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By EMMA ROSS and JOSEPH B. VERRENGIA=20
Associated Press Writers=20
It's a bitter truth to swallow: About every fourth person on Earth is =
too fat. Obesity is fast becoming one of the world's leading reasons why =
people die.=20
In an astonishing testament to globalization, this outbreak of girth is =
occurring just as doctors are winning the fight against a number of =
vexing diseases.=20
Except in the poorest nations of Africa, new drugs and improved public =
health have corralled, if not cured, infectious diseases like smallpox, =
malaria and influenza that used to kill millions.=20
Now a new enemy is emerging in the 21st century - our appetite. Around =
the globe, about 1.7 billion people should lose weight, according to the =
International Obesity Task Force. Of those who are overweight, about 312 =
million are obese - at least 30 pounds over their top recommended =
weight.=20
Already, a third of all deaths globally are from ailments linked to =
weight, lack of exercise and smoking. And perhaps most worrisome is =
obesity's spread beyond wealthy western nations.=20
From the glaciers of Iceland to the palm-fringed beaches of the =
Philippines, there are now more fat people in the world than hungry =
people. And in extreme cases, people who are heavy since childhood could =
die as much as five to 10 years early.=20
"What's clear is that the developing world in particular is going to =
bear the enormous brunt of this weight gain," said Neville Rigby, policy =
director of the obesity task force.=20
"It's rapidly accelerating. We're even seeing obesity in adolescents in =
India now. It's universal. It has become a fully global epidemic - =
indeed, a pandemic."=20
U.S. nutrition scientist Barry Popkin agrees. He serves as a key adviser =
to the World Health Organization, which will propose the first global =
strategy on diet, physical activity and health next week at its annual =
meeting in Geneva, Switzerland.=20
"When you find nary a country that's being missed, nary a rural area =
that's being missed, let alone an urban area," Popkin said, "you've got =
to say it's more than an epidemic."=20
---=20
No country immune=20
---=20
Certainly the United States - home of the Whopper and the Super Big Gulp =
- remains a nation of scale-busters, with two of every three Americans =
overweight.=20
But there are a dozen places even worse:=20
South Pacific islands like Tonga, Kosrae and Nauru, where traditional =
meals of reef fish and taro are replaced by cheap instant noodles and =
deep-fried turkey tails.=20
Greece, birthplace of the Olympic Games, where the traditional =
Mediterranean diet is as much a relic as the Parthenon.=20
Oil-soaked Kuwait where Mercedes-driving mothers draped in black burqas =
feed french fries to their children while shopping for $375 =
giraffe-leather Italian loafers.=20
Soon China will be the world's biggest country in more ways than sheer =
population, experts predict. It's a stunning reversal from the Mao =
Zedong era when as many as 40 million people starved in the Great Leap =
Forward famine of 1958-61.=20
Pursuing a new doctrine of a "well-off society," Chinese cities =
represent the world's biggest growth market for restaurants that until =
recently were considered to be counterrevolutionary. Now a new KFC, =
Pizza Hut or Taco Bell opens almost every day. Virtually every mainland =
home now has a television blaring junk food ads.=20
When university student Li Guangxu was a baby, rice was rationed. Now he =
eats cookies for breakfast.=20
Shopping at a CarreFour supermarket in western Shanghai, the solidly =
built young man fills a shopping cart with cookies, potato chips, soda =
and beer.=20
"I like these things. They taste great," Li said. "I don't have time for =
anything else. Older folks don't eat this stuff, but we do. We like =
snacks."=20
Most scientists believe our bodies have retained a prehistoric tendency =
to store fuel for periods of deprivation. Modern foods are so plentiful =
and so packed with calories that getting fat might be biologically =
difficult to avoid.=20
But the problem is rooted in something deeper than nutrition math. =
Pleasure and emotional comfort are basic instincts, and eating tends to =
stimulate those circuits in the brain, not unlike addictive drugs.=20
A food fix always is within arm's reach.=20
Hardware emporiums host parking lot barbecues, and airports sell gooey, =
hot cinnamon rolls. You can buy potato chips whether you are trekking in =
