivity and $213 billion in direct medical costs.

Despite obesity costing the US $147 billion in direct healthcare costs each year, and two thirds of Americans currently either obese or overweight, the US has adopted a tentative strategy towards the activities of the food industry.

The US drafted “Voluntary Guidelines for the Marketing of Food to Children” — self regulatory guidelines that businesses are free to adopt or ignore. The UK, facing similar issues, set out a similarly tentative guidelines in a business “Pledge” – companies volunteer to “pledge” to meet salt and fat targets and remove trans fats.

Both schemes are voluntary ‘opt in’ recommendations. According to Small Business, only 11% of UK companies have signed up for the Pledge scheme.

Investment in the future health of the US, and the UK, needs to be big.

According to a report by The Telegraph, Kraft has recently set aside a $26million pound investment in the development of a Research and development for its UK base alone, more that the US government has budgeted for collecting US health statistics for the whole US population.

The opening of the R and D center in Bournville in Birmingham, UK, which includes innovation labs, a pilot plant facility, 3D printers and a ‘collaborative kitchen’ for experimentation, comes after Kraft revealed that profits rose 54% to £521m ($830m) for the final quarter of 2011.

“Joyville” perhaps for the financial futures of Kraft and their shareholders, but not for the US and the UK who face a tough battle for a healthy future.

Notes:

The Truth About the Prevention and Public Health Fund
http://healthyamericans.org/assets/files/Truth%20about%20the%20Prevention%20and%20Public%20Health%20Fund.pdf
Fact Sheet – Health Prevention Fund
http://www.apha.org/NR/rdonlyres/3060CA48-35E3-4F57-B1A5-CA1C1102090C/0/APHA_PPHF_factsheet_May2013.pdf

Dept of Health and Human services (budget appropriations):
http://www.cdc.gov/fmo/topic/Budget%20Information/appropriations_budget_form_pdf/FY2013_CDC_CJ_Final.pdf

Joyville at Cadbury (Kraft)
http://www.cadburydairymilk.co.uk/

UK Gov: “Obesity can not be prevented by individual action alone.”

nazreth (Michael Lorenzo)Obesity is no longer a problem that just threatens the future of the US. A research paper published by Foresite of the Government Office for Science warns that 61.3% of adults and a third of children in the UK are now clinically overweight or obese.

Incidents of obesity have increased since 2001 with alarming speed. Figures published by the National Office of Statistics report that 11,736 children and adults were admitted to hospital with a primary diagnosis of obesity in 2011/12 – a ten fold increase in just ten years.

Stomach stapling, gastric bypass and sleeve gastroectomy have seen a year on year increase in the number of procedures recorded. 261 procedures were carried out in 2000/01, and according to the NHS this figure has risen to 6,723 in 20011/12. Gastric bands alone reportedly cost the UK health service £85 million a year.

Obesity is life limiting,  life threatening and leads to premature death. Obese patients can suffer heart disease, strokes, obesity related cancers, hypertension, arthritis and asthma as well as serious physical injuries resulting from falls. According to the UK Government research, obesity can also cause feelings of low self worth, mental health problems and difficulties in gaining and sustaining employment.
Three major findings of the Foresite report are –

  • Modern living ensures every generation is heavier than the last
  • The obesity epidemic cannot be prevented by individual action alone
  • Preventing obesity is a societal challenge, similar to climate change

Costs are high to health and to society. Using Department of Health data, the projected price tag to the NHS could double to £10bn a year by 2050. The wider cost to employers and the economy will be much greater – higher rates of obesity are associated with absence from work, early retirement and an increase in disability pensions.

In response to the Foresite report, the government has set out a target for a “downward trend in obese adults and a sustained downward trend in excess weight in children.” Tame rhetoric for a health crisis that is as pressing to health as climate change is to the environment.
The US and the UK are hit with an obesity epidemic which is only set to worsen. Marketing of “junk” – high fat and zero nutrient convenience foods, are a major factor in damaging public health. Yet, despite the role that the food industry plays in the health of future generations the guidelines for business set by the US and the UK are voluntary and self-regulatory.

The US drafted “Voluntary Guidelines for the Marketing of Food to Children” while the UK has similarly set out a tentative business ‘Pledge’ – companies volunteer to commit to a pledge to meet salt and fat targets and remove trans fats. Both are ‘opt in’ recommendations that businesses are free to adopt,or ignore. According to Small Business only 11% of UK companies have signed up for the scheme.

Critics claim that the Foresite report should push governments to react with more gumption. The British Heart Foundation said in response to the obesity report that if it was was setting off alarm bells, the government’s response was “met only by repeated pushes of the government’s snooze button.”

Professor Rob Moodie of the University of Melbourne recently researched multinationals, their impact on health and government policy and expressed similar disappointment. Commenting on the “nudge theory” and reliance on voluntary self-regulation, he told The Independent;

“You can’t expect self-regulation to work. It is like having the burglars install your locks. You think it might work and you are safe but you are not,” he said.

Notes:

Foresight Report – Tackling Obesities – Future Choices (2007)
http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publichealth/Healthimprovement/Obesity/DH_079713

National Office of Statistics –
https://catalogue.ic.nhs.uk/publications/public-health/obesity/obes-phys-acti-diet-eng-2013/obes-phys-acti-diet-eng-2013-rep.pdf

Food Pledges – UK Gov voluntary agreement for food companies
https://responsibilitydeal.dh.gov.uk/food-pledges

Image: RGB Freestock: nazreth (Michael Lorenzo)