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Fighting the obesity epidemic in Pennsylvania communities By Celena E. Kusch
Dr. Jill Patterson, assistant professor of nutrition, served as faculty chair of the Penn State Nutrition Update conference, held at The Penn Stater Conference Center Hotel. Dr. Barbara Rolls, Guthrie Chair in Nutrition and author of Volumetrics: Feel Full in Fewer Calories, spoke about her research during the College of Health and Human Development’s annual nutrition conference. Dr. Penny Kris-Etherton, Distinguished Professor of Nutrition, made a presentation on “Weighing the Evidence on Popular Diets” during the Penn State Nutrition Update conference. photos by Dick Ackley Penn State Image Resource Center To Calculate Body Mass Index (BMI) BMI = weight in kilograms/ (height in meters)2 or BMI = ((weight in pounds)* 705)/(height in inches)2 Did you know? Fast food consumers can buy a full day’s worth of calories (2,000 calories) for under $3. In 1990, no state reported prevalence of obesity at higher than 15 percent and fewer than two-thirds were in the 10–15 percent range. Today, only six states can report a 10–15 percent prevalence of obesity; 44 states have greater than 15 percent. Over the course of the day, people tend to eat a constant weight of food, no matter what the food is. Only 5 percent of dieters maintain weight loss.	In the last 20 years, the major national nutrition monitoring surveys report that the prevalence of obesity and excessive weight among adults has increased at an alarming rate. Today, 61 percent of American adults are overweight or obese.   Obesity is defined as being 30 percent or more overweight or having a Body Mass Index (BMI) of 30 or higher. The healthiest BMI range is from 19–25.   “Being overweight is now the norm,” warned Dr. Penny Kris-Etherton, Distinguished Professor of Nutrition.   “More than a quarter of a million deaths per year can be attributed to obesity, and this will continue to be a growing health problem in the next 20 years. We are sitting on a ticking time bomb that will have serious consequences on future health care and national budgets,” she stressed.   Kris-Etherton spoke at the Penn State Nutrition Conference Update 2001: Weighing the Evidence on Adult Weight Management. During the conference, nearly 150 dietitians, Penn State Cooperative Extension agents, nurses, health educators, physicians, physicians’ assistants, health and fitness professionals, certified health education specialists and nutrition researchers met at The Penn Stater Conference Center Hotel to examine the latest research on weight management and to learn to apply that research in their own practices.   Dr. Jill Patterson, assistant professor of nutrition, served as faculty chair for the conference.   “This conference brought nationally acclaimed leaders in the field of obesity to Penn State to discuss the latest findings and intervention strategies for weight management,” Patterson said. “I felt the participants left energized with new knowledge to put research-based findings and realistic expectations into their professional practice.”   Patterson noted the cause of obesity is multifaceted, and management is even more complex; however, change in physical activity and dietary habits is a viable target for tackling this most critical issue.   According to conference speaker Dr. Christopher Still, section head of nutrition and director of the High Risk Obesity Clinic of the Geisinger Health Care System, obesity is essentially an incurable disease.   “Obesity is a chronic disease similar to diabetes, sleep apnea and other chronic diseases, and we need to set up realistic expectations and goals for our patients. We do not have the medical and surgical wherewithal to get people down to a 22.5 BMI from a 45 and keep it off.”   Instead, Still’s presentation advocated managing life-threatening weight problems by setting weight loss goals people can achieve. With just a 10 percent weight loss, he said, obese patients can make significant improvements in weight-related health problems, including diabetes, high cholesterol, sleep apnea syndrome and high blood pressure.   Given the overwhelming odds against successful weight loss, two Penn State professors of nutrition focused on helping conference participants use new University research to manage their clients’ relationships with food and diet.   Dr. Barbara Rolls, Guthrie Chair in Nutrition and author of Volumetrics: Feel Full in Fewer Calories, agreed with Still that current approaches to weight management are unrealistic.   “You are setting people up for failure if you tell them just to eat tiny portions,” Rolls said. “Satiety is at issue, and we need to look for foods that control hunger by making them feel more satisfied.”   Rolls studies the effects of energy density — the number of calories in a given weight of food — on making people feel hungry or satisfied. Interestingly, she has found that the overall weight of food consumed, not energy density, determines feelings of satiety.   “Fat in food raises the energy density (as high as 9 calories per gram); water and fiber lower it. Water has been the ingredient in food that we have overlooked to influence our food supply. Water can dilute the energy density of even high-fat foods.”   Rolls argues that increasing intake of broth- or vegetable-based soups in the diet can make people feel more satisfied with fewer calories, and satiety can help them lose weight.   Like Rolls, Kris-Etherton maintained that the only “diet” that works is to adopt balanced-nutrient, reduced-calorie eating habits. In her presentation, “Weighing the Evidence on Popular Diets,” Kris-Etherton reported on the health risks of popular diets, including the low-carbohydrate, high-protein/high-fat and very low-fat diets. Such diets, she explained, are not nutritionally sound and can lead to negative effects on bone density, cholesterol levels, kidney function and heart health. According to Kris-Etherton, the only way to lose weight is to burn more calories than are consumed, and the only way to maintain weight loss is to build muscle mass through exercise.   Misinformation about diet and nutrition poses a serious health problem in communities, she claimed.   “We need to be proactive in discussing the negative aspects of dieting and the health benefits and health risks of different kinds of diets with our clients,” Kris-Etherton said.   Rolls also agreed, saying, “We all need to become activists. We need it to be easier to get access to fresh fruits and vegetables and get them into our daily diets.   “It’s actually more expensive to eat this way, because sugar and fat are so subsidized in this country, so this will be a political issue, as well,” she added.   The Penn State Nutrition Conference Update was just one of the 43 programs offered by the College of Health and Human Development through Continuing Education’s Conferences and Institutes this year. The college’s conferences and institutes reach nearly 2,200 participants each year, providing health professionals and educators with continuing education credits in a variety of fields.   Bristol-Meyers Squibb, Penn State Outreach and Cooperative Extension and the College of Health and Human Development sponsored the Penn State Nutrition Conference Update 2001: Weighing the Evidence on Adult Weight Management. An outreach program of the College of Health and Human Development and Conferences and Institutes