Tennessee’s obesity epidemic
Three California obesity researchers struck a nerve in Tennessee’s sweet tooth last month when they proposed regulating sugar in the same way government regulates tobacco and alcohol.
In the journal Nature , they pegged a litany of chronic illnesses to excess sugar consumption — diabetes, hypertension, fatty liver disease and others. Their article proposed taxing foods with added sugar, restricting purchases to ages 17 and over, and limiting convenience stores in poor neighborhoods.
Days before the Nature article published, U.S. Rep. Scott DesJarlais made a proposal on the other side of the political spectrum: a bill that would bar federal dollars from being used to publicly criticize foods already approved by the Food and Drug Administration. He’d learned federal stimulus funds financed healthy living campaigns that, in part, discouraged drinking sugary soda.
“It’s a slippery slope of government intrusion in our lives,” said DesJarlais, a Republican whose district includes Columbia and Crossville. “What’s next? Telling us how many jumping jacks to do?”
These days, sugar — more than fat or lack of exercise — is drawing debate in the nation’s obesity epidemic. As researchers explore the possibility of sugar as an addictive substance, label-reading consumers are finding it packed into foods they never even suspected.
DesJarlais and other lawmakers — plus the wider culture of personal choice over government oversight when it comes to eating — have made it clear the nation is a long way from forcing changes in the food supply.
But in the South, the issue of sugar has special resonance. In Southern cuisine, sucrose — or table sugar — is used in large quantities in home cooking. Order an iced tea in one of Tennessee’s famed meat-and-three restaurants, and the server assumes it’s sweet until told otherwise.
Obesity was far from rail-thin Sonja Ridley’s thoughts last week as she bustled about the Nashville Biscuit House kitchen, sprinkling sugar in the day’s coleslaw. It also goes into her carrot-raisin salad and, of course, cobblers, touted on the sign out front under her moniker: “PeeWee’s Cobblers. Blackberry and Peach.”
She makes no apologies for any of it. People know what they’re eating, she said.
“I am a Southern girl, and I do Southern cooking,” said Ridley, who’s been with the East Nashville eatery for 15 years. “I don’t think it’s right for the government to tell anybody what to cook and or what to eat.”
No intervening here
A Tennessee bill that would have imposed a 1-cent-per-ounce state tax on producers or importers of sugar-sweetened beverages stalled last year. A similar federal proposal in 2009 went nowhere but occasionally comes up in health-care discussions.
Tennessee cities have avoided food-related intervention that some in California and New York have taken up, such as banning trans fats or taking free toys out of fast-food kids meals.
Tennessee ranks among the highest states for diabetes prevalence — nearly 11 percent of the population in 2010, compared with 6.5 percent nationally, Centers for Disease Control and Prevention figures show. It ranks fourth highest for overall obesity and sixth for childhood obesity, according to the Robert Wood Johnson Foundation’s 2011 report on the topic.
Gov. Bill Haslam last week announced a task force to tackle obesity among Tennesseans, noting that 32 percent of adult Tennesseans are obese, and 30 percent of schoolchildren.
The result of so many obese children here and nationwide will be a “tsunami of chronic disease and mortality as this generation ages,” wrote Vanderbilt University pediatrician Dr. Andrew Bremer and Dr. Robert Lustig, the University of California-San Francisco pediatrician who also co-wrote the controversial Nature article.
Bremer and Lustig teamed for a piece in the Feb. 24 issue of Pediatrics, writing about the metabolic and related problems they were encountering in their young patients because of excess sugar.
Bremer treated some of those Tuesday at the Monroe Carell Jr. Children’s Hospital at Vanderbilt-Franklin, mixing high energy and humor with blood tests and serious talk. His patients come in overweight, some with excess liver fat and problems producing insulin, some even with diabetes, some complaining that pain in their joints keeps them from exercising.
Their problem is typically excess sugar, Bremer said, whether it’s simple table sugar, high fructose corn syrup in foods or even too much fruit juice, which he lumps in with sodas. Those drinks should be reserved for celebrations and otherwise replaced with water, he said.
“Typically, generations get healthier and healthier,” Bremer said. “This generation is encountering adult problems younger and younger. They won’t die young, but they will be living with chronic disease and the related financial implications for decades.”
He said he supports the sugar-sweetened beverage tax but wouldn’t comment beyond that.
“With government regulation, you have to start small,” Bremer said.
What parents can do now, he said, is become avid label readers and inform themselves which foods are high in corn syrup or sucrose.
Fort Campbell mom Stephanie Smith said she always read labels but started minding sugar consumption even more after her son, Nicholas, became one of Bremer’s patients two years ago. She was concerned about his excess weight.
Today, the 6-year-old stays active in Cub Scouts, proudly recites what he eats and understands some foods are only for treats.
“At school, I eat broccoli, and it’s good,” he said. “I eat peaches, apples, bananas. … I can have a soda, but only if we go out for pizza.”
Is sugar an addiction?
While his colleague Lustig is studying the possibility that sugar is addictive, Bremer and others said the brain research just isn’t there yet. Still, those who deal with Tennesseans’ diets see addict-style behavior when it comes to sugar.
Many don’t understand how much they’re consuming, said Kelly Shinton, a registered dietitian affiliated with Baptist Hospital. It’s why she starts each consultation with gathering a one- to three-day food journal from patients.
“I can’t tell you how many times I see they have trouble with sweets,” Shinton said. “I try to get them to fill those cravings with fresh fruit and work their way out of candy and sugar. Some people can have it in moderation, and some people just can’t.”
East Nashville resident Dolly Thomas readily labels herself a reformed sugar addict. Six years ago, she was 41 years old, 5-foot-6 and 250 pounds, and battling high blood pressure. In those days, she said, her first food of the day was Pop-Tarts, and her last was a Snickers bar, and she added sugar to nearly everything she cooked in between, including vegetables.
A flight of stairs that left her gasping changed her life. She dropped sugar from her daily diet. Within the first year, her blood pressure returned to normal. Over time, she dropped 75 pounds.
She switched jobs from short-order cook at a chicken joint to nutritional supplements manager at the Turnip Truck, a health-food store, and started the nonprofit DP Thomas Foundation, counseling obese people and speaking to community groups. After her journey, she favors government regulation of sugar because it’s so prevalent in food, she said.
“Most people can’t give up their addiction to sugar,” she said. “It’s heroin.”