[greymule]

Much of my work involves editing of medical papers, and one of my clients studies issues of obesity for federal and state governments. In fact, I just finished editing a proposal for a follow-up to a 2002 study of the nutrient intake of children in America. Such a study costs millions of dollars.

Obesity is termed an "epidemic" today. Go to your local shopping mall and sit on a bench for half an hour, and you will see a dozen morbidly obese people go by. These are not just people who should lose some weight (like me); they are people with a body mass index of 35 or more (that would be 5'10", 244 lb.), and a 100% likelihood of severe health problems. In 1957, a person with a BMI of 40 (5'10", 278 lb.) was 1 in 20,000. Today, you see one or two at every ball game you umpire.

The federal government is particularly concerned, because the cost of related diseases is so high. For example, in the St. Louis metropolitan area alone, diabetes costs Medicare and Medicaid several billion dollars. It is ironic that in America obesity is far more prevalent at lower-income levels. In India and Africa, the poor people are not fat.

It doesn't take a genius to figure out most of the reasons behind the epidemic. For the first time in American history, for example, many children are sedentary, so much so that researchers speak of their high volume of "screen time." Sweets are also cheaper and more plentiful: in real dollars, Coca-Cola costs 1/20 of what it did in 1957. (If at the movies a "Big Gulp" of 52 ounces—with a pound and a half of sugar—cost $25 instead of $1.29, how many people would buy one?) Further, many people get 90% of their "nutrients" and calories through high-fat, high-sugar, high-salt fast food. Supersized portions eventually create supersized people.

But though the various culprits are largely obvious, no one is certain about their individual degree of significance. So much has changed over the years that it's impossible to get treatment and control groups, or to measure the effect of any single factor alone.

There is also growing concern about a particular ingredient that may be far more nefarious than anyone suspected: high fructose corn syrup (HFCS), a cheap form of sugar that has fast replaced cane sugar in soft drinks and even many baked goods. (It was developed in the 1970s, but only recently has it surpassed cane sugar in use.) The evidence is hardly all in, but much of the problem might lie with HFCS, which, while it certainly sweetens, does not satisfy a person's desire for sweets. We all crave sweets at times, but we quickly "overdose" with cane sugar. But you can ingest HFCS all day and still want more. HFCS also has quite a different chemistry. Google it to learn some of its health concerns.

Note: BMI over 30 is considered overweight (and under 25 underweight), but this is just a general rule. Much depends on the person's body type. Still, BMI of 35 is obese no matter what the body type, and BMI of 40 is extremely serious. It's like having blood pressure of 180/130.