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DHS news release

Sept. 13, 2004

This guest opinion is by Mel Kohn, M.D., state epidemiologist in the Oregon Department of Human Services.

Length: 685 words

Contact: Bonnie Widerburg (503) 731-4180

Obesity challenge is about good choices - and good information

By Mel Kohn, M.D.

Morgan Spurlock's film "Super Size Me" was among the year's box office surprises. It grossed several million dollars and got Oregonians talking about the connection between fast food and obesity.

No question, the premise was a gimmick: Spurlock ate only McDonald's fare for 30 days, and this formerly active guy also stopped exercising. In one particularly sophomoric scene, we saw him throwing up because he didn't have the good sense to stop eating.

But the film did deliver sensible messages in a compelling way: Food choices and daily physical activity are essential to good health. And how food is marketed can make it a lot harder -- or easier -- to make healthy choices.

These messages are not only sensible, but also critical to our ability to confront one of the most important emerging public health problems of our time. Nearly two-thirds of Americans -- and Oregonians -- are overweight, and obesity challenges tobacco as the nation's No. 1 cause of preventable death. Overweight and obesity are associated with higher levels of heart disease, stroke, diabetes, joint problems and some cancers.

If we don't address this problem it will ruin our health and seriously strain our healthcare system.

It's easy to say that people simply ought to make better choices. But there's more to it than that. People need accurate information.

Here's a quiz: When you order a McDonald's Double Quarter Pounder instead of a small hamburger, how many extra calories are you choosing? How about the Cinnabon Classic instead of the minibon, or a medium box of popcorn at the movies instead of a small one? (Answers: small hamburger 280 calories versus 770 for the Quarter Pounder; minibon 300 versus 670 for the Classic; small popcorn 400 versus 900 for the medium.)

If you're like me you know that each of these "supersizings" increases the number of calories, but I bet you're surprised that they more than double them.

These numbers of calories may seem small compared with all the calories you should take in during a day, which nutritionists usually peg at 1,600 to 2,800 depending on the person's size and physical activity. But research shows that if one eats an average of only 100 excess calories a day -- far fewer than any of the increases from the choices mentioned above -- he or she can expect to gain 10 pounds in a year.

Hefty calorie counts aren't restricted to fast food, but fast-food restaurants are beginning to respond in some limited ways. McDonald's announced an end to "supersizing." Wendy's kids' meals now permit substitutions of fruit for fries and milk for sodas. Consumer demand does get results.

Physical activity is the other half of the equation, and one where similarly small changes add up to weighty problems. When I've spoken to parent groups, I've often asked them how many walked to school as kids. Lots of hands. Then I asked how many of their children walk to school. Almost none.

This is a result of choices we've made about where new schools are located and about measures to ensure safe routes to school. The good news is that, armed with information, we can make those choices differently.

This October we will work with a variety of partners to put on Walk to School Day, promoting this easy way for children (and their parents, if they accompany their kids) to incorporate physical activity into their daily routine.

Across Oregon, we're beginning to work with local coalitions to support sensible decisions about food and physical activity. These include such activities as helping employers develop workplace programs, training school staff to increase students' healthy food choices, and providing city planners with information about the importance of building communities that make it easy to be physically active.

Obesity is indeed a super-size problem that's becoming an urgent health issue. As Spurlock's film showed, we have a responsibility to make good food choices for ourselves. And we need to demand environments that help us make healthy choices, whether it be food or physical activity.

Mel Kohn, M.D., is state epidemiologist in the Oregon Department of Human Services.