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Martin Collis

« PLURES CRAPULA QUAM GLADIUS »
(Gluttony Kills More Than The Sword)

In the past couple of months I have sensed a shift in our attitude towards the obesity epidemic and our willingness to do something about it. This does not show up in statistics for the Center for Disease Control in the US or Statistics Canada, and you certainly wouldn't know it to see the shape of people at state fairs, airports, Wal Mart, Disneyland or any public place. Things will get worse before they get better; the obesity lifestyle is like a supertanker, even when it tries to stop, its massive momentum still carries it forward. But, optimist that I am, I believe "the times they are a changing', if for no other reason that we can't afford the insanity of an obese nation, we don't want to raise a generation of children, many of whom will die before their parents and nobody wants to live a 'c-' or even an 'f' lifestyle on their one appearance on this planet.

Before reporting on my perspective that there are positive shifts in a fat land, I'll give you two graphic examples of why the shape of a nation has to change.

I was watching Martin Scorsese's TV documentary on 'The Blues' and they showed a segment of Fats Domino playing and singing in the late 50's. I was struck by the fact that by today's standards he didn't seem particularly fat and were he performing now might be thought of as 'Overweight Domino' or, like some rappers, "Big Domino'. Then there was an article in the Sept. 28th issue of the New York Times titled, "The Final Journey: One Size Doesn't Fit All". The article is about the funeral industry and their need to provide caskets fit for their dead clients, or at least caskets into which their dead clients fit. There is actually a company called Goliath Casket of Lynn, Indiana (you'd laugh if you heard that in 'Six Feet Under') whose monster coffin business has been booming. One of the owners, Julane Davis, doesn't study demographics; she just looks at the world around her. "It's just going to local restaurants or walking into Wal-Mart. People are getting wider and they're getting thicker." Goliath not only produces doublewide caskets, but has found a growing need for 'triple-width' models. Fifteen years ago they averaged one triple-wide a year, now it's 5 per month.

In a trailer park Mr. Smith died
"He's too big!" the mortician sighed
We need a monstrous coffin
To carry him off in
In trailer park terms, "triple wide".

A standard coffin is 2 feet wide whereas the 'triple-width' is 3 feet 8 inches across. This leads to a ripple effect of having to create reconfigured hearses to carry the caskets and bigger cemetery plots to place them in. (No mention is made of the pall bearers who might need to be hired from the local weight training gymnasium. "He is heavy, he's my brother.")

"Don't miss this"


[click graphic for 'Life is Short' mpeg]

I overate, I'm overweight and I'll die
And blubber-bellied cherubim will lift me up on high
The Pearly Gates will be padlocked and I'll turn and ask them why
They'll say, "Go through the Golden Arches to our franchise in the sky."
(Extract from one of Martin's unrecorded songs).

Symptoms of Success in the Schools
Boosting Healthy Nutrition, Banning Junk Food and Soda

Administrators, parents and in some cases students, no longer want their schools used as convenience outlets for soda and junk food. This movement began with handfuls of concerned individuals and small groups but is now becoming mainstream. I will include a few examples and a reference for more information.

In response to a UCLA survey, which found 40% of their children were obese, Los Angeles Unified School District has banned the sale of soft drinks from vending machines or school stores during school hours. After a huge outcry Oakland Unified School District rejected a $5 million contract with Pepsi and banned the sale of all soft drinks and candy in all of its schools. Sacramento City Unified School District also vetoed a $2 million deal with Pepsi. In New Hampshire, the Portsmouth School Board eliminated all drinks, which were heavily caffeinated and sugared and replaced them with healthier alternatives and did the same with unhealthy snacks. Similar stories can be found in Texas, Wyoming, Southern California, Minnesota and Montana. In Seattle, Coca-Cola has little chance of renewing its $6 million 'pouring rights' contract after huge opposition from Citizen's Campaign for Commercial-Free Schools who feel that things don't go better with Coke. In 2004, California's State Wide SB 19 Pupil Nutrition, Health and Achievement Act takes effect, and New York has brought in legislation curtailing the sale of junk food and drinks and offering healthier alternatives. For more detailed information see "Stories of Success: Healthy Foods in Schools Case Studies"

I've had school principals and PTA groups (PAC in Canada) tell me that they might as well sell the junk food, because if they don't, children will just buy it elsewhere. This has elements of truth, but is also the rationale used by nearly every drug pusher who sells stuff to kids.