Nepal or paddling a muddy river in the jungles of Borneo.=20
Who can resist? Almost no one.=20
"I compare the propensity to eat as somewhere between the propensity to =
breathe and the propensity to have sex," said Stephen Bloom, chief of =
metabolic medicine at the University of London's Imperial College.=20
---=20
Weight's health effects=20
---=20
Simply being fat won't necessarily kill you outright. And it's not =
weight alone that determines your risk from several diseases. But being =
overweight carries severe consequences.=20
Diabetes, heart disease and some cancers have been linked to weight, and =
all are on the rise.=20
Type 2 Diabetes is the illness most directly linked to obesity. A =
condition that often leads to heart disease and kidney failure, it is =
blamed for more than 3 million deaths a year. It afflicts 154 million =
people - nearly four times the number who have HIV or AIDS - and the WHO =
forecasts more than twice as many people will develop diabetes in the =
next 25 years.=20
Obesity can triple the risk of heart disease. One-third of all deaths =
globally - about 17 million - are blamed on heart disease, stroke and =
related cardiovascular problems, WHO figures show.=20
Some scientists predict it will outstrip infectious killers by the end =
of the decade.=20
Countries with extensive health care have stalled the onset of heart =
disease into old age and saved lives. But in much of the world, the =
latest drugs and arterial scouring procedures are not widely available.=20
In those countries, fatal heart attacks and strokes are much more common =
among younger, working age adults.=20
Researchers from Columbia University's Earth Institute examined Brazil, =
China, India, South Africa and the Russian republic of Tartarstan. They =
found that the heart disease death rate for adults ages 30-59 was up to =
twice as high as the U.S. rate. Among Russians in the study, the rate =
was up to five times higher.=20
Obesity was cited as a primary factor, along with smoking, lack of =
exercise and untreated high blood pressure. The researchers described =
the influence of unhealthy diets as "surprising."=20
In South Africa, 11 percent of the population has HIV. Yet =
cardiovascular disease there still accounts for a higher rate of death =
among men and women under age 45.=20
In India, more than a quarter of the 5 million people who die from heart =
attacks and strokes every year are younger than 65.=20
Obesity also plays a significant, if poorly understood, role in many =
cancers. WHO data shows cancer accounts for about 12.5 percent of the =
world's deaths, and that rate is expected to increase dramatically, =
mostly in developing countries.=20
The fact that obesity is on the rise in these countries as well is due =
to a confluence of factors that researchers say must be examined.=20
The global trend toward weight gain and its associated illnesses is not =
restricted to the well-off. High-fat, high-starch foods tend to be =
cheaper, so poor people eat more of them.=20
In Mexico, 40 percent of its 105 million people live in poverty. Yet =
two-thirds of men and women there are overweight or obese.=20
In the slums of Sao Paulo, Brazil, 30 percent of the schoolchildren in =
500 poor families have stunted growth due to poor diet. Yet, reports the =
Pan American Health Organization, about 6 percent of the children and 9 =
percent of the adults were obese, too.=20
In southern Africa, Zambia, which experienced a food crisis in 2002, =
reports that 10 percent to 15 percent of urban schoolchildren are obese. =
"It's a myth that you can't have poverty and obesity coexisting," said =
Tufts University nutritionist Bea Rogers.=20
---=20
How it happened=20
---=20
Many factors contribute to the widening of the world's waistline.=20
"For the last 150 years we've been getting fatter," said Bloom. But now, =
he says, "everything has kind of come together."=20
For starters, there is cheap, plentiful food. In developing countries, =
people still spend 40 percent of their income on food, as opposed to 15 =
percent by American families.=20
But even in poor nations, the relative cost of eating is declining as =
the world's farmers are able to grow huge quantities of grain that is =
quickly processed and shipped without spoilage.=20
According to U.N. figures, the consumption of oils and fats over the =
last 30 years has doubled and is forecast to keep growing.=20
"In the developing world, it happened overnight," said WHO adviser =
Popkin, who heads nutrition epidemiology at the University of North =
