I’ve just received the latest cancer statistics from CA–A Cancer Journal for Clinicians. The good news is that overall cancer death rates are down from their peak in the 1990s and rates of specific cancers are stable or decreasing.  None seems to be increasing.

Look at what is happening with heart disease (page 15).   Its rates have fallen by half since the mid-1970s for people under age 85.  Even for people over 85, heart disease death rates are falling rapidly.

Obesity is a risk factor for both cancer and heart disease.  So ideas about its effects on health need to take these statistics into consideration.  But before dismissing obesity as a risk factor, note that both heart disease and cancer remain leading causes of death, and both disproportionately affect low-income groups.   Groups with low income and education tend to have many risk factors for these diseases, among them high rates of obesity.

Public health still has plenty of work to do.

Today is the official release date for Food, Inc., the latest film about our food production system and its discontents.  This one has generated tons of interest, and for good reason (I’ve seen it twice).  For one thing, it is star-studded: Eric Schlosser!  Michael Pollan!  For another, it takes a hard look at the less savory aspects of industrial food production for a purpose: to make you think before you eat.

To that end, the film comes with:

• A participant’s guidebook to which I, among others, contributed articles.
• A discussion guide for grades 9-12 produced by the Center for Ecoliteracy.
• The DVD, which you can order now but will not be available until September.

And, not least,

• Its very own anti-Food Inc. website, a contribution from meat and poultry trade associations eager to provide a point-by-point rebuttal of every scene in the movie.

Here’s my favorite quote from the review in the New York Times:

one of the scariest movies of the year, “Food, Inc.,” [is]an informative, often infuriating activist documentary about the big business of feeding or, more to the political point, force-feeding, Americans all the junk that multinational corporate money can buy. You’ll shudder, shake and just possibly lose your genetically modified lunch.

Go see it and decide for yourself!

I’m getting caught up on my journal reading and have just run across the May 16-22 issue of The Lancet devoted to a commission report on climate change.  The cover quote: “Climate change is the biggest global health threat of the 21st century.”

Among other things, the report addresses the effects of climate change on food production and water availability, none of them good.  It raises issues well worth discussion:

The present structure, organisation, and control fo the globalised food and agricultural system are failing to address the needs of both poor people and the environment.  For example, profits of giant agricultural and food corporations increased greatly in 2008, when the number of hungry people grew.

The report is well referenced and is a great resource for information about what climate change will do to food and agriculture.  But the report does not deal with the ways in which agriculture contributes to climate change.  For that angle, see previous posts.

I list my public speaking gigs on this site but am often asked when I am doing something in New York.  Here’s one coming up soon.  I’ve given more information about this event in the links to the right.   Come if you can!

On June 3, the New York Times editorial page endorsed the idea of a tax on sugary sodas, and I especially liked the way the writer placed the issue in context:

Bigger fixes are needed, of course, starting with decent health care. The young need more exercise, healthier lunches and better education on nutrition. All consumers — not just those lucky enough to live near farms or large grocery stores — should be able to buy fresh fruits and vegetables at affordable prices. While we wait, Congress could impose an excise tax on sugary drinks — one of the main culprits in the obesity epidemic.

Yesterday, the Times published three letters in response, a set remarkable for concisely summarizing the same tired, old arguments.

From the American Beverage Association: “Balancing calories consumed with those expended through physical activity is the critical factor in preventing obesity. Therefore, we must continue to educate Americans about the importance of energy balance.”  Yes, but that won’t be enough.  As I have explained in previous posts, overeating calories has a much greater impact on weight gain than physical activity has in preventing it, and plenty of those overeaten calories come from sugary drinks these days.

Another writer, complaining that personal responsibility and parental responsibility have been lost in this discussion, then goes on to propose precisely the non-personal, societal approaches that the editorial was promoting: “Let’s try removing soda machines from our schools, providing healthier school lunches and ensuring that our gym classes are financed.”

Good ideas.  But I still think soda taxes could be an interesting experiment, well worth a try.

Thanks to Phil Lempert, the Supermarket Guru, for alerting me to the current HFCS-free sales boom.  HFCS, of course, is High Fructose Corn Syrup, the liquid sweetener made from corn (see previous posts).  Food marketers have gotten the message that many people consider HFCS to be the new trans fat, even though it is not much different biologically from common table sugar (sucrose).

HFCS is replaced easily by sucrose, which used to be much more expensive.  Now, because of the use of corn for ethanol, sucrose is only slightly more expensive than HFCS.

Click on the Table to see the overall 13% growth in sales over the last year, with products like HFCS-free milk drinks, juices, salad dressings, and teas registering 1,500% to 16,000% increases.  Like “trans fat-free,” the term “HFCS-free”  is a calorie distractor.  It too will make you forget about the calories.

The irony is that white table sugar – formerly a leading target of “eat less” messages – suddenly has a health aura.  Marketers have wasted no time moving in to use that aura to sell the same old products.

If you take the Washington, DC Metro this month, be sure to look for the posters at the Capitol South and Union Station stops (the ones closest to the Senate and House staff offices).  The ads are part of the Pew Charitable Trusts’ Campaign on Human Health and Industrial Farming, aimed at reducing the use of antibiotics in animal agriculture.  Take a look at who is “hogging our antibiotics” and encourage your representatives to do so too.

I usually don’t say much about the physical activity side of the obesity equation, mainly because overeating calories is so much greater a contributor to weight gain.  But don’t get me wrong.  I favor “move more” as much as “eat less,” especially for kids.

I’m dismayed by how kids these days are basically under house arrest.  So, apparently, is the American Academy of Pediatrics, which has just produced a thought-provoking report about how to create a kid-friendlier “built environment” (public health-speak for sidewalks, playgrounds, and the other ways cities are constructed to discourage physical activity).

My favorite statistic from the report: In 1969, about 41% of kids walked to school on their own.  Today it is 13% on average and just 5% in some areas.

Try this for comparison: When I was 8 years old and living in Manhattan, I walked 6 blocks to school in the morning, came home for lunch, walked back to school after lunch, and then walked home, got my bicycle, and headed off to the park – unsupervised – and lived to tell about it.  I took subways – by myself – to piano lessons.  After school, I was sent out to play and expected to stay out until dinner time.

Well, society has changed and it is hard to imagine letting children so young do that today.  The question is what to do about it.  Pediatricians urge us to ask that question.  And about time, too.