Healthiest children … in wealthy zip-codes

It’s a little provocative sounding, but the research from Adam Drewnowski at the University of Washington shows most of the obesity and overweight epidemic is closely tied to poverty.

I’ve been blogging about obesity issues all week (see “recent posts” or the tag “obesity”).  Today, I talked to Drewnowski.  I’ll share more about his ideas later. But, this one merits re-stating.  In work that was published in 2008, he took the basic federal data on obesity trends, and overlaid that onto a map of King County.  The wealthier the zip code, as measured by property values, the lower the obesity rates, and vice versa.

He told me the data might have been even more dramatic, because it turns out that the wealthiest areas (such as Medina) are not even represented.  As he put it, Rich people don’t answer surveys.

For the past two years, he’s been digging into some of the reasons why poor people are less healthy.  His baseline theory is the most obvious: eating well and taking care of yourself can be expensive, in time and money.

In work to be presented soon, he’ll argue against the idea that poor people need more grocery stores and fresh produce sold in their neighborhoods.  It turns out, most people will go several miles to get their groceries (except for the very poorest 1%).  Some people drive to the cheapest store, others drive to what they see as the better quality store. So, having more grocery stores wouldn’t make a difference.

You might get different results in Los Angeles, or Detroit — two cities where a lot of the research was conducted re.  lack of access to grocery stores.  He says that work doesn’t hold for Seattle/King County.

He does see a role for better food education (such as, cooking classes).  I’ll have that report Friday morning on KPLU.

Sodas and sugary drinks, an obesity culprit

How much blame goes to the beverage industry?  NPR’s All Things Considered is looking into this topic (yesterday and today).

Many states are planning to tax sodas.  Washington has jumped on this one, too. The taxes are mostly to help fill budget gaps, and way too small to make a meaningful health difference.

The man who’s studied this the most, and made it into a crusade, says the tax needs to be much higher than any state is considering: a penny-an-ounce.  That would add 12 cents to a can of soda, and more than 60 cents to those 2-liter bottles.  Kelly Brownell, of Yale University’s Rudd Center on Food Policy and Obesity, argues this would compel Americans to make healthier choices.

Yesterday’s NPR reports included a good overview from Jeff Brady, plus a pair of interviews by Michelle Norris.  Several listeners told me they felt Norris was too easy on the beverage industry spokesperson.

Studies have shown a pretty strong correlation between soft-drink consumption and weight gain.  And, the beverage industry response that Americans just need more exercise?  Exercise is good, but it’s not a major factor in the obesity crisis and can’t compensate for the big jump in calorie consumption.  The scientific evidence is pretty strong on that.  But, nutritionists will also tell you it’s too simplistic to think that cutting down on sodas by itself will solve the weight-gain problem.  It’s an important step, but there are additional dietary problems.

Why eating in America may be less healthy than in Mexico

Another angle on obesity.  I just got back from interviewing Marian Neuhouser, a nutritional scientist at the Fred Hutchinson center.  She’s launching a new study of Mexican-American women.  She says more than 76% of Hispanic women in the U.S. are overweight or obese (the overall rate for women in the U.S. is 64%).  The experience of Mexican immigrants is similar to Japanese immigrants – within one generation in this country, the rates of obesity skyrocket.  That’s why many scientists say there’s something about living in modern America that is “obesogenic” – causing people to become obese.  The most likely and most important factor: diet.

Neuhouser’s hypothesis is that the switch in diet is a trigger, going from typical rural Mexican meals dominated by beans, rice and fresh-made tortillas, to a more American diet that’s full of processed foods, white flour, fatty meats, and sugary drinks.  But, she also suspects the problem for Mexican immigrants is exacerbated by their genetic profile and how it reacts to the American foods.

She just received funding to study this in detail, by getting 50 Seattle-area Mexican women to eat their meals at the Hutch for a month, so she can control their diet, while monitoring their blood for a number of biomarkers.

