# Obesity

Vaxxing, Trump, and JFK

Dan Piller reviews presidential attitudes toward public health and physical fitness.

If you needed a good laugh during the hassle of Christmas weekend, one could be had by watching the sudden fracture of Donald Trump and the nation’s anti-vaccine cult. This surprising development came about during a Trump podcast interview with Candace Owens, for whom no conspiracy theory is too outrageous.

Trump and Owens should have enjoyed a convivial chit-chat, but the former president took issue with Owens’ anti-vaccine sentiments. Trump’s Operation Warp Speed initiative to give us COVID-19 vaccines was arguably the highlight of his otherwise inept presidency. Even President Joe Biden has praised it.

Owens uncharitably attributed Trump’s pro-vaccine sentiment to his being “too old” to find websites that give alternatives to vaccinations, which probably will prove sufficient for her to be turned away for good at the Mar-a-Lago main gate.

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A few links and two inconvenient truths about obesity in Iowa

Public policy has been slow to make a dent in the obesity epidemic, which turns out to be “a lot more deadly than previously thought.” But a new report from the U.S. Centers for Disease Control shows that Iowa is one of eighteen states where obesity among low-income preschoolers declined by a statistically significant amount from 2008 through 2011. An estimated 14.4 percent of low-income two- to four-year-olds in Iowa were obese in 2011. Iowa Department of Public Health officials credited several programs with helping to reverse the trend.

Adult obesity is still a major health problem, according to the latest “F as in Fat” report by the Trust for America’s Health and the Robert Wood Johnson Foundation. Iowa had the twelfth-highest adult obesity rate in the country at 30.4 percent in 2012. The sort-of good news was that for the first time in decades, obesity rates held steady in most states. But it’s depressing to see that the adult obesity rate exceeds 20 percent in even the “healthiest” state of Colorado now. As recently as 1991, not a single state had an obesity rate that high.

Speaking to Radio Iowa about the new obesity estimates, Iowa Department of Public Health Director Mariannette Miller-Meeks had sensible advice:

“People don’t have to go out and do a programmed physical aerobics program for 30 minutes or an hour or two hours a day. […] Just eating less, a plant slant to your diet, and trying to get in 30 minutes of exercise a day.”

Mark my words: the Iowa Farm Bureau and other groups representing industrial agriculture will go nuts over Dr. Miller-Meeks encouraging Iowans to bring “a plant slant” to their diet, especially if she runs for Congress a third time in Iowa’s second district. But here’s an inconvenient truth for Big Ag: peer-reviewed research shows that “meat consumption is associated with obesity” in U.S. adults.

Here’s the second inconvenient truth: even if everyone ate responsibly and exercised regularly, Americans would be more prone to obesity because of exposure to certain chemicals, such as the endocrine disruptors Bisphenol-A (BPA) and phthalates, and some organotins used in pesticides. Long-term, low-level exposure to the prevalent herbicide atrazine can cause insulin resistance and obesity too (click here for an explanation of that research in layman’s terms).

Three years ago, a White House Task Force on Childhood Obesity called on federal and state agencies to “prioritize research into the effects of possibly obesogenic chemicals.” That won’t happen in my lifetime, at least not in Iowa.

P.S.- For anyone wondering, Iowa Department of Public Health Medical Director Dr. Patricia Quinlisk warns against ingesting a tapeworm as a weight-loss method.

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Steve King gains new platform for battling USDA

U.S. House Agriculture Committee Chair Frank Lucas announced today that Representative Steve King (IA-04 in the new Congress) will chair the Subcommittee on Department Operations, Oversight, and Nutrition. King has been one of the loudest critics of the U.S. Department of Agriculture in recent years. His new position will give him a more visible platform to battle policies championed by U.S. Secretary of Agriculture Tom Vilsack--the husband of King's most recent Congressional challenger, Christie Vilsack.

King opposed the USDA's settlement in the Pigford case, which involved longstanding government discrimination against African-American farmers. He also objected to the hiring of a claimant in the Pigford settlement to a prominent USDA position. Though King has tried and failed to block spending on the Pigford settlement, chairing a subcommittee may allow him to investigate what he describes as "fraud" in USDA payments to African-Americans.

Regarding the USDA's nutrition programs, King wants to spend less on the Supplemental Nutrition Assistance Program (commonly known as food stamps) than the Obama administration. He wants to overhaul the USDA's new school lunch standards and has sponsored a bill to overturn restrictions on calories and portion sizes for children in public schools. In King's view, "nutrition Nannies" at the USDA, led by Vilsack, have "put every kid on a diet." Vilsack announced earlier this month that school districts will have more time to adapt to the new rules, but he defended the standards as an important weapon against the childhood obesity epidemic. I expect King to hold hearings on this issue in early 2013.

After the jump I've posted King's press release about his new position. He vowed to make sure tax dollars are spent wisely in USDA programs.

Following the 2010 elections, King was expected to become chairman of the House Judiciary Committee's subcommittee on immigration issues, but House leaders feared he was too much of a lightning rod for that job.

