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By LISA GREENE, Times Staff WriterA new study says that poor diet and lack of exercise are on track to overtake smoking as the No.1 preventable killer.
Americans eat the wrong things, don't exercise enough and smoke too much - and it's killing them.
Deaths caused by poor diet and lack of exercise are increasing so fast they are on track to overtake deaths from smoking for the first time, says a major study published today, written by scientists at the federal Centers for Disease Control and Prevention.
More than one-third of American deaths can be traced back to those three factors, a sign that the U.S. health system needs to pay far more attention to preventive care, say the study authors.
"We've known there is an obesity epidemic in this country, but we didn't expect it would translate into higher mortality that fast," said Ali Mokdad, lead author of the study and chief of the CDC's behavioral surveillance branch. "It's a call to action."
The study sparked broad response Tuesday, from the unveiling of a new antiobesity ad campaign by federal health leaders to scientists' calls for more research to more personal stories of weight struggles from some Tampa Bay residents.
Today's study updates a decade-old landmark study that analyzed the number of American deaths from underlying causes, such as smoking, rather than diseases, such as cancer. Researchers looked at the 2.4-million U.S. deaths in the year 2000 and the diseases that caused them. Then they determined the risk levels from underlying factors by reviewing data from other studies, and used those levels to estimate total deaths.
They found about 1.16-million preventable deaths with an identifiable cause. Ranking well behind smoking and diet/inactivity were alcohol, infections and toxic agents such as pollutants and asbestos.
"The most rapidly increasing problem we have is the combined problem of sedentary lifestyles and poor diet choices," said Dr. J. Michael McGinnis, who wrote an editorial about the study, both published in the Journal of the American Medical Association. "These chronic diseases - heart disease, cancer and stroke - aren't just inevitable consequences of the aging process. They don't just happen."
If anything, the new study understates obesity as a killer, said McGinnis, co-author of the first study and senior vice president at the Robert Wood Johnson Foundation. Those deaths may already have overtaken those caused by smoking, he said.
But the study's news about smoking wasn't good, either. Smoking deaths continued to increase, although their percentage of total deaths dropped slightly. That was "the most disappointing finding," the authors said, and they criticized state officials across the country for cutting programs to help smokers quit.
The study shows more programs are needed, said Thomas H. Brandon, director of the Tobacco Research and Intervention Program at Tampa's H. Lee Moffitt Cancer Center & Research Institute.
"My big worry is we're getting bored with tobacco," Brandon said. "The big trials are over with, the settlement is over with. Obesity is poised to be the problem that gets all the attention. And it should, but it can't come at the price of tobacco cessation. They're both serious."
But Dr. Robert Campbell hopes that people will realize just how serious the obesity epidemic is once they hear that it's as big a killer as smoking.
"Everyone knows smoking is horrible for your health," said Campbell, a University of South Florida assistant professor and family physician who specializes in treating obese patients. The study "re-emphasizes the attention that obesity is finally starting to get."
Eighteen months ago, Tampa jeweler Sergio Pages Jr., met with Campbell, his doctor, and talked about dying young. Now 42, he already had diabetes, high blood pressure and high cholesterol.
"He sat me down and said, "Sergio, it's like this. You've got a 50-50 chance of being dead in the next five years."'
Pages started his 28th diet. It didn't work. Last September, weighing 401 pounds, Pages had gastric bypass surgery. Since then, he has lost 134 pounds. The study results don't surprise him. He came too close to living them.
Campbell also praised the study for calling for more preventive health.
"As a society, we all jump to the thing that kills you immediately - for example, coronary heart disease - and forget about the preventive side," he said.
Psychologist Kelly Brownell, director of the Center for Eating and Weight Disorders at Yale University, said the federal government has done far too little to attack the obesity problem.
"I think the administration has been slow to react, has been completely unwilling to confront the food industry for the role it plays and therefore has only weak reactions to the obesity crisis," he said.
On Tuesday, federal officials timed the unveiling of a new ad campaign to the release of today's study and announced a new "research strategy" to focus more on obesity. Next year's health budget request for obesity research is $440-million, a 10 percent increase over this year.
Such efforts are "well-meaning," Brownell said, but broader measures are needed. He wants to see tougher stands, such as taking soft drinks out of schools, restricting food ads aimed at children and mandatory calorie labels at restaurants.
More research funds for obesity are badly needed, Campbell said. For people who need to lose weight, being bombarded with miracle diets from every women's magazine and infomercial is bad enough. Worse is the current controversy among respected scientists over whether low-carbohydrate diets or more traditional low-fat plans are better.
"You get so many mixed signals from all the different sources," Campbell said. "I've discussed with my patients trying out a low-carb diet, and they say, "Oh, my last physician said that would kill me.' ... So of course, patients are confused."
But when St. Petersburg resident Connie James set out to lose weight nearly a decade ago, she was clear on one point: Her weight could kill her.
"Diabetes, heart disease, cancer - it runs in my family," she said.
It took a year and a half, but James reshaped her body and her life, losing 62 pounds. Since 1996, James has kept the weight off by eating healthily and staying active. She's become program director at Jenny Craig Personal Weight Management in St. Petersburg and, at 5 feet tall, now weighs 100 pounds.
"I had to make up my mind, this is going to be forever," she said.
Pages, too, aims for permanent change. These days, his daughter calls him her "incredible shrinking daddy." He recently took his sons out to play paintball. His waist size has gone from 64 to 48.
"It really was my last hope," he said of the surgery. "I was fixing to die."