"We're what we eat"- 1 burger 20 yrs ago: 333 calories; today: 590 calories. Av. weight(M) in 1960-62: 166.3 lb; 1990-02: 191 lb

Obesity rates rise at least 90% in 17 states since ’95, study says. One-third of children are overweight or obese.

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Obesity rates climbed at least 90 percent in 17 states from 1995 to last year, gains that have a direct bearing on US health spending, according to a report released yesterday.

Nine of the 10 states with the highest obesity rates are in the South, led by Mississippi at 34.4 percent, followed by Alabama and West Virginia, according to the report by the Trust for America’s Health and the Robert Wood Johnson Foundation. Those states also lead the nation in diabetes and high blood pressure, the report found. Michigan was listed as 10th at 30.5 percent. Massachusetts ranked fourth best at 22.3 percent.

Medicare and Medicaid, the public health plans, each spend more than 20 percent of their budget to treat illnesses related to obesity and smoking, which are avoidable medical risks.

The survey’s authors dubbed a swath of 644 counties in 15 mostly southern states the “diabetes belt,’’ as reported in the Journal of Preventive Diseases. Colorado, the slimmest state with a 19.8 percent obesity rate, had the second-smallest rise since 1995, though its rate is still higher than Mississippi’s was at that time, according to the study.

Obesity is defined as having a body mass index above 30. A 6-foot-tall adult man weighing 221 pounds or more is considered obese, as is an adult woman standing 5 feet, 6 inches tall weighing 186 pounds or more, according to the National Institutes of Health. People with obesity are at higher risk for diabetes and hypertension, according to the US Centers for Disease Control and Prevention.

Bigger servings and food consumed on the go are not helping, said Steven Gortmaker, a professor at Harvard University School of Public Health. “It’s gotten easier and easier to consume lots of foods at more times of the day,’’ he said in a telephone interview. “That’s been the biggest shift in the last 20 years.’’

Lawmakers have considered using tax policy to influence eating habits. A tax on sugar-sweetened beverages was discussed and eventually rejected during debate on the 2010 health care law.

Colorado’s director of Prevention Services, Chris Lindley, said that while his state is the slimmest, it has still lost ground. “Just like the rest of the country, we’re continuing to grow,’’ he said in a telephone interview. Obesity-related health conditions cost the state more than $1 billion a year, he said.

Portion Size, Then vs. Now

Over the past few decades, portion sizes of everything from muffins to sandwiches have grown considerably. Unfortunately, America’s waistbands have reacted accordingly. In the 1970s, around 47 percent of Americans were overweight or obese; now 66 percent of us are. In addition, the number of just obese people has doubled, from 15 percent of our population to 30 percent.

While increased sizes haven’t been the sole contributor to our obesity epidemic, large quantities of cheap food have distorted our perceptions of what a typical meal is supposed to look like. These portion comparisons, adapted from the National Heart, Lung, and Blood Institute’s (NHLBI) Portion Distortion Quiz, give a visual representation of what sizes used to be compared to what they are today.

Two Slices of Pizza
Twenty years ago: 500 calories
Today: 850 calories

Those extra 350 calories, if eaten a two times a month, would put on two extra pounds a year, or forty pounds in the next two decades.

Cup of Coffee
Twenty years ago: Coffee with milk and sugar, 8 ounces, 45 calories
Today: Grande café mocha with whip, 2% milk, 16 ounces, 330 calories

When our parents ordered a coffee two decades ago, they weren’t given as many size options—a standard cup of joe was eight ounces, the size of a small coffee cup. Nowadays, most of us feel like we don’t get our money’s worth unless the cup is at least twelve ounces; it’s not unusual to see thirty-two ounce coffee cups, four times the size they used to be. When made into a mocha, the morning coffee has as many calories as a full meal.

