Fat land : how Americans became the fattest people in the world (29 page)

128 "Chocolate iced custard filled" became: "Durante los ultimos 62 ahos hemos vendido nuestras doughnuts frescas y calientitas,"

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Krispy Kreme promotional flyer, Wendy R. Glickman, public affairs, Great Circle Family Foods, Los Angeles, California.

28 "See," he said, checking his watch: Author interview.

29 "The insulin-resistance gene has protected . . .": Leif C. Groop and Johan G. Eriksson, "The etiology and pathogenesis of non-insulin-dependent diabetes," Annals of Medicine, v. 24, 1992, pp. 483-489.

30 "What we are seeing is a mismatch ...": Interview with Barry Bogin. See also Barry Bogin and James Loucky, "Plasticity, political economy, and physical growth status of Guatemala Maya children living in the United States," American Journal of Physical Anthropology, v. 102, 1997, pp. 17-32. For an example of in utero programming theory and its application to fetal nutrition, see K. M. Godfrey and D. J. Barker, "Fetal nutrition and adult disease," American Journal of Clinical Nutrition, v. 71, 5 (supp.), 2000, pp. S1344-S1352.

Bogin also notes: Bogin and Loucky, "Plasticity, political economy, and physical growth ..." p. 27.

31 Studying fifty-eight pre-pubertal boys: D. J. Hoffman, A. L. Sawaya, et al, "Energy expenditure of stunted and nonstunted boys and girls living in the shantytowns of Sao Paulo, Brazil," American Journal of Clinical Nutrition, v. 72, 2000, pp. 1025-1031.

"the child of obese parents is at increased risk . . .": T. J. Parsons et al, "Childhood predictors of adult obesity," International Journal of Obesity, v. 23, supp. 8, 1999, p. s6. For a discussion of childhood obesity tracking into adult obesity, see Nicolas Stettler, "Infant weight gain and childhood overweight status," Pediatrics, v. 109, 2002, pp. 194-199-

The current obesity rate for Mexican American children: R. R. Suminski, W. S. Poston, A. S. Jackson, and J. P. Foreyt, "Early identification of Mexican American children who are at risk for becoming obese," International Journal of Obesity-Related Metabolic Disorders, v. 23, 1999, pp. 823-829.

32 "And it's one of the first things . . .": Interview with Scott Loren-Selco.

"As endocrinologists, all of us were aware . . .": Interview with Francine Kaufman.

33 "we could see that. . .": Ibid.

In 1992, for example, most pediatric diabetes centers: Francine Ratner Kaufman, "Type 2 Diabetes in Children: A New Epidemic," unpublished paper, Department of Endocrinology and Metabolism, Children's Hospital Los Angeles, 2001. 35 "thrifty gene" scholars have even pinpointed: Leif C. Groop and

NOTES

Tiinamaija Tuomi, "Non-insulin-dependent diabetes mellitus — a collision between thrifty genes and an affluent society," Annals of Medicine, v. 29, 1997, pp. 37-53; see also Silva Arslanian and Satish Kalhan, "Correlations between fatty acid and glucose metabolism," Diabetes, v. 43, 1994, pp. 908-914.

136 "the more obese you are": Gerald Reaven, Syndrome X (New York: Simon & Schuster, 2000), p. 59.

When that happens, according to Victor Zammit: For an outstanding summary of this work see Gail Vines, "Sweet but Deadly," New Scientist, September 1, 2001, p. 26; see also A. W. Thorburn, L. H. Storlein, et aL, "Fructose-induced in vivo insulin resistance and elevated plasma triglyceride levels in rats," American Journal of Clinical Nutrition, v. 49, 1989, pp. 1155-1163.

137 when researchers at the University of Toronto: Vines, "Sweet but Deadly."

Two years ago: John P. Bantle, Susan K. Raatz, et aL, "Effects of dietary fructose on plasma lipids in healthy subjects," American Journal of Clinical Nutrition, v. 72, 2000, pp. 1128-1134. To put a point on such observations: C. B. Hollenbeck, "Dietary fructose effects on lipoprotein metabolism and risk for coronary artery disease," American Journal of Clinical Nutrition, v. 58, 1993, pp. S800-S809.

The fructose trouble hardly ends there: Y. K. Park and E. A. Yetley, "Intakes and food sources of fructose in the U.S.," American Journal of Clinical Nutrition, v. 58, 1993, pp. S737-S747; and Vines, "Sweet but Deadly," p. 29.

138 The theory has its origins in the 1970s, when European: J. Bremer, K. S. Bjerve, et aL, "The glycerophosphate acyltransfereses and their function in the metabolism of fatty acids," Molecular Cell Biochemistry, v. 12, 1976, pp. 113-125.

