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Obesity on track as No. 1 killer
By Nanci Hellmich, USA TODAY
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Posted 3/9/2004 2:01 PM Updated 3/9/2004 11:37 PM

Obesity on track as No. 1 killer
By Nanci Hellmich, USA TODAY
CHICAGO — Inactive Americans are eating themselves to death at an alarming rate, their unhealthy habits fast approaching tobacco as the top underlying preventable cause of death, a government study found.
Poor diet and lack of exercise might end up killing more people than tobacco use and become the leading cause of preventable deaths in the USA by as early as next year, a new study says. (Related story: Anti-obesity public service ads may be too much to stomach)

Diet and physical inactivity accounted for 400,000 deaths in 2000, or about 16.6% of total deaths. Tobacco, with 435,000 deaths, was 18.1% of the total, says research in today's Journal of the American Medical Association.

"This is really a tragedy," says Julie Gerberding, director of the Centers for Disease Control and Prevention and one of the authors of the study. "Obesity is the overt manifestation" of poor diet and sedentary lifestyle, and it's a "preventable risk factor," she says.

Smoking rates are dropping, but Americans are increasingly overweight. That's why obesity probably will overtake smoking as the leading preventable cause of death by 2005, says CDC epidemiologist Ali Mokdad, another study author. Almost 65% of Americans weigh too much, increasing their risk of heart disease, diabetes and cancer.

On Tuesday, the government announced two ways it intends to help: by running public service ads on the importance of controlling weight and by paying for new obesity research.

For the latest study, CDC researchers reviewed about 1,000 studies linking certain behaviors and death, and they came up with an equation that determines the actual risk from those behaviors. Often, more than one cause or condition contributes to a single death. The top killers are heart disease, cancer and stroke. The researchers say poor diet and inactivity are considered "modifiable" behaviors that give those killers ammunition.

Nutrition experts say Americans must take this news seriously. "Obesity and unhealthy lifestyles are now the most important public health problems of this century," says Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis.

"It's not just the increase in premature deaths that's a problem, but also the illness, disability, suffering and economic costs that go with it," he says.

Roland Sturm, a senior economist with Rand Corp., a research think tank, says Americans have been getting healthier and living longer. But he says that if the obesity rate continues to rise, "it will reverse that trend." People now in their 40s will develop conditions such as diabetes, arthritis and back pain that will reduce their quality of life, he says.

In a study in the March issue of Health Affairs, Sturm predicts that by 2020, one in five health-care dollars spent on people ages 50 to 69 could be for medical problems related to excess weight.

"People need to get off the train of overeating, gaining weight and being sedentary," says George Blackburn, associate director of the division of nutrition at Harvard Medical School. "These are 400,000 avoidable, premature deaths that wouldn't occur if we didn't overeat and weren't coach potatoes."

Gerberding says she would like to see Americans take small steps to a healthier lifestyle, and those steps would "add up to a more fit body. That means eating healthy foods in healthy portion sizes and finding ways to incorporate exercise into their everyday lives."

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