Movie Popcorn
Twenty Years Ago: 5 cups - 270 calories
Today: Tub - 630 calories

We don’t have to eat those extra 360 calories in the tub of popcorn, but that’s easier said than (not) done. Studies indicate that when given food in larger containers, people will consume more. In a 1996 Cornell University study, people in a movie theater ate from either medium (120g) or large (240g) buckets of popcorn, then divided into two groups based on whether they liked the taste of the popcorn. The results: people with the large size ate more than those with the medium size, regardless of how participants rated the taste of the popcorn.

Bagel
Twenty Years Ago: 3-inch diameter, 140 calories
Today: Noah’s Plain Bagel, 5-6-inch diameter, 350 calories

Because portions are now so large, it’s hard to understand what a “serving size” is supposed to be. Today’s bagel counts for three servings of bread, but many of us would consider it one serving. Larger sizes at restaurants have also contributed to larger sizes when eating at home. A study comparing eating habits today with twenty years ago found that participants poured themselves about 20 percent more cornflakes and 30 percent more milk than twenty years ago.

Cheeseburgers
Twenty years ago: 333 calories
Today’s Burger: 590 calories

According to a 2007 paper published in the Journal of Public Health Policy, portion sizes offered by fast food chains are two to five times larger than when first introduced. When McDonald’s first started in 1955, its only hamburger weighed around 1.6 ounces; now, the largest hamburger patty weighs 8 ounces, an increase of 500 percent. And while a Big Mac used to be considered big, it’s on the smaller side of many burger options. At Burger King, you can get the Triple Whopper; at Ruby Tuesday’s there’s the Colossal Burger; and Carl’s Junior has the Western Bacon Six Dollar Burger.

Soda
Original 8-ounce bottle: 97 calories
12 ounce can: 145 calories
20-ounce bottle: 242 calories

While the 12-ounce can used to be the most common soda option, many stores now carry only the 20-ounce plastic bottle, which contains 2.5 servings of soda. When presented with these larger sizes, humans have a hard time regulating our intake or figuring out what a serving size is supposed to be. A 2004 study, published in Appetite, gave people potato chips packaged in bags that looked the same, but increased in size. As package size increased, so did consumption; subjects ate up to 37 percent more with the bigger bags. Furthermore, when they ate dinner later that day, they did not reduce their food consumption to compensate for increased snack calories—a recipe for weight gain.

Plates
It’s not just food portions that have increased; plate, bowl, and cup sizes have as well. In the early 1990s, the standard size of a dinner plate increased from 10 to 12 inches; cup and bowl sizes also increased. Larger eating containers can influence how much people eat. A study published in the American Journal of Preventive Medicine found that when people were given larger bowls and spoons they served themselves larger portions of ice cream and tended to eat the whole portion.

Prices
32 ounces: 388 calories, $0.99
44 ounces: 533 calories, $1.09
64 ounces: 776 calories, $1.19

We Americans love to get the most bang for our buck. When confronted with a 32-ounce drink for 99 cents versus a 44-ounce drink for ten cents more, the decision is easy. You’d have to be a sucker not to go big. But our ability to get the most out of our dollar doesn’t always serve us well. Value pricing, which gets us a lot more food or drink for just a little increase in price, makes sense from an economic standpoint, but is sabotage from a health standpoint. A study published in the Journal of the American Medical Association found that Americans consume around 10 percent more calories than they did in the 1970s. Given no change in physical activity, this equates to around 200 extra calories per day, or 20 pounds a year.

What is normal?

Increased portion sizes give us more calories, encourage us to eat more, distort perceptions of appropriate food quantities, and along with sedentary lifestyles, have contributed to our national bulge. Unless you’re trying to gain weight, it might help to reacquaint yourself with serving sizes. The NHLBI tells us that a serving of meat should be the size of a deck of cards while one pancake should be the size of a CD. It’s unlikely that we’ll see a scaling down of food to these sizes anytime soon, so perhaps we should all become familiar with another image: the doggy bag.