For an interesting manifesto concerning junk food in schools go to www.commercialalert.org/ and go to Childhood Obesity Prevention Agenda.

More good news in schools

The province of Alberta is going to institute daily physical education in grades K-12 over the next two years. Learning Minister Lyle Oberg (a physician) said, "When you take a look at what's happening, I don't think there's anyone who can argue with more Phys Ed, more fitness, and we have to find a way to make it happen, and we will. I think it's critically important. If it means extra funding, if it means extra staffing, then we have to look at it." It takes courage and vision for a province or state to offer quality daily physical education. The incoming president of the Alberta Teachers Association described the move as "bold and courageous." He went on to say, "It recognizes the value of daily physical activity on youth today. This has absolutely no down side. It's a step in the right direction, even though we won't see benefits for years and years to come."

It's been said that, "Politicians think of the next election and states people think of the next generation." Congratulations to Lyle Oberg for being in the latter category.

An interesting footnote is that two leading Alberta politicians have successfully dealt with their own weight problems in the last few months. Iris Evans, Minister of Children's Services, has shed almost 50 lbs. while Premier Ralph Klein has lost 25 lbs. As Ghandi said, "You must become the change you wish to see in others." Also, a tip of the hat to my own Premier, Gordon Campbell, in British Columbia who has recently shed 35 lbs.

As I was writing this article the local paper arrived quoting the BC Minister of Education, Christy Clark, that "Physical Education will be an integral part of the BC curriculum starting next fall, with fitness assessed just like the '3 R's'. It sounds good but I have some concerns about its implementation. Ministry officials say the changes won't necessarily mean more phys. ed. classes, but could include activities such as walk-to-school events, sprints around the block and classroom calisthenics. (This would be akin to saying you'll teach English by speed reading magazines, having pop spelling bees in class and have some read-at-home events.) When they consider testing I hope they look carefully at Fitnessgram. However, the good thing is they're aware of the problem and Terri Watson of the BC Parent's Advisory Council says her organization is strongly supportive. "It's a motherhood issue - as important as literacy." It's an interesting comment as one can look at many of our children as being physically illiterate. Minister Christy Clark said she has urged her fellow ministers across the country to establish national standards for physical activity in all schools.

If anyone is concerned that more time spent in physical activity will rob students of academic preparation, I've never seen a school which has instituted quality daily physical education where academic performance has declined, it almost invariably improves.

The correlation between fitness and academic performance was clearly demonstrated by the California Ministry of Education last year. [see our previous article in the summer issue ]

Personal Insights

Everywhere I go I see wonderful lifestyle initiatives and meet creative, dedicated people who want to spread the word on wellness, but everywhere I go I also see people getting bigger and bigger and every little town I enter is approached through an avenue of fast food franchises. The fast food industry is a multi-billion dollar enterprise and they use their dollars to buy a place in our convenience driven culture. But the wealthy Goliath's have to be wary, because there are many David's out there. These 'David's' are organizing wellness conferences, selling organic food, teaching yoga classes, lobbying for bike paths or daily physical education programs, leading exercise breaks at work and generally making it easier for people to eat well and be physically active. I met one such 'David' recently in Iowa named Tim Lane. Tim seems to be involved in many successful wellness initiatives in the State of Iowa. One is "Lighten Up Iowa", which involves Iowa State University Extension, the Iowa Games and Iowa Department of Public Health. If you 'Google' "Lighten Up Iowa" you'll find a personal online risk profile, nutrition tips, cardio-quest, employee health, walking programs and the remarkable State weight loss program which was a big success last year and is being repeated in 2004. Tim has been a long time participant in R.A.G.B.R.A.I., which stands for the (Des Moines) Register's Annual Great Bike Ride Across Iowa. This event is the world's largest bike tour, annually attracting over 10,000 riders from around the world and from every state in the Union. There is an official RAGBRAI website www.ragbrai.org but some of the fun flavor of the ride can be found at www.danenet.wicip/org/bcp/ragbrai. In some ways it looks like a 7 day wheeled version of the Bay to Breakers run in San Francisco. When I asked Tim if he would make a small contribution to 'Well', he typically chose to write about someone other than himself.