Carolina. "One year they had very expensive butter and the next year =
edible oil came on the scene. It was a tenth of a cost and all of a =
sudden for very little money you could make your food taste better."=20
Nutritionists say more and cheaper sugar is another factor, despite the =
industry's strenuous denials.=20
James E. Tillotson, director of Tufts University's Food Policy =
Institute, calculates the average American drinks the equivalent of a =
55-gallon drum of soda every year, compared to 20 gallons of sweetened =
beverages a year in 1970.=20
Increases almost as dramatic have occurred in Europe, and soft drink =
factories are increasingly popping up in developing countries.=20
Tillotson, who developed fruit-based drinks for Ocean Spray in the =
1980s, says the beverage industry did not consider the health =
ramifications of their now-ubiquitous products: "We never thought people =
would abuse them."=20
Slowly, the food industry is responding.=20
McDonald's has healthier menus and is phasing out super-sizing. Kraft =
Foods, whose products range from Oreos to Jell-O in 150 countries, has a =
scientific advisory panel. Among the company's initiatives: capping the =
portion size of single-serving packaging.=20
Much of Big Food's response comes after failed efforts by obese people =
to sue fast-food chains for damages.=20
"A lot of chief executives are really in a state of shock right now," =
said international nutrition expert Andrew Prentice of the London School =
of Hygiene and Tropical Medicine. "They've produced this stuff, cheaper =
and cheaper, feeding the world. All of a sudden, we're saying, 'Stop =
doing this!'"=20
Another factor is how food is promoted and distributed. Brightly =
packaged brands that remain safe for months have widely replaced fresh =
bulk foods. In 1990, no more than 15 percent of food bought in Latin =
America came from supermarkets. Now, 60 percent is from six supermarket =
chains.=20
Experts say that because the changes occurred so rapidly and medical =
care is so lagging, the developing world's obesity problem - combined =
with more cigarette smoking - could be both public health and economic =
disasters in countries that were verging on prosperity.=20
There are demographic changes, too. In many nations, women joining the =
work force created a demand for convenience foods.=20
"We already are tired from working and we buy only packaged foods," said =
Bertha Rodriguez of Mexico City. The 61-year old great-grandmother is a =
widow who supports herself by frying quesadillas in a streetside stand.=20
---=20
Technology triumphs=20
---=20
People spend more time sitting in the car, at the computer and =
especially in front of the television - an average of 1,669 hours a year =
in the United States, a habit that is extending internationally.=20
With such low activity levels, as little as 100 extra calories a day =
translates into 10 pounds in a year.=20
In China's megacities, crowds once pedaled identical black bicycles to =
work. Now adults drive cars and ride trains and buses. In southeast =
Asia, farmers are replacing water buffalo plows with tiny tractors.=20
"It was done with the best of intentions," Bloom said. "Telephones, =
cars, computers all come from the freedom from hunger and fear. But it's =
had a bad side effect."=20
Governments in some developing nations are taking steps.=20
Singapore schools have added physical activities and replaced soft =
drinks with bottled water. Brazil is making school lunch programs serve =
fruits and vegetables.=20
Such efforts are among those the World Health Organization says will be =
necessary to prevent a worldwide crisis.=20
But it's a battle against human nature.=20
"It would be a huge public health achievement if we simply stopped the =
weight gain where it is now," said Stephen Blair, research director at =
the Cooper Institute of Aerobics Research in Dallas.=20
"I think that's what we're stuck with."=20
---=20
EDITOR'S NOTE: Medical Writer Emma Ross reported from London and Science =
Writer Joseph B. Verrengia reported from Denver. Elaine Kurtenbach in =
Shanghai and Morgan Lee in Mexico City contributed to this report.=20
------=_NextPart_000_0008_01C43502.8A452310
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<DIV><FONT face=3DArial size=3D2>
<P><B>By EMMA ROSS and JOSEPH B. VERRENGIA</B>=20
<P><B>Associated Press Writers</B>=20
<P>It's a bitter truth to swallow: About every fourth person on Earth is =
too=20
fat. Obesity is fast becoming one of the world's leading reasons why =
people die.=20
