The World's Fattest People
Why make an effort to reform our dietary habits from the ground up? I hate to say it, but at this stage in the game, it's because we have no choice. In recent decades, we've seen a disturbing trend ripple around the world: people are getting fatter, and as a consequence, their lives are getting shorter. In 2006 there were more than 1.6 billion overweight people in the world, and the World Health Organization (WHO) projected that these numbers would grow by 40 percent by 2016.1
According to WHO, these are the places in the world with the most overweight adults:2
1. Nauru (94.5%)
2. Federated States of Micronesia (91.1%)
3. Cook Islands (90.9%)
4. Tonga (90.8%)
5. Niue (81.7%)
6. Samoa (80.4%)
7. Palau (78.4%)
8. Kuwait (74.2%)
9. United States (74.1%)
10. Kiribati (73.6%)
11. Dominica (71.0%)
12. Barbados (69.7%)
13. Argentina and Egypt (tie) (69.4%)
14. Malta (68.7%)
The number you see after each country reflects the percentage of adults (age fifteen and up) who have a body mass index greater than or equal to 25, which is considered overweight. Even though the United States isn't number one, experts consider it to be the most alarming country on the list. That's because with more than 225 million overweight people, the United States has the largest number of obese individuals in the world. It also exports its unhealthy habits to countries all over the globe. The passion for fast food that started in America is now a worldwide phenomenon.
According to the National Center for Health Statistics, nearly
two-thirds of the U.S. population qualifies as overweight. Half of that group--or nearly one-third of the population as a whole--has been categorized as obese, which is defined as having a body mass index over 30, or more than thirty pounds over a healthy body weight.3
In the United States alone, obesity costs $117 billion a year, a figure that seems to get bigger every day.4 In 1997-1999, hospital costs for obese children and adolescents topped $127 million. Just twenty years earlier, those costs were only $35 million.5 Not only that, but our collective girth is triggering huge health problems across the board. Carrying extra weight can increase a person's risk for a wide range of conditions: hypertension, cardiovascular disease, diabetes, and some types of cancer, to name just a few. The saddest part of all is that most of the illnesses associated with obesity are 100 percent preventable.
Of course, it's not just what we Americans eat that keeps thickening our waistlines. It's also our misconceptions about eating in general--from how we prepare our meals to when and where we eat them. In this book, we'll be looking abroad to learn how to make more responsible, and more fun, decisions about every aspect of eating--decisions that will keep the pounds off, prolonging and enhancing the quality of our lives.
But before we set about studying, and eventually imitating, how other cultures live and eat, we need to focus on the home front--on the bad habits that got us into all this trouble in the first place. Of all the nations on earth, we have no excuse for being this fat and unhealthy. America is the richest nation on the planet; we have top-notch doctors, advanced medical technology, widespread food availability, and gyms on every corner. So shouldn't we be the healthiest nation in the world as well? And if so, why aren't we?
WHAT WE'RE DOING WRONG
Let's first identify the problems that we need to address in our collective lifestyle here in the United States, and in other industrialized nations--the choices that are eroding our health and shortening our lives.
To put the problem as bluntly as I can, Americans are overweight because we take in more calories than we burn. On some level, it really is that simple. WHO calls it "overnutrition," and it's a problem in many other industrialized countries as well. But Americans have a particularly egregious case of it. In 2003, the American food supply provided 3,800 daily calories for every person. That's roughly twice the Food and Drug Administration's recommended daily allowance.7
According to a study conducted by the Centers for Disease Control and Prevention (CDC), our caloric intake has skyrocketed since the 1970s. In 2000, women took in 22 percent more calories than they did in 1971 (1,877 calories a day in 2000 versus 1,542 in 1971). Men consumed 7 percent more (2,618 calories in 2000 versus 2,450 in 1971).8 The figures for 2000 far exceeded the U.S. government's recommendations that women eat 1,600 and men eat 2,200 calories a day.
What might be even more troubling in the long run is that Americans are living off foods that are high in calories and artificial trans fats and precariously low in the nutrients our bodies need to thrive. High-fructose corn syrup, an all-purpose sweetener that's added to just about every packaged food you can name, is a great example of the kind of nutrient-poor, calorie-dense ingredients that have become the mainstay of the American diet. Americans also drink more sugary beverages today than at any time in history. Instead of milk and water, we are chugging gallons of high-sugar soft drinks.
