# Obesity

Was childhood obesity a real concern or pretext for Iowa's governor?  

Bernie Scolaro is a retired school counselor, a past president of the Sioux City Education Association, and former Sioux City school board member.

My mother used to make our lunches and send us off to school. Our packed lunch consisted of something like a peanut butter and jelly sandwich and for dessert, something like a Hostess Ho Ho or Ding Dong. I would come home and have a snack, usually a couple of chocolate chip cookies. At dinner, my parents always wanted to make sure my siblings and I ate everything on our plate—after all, people were “starving to death in Biafra.”  

I was never heavy, but I do remember my mother calling me “pleasantly plump” a few times. I guess that phrase made it more “pleasant” to carry a little more weight. My mother never looked to Governor Nelson D. Rockefeller to tell me when or how much to eat. That was personal and a family matter, certainly not political.

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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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Soft drink makers pit public health advocates against "moderation moms" and "hard-working families"

With numerous studies linking soft drinks to rising rates of obesity and type 2 diabetes, especially in children, reducing consumption of sugary drinks would appear to have obvious benefits for public health. Limiting access to soft drinks at school has been shown to reduce children’s overall consumption of such beverages, and raising the price of soft drinks through new taxes would likely reduce consumption among adults too.

Iowa native Susan Neely will lead the opposition to policies aimed at getting Americans to drink less pop, soda or sugary juice and sports drinks. In the Sunday Des Moines Register, Philip Brasher profiled Neely, who has been president and chief executive of the American Beverage Association since 2005. I recommend reading his whole article, but I will comment on a few key points after the jump.

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My case against Hanna Rosin's case against breastfeeding

Warning: long diary ahead.

Hanna Rosin makes “The Case Against Breastfeeding” in the April issue of the Atlantic Monthly. The provocative title is misleading, because as Rosin explained in an interview on NBC’s Today show on March 16, she isn’t against breastfeeding. In fact, she kind of likes breastfeeding. Her problem is with the people who promote breastfeeding. Here’s the lead-in to her piece:

In certain overachieving circles, breast-feeding is no longer a choice-it’s a no-exceptions requirement, the ultimate badge of responsible parenting. Yet the actual health benefits of breast-feeding are surprisingly thin, far thinner than most popular literature indicates. Is breast-feeding right for every family? Or is it this generation’s vacuum cleaner-an instrument of misery that mostly just keeps women down?

Rosin packs a lot into the article, but I would summarize her main points as:

1. American women face intense social pressure to breastfeed exclusively.

2. Advocates exaggerate the benefits of breastfeeding, which the scientific research does not support.

3. Advocates downplay the negatives about breastfeeding and fail to acknowledge that formula-feeding can be the right choice for some mothers. On a related note, Rosin depicts breastfeeding as extremely inconvenient for mothers who work outside the home.

4. Advocates have medicalized the conversation about breastfeeding, and American women are wrongly led to believe they are harming their babies if they give formula instead.

I address those points and more after the jump. Rosin’s conflicted feelings about breastfeeding are valid, but unfortunately, she draws too many broad conclusions based on her personal experiences.

For those who don’t care to read the rest of this post, be assured that as a feminist and pro-choice woman, I respect the right of women to decide what and how to feed their own babies. I am also aware that some women are unable to breastfeed for physical or medical reasons, and many more women are unable to breastfeed because they lacked the information and support they needed in the critical early weeks.

My intention is not to judge any mother for her choices or add to the pain of any mother who did not have the breastfeeding experience she sought.

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More speculation about Obama's secretary of agriculture

Iowa politicians from both parties, as well as representatives of influential ag lobbies, like the idea of former Governor Tom Vilsack as secretary of agriculture, according to this piece from the Des Moines Register:

The ag secretary, whose department oversees such organizations as United States Forest Service, the U.S. Food Safety and Inspection Service and the food stamp program, must have a strong relationship with the industry, be a strong manager, and be politically in tune with the president.

