OBESITY IN THE DEEP SOUTH

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OBESITY IN THE DEEP SOUTH

• By Scot E. Long, Ph.D., CSCS

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Obesity in the United StatesSource Behavioral
Risk Factor Surveillance System, CDC.
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Prevalence of Self-Reported Obesity Among U.S.
Adults by State and Territory

• Definitions
• Obesity Body Mass Index (BMI) of 30 or higher.
• Body Mass Index (BMI) A measure of an adults
  weight in relation to his or her height,
  calculated by using the adults weight in
  kilograms divided by the square of his or her
  height in meters.

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Prevalence of Self-Reported Obesity Among U.S.
Adults by State and Territory

• Source of the Data
• The data were collected through the Behavioral
  Risk Factor Surveillance System (BRFSS), an
  ongoing, state-based, telephone interview survey
  conducted by state health departments with
  assistance from CDC.
• Height and weight data used in the BMI
  calculations were self-reported.

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Prevalence of Self-Reported Obesity Among U.S.
Adults by State and Territory

• BRFSS Methodological Changes Started in 2011
• New sampling frame that included both landline
  and cell phone households.
• New weighting methodology used to provide a
  closer match between the sample and the
  population.

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Prevalence of Self-Reported Obesity Among U.S.
Adults by State and Territory

• Exclusion Criteria Used Beginning with 2011 BRFSS
  Data
• Records with the following were excluded
• Height lt3 feet or 8 feet
• Weight lt50 pounds or 650 pounds
• BMI lt12 kg/m2 or 100 kg/m2
• Pregnant women

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Prevalence of Self-Reported Obesity Among U.S.
Adults by State and Territory, BRFSS, 2014
State Prevalence 95 Confidence Interval
Alabama 33.5 (32.1, 35.0)
Alaska 29.7 (27.8, 31.7)
Arizona 28.9 (27.7, 30.2)
Arkansas 35.9 (33.8, 38.0)
California 24.7 (23.5, 25.9)
Colorado 21.3 (20.4, 22.2)
Connecticut 26.3 (24.9, 27.7)
Delaware 30.7 (28.6, 32.8)
District of Columbia 21.7 (19.5, 24.0)
Florida 26.2 (25.0, 27.5)
Georgia 30.5 (28.9, 32.1)
Guam 28.0 (25.6, 30.5)
Hawaii 22.1 (20.7, 23.5)
Idaho 28.9 (27.1, 30.8)
Illinois 29.3 (27.6, 31.1)
Indiana 32.7 (31.6, 34.0)
Iowa 30.9 (29.6, 32.3)
Kansas 31.3 (30.3, 32.2)
Kentucky 31.6 (30.2, 33.1)
Louisiana 34.9 (33.4, 36.4)
Maine 28.2 (26.9, 29.5)
Maryland 29.6 (28.1, 31.1)
Massachusetts 23.3 (22.3, 24.4)
Michigan 30.7 (29.4, 32.0)
Minnesota 27.6 (26.8, 28.5)
Mississippi 35.5 (33.4, 37.6)
State Prevalence 95 Confidence Interval
Missouri 30.2 (28.6, 31.9)
Montana 26.4 (24.9, 27.9)
Nebraska 30.2 (29.2, 31.3)
Nevada 27.7 (25.4, 30.1)
New Hampshire 27.4 (25.8, 29.1)
New Jersey 26.9 (25.7, 28.1)
New Mexico 28.4 (27.0, 30.0)
New York 27.0 (25.6, 28.5)
North Carolina 29.7 (28.4, 31.0)
North Dakota 32.2 (30.5, 34.0)
Ohio 32.6 (31.2, 34.1)
Oklahoma 33.0 (31.7, 34.3)
Oregon 27.9 (26.3, 29.6)
Pennsylvania 30.2 (28.9, 31.4)
Puerto Rico 28.3 (26.8, 29.8)
Rhode Island 27.0 (25.4, 28.6)
South Carolina 32.1 (30.9, 33.3)
South Dakota 29.8 (27.9, 31.8)
Tennessee 31.2 (29.3, 33.2)
Texas 31.9 (30.6, 33.3)
Utah 25.7 (24.9, 26.6)
Vermont 24.8 (23.5, 26.1)
Virginia 28.5 (27.2, 29.7)
Washington 27.3 (26.0, 28.5)
West Virginia 35.7 (34.2, 37.2)
Wisconsin 31.2 (29.6, 32.8)
Wyoming 29.5 (27.5, 31.5)

