PERSPECTIVES • We've got a state with too many couch potatoes, but it's not too late to get off the cushions and go after good health

The word 'crisis' gets tossed about almost casually these days. So when I tell you that Oregon's ranking as the fattest state west of the Rockies constitutes a public-health crisis, you might not be impressed.

But what if I told you that the obesity crisis threatens to destroy the gains we've made in preventing heart disease, stroke and certain cancers?

What if I said that nearly six in 10 Oregonians are overweight or obese, and this will lead to more illness, higher rates of diabetes and cardiovascular disease and even higher medical bills?

What if I said obesity is the second-leading preventable cause of death, right behind tobacco, taking an estimated 300,000 lives nationally last year?

Then it begins to hit home. It hits home because you can see that obesity very likely will hurt someone you love, if not yourself, and also push your health care costs even higher.

It's easy to judge people by their weight. But the discouraging fact is, Americans have to work hard not to be overweight.

Consider: Not only do we have easy access to low-nutrition fast foods high in fat and sugar, but offers to 'supersize' them also appeal to our thrift ethic. When we seek entertainment, we are more likely to pop in a video or watch television than to play a sport or take a walk. Few of us are engaged in hard work around the farm. Eighty-nine percent of our travel is by automobile.

You might say that physical activity has been literally engineered out of most of our lives.

Meanwhile, it's so easy to gain weight. If you eat an extra 120 calories a day without increasing your activity Ñ that's just 12 potato chips Ñ you will gain a pound a month. This helps explain why the obesity rate among Oregon adults has doubled just since 1980.

Almost 60 percent of Oregon adults are either obese or overweight. Since 1980, the rate of obesity among U.S. teens has nearly tripled, while the rate among 6- to 11-year-olds has almost doubled.

When I was in medical school, Type 2 diabetes Ñ the kind linked with obesity Ñ was almost solely a disease among older adults. Today, Type 2 diabetes accounts for a growing proportion of pediatric diabetes and can lead to heart disease, stroke, limb amputation, kidney failure and blindness.

But we can do something about it. Examples:

• Set a healthy example for children through your own healthy eating habits.

• Follow the U.S. surgeon general's advice to exercise 30 minutes a day, five days a week.

• Encourage children to enroll in daily physical-education classes (now, fewer than half of eighth-graders do).

• Reduce sedentary TV-watching time, which research also associates with unhealthy snacking.

• Stock vending machines with fruit, vegetables and low-fat milk instead of candy bars, cookies and chips.

• Create more workplace activity.

• Promote designated routes where children can safety walk or bicycle to and from schools and parks.

Here in Portland, a concept called 'walking school buses,' in which adults walk designated routes to accompany children on their way to school, is being promoted. This not only encourages children to walk but is good for the adult volunteers, as well.

A crisis? It needn't be.

Mel Kohn, M.D., is state epidemiologist in the Oregon Department of Human Services. He earned a bachelor's in Russian and East European studies from Yale University. Contact him at This email address is being protected from spambots. You need JavaScript enabled to view it.. He lives in Northeast Portland.

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