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Weekend open thread: Anti-obesity edition

First Lady Michelle Obama visited Des Moines on February 9 as part of her Let's Move campaign. After the jump I've posted the priceless video of her doing the "Interlude Dance" with University of Northern Iowa students, Governor Terry Branstad and former Governor Tom Vilsack dancing on the right-hand side of the screen. Olympic gold medalist Shawn Johnson moves in and out of the frame in this clip.

I hadn't heard of the Interlude Dance before last Thursday, but anything fun that encourages people to exercise is all good as far as I'm concerned. I wish kids had physical education every day in school and more time to run around at recess. Besides burning calories, exercise improves brain function and mitigates some behavioral problems.

Preventing obesity in kids is critical for lifelong health, because it is much more difficult for people who have been obese to stay at a healthy weight, even after a successful diet and exercise program. Excerpts from Tara Parker-Pope's article "The Fat Trap" are below, but I encourage you to click the link and read the whole piece.

The Let's Move campaign focuses on eating well and increasing physical activity. While those factors are extremely important, new research suggests a baby or toddler's emotional security is also correlated with the risk of becoming obese. I posted some findings below from a long-term study of nearly a thousand children.

This is an open thread.

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CDC birth control guidelines could reduce breastfeeding

The Academy of Breastfeeding Medicine warns that recently updated “birth control guidelines released by the U.S. Centers for Disease Control and Prevention (CDC) could undermine mothers who want to breastfeed,” I learned from the ByMomsForMoms blog, sponsored by Lansinoh. From the Academy of Breastfeeding Medicine’s news release:

“The new guidelines ignore basic facts about how breastfeeding works,” says Dr. Gerald Calnen, President of the Academy of Breastfeeding Medicine (ABM). “Mothers start making milk due to the natural fall in progesterone after birth. An injection of artificial progesterone could completely derail this process.”

The CDC report, “U.S. Medical Eligibility Criteria for Contraceptive Use, 2010,” released in the May 28 issue of Morbidity & Mortality Weekly Report (MMWR), contains important changes in what constitutes acceptable contraceptive use by breastfeeding women. The criteria advise that by 1 month postpartum the benefits of progesterone contraception (in the form of progestin-only pills, depot medroxyprogesterone acetate (DPMA) injection, or implants), as well as the use of combined (progestin-estrogen) oral contraceptives outweigh the risk of reducing breastfeeding rates. Previously, progesterone birth control was not recommended for nursing mothers until at least 6 weeks after giving birth, and combined hormonal methods were not recommended before 6 months.

Based on clinical experience, breastfeeding support providers report a negative impact on breastfeeding when contraceptive methods are introduced too early. One preliminary study demonstrated dramatically lower breastfeeding rates at 6 months among mothers who underwent early insertion of progesterone-containing IUDs, compared with breastfeeding rates of mothers who underwent insertion at 6-8 weeks postpartum.

I have met women whose milk supply collapsed after they received a progesterone shot. One acquaintance had successfully nursed previous babies and was never informed by her health care provider that a birth control shot could impede her ability to produce enough milk for her infant.

It’s illogical for the CDC to give its blessing to early postpartum use of hormonal birth control when the federal government has supposedly been trying to promote breastfeeding for more than a decade. Earlier this year, the White House Task Force on Childhood Obesity set a goal of having half of U.S. babies breastfed for at least nine months by 2015, and recommended a number of specific policies to help reach that goal. But breastfeeding without a full milk supply is quite difficult no matter how educated the mother is or how supportive her environment. I hope the CDC will revise its guidelines and recommend non-hormonal forms of birth control for women in the early months of breastfeeding.  

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Breastfeeding infant labeled obese, denied health insurance

Breastfed babies can be long and lean, short and fat, or anywhere in between. But I never heard of an insurance company citing a breastfeeding infant’s “obesity” as a pre-existing condition before reading this story from the Denver Post:

By the numbers, [four-month-old] Alex [Lange] is in the 99th percentile for height and weight for babies his age. Insurers don’t take babies above the 95th percentile, no matter how healthy they are otherwise. […]

Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.

” ‘Your baby is too fat,’ she told me,” Bernie said.

Up until then, the Langes had been happy with Alex’s healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their “happy little chunky monkey.” […]

“I’m not going to withhold food to get him down below that number of 95,” Kelli Lange said. “I’m not going to have him screaming because he’s hungry.”

Good call, Mrs. Lange. There is “no evidence to support ‘dieting’ or substituting other foods or liquids for human milk to reduce weight gain.”

It’s outrageous for an insurance company to use Alex’s weight at four months of age as an excuse to deny coverage. Not that exclusions for other “pre-existing conditions” (such as a benign heart murmur that a child would grow out of without treatment) are any more defensible.

Also, the Lange family wouldn’t have been shopping around for new coverage if their previous carrier hadn’t raised their rates by 40 percent after Alex was born. I remember our insurance premiums went up quite a bit after our second child was born, but I don’t think it was by that much. Then again, they went up 10 percent last year even without any new babies or health problems in our family.

Share any relevant thoughts in this thread.

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