• Prevalence estimates reflect BRFSS
  methodological changes started in 2011. These
  estimates should not be compared to prevalence
  estimates before 2011. Source Behavioral Risk
  Factor Surveillance System, CDC.
• .

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PREVALENCE OF SELF-REPORTED OBESITY AMONG U.S.
ADULTS BY STATE AND TERRITORY, BRFSS, 2014

• Summary
• No state had a prevalence of obesity less than
  20.
• 5 states and the District of Columbia had a
  prevalence of obesity between 20 and lt25.
• 23 states, Puerto Rico, and Guam had a prevalence
  of obesity between 25 and lt30.
• 19 states had a prevalence of obesity between 30
  and lt35.
• 3 states (Arkansas, Mississippi and West
  Virginia) had a prevalence of obesity of 35 or
  greater.

Prevalence estimates reflect BRFSS
methodological changes started in 2011. These
estimates should not be compared to prevalence
estimates before 2011. http//www.cdc.gov/obesity/
data/prevalence-maps.html
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Obesity

• The United States is the only country in the
  history of civilization in which poverty-stricken
  people suffer from obesity
• The United States is the 11th most obese country
  in the world and Mississippi is the 3rd most
  obese state in the nation
• Why?

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Most Obese Countries

• 1-Kuwait 42.8
• 2-Saudi Arabia 35.2
• 3-Belize 34.9
• Source CDC (2015)

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Most Obese States

• 1-Arkansas 35.9
• 2-West Virginia 35.7
• 3-Mississippi 35.5
• Source CDC (2015)

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Definitions

• Health Free of disease
• Physical Activity Activity of the body requiring
  the use of skeletal and cardiac muscles such as
  mowing the grass, cutting firewood and raking
  leaves
• Exercise Structured, repetitive activity such as
  walking, jogging and strength training

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Why We Must Exercise Today

• 1760 The Industrial Revolution (a transition in
  parts of Great Britain's previously manual labor
  and draft-animalbased economy towards
  machine-based manufacturing.)
• 1860s The Civil War Technology (weapons,
  telegraphs, cameras, tin cans)
• 1900-1913 Henry Ford Automobile Assembly Line
  
• 1920-1940s TV Mechanized farm equipment
• 1950s TV remote control (The first TV remote
  control, called "Lazy Bones," was developed in
  1950 by Zenith Electronics Corporation)
• 1960s Power tools (The first cordless power
  tool was unveiled by Black Decker in 1961)
• 1970s Silicon Valley ("Silicon Valley USA,"
  began in the weekly trade newspaper Electronic
  News issue dated January 11, 1971.)
• 1980s MTV, Computer games (MTV launched on
  August 1, 1981)
• 1990s DVD players, Cell phones, MP3 players
  (The DVD Video format was first introduced by
  Toshiba in Japan in November 1996)
• New Millennium iPod, iPhone, Wireless Internet,
  All things electronic

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FOOD For thought

• TV will never be a serious competitor for radio
  because people must sit and keep their eyes glued
  on a screen the average American family hasn't
  time for it.  Author Unknown, from New York
  Times, 1939

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• Look at the evolution of Coca-Cola
• 1960s 8 oz glass bottle (96 calories)
• 1970s 12 oz can (146 calories)
• 1980s 16 plastic bottle (192 calories)
• 1990s 20 oz Big Gulp (240 calories)
• New Millennium 40 oz drinks (480 calories)
• Not to mention ALL places offer free refills in
  contemporary society!

