Maine continues to lose ground in the battle against obesity and is now the 27th fattest state in the nation, according to a new report — up from 29th in 2010 and 35th in 2009. Maine’s top public health official says that despite the distressing news, existing programs to encourage healthier diets and more physical activity are the way to go.
Among Maine adults, 26.5 percent are obese — defined as having a body mass index of 30 or higher — and 63.2 percent are either overweight or obese, according to the 2011 “F as in Fat” report released on Thursday by the Trust for America’s Health with funding from the Robert Wood Johnson Foundation. The annual study draws on publicly reported data from the past three years.
Body mass index, or BMI, measures the relationship between weight and height. The calculation has been criticized for not taking into account the reality that some people weigh more because of having well-developed muscles and not because they are fat, but it remains the most popular reference used by public health officials for discussing overweight and obesity trends. A BMI of 18.5 to 24.9 is considered normal. A BMI of 25 to 29.9 is considered overweight, and 30 and over is considered obese.
In children and youth, BMI is calculated differently, taking into consideration children’s highly variable growth rates. The report finds about 13 percent of Maine youth between 10 and 18 are considered obese, a rate that is in keeping with national trends.
Obesity is a powerful factor in accelerating rates of chronic disease such as Type 2 diabetes and heart disease. The report notes that diabetes rates in Maine have doubled over the past 10 years, and the rate of high blood pressure among adults has risen from 21.3 percent to 28.1 percent over the same period.
In Bangor, registered dietitian and certified diabetes educator Heather Leclerc said she sees many more children and teens for diabetes and obesity than when she first started working at the Eastern Maine Medical Center’s Diabetes, Endocrine and Nutrition Center 24 years ago.
“It used to be that if a child was diagnosed with diabetes, it was always Type 1,” she said. “Now it’s 50-50 that it will be Type 2.” Type 2 diabetes is closely linked with obesity and poor diet.
Leclerc said that in addition to diabetes, many of the youngsters she sees already are suffering from the early stages of heart disease, skeletal dysfunction, breathing difficulties, liver disease and other consequences of their obesity.
Despite growing public concern, she said, most of the adults she counsels don’t know even the basic concepts of healthy diet and nutrition.
“There is a disconnect between [how many calories] they need and what they are consuming,” she said. Many do not know that the average moderately active adult should consume no more than about 2,000 calories each day in order to maintain a healthy weight, she said, and that an average 5-year-old needs about 1,500 calories.
What’s more, she said, many people have no idea how many calories are contained in the foods and beverages they consume each day. She said society has developed the expectation of oversized portions, including “snacks the size of whole meals” and daily meals too bountiful to be healthy.
Leclerc thinks bottled, sweet beverages — such as soda, iced tea, power drinks, juices and juice-based drinks — play a much bigger role in the obesity epidemic than most people realize. Even people who are otherwise careful about watching their diets “forget about beverages,” she said, and can easily consume several hundred extra calories each day as a result. Adults and children both should drink plain water and low-fat or fat-free milk, she said, with an occasional sugar-free soda to satisfy a sweet tooth.
In addition, Leclerc said, it is essential for people of all ages to be physically active in order to to build fitness and burn off extra calories.
Nationwide, obesity is a bigger problem in low-income populations and those with low educational attainment, the new study finds.
The epidemic has evolved over a relatively short time: 20 years ago, no state had an obesity rate above 15 percent. Five years later, Mississippi had the highest rate in the nation, at 19.4 percent, which is lower than Colorado’s current lowest-in-the-nation rate.
“When you look at it year by year, the changes are incremental,” says Jeffrey Levi, executive director of the Trust for America’s Health. “When you look at it by a generation, you see how we got into this problem.”
Adult obesity rates rose in 16 states compared with last year. No state decreased its rate. The five states with the highest rates of adult obesity are Mississippi (34.4 percent), Alabama (32.3 percent), West Virginia (32.2 percent), Tennessee (31.9 percent) and Louisiana (31.6 percent). The five lowest are Colorado (19.8 percent), Connecticut (21.9 percent), Massachusetts (22.3 percent), Hawaii (23.1 percent) and Utah (23.4 percent). The District of Columbia had an adult obesity rate of 21.7 percent.
Although the Northeast in general is in better shape than much of the rest of the nation, Maine retains the dubious distinction of being the most obese of the New England states. Connecticut is the leanest of the New England states.
At the Maine CDC, Dr. Pinette said Maine must continue to fund local programs that seek to educate children and adults about the value of the foods they eat. She said most schools have substituted water, milk, juice and sugarless beverages for soda in vending machines and that federal food assistance programs such as the Women, Infants and Children’s program and the Supplemental Nutrition Assistance Program, formerly known as food stamps, support the selection of healthy foods.
“Maybe we need more sidewalks, bike paths and and safe places for children to play,” she said, but in difficult budgetary times the state has to work with the programs it has.
Recommendations included in the report focus on the importance of public policy and the engagement of the food and beverage industries. Specifically, the authors call for prioritized funding for public health, anti-hunger and physical activity initiatives, particularly in schools and other public settings. They also note the importance of developing industry guidelines for labeling and marketing foods and beverages.