Tighten Your Belt: By and large, Middle Georgians losing battle of the bulge


May 3--SPARTA -- It is lunchtime in the third-fattest county in Georgia.

At the Palm Tree Restaurant, a fish-and-burger parlor on the outskirts of one of the state's most economically depressed towns, a house painter is hunched over a perch plate.

"Judge Alex" is on the snowy, outdated, big-screen TV in the corner of what was once an American Legion hall. The color of the concrete floor almost matches the green felt on the dining-room pool table. On this particular day, the painter, a 36-year-old local of average build named Alton Andrews, is the restaurant's only eat-in diner.

Other patrons, including a corrections officer from the nearby prison, trickle in to grab takeout orders. Near the counter, tacked on a bulletin board next to the "100 A" health department rating form, is a hot-pink card advertising "Grease Trap Services."

A reporter asks Andrews about his eating habits, telling him where Hancock County ranks in the Centers for Disease Control and Prevention's latest estimates, how more than a third of the area's adults are obese.

"I might have some fish today, grab a burger tomorrow," Andrews says. "But a lot of people fall into eating out all the time and don't exercise or do any activities."

Andrews, who likes his fish and fries with mustard and hot sauce, notices the plastic-wrapped slices of red-velvet, caramel and key-lime cake on the front counter near the "No Smoking" sign. He doesn't order dessert.

"They add to the pounds," he says.

To an outsider cruising past on the highway, the Palm Tree, in business since the late '90s, looks more like some forgotten, steepleless, back-roads church. The Palm Tree sits up a sloped gravel driveway from Ga. 22 and doesn't have a single sign -- or palm tree for that matter -- save for a placard by the door that mentions how they fry with "100% Peanut Oil." Folks find it by word of mouth. "When it's good food," Andrews says, "it tends to sell itself."

A couple of years ago, Andrews lived over toward Augusta, in Jefferson County, a place designated by the CDC as the state's most overweight.

Andrews' cell phone rings.

"I'm eating fish right now," he tells the caller. "Chitlins? Noooo. Too hot for them."

Andrews explains to someone on the other end how he is talking to a reporter about the county's weight problem. When he hangs up, he says, "My lady says not only are we the third fattest, we're also the poorest. Looks like to me if we're the poorest, we wouldn't eat as much."

* * *

Studies have linked poverty and obesity.

As the thinking goes, eating cheap often means eating junk. Low-income jobs don't tend to come with gym memberships.

When work is hard to find, working out is an easily dismissed luxury. As physically draining as some blue-collar jobs can be, exercise before or after work can seem more like piling on the fatigue than being beneficial.

One need only look at the CDC's glowing-red map of Georgia's obesity hot spots to see the glaring connection: The state's heftiest counties also are among its poorest.

A swath of counties, including Hancock, from Baldwin, Wilkinson, Laurens and Wheeler east-northeasterly to the South Carolina state line, is made up of locales where roughly a third or more adults -- between 31 and 36 percent -- are believed obese. The figures are based on monthly telephone interviews and predictive-modeling data that factor in people's heights and weights.

The diagonal bulge across the state's waistline, from Augusta to Albany, which was fourth-poorest nationally on Forbes magazine's list of impoverished metro areas, and on over to the edge of Alabama, includes many of Georgia's most unemployed communities.

Jobless figures for March had the unemployment rate for Hancock at 22 percent, the highest in the state.

The Macon metro area, which includes Houston, Jones, Monroe and Peach counties -- a region that, according to a 2009 article in Forbes magazine, is the nation's seventh-poorest -- checks in with an adult-obesity rate between 27 percent and 31 percent, about the state average.

Most of northern Georgia, from Atlanta to Athens and on up to the Tennessee line, fell in the 23- to 27-percent obesity range, the lowest in the state.

According to the widely recognized body-mass index chart, which computes body fat based on height and weight, a 5-foot 8-inch person is considered overweight at 164 pounds and obese at 197 pounds.

Kathleen Glass of Macon-based Community Health Works, a midstate agency that last fall hosted a regional health summit here, says, "I think a lot of people don't realize where that line is between being overweight and obese. They might think of themselves as being average size."

A recent Georgia State University focus-group survey of midstate residents found that a fourth of them listed the cost of healthy food as a major obstacle in leading a fitter lifestyle. The other leading hurdles, after the No. 1 response, "finding time to exercise," were: work schedules, eating junk food, finding a safe place to exercise and family schedules.

