Will obesity reverse the life-span gains made over decades of health triumphs? - Los Angeles Times
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Will obesity reverse the life-span gains made over decades of health triumphs?

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New statistics on death rates in the United States appear to confirm a grim prediction — that obesity is reversing decades of steady expansion in Americans’ life spans, according to a Harvard University researcher calling for more and better research and the urgent adoption of policies that could improve Americans’ food and drink choices.

In the first nine months of 2015, more Americans of all ages died of obesity-related diseases compared with the same period in 2014, writes Dr. David S. Ludwig, an obesity-prevention specialist at Boston Children’s Hospital and Harvard Medical School.

In one year alone, deaths from stroke ticked up 4%, chronic liver disease deaths jumped 3% and deaths attributed to heart disease and to diabetes rose by 1% each, according to the Centers for Disease Control and Prevention. Deaths because of Alzheimer’s disease, which has been linked to midlife obesity, rose 19% over the year before.

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“The new rates potentially signal a looming social and economic catastrophe that demands a comprehensive national strategy,” writes Ludwig, who acknowledges that one-year increases do not, by themselves, establish a clear trend.

The recently released CDC data “suggest that a tipping point has been reached beyond which technological advances no longer compensate,” Ludwig warns in an article published Monday. “It’s probably been underway for years,” he writes, citing county-level statistics that show that two decades of steady nationwide gains in life expectancy began to turn as early as 1983.

Translation: no pills, no widely available procedures and no life-prolonging improvements in medical care or public health measures are likely to be able to compensate for the life-shortening effects of obesity that are now coming home to roost.

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In a “Viewpoint” article in the Journal of the American Medical Assn., Ludwig writes that it’s time — past time, in fact — to move beyond the bland admonishments the federal government is making to Americans to improve their diets.

The “confluence of uncertain science and special interests” has allowed obesity to grow rampant — some 35% of U.S. adults are now obese. Obesity, and the diseases linked to it, will not be reversed with “the notion that ‘all calories are alike’ and that weight loss will result from simply eating less and being more active,” he writes.

First, the U.S. government must ante up the research funds to undergird better advice to Americans, Ludwig writes.

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The National Institutes of Health in 2015 spent $900 million on obesity research — about the investment required to bring a major drug to market in the United States. Funding limitations have kept studies and clinical trials on weight gain and loss small, short and plagued by problems, he wrote. A five-year effort to give Americans dietary guidelines to live by can do little more than urge them to “choose... an appropriate calorie level to help achieve and maintain a healthy body weight.”

The food and beverage industry has been only too happy to offer its views on maintaining and losing weight, writes Ludwig, while “lobbying against sensible regulations” such as taxing sugar-sweetened beverages and limiting advertising that entreats children to demand “demonstrably unhealthful products.”

Ludwig writes that the kind of basic nutrition research that’s needed to better advise Americans struggling with weight will not benefit any single company. And industry sponsorship of nutritional research raises “important concerns about conflicts of interest,” he adds. So it must be the federal government that funds more and better research aimed at replacing its “calories-in-must-equal-calories-out” message.

But we need not let obesity-related death come while that research proceeds, Ludwig writes. The federal government should end its farm policies that support production of corn and wheat and encourage instead the production of high-quality proteins, nuts, legumes, fruits and vegetables, he argues. It could make more nutritious foods more accessible and affordable with subsidies and taxes. Schools should get more money to offer children more nutritious meals. And children, he writes, “must be protected from predatory advertising.”

Taking such actions, Ludwig concludes, may forestall the prediction that obesity will cause today’s children to live shorter, unhealthier lives than their parents.

Follow me on Twitter @LATMelissaHealy and “like” Los Angeles Times Science & Health on Facebook.

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