Aug. 20--Blame it on the sweet tea and fried chicken.
The Southern tradition of fueling bodies with greasy, high-fat foods consistently lands Alabama and its neighbors in the top five rankings for obesity.
Alabama was ranked as the third most obese state in the country -- behind Mississippi and West Virginia -- in the "F as in Fat: How Obesity Policies are Failing in America" report, which uses an average of states' obesity data for the past three years, 2005 to 2007.
The good news was Alabama's rank was no worse than last year in which it also ranked the third worst. The bad news is while the state didn't gain in the rankings, it did gain.
Alabama's adult obesity rate increased from 29.4 last year to 30.1 percent this year, according to the fifth annual report released Tuesday by the Trust for America's Health and the Robert Wood Johnson Foundation.
Miriam Gaines, Alabama's nutrition and physical activity director for the state health department, has little question that Southern cooking is one of the main reasons that nine of the 10 states with the highest obesity rates are in the South.
"Obesity in the South is complicated," Gaines said. "When you ask someone to give up family traditions, that's hard to do," she said.
"We're actually asking people to alter their cooking style ... to cut back on all the added fats and sugars."
Nationally, there are 28 states in which more than 25 percent of adults are obese, an increase from 19 states last year, according to the TFAH report. More than 20 percent of adults are obese in every state except Colorado, which had the smallest percentage of obese residents.
Adult obesity rates rose in 37 states during the past year, according to the report. Rates rose for a second consecutive year in 24 states and for a third consecutive year in 19 states. No state saw a decrease.
Jeff Levi, executive director for Trust for America's Health, said during a Tuesday conference call that the country is not giving the "obesity epidemic" the attention it deserves.
"Obesity has a huge impact in the U.S. economy, by lowering our productivity."
Last month, Alabama was ranked the second fattest state in America by the Centers for Disease Control, falling behind Mississippi.
Since 1998, Alabama has been in the top five states for obesity, according to the CDC rankings.
Obesity is literally becoming a bigger and bigger problem. In 1990, the CDC reported Alabama was 12.3 percent obese -- in 2007, the number had grown to 30.9 percent.
In 1991, no state had an obesity rate above 20 percent, according to the TFAH. In 1980, the national average of obese adults was 15 percent.
Now, the group estimates two-thirds of American adults are overweight or obese, and an estimated 23 million children are either overweight or obese.
The estimates of how obese Alabama is and the percentages of people who are obese differ from study to study, but Gaines said whether Alabama ranks second or third in obesity doesn't matter.
"The take-home message is that we do have a health problem in obesity," she said. "The other message is how quickly it is increasing."
The culprit isn't just Southern food, but Southern inactivity.
Alabama ranked sixth, falling behind Southern states such as Mississippi, Louisiana and Tennessee, with 29.6 percent of its adult males being physically inactive.
Although many promising policies have emerged to promote physical activity and good nutrition in communities, the TFAH report concludes that they are not being adopted or implemented at levels needed to turn around the health crisis.
There are plenty of things the state still needs to do, said Evelyn F. Crayton, assistant director of family programs with the Alabama Cooperative Extension System at Auburn University.
The state needs to focus on teaching smart food habits at the pre-K level, she said.
"We also need to get physical activity as part of the core curriculum in all schools in the state," she added. "We need 30 minutes, or even 15 minutes, of (physical education) every day."
There are 27 schools in the River Region that have implemented the School Health Index, which is an assessment and planning program. It was developed as a tool to help schools assess and improve their physical activity, healthy eating and tobacco-use prevention policies and programs.
Changes this program has brought about in the schools include healthier choices in vending machines and cafeterias and healthier fundraising activities -- for example, instead of selling doughnuts, they might sell fruit -- said Heidi Hataway, program director for Steps to a Healthier Alabama.
She said some schools have also incorporated more physical activity in classroom lessons.
But fingers are not pointed at just one area.
Gaines said to look at the lack of neighborhood parks and sidewalks, adding that when the environment is more walker and bicycle friendly, "then we will get out and do that."
"I guess it's so frustrating because we have been addressing obesity actively for eight years," she said. "Eating is very emotional at times ... It doesn't have to deal with hunger all the time."
Crayton said obesity starts with the parents.
"Children are not born not liking broccoli," she said. "They develop that based on modeled behavior. Children can develop a taste for anything."
A registered dietitian, Crayton said the state needs to be very concerned about the obesity rate. She stresses that families should eat together as often as they can.
"We need to be alarmed, and we need to move to action," she said. "We're looking at too many calories and not enough physical activity."
Levi said America's future depends on the health of the country, and the obesity epidemic is lowering "our productivity and dramatically increasing our health care costs."
"Even though communities have started taking action, considering the scope of the problem, the country's response has been severely limited. For significant change to happen, combating obesity must become a national priority."
Gaines agrees. But the South still has the sweet tea and the fried foods that it's known for. And the South still has the large sizes.
"A lot of the way we eat is tradition," she said. "And when that tradition started, we were out in the fields more and really did need that high calorie intake (each) day. But now, when you think of the typical Southern job, we're inside at our desks." To see more of the Montgomery Advertiser, or to subscribe to the newspaper, go to http://www.montgomeryadvertiser.com. Copyright (c) 2008, Montgomery Advertiser, Ala. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
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