The biomarkers might also help explain why Hispanic women tend to get a more virulent, hard-to-treat form of breast cancer.

The leanest kids live in …

All states are not equal, when it comes to obesity.  It’s well-known that the problem is much worse in southern states, and not quite as bad in the Rocky Mountain states and on the West Coast.  A new study is the first to allow comparisons of childhood obesity trends among the 50 states.  Here’s the condensed story from the Associated Press, although I added the third paragraph and the Washington state numbers:


CHICAGO – A new government study finds that most states are failing to meet federal goals for childhood obesity.

The federal Healthy People initiative set a childhood obesity goal of 5%. Oregon has the nation’s lowest rate of hefty kids, at just under 10%. Oregon was the only state whose childhood obesity fell significantly from 2003 to 2007.  Washington’s obesity rate went up slightly, to about 11% – tied for third lowest among the states.  Mississippi topped the nation with more than one-in-five of its kids obese.

By another measure – how many kids are simply overweight — Washington’s near the national average, with about 30% of kids overweight.  (Oregon places 3rd in this category, with Minnesota and Utah having the lowest percentage of overweight youth, at 23%.)

What works? That’s still debated.  Diet and nutrition have a role. But poverty, race and family history all have complex links to obesity.

The study appears in May’s Archives of Pediatrics and Adolescent Medicine.

More links:

Whose truth about childhood obesity?

It’s no secret Americans have been getting fatter — and the future’s not so bright when children are getting fatter, at younger ages.  I’m looking into why, and what should be done.

A lot of solutions have been proposed.  Some are promoted by trusted sources.  But they may miss the mark, even if they’re good ideas for overall health.

  • Couch potatoes and too much TV?  This may seem like common sense, but there’s pretty decent data that “sedentary behavior” has not changed over the past 30 years.  So, promoting exercise and walkable communities — while good for overall health — may do very little to slow the rise of obesity rates.
  • Poverty?  There’s a lot of data showing that the more poor you are, the more likely you are to be overweight.  But why?  Adam Drewnowski at the University of Washington says it’s because of simple food economics.  It’s cheaper to buy a filling meal that’s unhealthy than it is to buy a healthy one.  Think dollar meals and junk food.  Sodas.  They’re full of calories, but low in nutritional value.  That’s his argument.  But, is that what’s really happening?
  • Too much food?  Many nutritionists argue it’s all about calories and consumption.  We’re eating on average more calories per day than we did 50 years ago.  Their story says, in the 1980’s some agricultural policies changed and food got really cheap.  Now, the temptation to eat is everywhere, all the time.  And, since the ingredients are cheap, portions got bigger.
  • Processed vs. whole foods? This is related to the ideas above.  And this has become a trendy way to frame the problem.  If we could only get more people, and especially poor people, to have “healthier food choices,” they would choose the delicious fruits and vegetables and whole grains.  Then, they’d lose weight.  I haven’t seen any good scientific evidence that demonstrates this, but it’s seen a logical conclusion to draw from other research about nutrition.

I’m still exploring these questions. If you know of scientific studies that support/undermine any of these arguments, please share them.   If there’s a better theory missing from this list, share that, too.

Plastics that bend the category of plastics

It sounds about as likely as a “healthy cigarette.”  I’m talking about “compostable plastic.”  I mean, the one thing we’ve all known for sure about plastics is, they’re bad for the environment, because they don’t bio-degrade.  Right?

Now comes this new generation of plastics that does biodegrade, and some of them even can go into a compost pile.

I’ve seen the product labels for a couple years, but I didn’t really take it seriously.  Someone told me, they’re made out of corn.  Yeah, corn and what else?

Compostable cups, fork, and other containers with the Cedar Grove seal.

It turns out, those corn-based plastics do in fact degrade into compost, according to the local experts at Cedar Grove Composting.  That’s the company that takes the yard waste from a million or so customers in King and Snohomish counties.  In the Seattle area, Cedar Grove has defined the category of composting, taking our leaves, branches, and clippings and selling it all back to us as bags of compost.  They also take all of our table scraps, from residences and many businesses.

