HBO's 'Weight of the Nation' examines the obesity epidemic

A compelling four-part documentary delving into the obesity epidemic sweeping the country is being aired on HBO and can be watched free by clicking here. A reporter wanting to write a series of stories on the issue would find "weight of the Nation" a good reference.

The program is divided into four parts. The first segment, "Consequences," looks at the scope of the epidemic and the ramifications of being overweight or obese. "Choices" looks at the science behind how to lose weight, how to maintain weight loss and prevent weight gain. The third part, "Children in Crisis," looks at how the problem is affecting American children, exploring the decline of physical activity, school lunch, the demise of school recess and how marketing of unhealthy food targets children. The final segment, "Challenges," looks at the major forces driving obesity, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the influence of the food and beverage industries.

The documentary is on a detailed website that answers questions that range from "What is obesity?" to "How do I know if I'm overweight or obese?"

The project is a presentation of HBO and the Institute of Medicine in association with the Centers for Disease Control and Prevention and the National Institutes of Health, with support from the Michael and Susan Dell Foundation and health insurer Kaiser Permanente.

Healthy food is less expensive than junk food, study finds

Though it's widely believed that healthy food is more expensive than junk food, a new government analysis shows that does not have to be the case.

"In fact, carrots, onions, pinto beans, lettuce, mashed potatoes, bananas and orange juice are all less expensive per portion than soft drinks, ice cream, chocolate candy, French fries, sweet rolls and deep-fat fried chicken patties," reports Nanci Hellmich for USA Today.

"We have all heard that eating a healthy diet is expensive, and people have used that as an excuse for not eating a healthy diet . . . but healthy foods do not necessarily cost more than less healthy foods," said Andrea Carlson, an economist and co-author of the report from the U.S. Department of Agriculture's Economic Research Service. "The price of potato chips is nearly twice as expensive as the price of carrots by portion size."

Carlson and colleague Elizabeth Frazão analyzed national pricing data on more than 4,000 foods and ranked them according to price based on calories, weight and portion size. The foods were placed in five food groups: grains, dairy, protein, fruit and vegetables. Another category was added for unhealthy items, which did not fall into any of the other calories or were high in sugar, sodium and/or saturated fat such as cookies, desserts, granola bars and many cereals. They found:

• Given portion size, the ranking from least expensive to most expensive is: grains, dairy, vegetables, fruit, protein and less healthy foods. Protein and less healthy foods cost nearly the same.

• Meat, chicken and fish are the most expensive sources of protein but there are low-cost options like eggs and beans.

• Fruit and vegetables are lower in cost overall than unhealthy foods.

• Grains, such as bread, oatmeal, pasta and rice, are the cheapest foods no matter how the portion is measured. (Read more)

Hospitals get antsy about leasing space to fast-food chains

McDonald's has space in the Cleveland Clinic. (AP photo)

While the U.S. Department of Agriculture decides what to suggest about junk food in schools, hospitals are likewise at a crossroads, with many administrators feeling conflicted about housing fast-food chains in their facilities.

At Truman Medical Center in Kansas City, the cafeteria features low-fat meals, on the other side of a wall from a McDonald's. CEO John Bluford said the golden arches send "an inconsistent message" to patients, staff and community because of the unhealthy offerings, but Truman agreed to a 25-year contract with the chain in 1992 "at a time when the financial benefit of having a stable food-service client in the hospital outweighed any potential health concerns," reports Elana Gordon for NPR.

Getting out of these contracts can be tricky. The Cleveland Clinic tried to end its agreement with McDonald's 10 years ago, but the restaurant remains in operation. "We're just going to live with it," said Bill Barum, director of hospitality and retail services. "When the contract ends, we'll have the opportunity to reexamine the space."

Of the 14,000 McDonald's in the country, there are 27 in hospitals, and officials say the restaurant's menu can be tailored to health-conscious diners.

Some hospitals have five fast-food outlets, a survey by the Physicians Committee for Responsible Medicine found. The report's top five "worst hospital environments" housed at least one fast-food restaurant. "In this day and age, you would think a hospital might be proud enough, if not shamed enough, to cut or end these contracts with fast-food outlets," said Susan Levin, a dietitian with PCRM.

But while some hospitals are looking to end fast-food contracts, some are signing them, including the Texas Medical Center's St. Luke's Episcopal Hospital and the Medical University of South Carolina University Hospital, where Chick-fil-A is  open for business. (Read more)

Where you live can affect your weight, studies find

A child's weight can be determined in part by what neighborhood he or she grows up in, a new series of studies indicate. (Photo by Getty Images)

In one of the studies, published in the American Journal of Preventive Medicine, researchers examined neighborhoods in King County, Wash., and San Diego County, Calif., and rated them in terms of physical activity and nutrition for kids ages 6 to through 11. A neighborhood received a high rating if its residents could easily walk to places like stores, libraries and parks. They also got a good grade if they had several grocery stores where healthy foods are sold, reports Kim Carollo for ABC News.

Poor-rated neighborhoods had few grocery stores or had lots of fast food restaurants. They also had few parks. "The biggest difference we found in rates of obesity were in the places where the environment was good for both nutrition and physical activity, the rates were less than 8 percent, but if the nutrition and physical activity were not good, the rates went up to 16 percent," said Brian Saelens, a co-author and professor of pediatrics at Seattle Children's Research Institute. (Read more)

The findings, explored using geographic information systems, are in keeping with an op-ed piece by Susan Blumenthal, public-health editor for the Huffington Post. Making the link between poverty and obesity, she points out the difference an affordable housing project has made in Greenbridge in King County, an immigrant community where more than 54 percent of adults are overweight or obese and more than 85 percent of children in grades 8, 10 and 12 do not meet federal physical activity recommendations.