«Education is not filling a pail but the lighting of a fire.» ~ William Butler Yeats If this quote above is true, let me introduce you to an arsonist from Iowa. Her name is Carol Mahlendorf and she is a fourth grade teacher at Crossroads Elementary in West Des Moines, Iowa [photo]. Twenty-eight years ago she got hooked on cycling after riding on RAGBRAI. It has generated similar rides in many other states and inspired Carol to plan a tour to end the school year. That event turned out to be a roundtrip of over 20 miles to various neighboring communities and back. It may sound simple but is a huge undertaking that involves teaching a safety unit, support vehicles, and dozens of other logistical items. For many it is their first serious ride. It is an event that opens a whole new world to them. The youth and many parents see the bike as a vehicle for the first time. Getting to and from a nearby town, teaches them they cannot only play with bikes, but they can tour. This event was such a hit; another teacher who transferred to a different school in the district initiated the event there. A teacher who transferred from that school to a third instituted it there, so that now there are three schools that are involved and thousands of youth and parents that have been introduced to a healthy, enjoyable and active lifestyle option. In listening to Carol's students, even those who are now 20 years removed from her classroom, it is evident that her passion made a lifelong impression. Even some of the parents who volunteered to help got hooked and are still riding. Just one more fire for this world-class educator.

I met Carol who has completed 31 RAGBRAI's, is discreet about her age, looks fabulous and is one of those teachers you hope your own children encounter as students. For many years Tim has produced a daily fitness column which is emailed to a worldwide list of subscribers. If you wish to add your name to the list he can be reached at tlane@idph.state.ia.us.

Many Politicians still don't "Get It"

I did the closing keynote address at the Governor's Conference on Public Health in Iowa. The opening day of the conference featured eight of the Democratic Presidential hopefuls presenting their thoughts on health care in the USA.

They were passionate and articulate and most mentioned health care for the old and the young and the 41 million uninsured Americans, but what they did not mention were words like 'exercise', 'diet', ' obesity ' and 'self responsibility ', which their speech writers obviously felt would not attract the average American voter. All the candidates also campaigned at the Iowa State Fair, where they could not have missed how overweight their potential voters were, and what disastrous food choices were available at the Fair.

Fortunately, the Des Moines Register newspaper highlighted the ugly food choices at the Fair and Iowa State University posted signs telling people how long it would take them to 'walk off' their deep fried disasters. It' s interesting that the cross section of a deep fried Twinkie resembles a cross section of a plaque-coated artery.

One worrying, but almost inevitable trend I have observed is that a number of morbidly obese people who, although still capable of walking, are now using motorized scooters to get themselves around. I was first aware of this at airports, but it was quite evident at the State Fair and 2 weeks later at the Grand Casino in Biloxi, Mississippi. Of course, many people using powered chairs and scooters have specific disabilities, which leave them unable to walk, but there is a growing percentage whose only disability is body fat.

Biloxi was fascinating, I was addressing a conference of US military medical officers in Region 4 (South/East) on the Future of Military Health Care. The Conference Center was attached to the Grand Casino and the difference between the conference delegates and the patrons of the casino was cosmic. The US military has fitness and weight standards and a dress code and the officers looked like another species besides the overweight, cigarette smoking, and badly dressed gamblers. The Center for Disease Control has designated Mississippi the fattest State in the Nation with over 25% obese and more than 1 in 10 diabetic, figures that didn't surprise me as I watched patrons making repeated trips to the pasta bar and the chocolate fountain, which was a feature of the dessert buffet.

