Rural Mississippi is the country's fattest state for the seventh year in a row, according to an annual obesity report issued Thursday. Colorado, a playground for hikers and outdoor enthusiasts, is the nation's thinnest.
The report by two public health groups has again delivered bad news: The nation is getting bigger and bigger every year. And looking at state-by-state statistics over the last 15 years, the groups found exponential waistline growth _ Colorado, with 19.8 percent of adults considered obese according to 2010 data, would have been the nation's fattest state in 1995.
"When you look at it year by year, the changes are incremental," says Jeffrey Levi, executive director of the Trust for America's Health, which writes the report with the Robert Wood Johnson Foundation. "When you look at it by a generation you see how we got into this problem."
The study says a dozen states topped 30 percent obesity in 2010, most of them in the South. Alabama, West Virginia, Tennessee and Louisiana were close behind Mississippi. Just five years ago, in 2006, Mississippi was the only state above 30 percent.
Jim Marks of the Robert Wood Johnson Foundation said the numbers have skyrocketed over the last couple of decades because of the growth of portion sizes and the ready availability of unhealthy foods. Schools have ditched physical education programs and school lunches have gotten less healthy.
No state decreased its level of obesity, which is defined as a body mass index of 30 or more. The body mass index is a measurement based on a calculation using a person's weight and height. A person who is 5 feet 5 inches and weighs 150 pounds would have a body mass index of 25, for example, but if that person weighed 180 pounds the BMI would be 30.
Although body mass index isn't always the best indicator for someone with a lot of muscle, such as an athlete, it is considered the best way to measure the general population. The authors of the study say it allows them to measure large numbers of people because those surveyed can easily provide their height and weight.
There was a bit of good news in the report: Sixteen states reported increases in their obesity rates, down from 28 states that reported increases last year. Levi says those increases have been gradually slowing, most likely due to greater public awareness of health issues and government attempts to give schools and shoppers better access to healthier foods.
"We're leveling off to some degree at an unacceptably high level," Levi said.
First lady Michelle Obama has tackled the issue with her "Let's Move" campaign, pushing for better school lunches, more access to fruits and vegetables and more physical activity. And Congress last year passed a new law requiring school lunches to be healthier. Republicans in Congress have pushed back somewhat against some of those programs, however, saying a rewrite of school lunch rules is too costly and questioning an Obama administration effort to curb junk food marketing aimed at children.
As in previous years, the study showed that racial and ethnic minorities, along with those who have less education and make less money, have the highest obesity rates. Adult obesity rates for African-Americans topped 40 percent in 15 states, while whites topped 30 percent in only four states. About a third of adults who did not graduate from high school are obese; about a fifth of those who graduated from college are considered obese.
Dr. Mary Currier, Mississippi's state health officer, says her state has struggled to drop its No. 1 status and it has been challenging because much of the state is poor and rural.
"We live in an area of the country where eating is one of the things we do, and we eat a lot of fried foods," she said. "Trying to change that culture is pretty difficult."
She says the state has had some success by making school lunches healthier, taking high-calorie foods and drinks out of school vending machines and trying to find more low-cost exercise facilities for residents of rural areas.
"It is frustrating, but we've had some progress," Currier said. "We just have to continue to work at this. It's not something that's going to change overnight."
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Trust for America's Health: http://healthyamericans.org
Calculate your body mass index: http://www.nhlbisupport.com/bmi