The neighborhood is "being designed and built as models for creating an environment that promotes healthy diets and active lifestyles for their residents," she explains. The neighborhood now boasts an elementary school, a Head Start program, a Boys and Girls Club, community gardens to grown fresh fruits and vegetables, a library, play areas, walking path, a food bank, a community center and a public health clinic.

"This integrative approach has turned a trouble neighborhood into a welcoming place to live," she writes. "Initiatives like this one that involve not only individuals but the entire family and community provide a model for how to improve the health of cities across our nation." (Read more)

Convenience, not expense, is making us avoid eating fruits, vegetables and other non-processed foods

A lack of convenience, not a high price, is the major obstacle to getting people to eat more fruit and vegetables, a study published in the journal Public Health Nutrition has found. The study analyzed the fruit and vegetable consumption in six low-income, mostly minority neighborhoods in Chicago.

"Participants who agreed that they had 'convenient access to quality' produce were more than twice as likely to eat the FDA-recommended amounts of fruits and vegetables," Sarah Kliff reports for The Washington Post. "Those who reported high cost as a barrier to the consumption of produce ended up eating just as much as those who didn't." (Post photo above by Barbara Damrosch)

The study seems to support New York Times columnist Mark Bittman's assertion that Americans are skipping nutritious food because it takes much more work to prepare, not because it's too expensive. "It's cooking that's the real challenge," he writes in a September 2011 column. "The core problem is that cooking is defined as work, and fast food is both a pleasure and a crutch." (Times photo by Daniel Borris)

Contributing to the problem, Bittman argues, is the addictive qualities of fast food and processed food: physically addictive, as a study by the Scripps Research Institute shows, and mentally addictive. Bittman cites David A. Kessler, former commissioner of the Food and Drug Administration and author of The End of Overeating, who said manufacturers created food that was "energy-dense, highly stimulating and went down easy. They put it on every street corner and made it mobile, and they made it socially acceptable to eat anytime and anyplace. They created a food carnival, and that's where we live. And if you're used to self-stimulation every 15 minutes, well, you can't run into the kitchen to satisfy that urge."

The answer is in changing mindsets, Bittman writes, and getting "people to see cooking as a joy rather than a burden, or at least as part of a normal life." That takes education and changing the environment, which, he points out, has been done with tobacco. Cultural change can happen by celebrating whole foods, he writes. Political action would mean limiting "the marketing of junk; forcing its makers to pay the true costs of production; recognizing that advertising for fast food is not the exercise of free speech but behavior manipulation of addictive substances; and making certain that real food is affordable and available to everyone. The political challenge is the more difficult one, but it cannot be ignored." (Read more)

Trans fat levels in white adults have fallen by more than half since FDA started requiring labeling of the unhealthy food ingredient

After the Food and Drug Administration required food manufacturers to label how much trans fat is in their products, levels of the unhealthy ingredient in the bloodstream dropped by 58 percent. (Associated Press photo by Ed Andrieski)

The numbers come from a study assessing blood levels between 2000 and 2008. FDA required trans-fat labeling in 2003. Researchers at the Centers for Disease Control and Prevention noted the decline after analyzing blood drawn for the annual National Health and Nutrition Examination Survey, a nationally representative sample of about 5,000 people. The drop was seen in white adults; more research is being conducted to see if it also dropped in other ethnic and racial groups.

"The decline, unusually big and abrupt, strongly suggests government regulation was effective in altering a risk factor for heart disease for a broad swatch of the population," reports David Brown for The Washington Post.

Trans fat is typically used for deep-frying and as an ingredient in baked goods. One study determined "if a person increases total calorie intake 2 percent all in the form of trans fat, risk of heart attack rises by about 20 percent," Brown reports.

"Our findings provide information about the effectively of these interventions," said Hubert W. Vester, a CDC chemist who led the analysis. "This reduction is substantial progress that should lower the risk of cardiovascular disease in people." (Read more)

Yum! Brands asks state to allow elderly, disabled and homeless to use food stamps at restaurants

Louisville-based Yum! Brands, which owns the KFC, Pizza Hut and Taco Bell chains, wants the homeless, disabled and elderly to be able to pay for their meals with food stamps. The company registered last month to lobby the administration of Gov. Steve Beshear on the matter. Yum! executives have given to Beshear's re-election campaign, The Courier-Journal's Tom Loftus notes.

"Under the federal food-stamp program, states may authorize (use of food stamps) by the elderly, disabled or homeless, who often have difficulty preparing meals," Loftus writes. "Only Michigan, Arizona and parts of California have done so."

"We think it's a win-win," said Paul Carothers, the company's vice president for government affairs. "It's obviously of interest from a business standpoint, and it provides access to the elderly, homeless and disabled who are often underserved."

But state Rep. Jim Wayne, D-Louisville, told Loftus, "My concern is that so much of that food is the most unhealthy food in America ... and it leads to obesity and all kinds of other health problems."

Carothers said he did not see a difference between customers being able to pay for their meals at KFC, Pizza Hut and Taco Bell with food stamps and being able to buy candy bars and soda at the grocery store, which is allowed. "The only thing they cannot use their benefits for ... now are household products, alcohol, tobacco and those sorts of things," Carothers said, adding that Yum! meals "stack up nutritionally quite well. For some of these people access to a restaurant may be their only opportunity for a hot meal."

The Cabinet for Health and Family Services told Loftus that about 814,000 Kentuckians receive food stamps, but could not say what percentage are elderly, disabled or homeless. (Read more)