Obesity. Halting the obesity epidemic: a public health policy approach

Nestle, Marion; Jacobson, Michael F.

doi:10.1093/phr/115.1.12

Cited by 488 publications

(315 citation statements)

References 20 publications

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“…Proposals in this area are in their infancy and are largely untested, but they are worthy of further discussion and testing (Brownell, 1994;Nestle & Jacobson, 2000;Sallis, Bauman, & Pratt, 1998). Those that follow are drawn from Horgen and Brownell (2002).…”

Section: Policy As Means For Preventionmentioning

confidence: 99%

Obesity: Responding to the global epidemic.

Wadden¹,

Brownell²,

Foster³

2002

Journal of Consulting and Clinical Psychology

438

328

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Obesity has reached epidemic proportions in the United States and other developed nations. In the United States, 27% of adults are obese and an additional 34% are overweight. Research in the past decade has shown that genetic influences clearly predispose some individuals to obesity. The marked increase in prevalence, however, appears to be attributable to a toxic environment that implicitly discourages physical activity while explicitly encouraging the consumption of supersized portions of high-fat, high-sugar foods. Management of the obesity epidemic will require a two-pronged approach. First, better treatments, including behavioral, pharmacologic, and surgical interventions, are needed for individuals who are already obese. The second and potentially more promising approach is to prevent the development of obesity by tackling the toxic environment. This will require bold public policy initiatives such as regulating food advertising directed at children. The authors call not for the adoption of a specific policy initiative, but instead propose that policy research, based on viewing obesity as a public health problem, become a central focus of research.Research on obesity has increased exponentially during the past decade and has yielded remarkable discoveries in the regulation of body weight. This same period, however, has witnessed an unparalleled increase in the prevalence of obesity, making it one of our nation's most pressing health problems. This article reviews the epidemiology and complications of obesity and the factors that have contributed to its sharp increase. Consistent with previous reviews, we examine advances in treatment including behavioral, pharmacologic, and surgical interventions (Brownell, 1982;Brownell & Wadden, 1992). Advances in treatment, however, must be complemented in the next decade by innovative public policy designed to prevent the development of obesity. Epidemiology and Complications of ObesityObesity refers to an excess of body fat, which normally accounts for about 25% of weight in women and 18% in men (Bray, 1998). Body fat can be measured by a number of methods but is now usually estimated by the body mass index (BMI), which is calculated as weight in kilograms divided by height in meters squared (i.e., kg/m 2 ; Bray, 1998). (Figure 1 provides for this calculation using pounds and inches.) The BMI is highly correlated with measures of body fat and has replaced the more traditional measure of percentage over ideal weight (VanItallie & Lew, 1992).The World Health Organization (WHO; 1998) has defined obesity as a BMI Ն 30 kg/m 2 , as has the National Institutes of Health/National Heart, Lung, and Blood Institute (NIH/NHLBI; 1998). By this criterion, in 1994 (the last period for which most complete analyses are available), 25% of U. S. women and 20% of men were obese (Flegal, Carroll, Kuczmarski, & Johnson, 1998). An additional 25% and 39%, respectively, were considered overweight, defined as a BMI of 25.0 to 29.9 kg/m 2 . Thus, 55% of adult Americans were either overweight or...

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Section: Policy As Means For Preventionmentioning

confidence: 99%

Obesity: Responding to the global epidemic.

