Going nowhere fast in New York City/Wikimedia Commons
America’s biggest public health problem
The U.S. Union of Concerned Scientists is out with a new report highlighting the costs of the country’s addiction to motor vehicles, but it misses one of the biggest issues while fixating on climate change and “social equity” agendas.
The group’s heavily footnoted, 65-page “Freedom to Move” report does embrace the idea that weaning Americans off the need to drive everywhere can “reduce toxic air pollutant emissions from cars and trucks on the roads that contribute to cardiovascular and respiratory illnesses, especially in communities of color and low-income communities.”
Unfortunately, the report overlooks the far larger American issue literally driving the decline in American cardiovascular health with its tunnel-vision focus on transportation as “the biggest contributor to heat-trapping emissions in the United States” which “has the highest-emitting transportation system in the world.”
Those emissions, the report argues, lead to “increased flooding, forest fires, extreme heat, and destructive storms across the country” and warns of coming “climate impacts” likely to cause “lasting damage on transportation infrastructure with staggering long-term costs for our families’ futures.”
A warming planet has, indeed, been blamed for all of these things, but there are a lot of complicating factors – the loss of North American wetlands, which influence both flooding and fires, the increase in construction in flood plains, bad forest management, development in coastal areas subject to flooding even in less than violent storms and more.
And the biggest climate change fears remain centered on predictions of how bad things could get in the future. Meanwhile, a health crisis driven by a lack of physical activity in which motor vehicles play a significant role is already here.
A lack of exercise has helped stall the steady rise in American life expectancy that began at the start of the 20th Century, contributed heavily to the inflated American death rate during the pandemic, and now has the U.S. military worrying about finding enough physically qualified recruits to field a future army with the Centers for Disease Control (CDC) warning that the situation has reached the point where “obesity and (lack of) physical activity are impacting national security.”
Don’t move
Welcome to the American slothdemic with its most visible sign – the country’s obesity epidemic – now so in your face it’s hard to imagine anyone could miss it. Just look around in any supermarket, restaurant, bar or shopping center in the country where you’re sure to find people nearly twice as wide as nature intended them to be.
No one should blame them for this. It’s not their fault. America has created a society designed to fatten people up in the same way feedlots fatten cattle by increasing how much the animals eat and limiting how much they exercise.
The human version of this involves a lot of relatively inexpensive, easily prepared, calorie-dense, processed food and a lot of sitting behind a computer looking at a video screen, sprawling on a sofa to watch a TV, or plopping down behind the wheel of a motor vehicle driving somewhere because walking and cycling have largely become relics of the past.
That average woman remains four and a half inches shorter than the average American male of 1960, but now outweighs that guy by four and a half pounds and sports a waistline that would make it impossible for her to squeeze into a pair of his jeans.
This transformation in the body shapes of Americans has been going on for a long time now with nobody seeming to care all that much. NBC News thought it was funny back in 2015 when it headlined “The ‘real’ shape of the American man: Dudes, you’re porky!”
We might not want the biggest waistlines, but we’ve got them, and it’s not by accident.
Americans have been warned and warned and warned again about the dangers of obesity, but they just don’t seem to care.
“An underappreciated primary cause of most chronic conditions is the lack of sufficient daily physical activity,” they wrote. “Overwhelming evidence proves the notion that reductions in daily physical activity are primary causes of chronic diseases/conditions and that physical activity/exercise is rehabilitative treatment (therapy) from the inactivity-caused dysfunctions.
“Three millennia of evidence exist to indicate historical recognition that physical inactivity is detrimental to health by reducing the functional capacity of most organ systems in humans, mammals, and rodents.”
This is only significant, however, if you believe in evolution which most of the American medical community would now appear to doubt given the desire of doctors to prescribe medications rather than tell people to get moving.
GLP-1 agonists – Ozempic, Wegovy, Zepbound, Mounjaro and others – designed to create weight loss and/or treat diabetes are the hot item of the moment although the long-term benefits and consequences of these drugs have yet to be determined.
Some physicians are, however, questioning the use of these drugs, especially to treat children who, like American adults, are also getting ever fatter. Dr. Dan M. Cooper, distinguished professor in the Department of Pediatrics at the University of California, Irvine Medical Center, and colleagues have warned the drugs can easily be misused.
“Cooper also observed that pediatric obesity has become epidemic in large measure because of environments without adequate venues for safe play and exercise for children and adolescents, coupled with the availability of popular, inexpensive, high-calorie fast-foods,” a UCI Health said in reporting on a commentary Cooper and colleagues published in the Journal of Clinical and Translational Science last year titled Unintended Consequences of Glucagon-like Peptide-1 Receptor Agonists Medication in Children and Adolescents – A Call to Action.
The report from Concerned Scientists blames “heavy industry lobbying” on the part of the automotive, trucking and oil industries for all of this, but the reality is that in the immortal words of Walt Kelly’s “Pogo,” “we have met the enemy, and he is us.”
We was warned
Ironically, for Alaskans at least, the report from the Concerned Scientists was issued about the same time the Alaska Department of Public Health put out its report on “chronic disease facts” outlining Alaska medical conditions largely linked to “lack of sufficient daily physical activity.”
Chronic diseases are those illnesses that came to be called “comorbidities” during the pandemic. Most of the people who died during that crisis were already struggling with these comorbidities before the SAR-CoV-2 virus killed them.
Simply put, a lot of the victims of the pandemic weren’t just sick before Covid killed them, they were chronically ill, and in Alaska many still are. The state report indicates most Alaskans are now living with some sort of “chronic condition” from the high-blood pressure reported to be affecting almost a third of the population to the 3 percent struggling with kidney disease.
