Would you like to supersize that? It's a simple question asked to patrons at many national fast food chains. It's actually quite a deal, for cents more you can increase the amount of food and drink you are given. What if by increasing the amount of food you were eating actually increased your chances of developing severe health issues? A person's risk for developing many life-threatening health conditions can be measured by how much excess fat is stored in their fat cells. The United States has had an influx in the number of individuals who are overweight; could 'supersizing' be to blame? While there are other causes for weight gain, increased portion sizes combined with inactivity have had a direct effect on the growing obesity cases.
Obesity is a condition in which an individual's body accumulates and stores more fat than what is considered healthy. To determine the amount of fat stored in a person's body, a Body Mass Index (BMI) number is calculated. The formula for determining a person's BMI is the weight (in pounds) divided by the height (in inches) squared multiplying that number by a conversion factor of 703. For example, to determine the BMI number for a person who weighs 150 pounds and is 65 inches tall, the formula would be: [150 ÷ (65) 2] x 703 = 24.96. A BMI range of under 18.5 is considered underweight, the normal range is between 18.5 and 24.9, while 25 29.9 is considered overweight, finally a BMI score of 30 and above is categorized as obese. (CDC, About BMI for Adults, 2009) The BMI calculations are only one small part in determining a person's health risks in relation to weight issues. This calculation does not take into account the difference between muscle and fat weight, so it is possible for someone to receive a higher BMI number but not have a high body-fat content because of muscle weight. It is important to take this into account when calculating one's body mass index number. One of the first actions taken by a technician when a patient is seen by a physician is they are asked to step on a scale. Then they are either asked how tall they are, or are physically measured. It is not a coincidence that these are the two measurements needed to calculate an individual's body mass index. The BMI ranges are based on a documented relationship between body weight, disease and death and are used as a tool to identify increased risk for diseases and health conditions.
Obesity is a contributing factor for several severe health conditions and diseases, most of which have proven to be life-threatening. These conditions include hypertension, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, sleep apnea and respiratory problems, dyslipidemia, osteoarthritis, and some cancers to include endometrial, breast and, colon cancer. Even though being overweight contributes directly to the development of such severe health problems, the rates of diagnosed cases of obesity have steadily increased over the past two decades. (CDC, Overweight and Obesity, 2007)
According to the Centers of Disease Control and Prevention, "during the past 20 years there has been a dramatic increase in obesity in the United States." (2007) The CDC collected information on the rise in obesity through the CDC's Behavioral Risk Factor Surveillance System, (BRFSS). In 1985, the CDC had gathered data for only 21 states which showed no more than 14% of each state's population diagnosed with obesity. In 2008, the CDC collected data on all 50 states; of which Colorado held the lowest percentage of obesity cases at 15-19%; however all other states were recorded between 20-30% of their population were severely overweight. (CDC, Overweight and Obesity, 2007) Andrew Cates, Portion distortion - analysis of food portion size to aid in weight control (2003), states "According to the U.S. Department of Agriculture, the average number of calories Americans eat each day has risen from 1,854 to 2,002 during the past 20 years. That increase of 148 calories per day works out to 15 pounds of extra weight each year." (2003) This data shows Americans are eating more today than what they were twenty years ago. However, the increased calorie intake alone is only part of the cause for the increased obesity in the United States.
While other causes for obesity include genetics, disease, and medication side effects; consuming large portions of food without expending enough energy to compensate is considered to be the root cause of weight gain. For example, a typical meal from a popular fast-food restaurant consists of a cheeseburger with condiments (760 calories), medium fries (360 calories) and a 22 fluid ounce soft drink (200 calories) for a minimum total of 1320 calories ingested. An average adult weighing 180 pounds would have to walk at a pace of four miles per hour for 4.02 hours or run at a pace of 6.7 miles per hour for 1.6 hours to burn off the calories ingested at this typical meal. However, the average American does not maintain physical activities for extended periods after each meal; therefore not exerting enough energy to fully expend the large number of calories. This results in excess calories to be in the body's fat cells, thus causing an increase in weight. Consider the diet of a professional athlete, these individuals can take in roughly 12000 calories per day, but maintain a lean muscle mass and body strength. They use every calorie ingested for fuel during physical training. For the average human, this high calorie diet is highly dangerous. While the increased consumption of calories is a global trend, the "supersizing" of fast food menu items has made the obesity epidemic worse for those living in the United States. (CalorieLab, 2007)
Lisa R. Young, PhD, RD and Marion Nestle, PhD, MPH conducted and documented a study titled The Contribution of Expanding Portion Sizes to the US Obesity Epidemic. This study compared past food portions to those currently sold to document historical changes. One example of the effect "supersizing" has had on the typical caloric intake was the comparison of soft drink sizes served at a McDonald's in the United States versus those sold at McDonald's in the United Kingdom. "Notably, the sizes of chain fast-food portions in Europe are smaller than those in the United States. McDonald's 'Extra Large' soda portions in London, Rome, and Dublin weigh the same as the US 'Large.'" (Young and Nestle, 2002) The study also noted the largest size of McDonald's fries sold in the United States in 1998-1999 contained 610 calories, during that time the United Kingdom's largest fry size contained 446 calories. While the serving sizes at fast food restaurants in America seem to be larger in comparison to other countries, this does not mean the restaurants are the only cause for America's increases in obesity cases.
Are restaurants largely at fault for the increase obesity rates in the United States? Because of data on portion sizes, it wouldn't be incorrect to place some blame on the food marketing industry. But this industry runs off supply-and-demand, if there was no demand for larger portion sizes theoretically the sizes would be reduced. Additionally, when faced with the increased portion sizes, consumers are more likely to ignore the recommended sizes and will attempt to ingest what they are served. In addition to high-calorie meals, additional excess calories are taken in throughout the day by snack foods, sodas, flavored waters, candy, and even gum. Nearly everything taken into a person's body through consumption contains a number of calories. As discussed before, the ingestion of excess calories is not what causes the build-up in body fat, but rather the lack of energy used to expend the calories.
So does 'supersized' food lead to supersized people? This seems to be the case for the average person who dines on large portions without expending the needed energy to burn through the extra calories. While there are other causes for weight gain, increased portion sizes combined with inactivity have had a direct effect on the growing obesity cases. The amount of food ingested is only part of the cause for the obesity epidemic, combine it with the decrease in daily activity and what is left is the formula for an unhealthy, possibly fatal medical condition that takes years to overcome. Would you still like to supersize that?
Centers for Disease Control and Prevention.(2007).Overweight and Obesity: Home.Retrieved from http://www.cdc.gov/nccdphp/dnpa/obesity/
Centers for Disease Control and Prevention. (2009). About BMI for Adults. Retrieved from http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
CalorieLab. (2007). Burger King Calorie Counter. Retrieved from http://calorielab.com/restaurants/burger-king/3
Cates, A. (2003). Portion Distortion - Analysis of Food Portion Size to Aid in Weight Control. Retrieved from http://findarticles.com/p/articles/mi_m0826/is_6_19/ai_111111456/
Rolls, B.J., Roe, L.S., & Meengs J.S.(2007).The effect of large portion sizes on energy intake is sustained for 11 days.Department of Nutritional Sciences, Pennsylvania State University.Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17557991
Young, L.R. & Nestle M. (2002). The Contribution of Expanding Portion Sizes to the US Obesity Epidemic. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447051/