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I live and practice in Mobile, Alabama. Alabama is ranked #2 in the supersizing of America with 31% of our adults in the obese range and 14% of our children. The Trust for America’s health, who compiled the above data, lists some policy opportunities to reverse the trend (should we in Alabama chose to). These include:

  • Support obesity- and disease-prevention programs through the new health reform law’s Prevention and Public Health Fund
  • Align federal policies and legislation with the goals of the forthcoming National Prevention and Health Promotion Strategy.
  • Expand the commitment to community-based prevention programs
  • Continue to invest in research and evaluation on nutrition, physical activity, obesity and obesity-related health outcomes and associated interventions.

I was reminded of the ranking of our state by a future medical student who is very interested in healthy eating and obesity prevention, and he met with me to call my attention to Wholesome Wave, a program designed to inexpensively deliver fruits and vegetables to low-income patients.

Obesity is a huge (no pun intended) problem without an easy fix. In my conversation with Will, we talked at length about how the problem is a mixture of diminished opportunity to purchase and eat healthful  foods combined with limited opportunities to participate in physical activities.Programs such as this are a start but need to be combined with biking, walking, and other means of burning calories.

US News and World Reports offers another opinion. They found 22 experts

including nutritionists and specialists in diabetes, heart health, human behavior, and weight loss

who reviewed and rated 25 diets in seven categories, including short- and long-term weight loss, ease of compliance, safety, and nutrition.

The winner, as identified by the experts, was the DASH diet, rated 4.1 out of 5 (lots of vegetables, fruits, low in fat). The loser, the Paleo diet (eat only what cave men eat) was only rated 2.0 out of 5. The website offers a feature where readers can identify with a YES or  NO whether or not the diet worked for them. Although liked by the experts, the DASH diet has only been tried by 1600 readers and only 24% found it effective. By contrast, the Paleo diet had been tried by 30,000 folks with roughly the same amount of weight loss. The winners, based on readers clicking YES were the Vegetarian, the Vegan, and the Eco-Atkins (#10, #14, and #17) which had 93% self reported success by over 40,000 readers.

Fad diets tend to work in the short run by limiting food choices and forcing participants to select lower calorie options. This is reflected in the number of people who reported losing weight with the “bad diets.” This weight tends to come back as people revert to old habits hence the ongoing problem of obesity. On the other hand, losing weight is more than choosing healthy foods. Losing weight is always ultimately about burning more calories than you take in. The DASH diet is a healthy long term diet and, for example, would work even better if it included actual dashes. The Paleo diet to be effective would have to include participation in activities only a cave man might do. As to what that might be, you’ll have to use your imagination.