"When people are poor, they don't necessarily have access to nutritious foods," says Robin Cleeland, an associate professor of social work at Dalton State College in north Georgia, "and so what they do is buy the cheapest foods with the most calories. ... The vegetables, the good-quality lean meats, tend to be much more expensive than the junk food. People are just doing what makes sense. They're trying to maximize a dollar."

Cleeland led a pilot health study of carpet-mill workers at three Dalton-area plants last summer.

Three-fourths of them were either obese (34 percent) or overweight.

Forty percent said that often they just couldn't afford balanced meals.

A third said they hadn't engaged in any "moderate physical activity" in the past 10 days.

About a fourth said they "always or often" bought meals from vending machines.

One in four were smokers.

Eighty-nine percent, meanwhile, believed their overall health was "average or better."

* * *

Reports suggest that as many as two-thirds of American adults are, if not obese, at least overweight.

The CDC's 2008 adult obesity rates for the country rank Georgia, where 27.3 percent of adults are obese, as the 18th most overweight state.

Mississippi (32.8) and Alabama (31.4) ranked Nos. 1 and 2. Colorado (18.5) was skinniest.

Obesity is associated with medical problems, from cardiovascular disease to some kinds of cancer to diabetes, stroke, high blood pressure, sleep apnea, gallstones and logically enough, even degenerative joint disease.

The latter of which, Dr. Rene J. Harper of the Medical College of Georgia says, is "just a direct consequence of the added weight."

Harper, an endocrinologist and associate professor at the Augusta school, says, "One thing I tell my patients is that it's not hard to gain the weight. It is extremely hard to lose it."

The Georgia Department of Community Health estimates that about 1.9 million adults here are obese. The department cites a 2004 study that projects state-by-state medical expenses and estimates the cost of obesity-related ills.

Georgia's present-day tab: $2.4 billion a year. That's $250 a person annually.

Perhaps the most revealing find in the Georgia State University midstate health survey, aside from the gloomy conclusion that "health in central Georgia is poor and getting worse," was that people across the board seem to know why they're not in shape. Most people surveyed said eating the right foods and exercising was the key -- a "very important" factor, in fact -- to being healthy.

State health officials, in a 2009 report on Georgia's 7-year-old Nutrition and Physical Activity Initiative, cited factors in residents' "poor dietary behaviors and sedentary lifestyles."

Among them, the fact that only 25 percent of adults consume five or more servings of fruit and vegetables each day and how just 44 percent of high school students meet physical activity requirements.

"People don't think about it, but eating is sensual," Harper, the Medical College professor, says. "It's gratifying to eat something that's good. A lot of people that don't have other sensual effects, they don't have social connections, hobbies or activities that they enjoy doing. Pretty much watching TV and eating, that's their central gratification."

To some degree, Harper, who has lived in Mexico and the Caribbean, where he says obesity rates aren't as high, blames America's bulk-up on modern conveniences.

"The other day, my kids wanted to turn off the TV and they were standing in front of the TV and they were looking for the remote. I was like, 'Press the button,' " Harper says. "I've heard of people that, to get to their mailbox, will get in the car and drive, and I'm not talking about a mile-away mailbox. ... In a lot of communities, we don't really emphasize the walking and the exercising."

Nor, he says, do we have much of a handle on the number of calories we gobble up or grasp the consequences of what is recognized as the golden rule of weight maintenance: burn off what you eat. Or, taking it a step further, to weight loss: burn more than you eat.

"It's very easy to exceed serving sizes," Harper says. "You'll look on the package and it says it's 200 calories per serving, but the serving size is half a cup, and nobody eats half a cup. ... You eat a couple of cups of cereal or whatever you're eating and you've got 600, 800 calories."

Harper mentions the shopping-mall food court staple Cinnabon.

"I like Cinnabon," he says, "but you can't eat but one a year."

The Caramel Pecanbon, whose maker describes it as "warm dough, filled with our legendary Makara Cinnamon, topped with pecans and smothered with rich caramel," is, according to Harper, also chock-full of 1,100 calories.

"It's amazing the amount of calories one of those products will have that people aren't aware of," he says.

