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Americans getting fatter, report warns
By Larry Lipman, Palm Beach Post Staff Writer

Six of 10 adults in this country are either overweight or obese,
according
to the 1999 National Health and Nutrition Examination Survey released
by the
National Center for Health Statistics. That's about 5 percent higher
than
the last study, conducted between 1988 and 1994, and 14 percent
higher than
the study from 1976 to 1980.

Most of the gain has come from people who are considered obese, the
study
said. While there has been a slight increase in the percentage of
adults
over 20 who are overweight, the percentage of obese Americans has
nearly
doubled in the past two decades.

The percentage of obese American adults grew from 15 percent in 1980
to 23
percent in 1994 and 27 percent last year. Meanwhile, the percentage of
overweight Americans grew from 32 percent in the first survey to 33
percent
in the second and 34 percent in the latest.

Over all, the percentage of American adults who are either overweight
or
obese has increased from 47 percent in 1980 to 56 percent in 1994 and
61
percent last year. To determine whether people are overweight or
obese, the
surveys used height and weight measurements to calculate people's
body mass
index. The index is equal to weight in kilograms divided by height in
meters
squared.

Using that system, men and non-pregnant women with a body mass index
of
between 25.0 and 29.9 are defined as overweight. Those with an index
of 30
or higher are obese.

A person 5 feet, 5 inches tall, has an index of 25 at 150 pounds and
30 at
180 pounds. A person 6 feet tall has an index of 25 at 184 pounds and
30 at
221 pounds, according to a table published by the National Institutes
of
Health.

Obesity has long been known as a health risk. The American Heart
Association
notes that obesity can be damaging to the heart and blood vessel
system, is
a major cause of gallstones, and can worsen degenerative joint
disease.
Reducing excess weight can also reduce high blood pressure and
cholesterol
levels.

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Apple-Shaped Obese Women Have Greater Risk Of Disease

Obese "apple-shaped" women have a higher risk of developing type 2
diabetes
and heart disease than overweight "pear-shaped" women who carry fat
on their
hips and thighs.
Although it is not known why some women are apple-shaped and others
are
pear-shaped, researchers at the University of Southampton believe that
abnormalities in the way insulin works may provide the answer.
Insulin is a key hormone that controls the metabolism of
carbohydrate, fat
and protein in many tissues, including skeletal muscle, fat and the
liver.
Dr. Richard Holt, of the UK's Southampton University Department of
Fetal
Origins of Disease, said: "There are very strong links between
obesity and
type 2 diabetes and heart disease. It is not just being obese that
matters
but where the fat is.

"If you are apple-shaped you are much more likely to get these
problems than
if you are pear-shaped and the risks are higher for women than for
men. We
want to find out why that is.

"We believe a key factor is insulin resistance. We are looking at how
insulin works in liver, fat and muscle in different shaped women and
how
important this is for development of disease."
The Southampton team led by Dr. Holt and Professor Chris Byrne aims to
recruit 40 healthy, middle-aged, overweight women half of whom are
apple-shaped and the other half pear-shaped.
Detailed body measurements will be taken and participants will
complete
physical activity and quality of life questionnaires. Blood tests
will also
enable doctors to look at insulin action and its relationship to fat
and
glucose metabolism.

A second part of the research will be done in collaboration with Dr.
Richard
Shreaves, consultant diabetologist and endocrinologist at Jersey
General
Hospital, also in the UK. It will examine the prevalence and likely
health
costs, both personal and financial, of central obesity among 300
middle-aged
women on the island.
The study is being funded by a £50,000 grant from The States of Jersey
Health and Social Services Committee through leading medical research
charity, Hope.

Dr. Holt, senior lecturer in endocrinology and metabolism, added: "As
central obesity is a major risk factor for type 2 diabetes, it is
important
to define precisely its prevalence.
"The association between central obesity and insulin resistance is
unclear.
An understanding may provide an insight into how type 2 diabetes and
heart
disease occurs and, in the future, provide strategies to reduce this
health
burden.

"Our hypothesis is there is difference in the way insulin works in
different
tissues between apple and pear-shaped obese women. If this is
confirmed, we
want to do further work to look at possible explanations which may
underlie
these differences."
It is estimated that 16 per cent of men and 17.5 per cent of women are
obese.
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