All this sugar takes its toll. The U.S. Department of Agriculture (USDA) recommends that people on a 2,000-calorie daily diet eat no more than 40 grams, or about 10 teaspoons, of added sugar every day. Americans go way over the recommended amount, which is no surprise given that sugary additives can be found in packaged foods such as soups, salad dressings, ketchup, and mayonnaise--the list is endless. In many instances, these sugars are adding only one thing to our diet: calories.
We aren't just eating too much sugar; we are eating too much of everything. As the size of our portions grows, so does the size of our jeans. Meals in America seem to get bigger with every passing year, with 40-ounce drinks, heaping servings of French fries, and gigantic desserts the norm. It's no wonder that so many Americans are losing the battle of the bulge.
A study out of Rutgers University found that the portion sizes Americans eat for breakfast, lunch, and dinner have increased between 20 and 50 percent since the 1980s.9 That means that Americans are eating 20 to 50 percent more calories at mealtime than they did just one generation ago. In restaurants, average portion sizes have doubled or even tripled over the past two decades.
You can see this "inflation" in all segments of the food industry. A Burger King burger, for example, weighed 3.9 ounces in 1954 and 4.4 ounces in 2004. (A Double Whopper weighed 12.6 ounces!)10 At other restaurants surveyed, steaks weighed 12 ounces or more 60 percent of the time. It doesn't cost restaurants much to supersize portions, and getting twice as much food for only a few pennies more gives consumers a false sense of value (false because they will end up paying big in doctors' bills later on). Thanks to supersizing, we have grown accustomed to eating massive quantities of high-fat foods in one sitting. And sometimes we don't even bother to sit down.
To accommodate these larger portions, the size of our dinner plates also has increased in recent decades.11 It seems that even our dishes are encouraging us to pile on the pounds.
So what's the big deal? Did you know that eating just 100 extra calories a day can add 10 pounds a year to a person's weight? Over 10 years, that's a whopping 100 pounds. To slim down as a culture, we need to start cutting our portions down to size.
In recent years, Americans have taken fast-food culture to an unhealthy extreme, with our famous multitasking abilities extending to mealtimes as well. Americans eat while watching TV, driving to work, even sitting in class or shopping.
No self-respecting Italian would slurp down his beloved cappuccino in the car! In many of the nations we'll be visiting, eating and drinking are not simply a means to an end, but ends in themselves. Some of the healthiest countries place a premium on eating for pleasure. Across the Mediterranean, people linger--sometimes for hours, even at lunchtime--over their meals. But fast-food chains have become more popular in some of these countries as well. According to McDonald's own website, in 2007 there were thirty-one thousand McDonald's across the globe, with more opening every year.12
Eating out is cheaper and more convenient than ever, but that doesn't mean it's good for you. When you aren't making your own food, you have a lot less control over what goes in it. There are no hidden ingredients in a meal you cook yourself, but you can't say the same for a meal you pick up at the drive-through.
According to a WHO report titled "The Epidemic of Overnutrition," there were 170,000 fast-food restaurants and 3 million soft-drink vending machines in the United States in 2002.13 A survey cited in this report found that only 38 percent of all meals eaten in this country were made at home. In fact, the USDA's14 food intake surveys found that Americans spend almost 50 percent of our annual food budgets on meals prepared outside the home. In the 5-Factor World Diet, we will be changing that. I will be teaching you how to prepare quick, delicious, and nourishing meals in a matter of minutes. Learning how to make your own food (and figuring out what exactly goes into that food) is an essential early step toward taking charge of your overall health.
Animal Products Excess
Compared to most other nations, Americans eat through-the-roof quantities of high-fat meat two or sometimes even three times a day, seven days a week. Red meat and dairy products are beneficial in moderation, but it pays to remember that too much of a good thing can be dangerous. The steaks and hamburgers that we love so much are significantly higher in saturated fats and cholesterol than plant-based foods. Too much meat can clog our arteries and increase our risk for heart disease and other long-term health problems.
