Obesity and a lean economy? Let's cure both

Causes of the current obesity epidemic read like a conspiracy theorist's dream.

"Many of our policies seem almost designed to promote obesity," Dr. David S. Ludwig, director of the Optimal Weight or Life Program at Children's Hospital Boston, said in an interview.

Consider:

-Farm subsidies support high-calorie commodities made into processed foods while more nutritious fruits and vegetables become more expensive.
-Fast food meals promote overeating while physical activity plummets.
-Federal spending builds highways instead of public transportation or bike paths.
-Neighborhoods in cities are too dangerous to play in and suburbs with no sidewalks put everybody in cars.
-Parents spend more time commuting and less time cooking at home while children watch more TV and use computers more.
-Gym classes and recreational sports programs get cut while children grow heavier than ever.

And the nation's troubled economy will only make matters worse, Ludwig and co-author Harold A. Pollack of the University of Chicago write in tomorrow's Journal of the American Medical Association.

"When the economy gets tight, it's very common for people to cut back on the quality of food they are eating," Ludwig said. "One of the few companies that have done well in the stock market collapse of late 2008 have been fast food companies like McDonald's."

Ludwig and Pollack see a vicious cycle, but they also sense an opportunity to break it.

"I think that in times of crisis we are motivated to reevaluate basic aspects of our economic and social models and reestablish priorities based on what is in the short- and long-term best interest of our country," Ludwig said. "Obesity takes a tremendous toll on the economy."

In his view, part of the economic stimulus package now before Congress could be steered toward programs that improve food quality and promote physical activity while creating jobs and cutting ballooning healthcare costs.

The ingredients would include policies to support family farming, to build parks and bike paths integrated with public transportation, and to create community health centers that would provide nutritious foods, recreation, and education. Shape up Somerville, a comprehensive program to prevent obesity gets a shout-out as a project to be emulated (and funded).

"We can not only achieve much better long-term public health through investment in the educational and public health infrastructure, but we can also provide a medical economic stimulus perhaps in some cases more potent than traditional programs like road construction, which may be relatively more resource than labor intensive," he said.

Ludwig sees more benefits under such a sweeping plan: Lower healthcare spending would make expanded coverage more easily within our fiscal grasp. And with more people getting out of their cars and onto bikes or public transportation, it's green.

"Failure to act now could ultimately cost society much more than even the sub-prime mortgage crisis," Ludwig and Pollack write.