A Global Epidemic in the Making?
Is America’s fast food industry contributing to a health epidemic of global proportions?
August 11, 2002
In the good old, bad old days, epidemics were fairly straightforward affairs. You "contracted" — read: caught — a deadly germ and became ill rather quickly. Today, epidemics come in many forms, but they are not necessarily infectious in origin — nor speedy in resolution.
Witness, for example, the increasingly worldwide epidemics of drug abuse, alcoholism and school violence. But none of these — with the exception of cigarette smoking — are as deadly or widespread as that of obesity.
What is especially insidious about obesity is that bad eating habits are established early in life and extend into adulthood.
Since 1970, the number of overweight children in the United States has more than doubled. In 2002, more than 20% of all preschool children in the United States are overweight.
Worse, about half of them — 10% of all preschool children — are clinically obese. These numbers alone should make any parent pause before allowing their child to respond to the question "Would you like fries with that?"
Recently, a team of Yale University pediatricians released a study diagnosing glucose intolerance in about 25% of the obese children and adolescents. What this means, in layman's terms, is that obese kids are very likely to go on to develop Type II diabetes, one of the leading causes of heart and kidney disease, blindness and death in the United States today.
Not coincidentally, physicians are reporting an increase in Type II diabetes each year. Moreover, obesity is a major factor in developing heart disease, atherosclerosis, colon cancer, hypertension, strokes and several other deadly conditions. This year, almost 300,000 Americans will die as a result of being overweight.
But there is even more bad news. The United States is leading the way in spreading this epidemic of fat to children around the globe. As a result, Americans may before long have to worry about something truly unfortunate.
In the eyes of the world, the United States is currently considered a leading force for democracy and capitalism worldwide. But there may come a time when the United States is better known as the world's leading purveyor of snacks and high-fat foods.
In a striking demonstration of the United States as the "land of opportunity", a 1999 Institute of Medicine report on trends among immigrant children showed that, shortly after settling here, these kids' eating habits and diets deteriorated to the level of their U.S.-born counterparts.
Nations such as the United Kingdom, Russia and France — where fast food now reigns — are also reporting a striking increase in childhood obesity.
In May of 2002, the World Health Organization announced a rise in obesity, diabetes and heart disease. Remarkably, this occurred not only in affluent developed nations — but also among developing nations in Africa, the Middle East, Latin America and the Caribbean, where malnutrition was once the major dietary issue.
The International Obesity Task Force currently estimates that 22 million of the world’s children under five years of age are overweight or obese.
The picture is worse for adults. Worldwide, 300 million of us are obese — and at least 750 million are overweight.
Much of this problem is our own doing. We Americans supersize our orders of French fries. We are no longer content to merely order a pizza. Instead, we crave a "pizza, pizza" with a cheese-filled crust. And we consume cholesterol-rich foods with a vengeance.
After such repasts, we steadfastly forego physical activity for the sweeter pastures of the television set, video game or computer terminal. To add insult to injury, our children are merely learning poor health habits from their elders.
At the same time, the U.S. fast food industry has aggressively entered into new domestic markets to sell their products. For example, Taco Bell is served in more than 4,500 school cafeterias. Other chains are salivating at the prospect of getting some of this profitable action.
The American School Food Service estimates that at least 30% of all U.S. public high schools offer some type of name-brand fast food. And more than a third of the hospitals selected as "America's Best" by “U.S. News and World Report” for 2002 boast a fast food outlet on premises.
Even when discounting charitable efforts by the fast food chains, such as the Ronald McDonald Houses — which offer lodging for parents of hospitalized children — these chains are far more adept than the tobacco companies in luring youths to enjoy their products.
The crucial difference is that the fast food chains can legally link their wares with toys, games and movies that draw in the kids.
Fast food, of course, is hardly the only culprit in our worldwide obesity epidemic — even though the companies' direct and highly-targeted marketing to “billions and billions” of children is troubling, to say the least.
But the industry is not the only villain in this high stakes drama. Consumers are big-time culprits, too. That is why it is high time that both fast food purveyors and consumers alike accept a long-known fact: Nutritional health is inversely proportional to the weight of the saturated fat you lift from the plate into your mouth.
Director of the Center for the History of Medicine at the University of Michigan Dr. Howard Markel is a professor of pediatrics and communicable diseases and the George E. Wantz Professor of the History of Medicine. He is also the Director of the Center for the History of Medicine at the University of Michigan. He […]