Wadden¹,

Brownell²,

Foster³

2002

Journal of Consulting and Clinical Psychology

438

328

View full text Add to dashboard Cite

show abstract

“…Preventing and treating obesity calls for involvement and participation from many sectors of society, including national and local governments, educators and legislators, health officials and researchers, food industry, etc. 2,3 From the economic perspective, the direct costs associated with obesity in 1994 was estimated to account for 5.7% of national health expenditures in the United States, 4 and 2-3.5% in other countries. 5 From the health perspective, obesity has been linked as a risk factor for many chronic conditions, including diabetes, hypertension, hypercholesterolemia, stroke, coronary heart disease, certain cancers, arthritis, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and endometrial, breast, prostate, and colon cancers.…”

Section: Introductionmentioning

confidence: 99%

Relationship between ambulation and obesity in older persons with and without low back pain

et al. 2003

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CONTEXT: For obese older persons, ambulation is both functionally important and a means of weight control. The relationship between weight and ambulation is not known in this population. Also, the extent to which pain interferes with ambulation is not studied. OBJECTIVE: To examine the relationship between obesity and ambulation, and to determine the effect of pain and body mass index (BMI) on ambulation in older persons. DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of 82 older persons, ages 55-79 y, some with no back pain recruited from the community, others with back pain or spinal stenosis recruited from a magnetic resonance imaging (MRI) scanner as part of a larger university study of spinal stenosis. OUTCOME MEASURES: Age, Visual Analog Scales for pain, BMI, patient diagnosis (no pain, mechanical back pain, and spinal stenosis), walking velocity and stride length on a 15-min laboratory ambulation test, and 1-week community ambulation measured with a pedometer (steps, distance, and energy expenditure). RESULTS: BMI had a significant inverse relationship with ambulatory measurements in terms of the distance walked, steps taken, and walking velocity. Pain severity and pain category also had a significant inverse relationship with these measures. A negative correlation was observed between pain and obesity, although the relationship was statistically nonsignificant. DISCUSSION: Obese older people walked less than the nonobese older people. Pain was associated with decreased ambulation. Clinicians who intend to encourage increased ambulation in older obese persons should consider possible barriers posed by musculoskeletal pain.

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“…The built environment's role in fostering increased energy consumption (through its influence on food availability) and decreased energy expenditure (by facilitating or impeding physical activity) has received increasing attention (7)(8)(9)(10)(11) ; however, this line of research is still in its early stages (12) . The built environment has been identified as obesogenic (i.e.…”

mentioning

confidence: 99%

Obesogenic neighbourhoods: the impact of neighbourhood restaurants and convenience stores on adolescents’ food consumption behaviours

Tucker

Irwin

et al. 2012

Public Health Nutr.

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AbstractObjectiveTo examine the relationship between the neighbourhood food environment and dietary intake among adolescents.DesignCross-sectional design using: (i) a geographic information system to assess characteristics of the neighbourhood food environment and neighbourhood socio-economic status; (ii) the modified Healthy Eating Index (HEI) to assess participants’ overall diet quality; and (iii) generalized linear models to examine associations between HEI and home and school food environmental correlates.SettingMid-sized Canadian city in Ontario, Canada.ParticipantsGrade 7 and 8 students (n810) at twenty-one elementary schools.ResultsStudents living in neighbourhoods with a lower diversity of land-use types, compared with their higher diversity counterparts, had higher HEI scores (P< 0·05). Students with more than 1 km between their home and the nearest convenience store had higher HEI scores than those living within 1 km (P< 0·01). Students attending schools with a distance further than 1 km from the nearest convenience store (P< 0·01) and fast-food outlet (P< 0·05) had higher HEI scores than those within 1 km. Those attending schools with three or more fast-food outlets within 1 km had lower HEI scores than those attending schools with no fast-food outlet in the school surroundings (P< 0·05).ConclusionsClose proximity to convenience stores in adolescents’ home environments is associated with low HEI scores. Within adolescents’ school environments, close proximity to convenience and fast-food outlets and a high density of fast-food outlets are associated with low HEI scores.

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Obesity. Halting the obesity epidemic: a public health policy approach

Cited by 488 publications

References 20 publications

Obesity: Responding to the global epidemic.

Obesity: Responding to the global epidemic.

Relationship between ambulation and obesity in older persons with and without low back pain

Obesogenic neighbourhoods: the impact of neighbourhood restaurants and convenience stores on adolescents’ food consumption behaviours

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