May 8, 5:26 PM
(ET)
By EMMA ROSS and
JOSEPH B. VERRENGIA
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. In an
astonishing testament to globalization, this outbreak of girth is occurring
just as doctors everywhere but sub-Saharan Africa are winning the fight against
infectious diseases from smallpox to malaria.
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.
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.
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.
"The
developing world in particular is going to bear the enormous brunt of this
weight gain," said Neville Rigby, policy director of the IOTF.
"We're
even seeing obesity in adolescents in India now. It's universal. It has become
a fully global epidemic - indeed, a pandemic."
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No country
immune
---
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.
But there are
a dozen places even worse.
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.
Greece,
birthplace of the Olympic Games. Kuwait and other wealthy, oil-soaked Gulf
States.
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.
When
university student Li Guangxu was a baby, rice was rationed. Now he eats
cookies for breakfast.
Shopping at a
CarreFour supermarket in western Shanghai, Li fills a shopping cart with
cookies, chips, soda and beer.
"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."
And a food
fix always is within arm's reach. Almost no one can resist.
"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. "It's much worse
than stopping smoking."
---
Weight's
health effects
---
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.
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.
Countries
with extensive health care have stalled the onset of heart disease into old
age. But in much of the world, fatal heart attacks and strokes are much more
common among working age adults. Over the next 30 years, the trend is projected
to worsen.
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, and
in Russia the rate was up to five times higher
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."
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.
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.
In Mexico, 40
percent of its 105 million people live in poverty. Yet two-thirds of men and
women there are overweight or obese.
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How it
happened
---
Many factors
contribute to the widening of the world's waistline.
For starters,
there is cheap, plentiful food. Even in poor nations, the relative cost of
eating is declining.
And the
consumption of oils and fats used in processed foods has doubled over the last
30 years.
"One
year they had very expensive butter and the next year edible oil came on the
scene," said Barry Popkin, who heads nutrition epidemiology at the
University of North Carolina and serves as a WHO adviser. "All of a sudden
for very little money you could make your food taste better."
Nutritionists
say cheaper sugar is another factor, despite the industry's strenuous denials.
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.
Increases
almost as dramatic have occurred in Europe, and soft drink factories are
increasingly popping up in developing countries.
"We
never thought people would abuse them," said Tillotson, who developed
fruit-based drinks for Ocean Spray in the 1980s.
Another
factor is how food is promoted and distributed.
In 1990, no
more than 15 percent of food bought in Latin America came from supermarkets.
Now, 60 percent is from six supermarket chains.
There are
demographic changes, too. In many nations, women in the work force created a
demand for convenience foods.
"We
already are tired from working and we buy only packaged foods," said
Bertha Rodriguez of Mexico City. The 61-year old great-grandmother supports
herself by frying quesadillas in a streetside stand.
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Technology
triumphs
---
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.
With such low
activity levels, as little as 100 extra calories a day translates into 10
pounds in a year.
Technology is
changing activity levels even in the poorest nations.
"Telephones,
cars, computers all come from the freedom from hunger and fear," Bloom
said. "But it's had a bad side effect."
Some
governments are taking steps.
Singapore
schools have added physical activities and replaced soft drinks with bottled
water. Brazil is making school lunch programs serve fruits and vegetables.
But it's a
battle against human nature.
"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.
"I think
that's what we're stuck with."
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EDITOR'S
NOTE: Medical Writer Emma Ross reported from London and Science Writer Joseph
Verrengia reported from Denver. Elaine Kurtenbach in Shanghai and Morgan Lee in
Mexico City contributed to this report.