Take a candy bar. You can down one in a couple of minutes. You open the wrapper and, poof, it's gone. But it takes about an hour of walking to burn off that many calories.

"There's a discordance there," Harper says. "People think, 'I just ate a candy bar, that's nothing.' "

And don't get him started on supermarkets. They are, he says, our emporiums of excess. "Just food, food, food."

* * *

On the cooking-oil aisle at Sandy's IGA supermarket in downtown Sparta, the Crisco and Mazola and Wesson shine like liquid gold.

The three shelves of glistening grease -- 7,680 calories per quart -- next to the Jell-O section and the Hooters wing breading are fronted by some 35-pound jugs of "Clear Frying Oil" taking up space on the floor.

Small plastic tubs of lard also are squeezed into the mix.

Store manager Mike Perkins, a 30-year Winn-Dixie man who has been with IGA for the past decade, says, "In my experience in 44 years, I sell more cooking oil in this store than any other store I've ever sold in. And I've had some Winn-Dixies that did $200,000 a week. And we're considerably smaller than that. And we sell tons of cooking oil. ... I order it by the pallet."

Sandy's is the only full-fledged grocery store within 25 miles of Sparta, Perkins says. Open every day of the year, including Christmas, it is far from some country-road mini mart where chips and sodas combine with cooked-all-day hot dogs to serve up a low-budget buffet.

The produce section is well stocked and about as visually appealing as one of those high-end markets where the lettuce, carrots and berries get jewelry-showroom display treatment. Baggers don't ask customers if they want their groceries hauled to their cars. They do it as a matter of old-fashioned courtesy.

If all you buy is a half-gallon of milk, they tote it.

On occasion, shoppers drop in from the Lake Oconee area. They are often more accustomed to fancy-schmancy suburban supermarkets.

"They love our meats," Perkins says. "When they come in sometimes they'll say, 'Do you have a low-fat or a low-salt area?' I say, 'You're in the wrong place. This is a high-fat, high-salt area, OK?' "

He says, "We sell tons of collards and cured pig tails and french fries and that's just our clientele. ... Pig tails, pig feet, smoked neck bones."

In Hancock, where the workforce is 3,300 strong, more than 700 people are unemployed.

Something Cleeland, the Dalton State professor, says about low-income workers and their eating habits seems to hold true in places such as Sparta and, on a wider scale, the country at large.

"We're all at risk. But (the poor) are much more prone to obesity because they don't have the same range of choices for healthy foods," she says.

"It's easy to have a public awareness campaign and say, 'You know, you really ought to walk X number of miles per day,' 'You really ought to eat this,' 'You really ought to do that,' but unless you understand the lives of the people involved and what they're up against and how they view the world, it doesn't (work).

"Those are nice programs that are not going to really help some of the people who need it the most."

It isn't hard to understand why regular exercise tends to fall by the wayside, Cleeland says: "By the time people get off from work, they don't feel like doing anything else. (In factory jobs) they're active, but they're not active enough to get the cardiovascular benefits. Then by the time they leave, they've got to go home, take care of children. ... They're exhausted."

Regional eating habits are another factor that she says toss deep-seated cultural aspects into the mix.

"We have learned to eat in a particular kind of way. Up in our part of the woods (in north Georgia), we've got Latino people who think you've got to have a homemade tortilla with every meal. So they're dealing with issues like very starchy foods and foods involving corn. ... Whereas our native Appalachian group of folks here, we eat fried chicken and everything fried. There's nothing you can't fry up here."

* * *

On a recent afternoon at Sandy's in Sparta, a shopper, a hefty man in overalls, is pushing his buggy through the meat department. He tosses in a couple of T-bone steaks -- one for his wife, one for him -- and a slab of ribs to go with a pack of Velveeta, a tub of IGA butter substitute, a small sack of russet potatoes and a few tomatoes.

The man, Wayne Hammock, 59, is wearing a patriotic cap with the image of an eagle on it. He says he moved to the area from around Atlanta a couple of years back.

He is not aware of his new home county's designation as the state's third-most obese. He also doesn't seem to mind someone taking notes on the contents of his shopping cart.

"I need to eat healthy," Hammock says. "I just don't make the grade most of the time. I just don't eat vegetables. I'm a meat-and-potatoes guy. If it's healthy eating, it don't taste right."

To contact writer Joe Kovac Jr., call 744-4397

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