Obesity Still On The Rise In Many States
Obesity rose last year in 16 states, a report issued Thursday found. More than 30 percent of the people in 12 states are obese, the report, issued by Trust for America's Health found, mainly in the South. No state reported a decrease in obesity rates, which the study defined as a body mass index (BMI) of 30 or more.

Obesity declined among women in Nevada, but increased for men in nine states.

Every state except Colorado now reports an obesity rate above 20 percent. Mississippi topped the list, followed by Alabama, West Virginia, Tennessee and Louisiana. Thirty-eight other states have rates above 25 percent. In 1995, no states had rates above 20 percent.

Other states reporting increaeses include Illinois, Kentucky, Massachusetts, Missouri, Rhode Island and Texas, Florida, Kansas, Maine, Oklahoma and Vermont.

However, geater public awareness of obesity may have stopped increases in some states, said Jeffrey Levi, executive director of Trust for America's Health. Twenty-eight states reported increases this year, compared to 16 percent the year before that.

One-third of children are overweight or obese, though the rate of childhood obesity may have leveled off, HealthDay reported. "This generation of kids could have shorter life spans, because people are getting diabetes and hypertension much earlier," Levi said.

*Update July 2, 2012*

Drug giant Glaxo pleads guilty, fined $3B for drug marketing
WASHINGTON – Drug giant GlaxoSmithKline will plead guilty and pay $3 billion to resolve federal criminal and civil inquiries arising from the company's illegal promotion of some of its products, its failure to report safety data and alleged false price reporting, the Justice Department announced Monday.

The company agreed to plead guilty to three criminal counts, including two counts of introducing misbranded drugs - Paxil and Wellbutrin - and one count of failing to report safety data about the drug Avandia to the Food and Drug Administration.

The $3 billion fine will be the largest penalty ever paid by a drug company, Deputy Attorney General James M. Cole said. The company also agreed to be monitored by government officials for five years to attempt to ensure the company's compliance, Cole said. Under the terms of the plea agreement, GSK will pay a total of $1 billion, including a criminal fine of $956,814,400. The company also will pay $2 billion to resolve civil claims under the federal government's False Claims Act.

Prosecutors said GlaxoSmithKline illegally promoted the drug Paxil for treating depression in children from April 1998 to August 2003, even though the FDA never approved it for anyone under age 18. The corporation also promoted the drug Wellbutrin from January 1999 to December 2003 for weight loss, the treatment of sexual dysfunction, substance addictions and attention deficit hyperactivity disorder, although it was only approved for treatment of major depressive disorder.

Crimes and civil violations like those in the GlaxoSmithKline case have been widespread in the pharmaceutical industry and have produced a series of case with hefty fines. One reason some have said the industry regards the fines as simply a cost of doing business is because aggressively promoting drugs to doctors for uses not officially approved — including inducing other doctors to praise the drugs to colleagues at meetings — has quickly turned numerous drugs from mediocre sellers into blockbusters, with more than $1 billion in annual sales.

The prior record-setting case involved Pfizer, the world's biggest drugmaker. Pfizer paid the government $2.3 billion in criminal and civil fines for improperly marketing 13 different drugs, including Viagra and cholesterol fighter Lipitor. Pfizer was accused of encouraging doctors to prescribe its drugs with free golf, massages, and junkets to posh resorts.

It is illegal to promote uses for a drug that have not been approved by the FDA — a practice known as off-label marketing. Justice Department officials also said that between 2001 and 2007 GlaxoSmithKline failed to report to the FDA on safety data from certain post-marketing studies and from two studies of the cardiovascular safety of the diabetes drug Avandia. Since 2007, the FDA has added warnings to the Avandia label to alert doctors about potential increased risk of congestive heart failure and heart attack.

The drug corporation agreed to resolve civil liability for promoting the drugs Paxil, Wellbutrin, Advair, Lamictal and Zofran for off-label, non-covered uses. The company also resolved accusations that it paid kickbacks to doctors to prescribe those drugs as well as the drugs Imitrex, Lotronex, Flovent and Valtrex.

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Image Courtesy healthmealexperts.com