F as in fat

Adult obesity rates could exceed 60 percent in 13 states by 2030, according to new study, and related health care costs could climb by more than 20 percent in nine states.(1) By contrast, the analysis also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index of their residents by just 5 percent by 2030.

The analysis, which was commissioned by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) and conducted by the National Heart Forum, is based on a peer-reviewed model published last year in The Lancet.(2) If obesity rates continue on their current trajectories, by 2030, in addition to the 13 states that could have adult obesity rates above 60 percent, 39 states could have rates above 50 percent, and all 50 states could have rates above 44 percent. By 2030, Mississippi could have the highest obesity rate at 66.7 percent, and Colorado could have the lowest rate for any state at 44.8 percent. According to the latest data from the U.S. Centers for Disease Control and Prevention (CDC), obesity rates in 2011 ranged from a high of 34.9 percent in Mississippi to a low of 20.7 percent in Colorado.

If states’ obesity rates continue on their current trajectories, the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase 10 times between 2010 and 2020—and double again by 2030. Obesity could contribute to more than 6 million cases of type 2 diabetes, 5 million cases of coronary heart disease and stroke, and more than 400,000 cases of cancer in the next two decades. Currently, more than 25 million Americans have type 2 diabetes, 27 million have chronic heart disease, 68 million have hypertension and 50 million have arthritis. In addition, 795,000 Americans suffer a stroke each year, and approximately one in three deaths from cancer per year (approximately 190,650) are related to obesity, poor nutrition or physical inactivity. On the basis of the data collected and a comprehensive analysis, TFAH and RWJF recommend making investments in obesity prevention in a way that matches the severity of the health and financial toll the epidemic takes on the nation. The report includes a series of policy recommendations, including: • Fully implement the Healthy, Hunger-Free Kids Act, by implementing the new school meal standards and updating nutrition standards for snack foods and beverages in schools; • Protect the Prevention and Public Health Fund; • Increase investments in effective, evidence-based obesity-prevention programs; • Fully implement the National Prevention Strategy and Action Plan; • Make physical education and physical activity a priority in the reauthorization of the Elementary and Secondary Education Act; • Finalize the Interagency Working Group on Food Marketed to Children Guidelines; • Fully support healthy nutrition in federal food programs; and • Encourage full use of preventive health care services and provide support beyond the doctor’s office.

Numerous cross-sectional epidemiological studies suggest that obesity is associated with periodontal disease.(3) A longitudinal study published in the Journal of Dental Research tested whether body mass index (BMI) was related to the development of periodontal disease in a sample of employed Japanese participants.(4) BMI is used to assess general body composition, and it is also an indicator of underweight, overweight, and obesity. The results demonstrate a dose-response relationship between BMI and the development of periodontal disease in a population of Japanese individuals. A 2005 study provided some evidence for how obesity may affect periodontitis.(5) The researchers hypothesized that obesity could affect periodontitis through an inflammatory pathway. They found that in adults representing the lowest and highest quartiles of BMI, the levels of tumor necrosis factor α and soluble tumor necrosis factor α receptors were found in those individuals with the highest quartiles of BMI, suggesting that tumor necrosis factor α and possibly other inflammatory mediators are elevated in obesity. This may contribute to increased inflammatory response to periodontal pathogens and, therefore more severe periodontitis. Since both obesity and periodontal diseases can be prevented, it is our duty to counsel our patients in self care, including nutrition.References 1. Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). F as in Fat: How Obesity Threatens America's Future 2012, September 2012. www.healthyamericans.org and www.rwjf.org. 2. Wang YC et al. Health and Economic Burden of the Projected Obesity Trends in the USA and the UK. The Lancet, 378, 2011. 3. Ostberg et al., 2009. 4. Morita I, Okamoto Y, Yoshii S, Nakagaki H, Mizuno K, Sheiham A and Sabbah W. Five-Year Incidence of Periodontal Disease Is Related to Body Mass Index. J Dent Res, 2011, 90: 199. 5. Genco et al. (2005).