<P>In an astonishing testament to globalization, this outbreak of girth =
is=20
occurring just as doctors are winning the fight against a number of =
vexing=20
diseases.=20
<P>Except in the poorest nations of Africa, new drugs and improved =
public health=20
have corralled, if not cured, infectious diseases like smallpox, malaria =
and=20
influenza that used to kill millions.=20
<P>Now a new enemy is emerging in the 21st century - our appetite. =
Around the=20
globe, about 1.7 billion people should lose weight, according to the=20
International Obesity Task Force. Of those who are overweight, about 312 =
million=20
are obese - at least 30 pounds over their top recommended weight.=20
<P>Already, a third of all deaths globally are from ailments linked to =
weight,=20
lack of exercise and smoking. And perhaps most worrisome is obesity's =
spread=20
beyond wealthy western nations.=20
<P>From the glaciers of Iceland to the palm-fringed beaches of the =
Philippines,=20
there are now more fat people in the world than hungry people. And in =
extreme=20
cases, people who are heavy since childhood could die as much as five to =
10=20
years early.=20
<P>"What's clear is that the developing world in particular is going to =
bear the=20
enormous brunt of this weight gain," said Neville Rigby, policy director =
of the=20
obesity task force.=20
<P>"It's rapidly accelerating. We're even seeing obesity in adolescents =
in India=20
now. It's universal. It has become a fully global epidemic - indeed, a=20
pandemic."=20
<P>U.S. nutrition scientist Barry Popkin agrees. He serves as a key =
adviser to=20
the World Health Organization, which will propose the first global =
strategy on=20
diet, physical activity and health next week at its annual meeting in =
Geneva,=20
Switzerland.=20
<P>"When you find nary a country that's being missed, nary a rural area =
that's=20
being missed, let alone an urban area," Popkin said, "you've got to say =
it's=20
more than an epidemic."=20
<P>---=20
<P>No country immune=20
<P>---=20
<P>Certainly the United States - home of the Whopper and the Super Big =
Gulp -=20
remains a nation of scale-busters, with two of every three Americans =
overweight.=20
<P>But there are a dozen places even worse:=20
<P>South Pacific islands like Tonga, Kosrae and Nauru, where traditional =
meals=20
of reef fish and taro are replaced by cheap instant noodles and =
deep-fried=20
turkey tails.=20
<P>Greece, birthplace of the Olympic Games, where the traditional =
Mediterranean=20
diet is as much a relic as the Parthenon.=20
<P>Oil-soaked Kuwait where Mercedes-driving mothers draped in black =
burqas feed=20
french fries to their children while shopping for $375 giraffe-leather =
Italian=20
loafers.=20
<P>Soon China will be the world's biggest country in more ways than =
sheer=20
population, experts predict. It's a stunning reversal from the Mao =
Zedong era=20
when as many as 40 million people starved in the Great Leap Forward =
famine of=20
1958-61.=20
<P>Pursuing a new doctrine of a "well-off society," Chinese cities =
represent the=20
world's biggest growth market for restaurants that until recently were=20
considered to be counterrevolutionary. Now a new KFC, Pizza Hut or Taco =
Bell=20
opens almost every day. Virtually every mainland home now has a =
television=20
blaring junk food ads.=20
<P>When university student Li Guangxu was a baby, rice was rationed. Now =
he eats=20
cookies for breakfast.=20
<P>Shopping at a CarreFour supermarket in western Shanghai, the solidly =
built=20
young man fills a shopping cart with cookies, potato chips, soda and =
beer.=20
<P>"I like these things. They taste great," Li said. "I don't have time =
for=20
anything else. Older folks don't eat this stuff, but we do. We like =
snacks."=20
<P>Most scientists believe our bodies have retained a prehistoric =
tendency to=20
store fuel for periods of deprivation. Modern foods are so plentiful and =
so=20
packed with calories that getting fat might be biologically difficult to =
avoid.=20
<P>But the problem is rooted in something deeper than nutrition math. =
Pleasure=20
and emotional comfort are basic instincts, and eating tends to stimulate =
those=20
circuits in the brain, not unlike addictive drugs.=20
<P>A food fix always is within arm's reach.=20
<P>Hardware emporiums host parking lot barbecues, and airports sell =
gooey, hot=20
cinnamon rolls. You can buy potato chips whether you are trekking in =
Nepal or=20
paddling a muddy river in the jungles of Borneo.=20
<P>Who can resist? Almost no one.=20