Multi-National Image Enhancing

It's hard to open a newspaper or magazine without reading about obesity and the way in which individuals, organizations and the fast food industry are choosing to respond. Some responses are laudable, others laughable, some fascinating, others fatuous, there are careful and care-filled programs and programs of blatant self-interest. Albert Schweitzer said that a positive progression is from "naive simplicity to profound simplicity" and in profoundly simple terms overweight people need to eat less (and better) and move more. But in the Orwellian world of the 21st century the fast food giants, who are part of the problem, are buying alliances with schools, hospitals, governments, sports events and even with organizations dedicated to fighting the diseases which convenience products might well exacerbate. Examples of this include Coca Cola's one million dollar grant to the American Academy of Pediatric Dentistry and their supporting of the National PTA Parent Involvement School Certification Program, Hershey Foods promotion of the American Diabetes Association's "Walk for Diabetes", Kraft Foods Inc. also have a link to the ADA through its Proud Sponsor Program. (It's really hard to take any health-related initiatives of Kraft too seriously, as its parent company is the Altria Group, formerly known as Phillip Morris). But in fairness to Kraft, they are going to create an "advising council" in 2004 who will:

1. Set guidelines for all Kraft products for the permitted content of calories, total fat, saturated fat, trans fat, sugars and sodium.
2. Develop new marketing practices, especially for kids. Kraft will stop in-school marketing. The council will determine products appropriate for school vending machines. It will create marketing guidelines that encourage healthy eating and active lifestyle.
3. Set a global labeling policy, even for markets where nutrition data isn't required.

I will watch with interest.

Other 'big food' companies who play the health card are Con Agra Inc (Healthy Choice) and PepsiCo Inc (Quaker Oats) who both collaborate with the American Dietetic Association. The American Heart Association has a food certification program, which includes General Mills' Cocoa Puffs and Yoohoo Chocolate Beverage Corporation's light drinks among the products listed. Professor Marion Nestle (unfortunate name), the author of "Food Politics", feels these alliances damage the credibility of professional groups. "This has nothing whatsoever to do with health and everything to do with selling products."

McDonalds, of course, are working hard to burnish their health image. A wealth of information regarding the involvement of big food and big business in "partnership" with government and other agencies can be obtained from the ever-watchful people at www.commercialalert.org/.

The McDonalds Connection

Fortunately for us all, McDonalds is concerned with our eating, exercise and general lifestyle. The origins of this concern have been interpreted by some as a response to their narrow escape in a recent lawsuit. (Fast food is referred to by public interest law professor John Banzhof III as "the next tobacco".)

In May, McDonalds established the "Global Advisory Council on Healthy Lifestyles", a global group of 15 experts in the field of nutrition, medicine, obesity and lifestyle. More than a quarter of the Council have strong Olympic connections including Patrick Schamasch MD, Medical and Scientific Director, International Olympic Committee, Jackie Joyner-Kersee, 6 time Olympic medallist, her husband Robert Kersee and Victoria's own rowing medallist, Silken Laumann (Update: In speaking with Silken recently, I discovered that she has withdrawn her name in order to focus on her many other commitments, not the least of which are her young family and the establishment of a Foundation concerned with the health and well-being of children.). I was delighted to see that James Hill from the Center for Human Nutrition, University of Colorado was included, along with a number of other well-known scholars in the areas of nutrition and health. Canadian Professor G. Harvey Anderson from the University of Toronto, also on the council, is quoted as saying; "It's better to work within the food industry itself to promote change." (Dr. Anderson should know, as he has also been a consultant for General Mills, Heinz and the Sugar Council of Canada.)

Personally, I'd like to have seen names like Marion Nestle, Ken Cooper and Dean Ornish on the Council, but I'm not paying the bills.

