1. Why is obesity a political problem? Cheap food? Corporate profits? Health care costs?

5. The leading causes of death

6. Actual causes of death 1990 and 2000

7. The Economic Burden of CVD Heart disease CAD Stroke HTN CHF Total CVD $0 $50 $100 $150 $200 $250 $300 $350 Billions $368 $239 $133 $54 $56 $29 CAD, coronary artery disease; CHF, congestive heart failure; CVD, cardiovascular disease; HTN, hypertension. Heart Disease and Stroke Statistical 2004 Update. American Heart Association. CAD, coronary artery disease; CHF, congestive heart failure; CVD, cardiovascular disease; HTN, hypertension. Heart Disease and Stroke Statistical 2004 Update. American Heart Association.

8. Prevalence of Diagnosed Diabetes Among US Adults,1991-2001

10. (*BMI  30, or about 30 lbs overweight for 5’4” person) 1995 200 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. Adults BRFSS, 1991, 1996, 2003 2005 Source: Behavior Risk Factor Surveillance System, CDC

11. Prevalence of the Metabolic Syndrome in the US Ford ES, et al. JAMA 2002;287:356-9

12. Metabolic Syndrome Costs Genetics Environment Hypertension IGT IFG Early DM Obesity Late DM Fertility drugs Aspirin Herbal supplements OTC Phentermine Orlistat Sibutramine Resins Fibrates Statins Niacin OTC Ezetimibe Diuretics Ace inhibitors Beta blockers Alpha agonists ARBs Other Insulin Glitizones Sulfonylureas Biguanides Others Fluoride Pesticides Antibiotics Fertilizers Sunblocks Antireflux Dyslipidemia HDL-C TG

13. Genetics Environment Hypertension IGT IFG Early DM Obesity Late DM Fertility drugs Aspirin Fluoride Pesticides Antibiotics Fertilizers Sunblocks Antireflux Herbal supplements OTC Phentermine Orlistat Sibutramine Resins Fibrates Statins Niacin OTC Ezetimibe Diuretics Ace inhibitors Beta blockers Alpha agonists ARBs Other 3.99 + $80.00 + $29.99 + $138.29 + $9.99 + $61.99 + $79.95 + $89.79 = Insulin Glitizones Sulfonylureas Biguanides Others $493.99 per month Dyslipidemia HDL Trig

18. This is the sacred cow of dietary advice And I am sad to say I have to kill this poor cow. homework.uoregon.edu:8080/dchat/images/cow.gif

21. What is in our food supply? We add 77.2 grams of fat and 29.7 grams of caloric sweeteners per capita into our food supply. This makes high calorie food very cheap! Source: USDA (2006)

22. The simple carbohydrate breakdown Early in 2005 a pound of beet sugar cost 24 cents but high fructose corn syrup cost about half as much 13 cents a pound. HFCS has become a very common and cheap sweetener.

24. The fiber trend… since 1907 We took out the fiber then put it back in

28. What do we eat? Males Females The calories we consume come from 49 %(males) to 52% (females) from carbohydrates {half that from sweeteners} 32.8% from fat 17.9 (males) 20.3 (females) from protein

29. How many calories do we eat? The average male consumes 2618 calories daily. The average female consumes 1877 calories daily.