CDC report says blacks more likely to be obese; progress in St. Louis far away
This article first appeared in the St. Louis Beacon, July 21, 2009 - For many years, an order of a burger, fries and a soda was a typical lunch for St. Louis police officer Latricia Allen, 43: "The drive-through was my friend," she said. In 2004, after Allen's weight ballooned to 208 pounds on her 5-foot-4-inch frame, she joined an obesity study, ate a low-carbohydrate diet and lost 60 pounds. But today, she's back up to 198.
As an African American, Allen is much more likely to be obese, according to a Centers for Disease Control (CDC) report released July 17. In the United States, nearly 36 percent of blacks are obese, and in Missouri, just over 36 percent. Nationally, that compares to 24 percent of whites and 29 percent of Hispanics. In Missouri, 26.5 percent of whites are obese, as are 28 percent of Hispanics.
Overweight is defined as having a body mass index (BMI) of 25 to 30; obese is having a BMI of 30 or more. At her present weight, Allen's BMI is 34. For the formula to compute your BMI, click here .
"I'm back on the wagon; this has to be a commitment for the rest of my life," Allen said.
INCREASED OBESITY IN BLACKS
In St. Louis, the problem is even worse. Figures from the Missouri Department of Health and Senior Services indicate that 40 percent of St. Louis blacks are obese and have higher incidences of obesity-related conditions like high blood pressure and diabetes.
The CDC and other experts offer several reasons: a greater acceptance of obesity, especially in women; a lack of exercise, often due to crime-related safety concerns; an overabundance of fat-laden fast food; and a paucity of grocery stores in predominantly poor, black communities.
"There are fried chicken places but not a Subway where people can get something healthy fast," said Cheryl Kelly, assistant professor of community health at Saint Louis University's School of Public Health.
Interestingly, the state health department found more blacks than whites ate the recommended five fruits and vegetables a day.
"The problem is in how they're prepared, like cooking with ham hocks and fatback and all that stuff that gets put on the greens," Kelly said.
Nationally, serious weight issues are most prevalent in black women, 39 percent of whom are obese. Most doctors and experts do not believe the cause is physiological, but Dr. Bernard Miller, a former Washington University researcher now with the National Institutes of Health, said his small, completed but unpublished study -- in which Allen participated -- supports the existence of an important biological component.
"It appears as if fat tissue breakdown is slower in black women than white women, and this may contribute to retention of body fat stores," Miller said.
The cause may be that black women are more sensitive to insulin, and it suppresses the breakdown of their fatty tissue. If so, that becomes a conundrum for the many African American women who take insulin for their diabetes: Their weight problem exacerbates their diabetes, and the insulin makes it more difficult to lose weight.
"It's like putting gasoline on a fire to try and put it out," Miller said. "The cure for one condition more or less could be a contributor to another."
Miller's findings replicate those of other studies but more research is needed to figure out the causes, Miller said. Dr. Samuel Klein, who runs Washington University's Center for Human Nutrition, agreed that scientists don't have all the answers.
"There are environmental issues and genetics involved, but we don't really have a good handle on all the mechanisms that are responsible for this difference," Klein said.
PROGRESS MAY BE YEARS AWAY
Missouri is not among the 25 states that the CDC offers funding and other help for obesity prevention and control. The state previously received CDC assistance, but it was pulled because of a failure by the Missouri Health Department to organize enough commitments, according to Kelly. It's the same mindset that has resulted in St. Louis' inadequate public transit system -- another reason for the obesity epidemic in blacks.
"When cities have good public transportation, the residents tend to be more active," Kelly said.
Kelly is in the early stages of efforts to use federal and state grant money to improve parks and sidewalks in north St. Louis, home to many poor black neighborhoods. Many parks have swing sets with no swings, broken-down slides and a high crime rate. Crime and poor maintenance also keep parents and children off their sidewalks and in their homes, where they're more likely to be sedentary.
The Monsanto YMCA in north St. Louis has lowered fees for those who can't afford memberships. The facility is also the centerpiece of a Washington University study that seeks to determine whether giving a free YMCA membership to obese African Americans who are also depressed and diabetic will help them lose weight and lift their depression.
Hundreds of community gardens created by Gateway Greening, along with the one-year-old North St. Louis Farmers Market, can help not only by providing fresh, inexpensive produce, but also by serving as gathering spots for nutrition education. A group called St. Louis for Kids provides nutrition information to kids who stay after school.
Many local programs are aimed at children and teenagers because it's difficult to re-educate adults, Kelly noted.
"We have to teach these kids some healthy habits," Kelly said. "Hopefully, in 10 to 20 years, when these kids are adults, we'll see lower obesity rates -- along with hospitalization rates and death rates."
Nancy Larson is a freelance writer in St. Louis.