Burgers Beat Out Broccoli in State Health Survey

The myth: California, haven of healthful eating and exercising, of gyms and sprouted grains, jogging and Jamba juice.

The truth: Lots of talk, little action.

So says a new survey by the state Department of Health Services, which found that despite an overarching concern about eating right, Californians followed national trends for poor diet and sloth--a trend researchers warn could signal a steep decline in public health.

Most troubling of all, nutritionists say, were the survey’s findings that poorer and less educated residents--who make up a growing portion of the state’s population--are the least healthful eaters.

“It’s not good news,” said professor Gail Harrison, director of the UCLA Center for Human Nutrition. “We’re talking about risk of cancer . . . risk of heart disease.”

Reversing eating trends is difficult, Harrison said, because the hazards of poor eating habits are not immediately apparent when you put down your fork.

“If what you’re eating is increasing your risk for breast cancer 40 years from now or from an early heart attack and you’re a teenage boy,” she said, “it’s much harder . . . to see the reason for a change in behavior.”

The state has surveyed more than 1,000 randomly selected adults every two years between 1989 and 1997, but last week’s was its first comprehensive release of results.

A fifth of Californians engaged in no exercise, compared with a quarter of all Americans, the study found. And the least educated were the least active in their leisure time, although survey authors allowed that may be because their work requires more physical exertion.

The combination of poor diet and little exercise left Californians fatter than ever. Nearly 29% reported being overweight, compared with fewer than 20% in 1984. New leaner federal weight standards could further inflate those numbers.

The dietary survey placed particular emphasis on five key nutrition recommendations: daily doses of fruits and vegetables; whole grain breads, tortillas and cereals; reduced fat milk; lean meat or other protein; and one serving of beans every other day.

Californians on average met just three of the five nutritional recommendations, worse than in the past. The study suggests that is partly because they opt for fast food over other restaurant fare half the time, up from a third in 1989.

Although people generally are eating out less, young adults and those with no high school diploma eat out more and are the most likely to eat fast food--typically high in fat, salt and sugar and low on greenery.

Fast food does not cause obesity, said Judith Stern, a professor of nutrition and internal medicine at UC Davis. But it does fall short in the vegetable department--a slice of pickle on a burger does not count--and the portions tend to be too large.

“With super sizing and super, super sizing, you end up eating more,” Stern said. Even if you do not finish it all, “it reinforces that that is the right portion size.”

Even in the nation’s richest agricultural state, people were loath to eat their peas and carrots, spinach and broccoli. Only a third consumed the recommended five or more daily servings, and an additional third ate two or fewer. Those with less education or lower salaries were least likely to eat fruits or vegetables, even though they are among the cheapest items on the grocery bill.

Mind over matter does not work with food. But that did not stop two-thirds of survey respondents from saying that they were eating less fat than a year previously.

Those who confessed to eating poorly tended to blame old habits, television ads that seduce them and the scarcity of healthful restaurant food. But a majority said they wanted to improve.

The nutritional backsliding occurred despite state campaigns to increase awareness of links between diet and heart disease or cancer. But the researchers called for more education and released the survey to coincide with a new series of public service announcements promoting healthful eating and exercise.

Desiree Backman, state director of nutrition marketing, said one difficulty has been inadequate funding to blanket the entire state. California spends about $16 million on nutrition education, compared with about $55 million on tobacco education.

Campaigns run just three times a year, which Backman compared to “lighting a firecracker, letting her go and then there’s nothing.”

And the survey hinted that some populations are not being reached. Although three-quarters of college graduates believed there was a connection between diet and cancer, about two-thirds of those with less than a high school education did.

There was a particularly poor response when people were asked to name ways to lower their cholesterol--such as eating whole grains, fewer eggs and unsaturated oil. Only 2% of those with less than a high school education could name some of those foods, compared with just 11% of college graduates.

Education and socioeconomic status far overshadowed ethnicity as a factor in healthful eating habits.

However, African Americans continued to be the least healthful eaters--rarely cutting fat off their meat or skin off their chicken and opting for deep fried foods more often than any other group.

Between whites and Latinos there was little difference in nutrition, largely because Latinos scored high for including beans and high-fiber corn tortillas in their diets. Latinos showed the most improvement of any group in the eight-year study, but still ate significantly more beef--more than twice a week--than any other group.

Whites had their own mealtime weakness, being the most likely to indulge in sweets, including breakfast pastries, desserts and ice cream. Asians were not assessed as a separate group because the number surveyed was too small for statistical accuracy.

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A State of Decline

Poor diet is the norm in California, with few signs of improvement in the last decade, according to a survey by the Department of Health Services. The state has conducted a dietary survey by telephone of more than 1,000 Californians every other year since 1989

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Source: California Dietary Practices Survey, Department of Health Services, Sept. 1999.