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OBESITY FACTS

• 64 of adults in the U.S. are either overweight
  or obese. Obesity increases the risk of
  diabetes, heart disease, hypertension, certain
  forms of cancer and other chronic illnesses.
• The number of children and adolescents who are
  overweight has doubled and tripled respectively,
  in the past 20 years.
• Overweight or obese children risk psychological
  social stress, increased risk of cardiac disease,
  hypertension, type 2 diabetes, and pulmonary
  diseases.
• The earlier a child becomes obese the more obese
  that child will become and more likely they will
  grow into obese adults.
• Adult obesity causes increased morbidity and
  mortality.
• These facts taken from the August 2006 (v
  28, 4) edition of the Strength and Conditioning
  Journal of the National Strength and Conditioning
  Association.

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• Approximately 17 (or 12.7 million) of children
  and adolescents aged 219 years  are obese
• The prevalence of obesity among children aged 2
  to 5 years decreased significantly from 13.9 in
  2003-2004 to 8.4 in 2011-2012.

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FAST FOOD

• In 1972, we spent 3 billion a year on fast
  foodtoday we spend more than 110 billion
• French Fries are the most eaten vegetable in
  America
• Each day, 1 in 4 Americans eats at a fast food
  restaurant
• McDonalds feeds more than 46 million people a
  day More than the entire population of Spain!
• These facts taken from the website of
  SUPERSIZE ME A Film of Epic Portions
  www.supersizeme.com

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SUGAR

• Simple sugar intake today represents more than
  the yearly equivalent of 70 pounds of table sugar
  (18 teaspoons of sucrose a day) and 50 pounds of
  corn syrup.
• 100 years ago, the yearly intake of simple sugars
  averaged only 4 pounds per person!
• Sports Exercise Nutrition, 2nd edition
  McArdle, Katch Katch

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Why Mississippians STRUGGLE WITH Obesity

• Southern Culture
• Lack of P.E. in schools (and vending/lunch foods)
• Low Socioeconomic Status (poorest state in the
  nation)
• Lack of Education of Citizens ()
• Weather (heat, humidity, direct sun, cold, rain)
• Poor city planning (roads, parks, sidewalks)
• Mindset (Think Miami or San Diego)
• Failure to Face Reality (energy equation)

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Being Sedentary is as Dangerous as Smoking a
Pack of Cigarettes Every Day! The Surgeon
Generals Report on Physical Activity and Health
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• Sitting Is the Smoking of Our Generation
• Harvard Business reviewNatalie Merchant
• Regular exercise and being physically active
  throughout the day are not the same thing

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ECONOMIC IMPACT

• U.S. economic competitiveness is hurting as our
  workforce becomes less healthy and productive.
• Obesity related health care costs are draining
  dollars from the bottom line of businesses.
• More than a quarter of U.S. healthcare costs are
  related to physical inactivity, overweight and
  obesity.
• If one-tenth of Americans began a regular walking
  program, 5.6 billion in heart disease costs
  could be saved.
• The estimated annual medical cost of obesity in
  the U.S. was 147 billion in 2008 U.S. dollars
  the medical costs for people who are obese were
  1,429 higher than those of normal weight.

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CALORIC EXPENDITURE

• Even a marathon only burns 2,620-3,390 calories
  The equivalent of many fast food meals that may
  only take minutes to consume!

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TIME

• You can never find the time to exercise. You
  must MAKE the time to exercisemuch like brushing
  your teeth, bathing and doing the laundry.
• P.S. We ALL only have 24 hours in a day..
• Tired of lying in the sunshine staying home to
  watch the rain, you are young and life is long
  and there is time to kill today Then one day you
  find, 10 years have got behind you, no one told
  you when to run, you missed the starting gun.
  PINK FLOYD, TIME

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FINALLY

• We dont just eat too much (the energy equation)
  in our contemporary society we also MOVE TOO
  LITTLE!
• Humans are simply made to be physically active
  and when we arenthypokinetic problems occur!
• i.e., CVD, Hypertension (MS 1 _at_ 32.7), NIDDM,
  Certain Cancers (kidney, colorectal, gall
  bladder, esophageal) Stroke, Obesity Obesity
  related problems (CVD, orthopedic), Psychological
  (stress, anxiety, depression)