Cedar Grove runs its own tests — by simply putting a so-called degradable plastic item into the compost pile, and checking to see if it turns into dirt.  “If it degrades and disappears then we approve it,” says vice president Jerry Bartlett.  Companies pay hundreds of dollars to get their products tested.

More than 400 plastic cups, forks, plates, and other items passed the test and do in fact turn to dirt.  Bartlett tells me they leave no visible residue, although no chemical testing is done at the end of the cycle.  On the other hand, 75% of the so-called “biodegradable” plastics submitted for testing do NOT turn into dirt. These are banned from the compost pile.

How does it work?  Through heat, mostly.  These industrial-scale compost piles get up to 170F degrees.  (If you put one of those compostable spoons in a bowl of hot chowder by the way, don’t leave it sitting in too long — the heat will start melting it.)

Apparently, many other new plastics are still made of traditional petro-chemical plastic, with additives that speed up the decomposition.  What might normally take 1,000 years, now takes 20 years.  But, Treehugger reports there are concerns that these actually may do more harm than good, by leaving tiny residual particles of plastic that then can enter the ecosystem.

So, if it says “compostable,” it’s probably made from corn or another plant-starch.

My story on KPLU has a few more details and links.

Tips for Barefoot Running

Yes, I tried it.  I found joy, and I found pain.  Here’s what I’ve learned, in case you’re thinking of trying barefoot jogging.

I’m not a hard-core runner.  But, I have been running since I was 11 years old (inspired by the famous training sequence in Rocky, and a big local event from that era–Tacoma’s Sound-to-Narrows run).  The idea of going barefoot sounded silly, when I heard about it a couple years ago.  But, once I got past my disbelief, I wanted to try it.

(For the full story on going barefoot, see the story I produced for KPLU, or the one for The World.)

I read as much as I could find online, and I started conditioning my foot and calf muscles.  I tried going a couple hundred yards on grass at a park, but never felt comfortable (I was so focused on what I might step on).  So, I got a pair of the Five-Finger shoes.

The first time running in them was liberating.  It felt strange and beautiful.  Then, after about 4 blocks, my calves tightened into a knot.  I limped home gingerly.  No harm, but I realized how much more strength my calves would need.  Over the next few weeks, running twice a week, I worked up to ten minutes, then fifteen minutes.  I would go until I felt my calves getting tired.

In reality, I was still ramping up way too fast.  One day, at the end of the run, I noticed my foot was sore. I still don’t know what I did exactly, but any time I tried to walk or run on the ball of my foot, for weeks, the whole area around my ankle felt sharp pain.  I’m fine running in shoes, but barefoot is on hold.

As Dr. Brian Krabak (Sports Medicine, University of Washington) told me: “Most people hurt themselves because of training errors … being too aggressive.” (Note-This was for an interview; he’s not my doctor.)

Here’s what several experts say:  Start with no more than a half kilometer, three days a week.  That’s a very short distance.  One lap around a track, plus the length of a football field.  And, then, apply the “10% rule,” which means, add 10% per week.

Just to give you a sense of how gradually you’ll be building up, here’s a chart:

Week Distance
1 .5 km / .3 mile
2 .55 km / .3 mile
3 .61 km / .4 mile
4 .67 km / .4 mile
5 .73 km / .45 mile
6 .80 km / .5 mile
7 .88 km / .55 mile
8 .97 km / .6 mile
9 1.07 km / .67 mile

After 9 weeks, still just 2/3 of a mile!  At this rate, you’ll need about three months to reach one mile.  (Barefoot Ted McDonald takes a more individualized approach. He says some runners, with stronger feet, will be able to progress faster.)

Everyone seems to say good stretching and some massage for your feet and calves will be essential.  And, if your pain lasts several days, cut back or get help, says Dr. Karak.

The Harvard Skeletal Biology website has a lot more detailed advice.

I plan to try it again, but with more patience.