The connection with obesity grew when: M. A. McCrory, Paul J. Fuss, et aL, "Dietary variety within food groups: association with energy intake and body fatness in men and women," American Journal of Clinical Nutrition, v. 69, 1999, pp. 440-447. The study is particularly important for its focus on dietary variety: Does increased, indeed excessive, variety account for the rising rate of obesity, particularly the astounding rise in high-sugar snacks?

139 "Long-term absorption of fructose": P. A. Mayes, "Intermediary metabolism of fructose," American Journal of Clinical Nutrition, v. 58, I993,pp. S754-S765.

By 1995 a farsighted team: J. M. Schwarz, R. A. Neese, etaL, "Short-

NOTES

term alterations in carbohydrate energy intake in humans," Journal of Clinical Investigations, v. 96, 1995, pp. 2735-2743; for a look at the subject of nutrient partitioning — how the cell "decides" what to burn and what to store, see also O. Ziegler, D. Quilliot, et al, "Macronutrients, fat mass, fatty acid flux and insulin sensitivity," Diabetes Metabolism, v. 27, pt. 2, 2001, pp. 261-270; for a look at how high-carbohydrate, high-sugar diets increase the rate of newly synthesized fatty acids and triglycerides, see L. C. Hudgins, "Effect of high carbohydrate feeding on triglyceride and saturated fatty acid synthesis," Proceedings of the Society of Experimental Biological Medicine, v. 225, 2000, pp. 178-183. 140 "Consumption of sugar[HFCS]-sweetened drinks": D. S. Ludwig, K. E. Peterson, and S. L. Gortmaker, "Relation between consumption of sugar-sweetened drinks and childhood obesity," Lancet, v. 357, 2001, pp. 505-508.

Palm oil's impact on insulin effectiveness: J. M. van Amelsvoort, A. van der Beek, et al, "Dietary influence on the insulin function in the epididymal fat cell of the Wistar rat. I. Effect of type of fat," Annals of Nutrition and Metabolism, v. 32, 1988, pp. 138-148; see also J. M. van Amelsvoort et al, "Effects of the type of dietary fatty acid on the insulin receptor function in rat epididymal fat cells," Annals of Nutrition and Metabolism, v. 30, 1986, pp. 273-280, which showed that a diet high in sunflower seed oil induced a better response of fat cells to insulin than did a diet high in palm oil.

142 "In contrast to other types of colic . . .": The Merck Manual of Diagnosis and Therapy (Whitehouse Station, N.J.: Merck Research Laboratories, 1999), pp. 400-410.

may contract liver steatosis: A. Must and R. S. Strauss, "Risks and consequences of childhood and adolescent obesity," International Journal of Obesity, v. 23, supp. 2, pp. S2-SI1. About 40 to 60 percent of adult women: Ibid., p. S4. Then there are the eyes: Merck Manual, p. 168.

143 (A new study shows that structural . . . ): Patrick Tounian, Yacine Aggouhn, et al, "Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study," Lancet, v. 358, 2001, pp. 1400-1404.

go something like this: Reaven, Syndrome X, pp. 54-55.

144 As the name suggests, this is a brain tumor-like: Must and Strauss, "Risks and consequences ..." p. S3.

Then there are the orthopedic problems: Ibid.

"The patient is a 14 and one half": Steven R. Boyea and J. Richard

NOTES

Bowen, "Clinical Case Presentation: Orthopaedic Dept." (Wilmington, Delaware: Alfred I. Du Pont Institute, June 10, 1996), p. 1.

145 The first, Pickwickian syndrome: Must and Strauss, "Risks and consequences ...," p. S3.

"Obese children with obstructive sleep apnea . ..": Ibid. Lastly there is the condition known as allergic asthma: Ibid. See also T. A. Platts-Mills, M. C. Carter, and P. W. Heymann, "Specific and non-specific obstructive lung disease in childhood: causes of changes in the prevalence of asthma," Environmental Health Perspectives, v. 108, supp. 4, 2000, pp. S725-S731; J. A. Castro-Rodriguez, C. J. Holberg, et al, "Increased incidence of asthmalike symptoms in girls who become overweight or obese during school years," American Journal of Respiratory and Critical Care, v. 163, 2001, pp. 1344-1349; and P. F. Belamarich, E. Luder, et al, "Do obese inner-city children with asthma have more symptoms than nonobese children with asthma?" Pediatrics, v. 106, 2000, pp. 1436-1441; March of Dimes, Nutrition Today Matters Tomorrow: A Report from the March of Dimes Task Force on Nutrition and Optimal Human Development (White Plains, N.Y.: March of Dimes, 2002), executive summary, pp. 1-10.

