Obesity, Diabetes Rates Soar in U.S.
The rates of obesity and diabetes in the United States have grown by 50% 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--at least 30 to 50 pounds overweight, depending on height--rose from 12% in 1991 to 19.8% in 2000. Over the same period, the proportion who are diabetic increased from 4.9% to 7.3%.
From 1999 to 2000 alone, the proportion of obese Americans increased from 18.9% to 19.8% and the incidence of diabetes rose from 6.9% to 7.3%, indicating that the growth rate of both problems is accelerating, the researchers said.
The findings are published in today’s edition of the Journal of the American Medical Assn.
The trend is particularly disturbing in children, researchers noted. Two decades ago, Type 2 diabetes accounted for 3% to 5% of diabetes in children. Now it accounts for 25% to 30%, said Dr. Dan Cooper of the UC Irvine School of Medicine.
Some of those factors leading to the increase include growing consumption of fast food, the prevalence of video games and other indoor activities, and the inability of many children to play safely outdoors in their neighborhoods.
The findings “are very alarming,” Cooper said. “People who work in the field are not going to be surprised, but it is still very worrisome.”
Already, health care costs associated with diabetes are estimated to be more than $100 billion a year. About 9.4% 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 P. 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% of all diabetics have Type 2 diabetes--known as adult-onset diabetes--and the primary risk factor 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 UCLA. “The more obese you are, the more likely you are to become insulin resistant,” he noted. In fact, 80% of Type 2 diabetics are obese.
In Type 1 diabetes, known as insulin-dependent diabetes, insulin-secreting cells in the pancreas are destroyed.
The increases in diabetes and obesity appear to affect all racial and ethnic groups.
Mississippi had the highest rates of both obesity (24.3%) and diagnosed diabetes (8.8%). Colorado had the lowest rate of obesity at 13.8% and Alaska had the lowest rate of diabetes at 4.4%.
In California, 19.2% of residents are obese and 8.8% have diabetes, the study found.
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 study found, for example, that 27.3% 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 a day.
At the opposite extreme, 17.5% of Americans are following the recommended guidelines of at least 30 minutes of moderate physical activity most days of the week, researchers said.
Researchers cautioned that all the figures were conservative. The data were based on self-reports of height and weight in a telephone questionnaire conducted by CDC called the Behavioral Risk Factor Surveillance System. 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%.
“It’s always perplexing to me. Here’s a problem that seems so simple to solve--change our diet and do a little exercise,” Cooper said. “But there is a conspiring of social factors which must be very powerful that prevent this from happening.”
“Our findings were striking,” said CDC epidemiologist Ali Mokdad, the lead author of the JAMA article. “Both obesity and diabetes are preventable and yet more than 60% of Americans are overweight or obese, and about 15 million Americans aged 18 years or older had diagnosed diabetes in 2000.”