<P>"I compare the propensity to eat as somewhere between the propensity =
to=20
breathe and the propensity to have sex," said Stephen Bloom, chief of =
metabolic=20
medicine at the University of London's Imperial College.=20
<P>---=20
<P>Weight's health effects=20
<P>---=20
<P>Simply being fat won't necessarily kill you outright. And it's not =
weight=20
alone that determines your risk from several diseases. But being =
overweight=20
carries severe consequences.=20
<P>Diabetes, heart disease and some cancers have been linked to weight, =
and all=20
are on the rise.=20
<P>Type 2 Diabetes is the illness most directly linked to obesity. A =
condition=20
that often leads to heart disease and kidney failure, it is blamed for =
more than=20
3 million deaths a year. It afflicts 154 million people - nearly four =
times the=20
number who have HIV or AIDS - and the WHO forecasts more than twice as =
many=20
people will develop diabetes in the next 25 years.=20
<P>Obesity can triple the risk of heart disease. One-third of all deaths =
globally - about 17 million - are blamed on heart disease, stroke and =
related=20
cardiovascular problems, WHO figures show.=20
<P>Some scientists predict it will outstrip infectious killers by the =
end of the=20
decade.=20
<P>Countries with extensive health care have stalled the onset of heart =
disease=20
into old age and saved lives. But in much of the world, the latest drugs =
and=20
arterial scouring procedures are not widely available.=20
<P>In those countries, fatal heart attacks and strokes are much more =
common=20
among younger, working age adults.=20
<P>Researchers from Columbia University's Earth Institute examined =
Brazil,=20
China, India, South Africa and the Russian republic of Tartarstan. They =
found=20
that the heart disease death rate for adults ages 30-59 was up to twice =
as high=20
as the U.S. rate. Among Russians in the study, the rate was up to five =
times=20
higher.=20
<P>Obesity was cited as a primary factor, along with smoking, lack of =
exercise=20
and untreated high blood pressure. The researchers described the =
influence of=20
unhealthy diets as "surprising."=20
<P>In South Africa, 11 percent of the population has HIV. Yet =
cardiovascular=20
disease there still accounts for a higher rate of death among men and =
women=20
under age 45.=20
<P>In India, more than a quarter of the 5 million people who die from =
heart=20
attacks and strokes every year are younger than 65.=20
<P>Obesity also plays a significant, if poorly understood, role in many =
cancers.=20
WHO data shows cancer accounts for about 12.5 percent of the world's =
deaths, and=20
that rate is expected to increase dramatically, mostly in developing =
countries.=20
<P>The fact that obesity is on the rise in these countries as well is =
due to a=20
confluence of factors that researchers say must be examined.=20
<P>The global trend toward weight gain and its associated illnesses is =
not=20
restricted to the well-off. High-fat, high-starch foods tend to be =
cheaper, so=20
poor people eat more of them.=20
<P>In Mexico, 40 percent of its 105 million people live in poverty. Yet=20
two-thirds of men and women there are overweight or obese.=20
<P>In the slums of Sao Paulo, Brazil, 30 percent of the schoolchildren =
in 500=20
poor families have stunted growth due to poor diet. Yet, reports the Pan =
American Health Organization, about 6 percent of the children and 9 =
percent of=20
the adults were obese, too.=20
<P>In southern Africa, Zambia, which experienced a food crisis in 2002, =
reports=20
that 10 percent to 15 percent of urban schoolchildren are obese.=20
<P>"It's a myth that you can't have poverty and obesity coexisting," =
said Tufts=20
University nutritionist Bea Rogers.=20
<P>---=20
<P>How it happened=20
<P>---=20
<P>Many factors contribute to the widening of the world's waistline.=20
<P>"For the last 150 years we've been getting fatter," said Bloom. But =
now, he=20
says, "everything has kind of come together."=20
<P>For starters, there is cheap, plentiful food. In developing =
countries, people=20
still spend 40 percent of their income on food, as opposed to 15 percent =
by=20
American families.=20
<P>But even in poor nations, the relative cost of eating is declining as =
the=20
world's farmers are able to grow huge quantities of grain that is =
quickly=20
processed and shipped without spoilage.=20
<P>According to U.N. figures, the consumption of oils and fats over the =
last 30=20
years has doubled and is forecast to keep growing.=20