“Four healthy lifestyle factors – never smoking, maintaining a healthy weight, being physically active, and following a healthy diet – are linked to as much as an 80 percent reduction in the chances of developing (these) most common and deadly chronic diseases,” the report added.
But Alaskans, like most Americans, have largely failed to embrace healthy lifestyles in the new millennium. Gallup, a national polling organization, is reporting a historic low in U.S. smokers with 11 percent this year reporting they had “smoked cigarettes in the past week,” down from 41 percent in 1944 and “about half as large as it was a decade ago and one-third as large as it was in the late 1980s.”
When it comes to weight, physical activity and healthy eating, however, the trend lines are running in the opposite direction. The state reported 69 percent of Alaska adults and 33 percent of the state’s high-school students are now overweight or obese. Eighty-two percent of high school students were reported to be getting too little daily exercise, and nearly a quarter of adults were reported to be engaging in no physical activity at all.
The report pointed out that “physical activity and healthy eating can prevent overweight, obesity and several chronic diseases, including many cancers, heart disease, and type 2 diabetes. It can also impact mental health. Healthy eating patterns have been associated with a reduced risk of depression. The mental health benefits of physical activity – for adults and
children – include better mood, sleep and focus.”
Alaskans, like most Americans, don’t seem to much care with too many happy to blame their genes for their girth and cardiovascular problems rather than accept the role of their own behavior.
This is a perfect cop-out in the new era of “social justice” where the National Association to Advance Fat Acceptance (NAAFA) is contesting “society’s stubborn generalizations that associate fatness with disease and poor health outcomes and push(ing) back against the assumption that fat people have little regard for themselves or their own well-being,” according to the Canadian Medical Journal Association. “They argue that thinking about obesity as a disease or medical risk (such as for severe COVID-19) contributes to stigma because it positions larger bodies as drains on an already-taxed health care system.”
Stigma or not, there is a health care problem here and no matter what any of us want to think about our weight problems, the latest research, published on the JAMA Open Network in March, has concluded that while genes do play a role in weight gain and/or loss, “genetic risk for obesity is not deterministic but can be overcome by increasing physical activity.”
At the end of the day, weight gain for any animal is a matter of calories in and calories out. No one has ever survived a starvation diet. But yes, some people clearly have a higher metabolic set point that naturally causes them to burn more calories than other people when sitting, sleeping or otherwise performing no physical activity.
These people are called ectomorphs and are characterized by longer limbs, thinner bones, and a flatter ribcage. Some still struggle to gain weight despite living in a society designed to fatten us all up.
As a high school football player, I was a classic ectomorph. No matter how much food I stuffed in my mouth, I couldn’t gain weight or as much muscle mass as desired at the time. At college, with my physical activity fallen from hours per day to minutes per week, I went whole-on endomorph for a brief period before one morning looking in a mirror at lakeside cabin in Minnesota before preparing to make an ice dive and wondering how someone had stuffed the Pillsbury Doughboy into my wetsuit.
That led to an increase in physical activity that eventually steered me back to a natural state as a metamorph (big bones are something no amount of exercise can change) who seriously took up running in midlife and struggled mightily, without success, to get back to being that ectomorph of my youth.
It was a losing battle. Even when running 100 to 140 miles per week, I had to seriously diet to get my marathon “race weight” down to 170 pounds, which was still five pounds heavier than the 165 I battled to get above as a high school football player.
There is now considerable, ongoing research into what causes these kinds of metabolic shifts with a variety of theories floated ranging from the old and simple – calories in, calories out – to those suggesting insulin as a driver of fat storage, reactive oxygen as a modifier of metabolism and the “obesogens model, which proposes that environmental chemicals interfere with hormonal signaling leading to” increases in body fat, as scientist suggested in the International Journal of Obesity in January.
They cataloged the “thousands of new chemicals (that) have entered our food supply and environment since the obesity pandemic began.” But in the end, they concluded that they could not say that “obesogen exposures per se are the sole cause of the obesity pandemic but that via effects on gene expression and reactive oxygen signaling, obesogens alter the function of metabolic tissues such that people are more sensitive to diet-induced weight gain and less sensitive to weight loss.”
And thus we need more physical activity to burn off the same number of calories our parents burned off at a time when we live in a society that actively discourages physical activity by making everything, and especially everyday mobility, easy.
When we should be burning more calories for our own good, we are burning ever fewer, and the design of our transportation systems plays a key role. The Concerned Scientists did get that right.
America has spent decades letting motor vehicles dictate transportation-system design or, as the Concerned Scientists put it, “the system we currently have revolves around car dependence bolstered by outdated policies and industry lobbying.”
In the name of safety, we have tried to make those automobiles ever safer with seat belts, airbags and impact-absorbing structures while paying little attention to the safety of the system in which they move.
Imagine the number of people dead if air travel were treated this way, if airplanes were made as safe as they could be but the air traffic control system was eliminated because it would make life inconvenient for those rushing from point A to point B.
Instead of controlling the rush on the roads, however, America has encouraged it by design and in the process only made it worse. Road deaths are on the rise, and
StreetLight Data in September reported traffic congestion and gridlock is now worse than it has ever been in most American cities despite constant road widening to make room for more motor vehicles.
Unfortunately, the political will to make changes to discourage driving and encourage people to use their muscles to get around is lacking in most communities, Anchorage among them, because one of the few things on which politicians left and right can agree is that they don’t want to upset motorists.
And most motorists want to keep on driving more and often faster even if it’s killing them slowly through lack of exercise or quickly in motor-vehicle collisions which now claim twice as many lives as firearms homicides each year and leave 2.3 million to 2.5 million people injured, many of them seriously, every year, according to the National Highway Traffic Safety Administration.
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