In fairness to McDonalds they have taken a lead in animal welfare and are spending millions of dollars to standardize and improve the treatment of cattle and chickens by their suppliers. Like all the other fast food purveyors, McDonalds faces a problem that would challenge the wisdom of Solomon. How do you improve the quality of animal welfare and the products you sell and still keep costs down and profits high? Somehow or other you are going to have to teach the general public to pay a little more for more nutritious and less calorie dense food and to actually care how it is produced.

The French Paradox

Scientists have often puzzled how the French seem to be able to eat, drink and be merry and yet have only 7% of their population obese, compared with more than 20% obesity in the US. For a while, red wine got the credit for their low rate of obesity and heart disease, but the September 2003 issue of Psychological Science offered a more likely explanation.

1. Portions are 25% smaller in France, averaging 9.8 oz. compared to 12.2 oz. in the US.
2. French supermarkets and cookbooks offer smaller sizes and portions.
3. Candy bars in the US are 41% bigger than those on the shelves of Paris stores.
4. US soft drinks are 52% bigger, hot dogs 63% and yogurt 82% bigger.
5. The French walk more and snack less.
6. Even if they go to fast food outlets, Parisians take more than twice as long to consume their food as their counterparts in Philadelphia.
7. Although the article didn't document this I'm sure they eat fewer French fries.

Summary

In summary, I think we are close to the zenith of our obesity in North America. I do believe we have a lost part of a generation of convenience fed, screen watching children who will move down their shortened years like a pig through a python. But there is an awakening.

1. Some politicians who tend to stay in shape jumping on and off bandwagons are now finally aboard the anti-obesity, pro-activity bandwagon.
   
2. In Canada, we finally have a Secretary of State for Physical Activity and Sport, who might be able to repair some of the damage left by the demise of Participaction, Fitness Canada and the lack of anyone with a real mandate to address national physical activity issues.
   
3. Some schools and school districts are beginning to see the light, both in terms of moving towards daily physical education and getting the junk food products and advertising off school grounds.
   
4. Food labeling is improving.
   
5. The fast food giants are concerned about huge class action lawsuits and their role in the obesity epidemic. Some are beginning to cap portion sizes, decrease fat and offer lighter alternatives.
   
6. The big health care providers are taking exercise and weight loss very seriously as a preventative measure. PacifiCare Health Systems, which serves millions of clients, offers significant discounts for Weight Watchers and similar discounts on memberships to more than 400 designated fitness clubs.
   
7. There are hundreds of thousands of independent projects, clubs and classes which are helping to turn the cultural tide from 'fat and sedentary' to 'slim and active'.
8. Massive amounts of research money are being made available for lifestyle related research.
   

   Sooner or later people are going to wise up and rise up and, in the words of 'Twisted Sister', join in the chorus of, "We're not going to take it any more." It doesn't make sense to be spending hundreds of billions of dollars to protect a culture and a country whose citizens are eating themselves to death. It's not the Taliban and the Al Qaeda that should be our biggest concern, but ourselves, and our eating and exercise behaviors. Shakespeare could have been speaking of us when he wrote, "I am my own executioner."

   Bob Dylan spoke of "the madness of becoming what we were never meant to be", and we're not meant to be sedentary and obese and we're not meant to be living miserable shortened lives because of our obesity related diseases, which include:

   Heart disease
   Strokes
   Diabetes
   Hypertension
   Hyperlipodemia
   Fibromyalgia
   Breast cancer
   Colo-rectal cancer
   Esophogeal cancer (related to acid reflux)
   Gallbladder cancer
   Kidney cancer
   Pancreatic cancer
   Prostate cancer
   Uterine cancer.

   

   Note: The relationship between obesity and the above cancers is documented in the October 2003 edition of Nutrition Action in an article titled, "Fat Chance".

   A recent study at Tufts University noted that as subjects lost weight their immune function improved (Tufts University Health and Nutrition Letter October 2003), so we can add a compromized immune system to the many other undesirable correlates with obesity.

   This article began with an observation about Fats Domino, so let's give him the final word. "I'm walking, yes indeed."