<P>"In the developing world, it happened overnight," said WHO adviser =
Popkin,=20
who heads nutrition epidemiology at the University of North Carolina. =
"One year=20
they had very expensive butter and the next year edible oil came on the =
scene.=20
It was a tenth of a cost and all of a sudden for very little money you =
could=20
make your food taste better."=20
<P>Nutritionists say more and cheaper sugar is another factor, despite =
the=20
industry's strenuous denials.=20
<P>James E. Tillotson, director of Tufts University's Food Policy =
Institute,=20
calculates the average American drinks the equivalent of a 55-gallon =
drum of=20
soda every year, compared to 20 gallons of sweetened beverages a year in =
1970.=20
<P>Increases almost as dramatic have occurred in Europe, and soft drink=20
factories are increasingly popping up in developing countries.=20
<P>Tillotson, who developed fruit-based drinks for Ocean Spray in the =
1980s,=20
says the beverage industry did not consider the health ramifications of =
their=20
now-ubiquitous products: "We never thought people would abuse them."=20
<P>Slowly, the food industry is responding.=20
<P>McDonald's has healthier menus and is phasing out super-sizing. Kraft =
Foods,=20
whose products range from Oreos to Jell-O in 150 countries, has a =
scientific=20
advisory panel. Among the company's initiatives: capping the portion =
size of=20
single-serving packaging.=20
<P>Much of Big Food's response comes after failed efforts by obese =
people to sue=20
fast-food chains for damages.=20
<P>"A lot of chief executives are really in a state of shock right now," =
said=20
international nutrition expert Andrew Prentice of the London School of =
Hygiene=20
and Tropical Medicine. "They've produced this stuff, cheaper and =
cheaper,=20
feeding the world. All of a sudden, we're saying, 'Stop doing this!'"=20
<P>Another factor is how food is promoted and distributed. Brightly =
packaged=20
brands that remain safe for months have widely replaced fresh bulk =
foods. In=20
1990, no more than 15 percent of food bought in Latin America came from=20
supermarkets. Now, 60 percent is from six supermarket chains.=20
<P>Experts say that because the changes occurred so rapidly and medical =
care is=20
so lagging, the developing world's obesity problem - combined with more=20
cigarette smoking - could be both public health and economic disasters =
in=20
countries that were verging on prosperity.=20
<P>There are demographic changes, too. In many nations, women joining =
the work=20
force created a demand for convenience foods.=20
<P>"We already are tired from working and we buy only packaged foods," =
said=20
Bertha Rodriguez of Mexico City. The 61-year old great-grandmother is a =
widow=20
who supports herself by frying quesadillas in a streetside stand.=20
<P>---=20
<P>Technology triumphs=20
<P>---=20
<P>People spend more time sitting in the car, at the computer and =
especially in=20
front of the television - an average of 1,669 hours a year in the United =
States,=20
a habit that is extending internationally.=20
<P>With such low activity levels, as little as 100 extra calories a day=20
translates into 10 pounds in a year.=20
<P>In China's megacities, crowds once pedaled identical black bicycles =
to work.=20
Now adults drive cars and ride trains and buses. In southeast Asia, =
farmers are=20
replacing water buffalo plows with tiny tractors.=20
<P>"It was done with the best of intentions," Bloom said. "Telephones, =
cars,=20
computers all come from the freedom from hunger and fear. But it's had a =
bad=20
side effect."=20
<P>Governments in some developing nations are taking steps.=20
<P>Singapore schools have added physical activities and replaced soft =
drinks=20
with bottled water. Brazil is making school lunch programs serve fruits =
and=20
vegetables.=20
<P>Such efforts are among those the World Health Organization says will =
be=20
necessary to prevent a worldwide crisis.=20
<P>But it's a battle against human nature.=20
<P>"It would be a huge public health achievement if we simply stopped =
the weight=20
gain where it is now," said Stephen Blair, research director at the =
Cooper=20
Institute of Aerobics Research in Dallas.=20
<P>"I think that's what we're stuck with."=20
<P>---=20
<P>EDITOR'S NOTE: Medical Writer Emma Ross reported from London and =
Science=20
Writer Joseph B. Verrengia reported from Denver. Elaine Kurtenbach in =
Shanghai=20
and Morgan Lee in Mexico City contributed to this report.=20
</P></FONT></DIV></BODY></HTML>
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