Former Gov. Tom Vilsack has those qualities, said Cary Covington, a University of Iowa political science professor.

Iowa Secretary of Agriculture Bill Northey (a Republican) likes the idea of Barack Obama picking someone from Iowa who understands the biofuels industry. Republican Senator Chuck Grassley tells the Register that it always benefits Iowa to have someone from our state is a position of power.

The heads of the American Farm Bureau Federation and the National Corn Growers Association also have good things to say about Vilsack’s knowledge and background in the article.

Although this was ostensibly a news piece and not an opinion column, the Register made its preference clear by not quoting any critic of Vilsack’s record on agriculture and not mentioning any reason why anyone might oppose him for this job.

Vilsack’s strong ties to the biotech and biofuels industries prompted the Organic Consumers Association to come out against his appointment as head of the USDA. When I wrote about that on Thursday, a few people questioned whether anyone else on Obama’s short list for this job would be better than Vilsack in terms of supporting organic foods and sustainable agriculture.

It’s a fair question. Here Jill Richardson/OrangeClouds115 makes the case against House Agriculture Committee Chairman Collin Peterson. She shows that Obama’s campaign platform includes a lot of good points on agriculture, most of which Peterson has used his position in Congress to block.

Yesterday, shirah argued here that Pennsylvania Secretary of Agricultre Dennis Wolff, another name on Obama’s short list, would be “about the worst person” for this job. The diarist has written extensively about “Wolff’s role in trying to take away the right of Pennsylvanians to know whether their milk was produced using rBST / rBGH (recombinant bovine somatrophin / recombinant bovine growth hormone).”

Looks like Obama’s agriculture policy is going to be “more of the same” rather than “change we can believe in.”

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10 ways to combat asthma (in honor of Asthma Awareness Month and World Asthma Day)

Asthma has been on my mind lately, because a child in my extended family was recently diagnosed with it after going to the hospital for respiratory problems. The chronic disease is one of the leading causes of hospitalization in children.

In addition, at least 20 million American adults are estimated to have asthma.

Today is World Asthma Day, in connection with Asthma Awareness Month.

Join me after the jump to read about five policies our society should implement, as well as five steps individuals can take, to reduce the incidence and severity of asthma in our households and across the country.

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Parents, get your kids outside to play

After an unusually long and cold winter, we are finally getting some nice spring weather.

But according to the Des Moines Register on Monday,

officials with the Polk County Health Department and Polk County Conservation are concerned that many kids will stay in front of the TV.

The two agencies have teamed up to combat what they say is the increasing threat of “nature-deficit disorder.”

Author Richard Louv identified the term in his 2005 book, “Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder.” Louv describes it as the consequences of children being alienated from nature.

Health risks from avoiding the outdoors include obesity and a lack of creativity, said Rick Kozin, spokesman for the Polk County Health Department.

The solution is in our own backyards and neighborhoods, Kozin said. “It’s a health issue with a conservation treatment.”

The role of parents in getting kids outdoors is key, Kozin said. “Children will follow the lead from their parents.”

The Register’s article includes 15 ideas for getting kids in touch with nature, so click the link if you are interested.

It’s tempting to try to keep your kids occupied indoors so that you can get chores done around the house (or spend too much time on your computer). But it’s so important for kids to get exercise outdoors, especially if they are not in school, where recess and P.E. class may be outdoors in good weather.

Any teacher can tell you how much easier it is for kids to learn, and how much better they behave, after they’ve been able to run around outdoors.

According to Dr. Paul Fleiss, a pediatrician, getting exercise with exposure to natural light in the morning helps children sleep better at night (the sunlight triggers brain chemicals that help establish circadian rhythms).

You can learn more about that in Dr. Fleiss’s book, “Sweet Dreams,” which is a good and easy read. Or, just read this article, which is a condensed version of the advice in his book.

Parents, get your kids outside to play this week, even if it’s just for a walk around your neighborhood.

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