In the last five months, White House emphasis has transitioned from growing heirloom tomatoes in the backyard garden and “Get Moving” to Diet Cokes and double scoops of ice cream for dessert. This regrettable change of focus tells me yet again that votes do matter in all sorts of ways. They matter on domestic and foreign policy and on what personal examples are set for Americans to emulate.

Only those who have been marooned in Antarctica for the last half-century are surprised by how much we Americans have “plumped up.” A new international study published this month in the New England Journal of Medicine reveals just how shockingly fast and furious this weight gain has been.  

Here come some numbers, so stay focused.

In 1990, no state in America reported an obesity rate of over 15 percent. Less than 30 years later, almost 36 percent of Americans are overweight or obese, with over 6 percent of us qualifying as “extremely obese.”  

North Carolinians are in the middle of the chubby pack, ranking 22nd of 51 states including the District of Columbia and with just over 30 percent of us weighing in as obese. The fattest state is Louisiana at more than 36 percent obesity, and the slimmest state is Colorado with only 20 percent obesity.

What is even more astounding is that other regions of the world also have rising obesity, including places that have historically had food shortages, including Africa and Asia. The study looked at 195 nations and found that obesity rates have at least doubled in 73 of those countries. Residents of Middle Eastern nations, including Saudi Arabia and Egypt, get the dubious achievement award for gaining the most weight over the last three decades. 

Perhaps scariest of all: With nearly 30 percent of the world’s population now either overweight or actually obese, not a single nation in the world has been able to reduce its obesity rate in 33 years.

Not one.

No finger-pointing here.  I have carried my extra 20 pounds around since the last Precious Jewel joined us, a full sofa pillow deposited by each of them, so I can hardly be holier than thou. What I can and do  wonder is how we all got this way and what, if anything, we are going to do about it.

The new study, funded by the Gates Foundation and involving researchers from around the world, did not focus on the causes of ballooning obesity, but its authors agree that the increasing availability of cheap, processed, and nutrient-poor packaged food is likely a major reason. Think foods that come in bags or boxes that have been on store shelves for who knows how long, with chemical ingredients no one can pronounce, and which have never needed the chill of a refrigerator. You recognize them — the foods we know we are not supposed to eat but which are guilty pleasures for too many of us.

Interestingly, researchers say the slowdown in physical activity predates our obesity epidemic and is not a major factor. In other words, being overweight is probably not our computers’ fault.

Make no mistake, though. Barry Popkin, a professor of nutrition at the University of North Carolina at Chapel Hill, stressed the study’s importance. “Its global implications are huge. ... This is astounding given the huge health and economic costs linked with overweight and obesity.” 

Popkin is referencing the reality that 4 million people died around the world in 2015 of weight-related conditions, including heart disease, diabetes, kidney disease, and others. Those people, wherever they may have lived, were someone’s loved ones. They suffered with their conditions, and their treatment came at various costs, likely the highest right here at home in the United States.

Some elements of the obesity epidemic are beyond our individual control, like the food deserts of inner cities and rural areas where fresh and nutritious foods are largely unavailable. In addition, fresh and nutrient-dense foods are more expensive than processed packaged “foods,” a word I use loosely in this context.

It is also true that a great deal of our obesity problem can be addressed by better individual choices about what we eat and how much we move our bodies.  You know the drill — an apple instead of a bag of chips, a walk around the neighborhood instead of a sitcom rerun.

These are small choices but they add up, one way or the other.

Michelle Obama made healthy living her signature issue as First Lady. Melania Trump clearly takes care of her health.  

Wonder if she has any tips for us….?

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