I'm not saying that you should give up meat altogether--not at all! But Americans need to learn from other countries and eat a little less of it. There are lots of low-fat sources of protein that we can start incorporating into our diet in place of our beloved rib eyes. Meat makes up just 4 percent of total calories in low-income countries, versus 13 percent in high-income countries, and America eats more meat than any other nation on earth. In 2000, the average American ate 195 pounds of red meat, poultry, and fish a year, which is 57 pounds more than people ate just half a century earlier.15 We absolutely must work on getting that down to a much more reasonable figure.
The American obesity epidemic cannot be attributed to diet alone. Americans' lives are fast-paced and high-stress to a fault. Not only do we eat on the go, without considering what we're putting into our bodies, but we also neglect other important aspects of a healthy lifestyle, such as exercise and sleep. Do you know that not getting enough rest can influence your metabolism? The Spanish do. Their insistence on squeezing in a midday nap might be one explanation for their relative slimness. And daily exercise--even if that means walking eight blocks to the grocery store every time you run out of milk--is crucial in maintaining a healthy weight. Studies have shown that we need to walk at least 10,000 steps a day to remain fit and healthy, but many Americans barely break the 3,000-step mark.16
This must change, because as it is, our superconvenient, sedentary culture is triggering all sorts of health issues. Compared to people in just about every other country, Americans move very little. With advances in technology, our day-to-day physical activities have taken a nosedive. A high percentage of us have cars, and we use them even for the shortest errands--driving three blocks to buy a gallon of milk, when walking the same distance wouldn't take much longer. In contrast to many European cities, our urban centers are, for the most part, built for driving instead of walking. Gas is cheaper in the United States than in Europe, and we don't have the same harsh restrictions on parking as some European cities do. As a result, we take public transportation far less frequently, which might explain why Europeans average 237 miles per year on foot and 116 miles on bicycles, while Americans get roughly one-third of that exercise, walking only 87 miles and biking 24 miles per year. And you better believe those discrepancies add up over time.
Modern jobs also don't require the same expenditure of energy that jobs once did, with manual labor severely on the decline in most major industries. The rise of various technologies (satellites, computers, wireless Internet, telephones, faxes) has made it very easy for most workers to get through the day without ever getting up from their desks--except maybe to hit the vending machine. You can buy just about anything and even do all your banking without taking a step. Although it's true that these modern conveniences make our workdays more efficient, they might be having the opposite effect on our bodies.
WHAT WE CAN DO ABOUT IT
Now that you have the basic rundown of what exactly Americans are doing wrong, you're probably asking what you can do to make improvements in your own life. Well, that's exactly the answer I propose to put forth in this book. Over the next chapters, I will be addressing each of these problems, mostly by way of contrasting Americans' increasingly unhealthy habits with those of people around the world--people who live longer and, not so coincidentally, weigh less than we do. Examining other countries' dietary and lifestyle secrets will reveal the key to keeping all of us healthy and slim through the decades.
The World's Healthiest People
Now that you have some sense of what we're doing wrong, I want to introduce you to the places where people are eating better and living longer, healthier lives. According to the CIA's World Factbook, these are the places that have the highest life expectancies in the world, ranked in order:1
1. Macau (84.36 years)
2. Andorra (82.51 years)
3. Japan (82.12 years)
4. Singapore (81.98 years)
5. San Marino (81.97 years)
6. Hong Kong (81.86 years)
7. Australia (81.63 years)
8. Canada (81.23 years)
9. France (80.98 years)
10. Sweden (80.86 years)
11. Switzerland (80.85 years)
12. Guernsey (80.77 years)
13. Israel (80.73 years)
14. Iceland (80.67 years)
15. Anguille (80.65 years)
16. Cayman Islands (80.44 years)
17. Bermuda (80.43 years)
18. New Zealand (80.36 years)
19. Italy (80.20 years)
20. Gibraltar (80.19 years)
21. Monaco (80.09 years)
22. Lichtenstein (80.06 years)
23. Spain (80.05 years)
So where, you might be asking, does the United States fall on this list? The answer is pretty grim.