146 In early 2001 the American Cancer Society: Edward Edelson, "Cancer Society Warns on Obesity," Healthscout Reporter, January 15, 2001; D. S. Michaud, E. Giovannucci, et al, "Physical activity, obesity, height, and the risk of pancreatic cancer," Journal of the American Medical Association, v. 286, 2001, pp. 921-929; J. R. Daling, K. E. Malone, et al, "Relation of body mass index to tumor markers and survival among young women with invasive ductal breast carcinoma," Cancer, v. 92, 2001, pp. 720-729; D. M. Purdie and A. C. Green, "Epidemiology of endometrial cancer," Best Practices of Residential Clinical Obstetrics and Gynaecology, v. 15, 2001, pp. 341-

354-

There are, first and foremost, the premature deaths: D. B. Allison and K. R. Fontaine, "Annual deaths attributable to obesity in the United States," Journal of the American Medical Association, v. 282, 1999, pp. 1530-1538.

147 Obesity takes its toll on our daily quality of life: A. M. Wolf and G. A. Colditz, "Current estimates of the economic cost of obesity in the United States," Obesity Research, v. 6, 1998, pp. 97-106.

"The economic and personal health costs . . .": Ibid.

148 "obesity would account for 132,900 cases of hypertension . . .": G. Oster, J. Edelberg, A. K. O'Sullivan, and D. Thompson, "The clinical

NOTES

and economic burden of obesity in a managed care setting," American Journal of Managed Care, v. 6, 2000, pp. 681-689.

148 "We believe the effect will be like that of secondhand smoke": Interview with James Hill.

149 "We have a long long way to go until . . .": Interview with Gerry Oster, Policy Analysis Inc.

"There's a moment in the Barbara Walters interview . . .": Quoted in Sarah Boxer, "Trash Tropes and Queer Theory: Decoding the Lewinsky Scandal," New York Times, August 5, 2001, Week in Review, p. 7.

150 "We got very interested in this area some time ago . . .": Interview with Johannes Hebebrand.

To find out if that were the case: J. Hebebrand, H. Wulftaig, et al, "Epidemic obesity: are genetic factors involved via increased rates of assortative mating?" International Journal of Obesity, v. 24, 2000,

PP. 345-353-

151 "It is not exactly a straight line": Hebebrand interview.

Yet in this case, recognizing such a dynamic might help prevent: For a discussion about how obese-prone individuals pass on enhanced obesity — in essence a metabolism that defends against weight loss because it has been triggered to do so by weight gain — to subsequent generations, see Barry E. Levin, "The obesity epidemic: metabolic imprinting on genetically susceptible neural circuits," Obesity Research, v. 8, 2000, pp. 342-347.

7. What Can Be Done

The discussion of obesity and treatment — both clinical and preventive — generally divides into two categories, that of public health interventions and that of individual medical treatment. An outstanding starting point for those curious about both can be found at the Web site (www. surgeon general.gov) for U.S. Surgeon General David Satcher; the site includes the complete 2002 report The Surgeon Generals Call to Action to Prevent and Decrease Overweight and Obesity, which does an admirable job of marrying the dual concepts of personal and public responsibility in meeting the challenge. (That both liberals and conservatives took such great umbrage at Satcher's call for all Americans to lose ten pounds says much about how on-spot this report was.) The Health Professionals Follow-Up Study and related reports run out of the Harvard School of Public Health are an important source of epidemiological data upon which an increasing number of organizations base their public health interventions. One can read the

NOTES

original studies, with footnotes, as well as a continually updated newsletter, at www.hsph.harvard.edu/hpfs. I was fortunate to have the cooperation of the study's two principal investigators, Walter Willett and Meir Stampfer. To read another important report, Innovative Approaches to Prevention of Obesity, and federally funded programs to do so, see www. grants.nih.gov/grants, where the National Institutes of Health tracks such efforts. For evaluations of school-based programs the American Council of School Health offers a number of publications, available at www .ashaweb.org.

At the community level, I interviewed a number of health and medical advocates, many of whom have already put their ideas into fruitful action. Among them were Dr. Robert Trevino, Dr. Francine Kaufman, Marsha MacKenzie, Dan Latham, and several members of the Sacramento Unified School District. Regarding public policy, I interviewed Andrew Hagelshaw at Berkeley's Center for Commercial-Free Public Education, Michael Ja-cobson at the Center for Science in the Public Interest, Patrick Escobar at the Amateur Athletic Foundation of Los Angeles, and Betty Hennessy of the Los Angeles County Department of Education. To understand more about industry and its response to the issue, I relied heavily on James O. Hill at the University of Colorado, and John Peters at Procter & Gamble.

155 About five years ago: Interview with Robert Trevino; see also R. P. Trevino, R. M. Marshall, D. E. Hale, R. Rodriguez, G. Baker, and J. Gomez, "Diabetes risk factors in low-income Mexican-American children," Diabetes Care, v. 22, 1999, pp. 202-207; an d Randi Hutter Epstein, "As Diabetes Strikes Younger, Children Get Lessons in Defense," New York Times, February 20, 2001, p. D7.

"We scared the hell out of them": Trevino interview.