West Virginia calls on disease investigators for obesity problem

CHARLESTON, W.Va. -- West Virginia, a state with one of the worst obesity problems in the country, has called in the big guns for help. For the first time ever, federal disease investigators in Atlanta are studying obesity, just as they would investigate the rapid spread of an infectious disease.

"We didn't suddenly realize we have this problem," state health official Keri Kennedy said Friday. "But we are facing a severe health crisis and this is a new way of looking at it."

West Virginia is consistently among the top three states in the nation for obesity, according to the Centers for Disease Control and Prevention and the state Bureau of Public Health. In 2002, the latest data available, 28 percent of West Virginians were considered obese.

The extra weight can lead to high blood pressure, diabetes, arthritis, some cancers and other problems. West Virginia leads the nation in high blood pressure and is fourth in diabetes.

"Health officials in West Virginia appropriately recognized that they had a serious problem with obesity in their state, and they really wanted to do more than just describe it," CDC director Dr. Julie Gerberding said on Thursday.

She said the state "wanted to get a team of people in there to ... use our best epidemiologic disease detective science to profile where the problem was, how is it growing, who had it, how bad was it, and really get a much deeper understanding of it."

Three CDC investigators teamed with Kennedy and two other state health officials for three weeks in April and May. The teams visited schools, businesses, restaurants, grocery stores, parks and communities. Gilmer County with its 7,160 residents was chosen as the rural site and Clarksburg with 16,743 residents was the urban site.

"People grew up on gravy and biscuits and they think they still need it, but they don't do the exercise they once did to work it off anymore," said Rose Clark, a health coordinator at United Hospital Center in Clarksburg. The hospital has been offering gastric bypass surgery since last year, Clark said.

Obesity, defined as having a body-mass index above 30, also is spreading among West Virginia's children. Nearly 43 percent of 5,887 children screened in a coronary artery risk project from 1999-2002 were considered overweight and more than 25 percent were obese.

"The purpose was not so much to determine what we already know and that is that poor nutrition and physical inactivity can lead to obesity," CDC spokesman Llelwyn Grant said Friday.

The purpose was to find out whether people have access to healthy food and exercise options, he said.

At schools, investigators wanted to know about physical education programs and food offerings, such as how many servings of fruits and vegetables were available daily.

For Tim Butler, principal of Normantown Elementary School in Gilmer County, the project made him reconsider food rewards given to the school's 150 students.

"I never saw a kid work hard for vegetables and fruits," Butler said. "Brownies, cookies, pop, that's what they like.

"I guess we should set an example, even with homeroom parties, to make sure there are healthy choices instead of just the greasy, fattening foods we usually offer."

At businesses, they asked about policies that encourage exercise, and at groceries and restaurants, the team checked on whether lowfat dairy was available.

The investigators also looked at recreational opportunities and whether towns had sidewalks and street lights for walking at night.

Michael Meit, director of the Center for Rural Health Practice at the University of Pittsburgh at Bradford, who has studied obesity in rural areas, says simply living in a rural setting often makes being healthy more difficult.

"The issue of food selection in rural areas is a big challenge," Meit said. "They tend to have smaller grocery stores with less selection, and exercising outdoors can be difficult because of the terrain and there are no malls for walking."

The CDC is analyzing the West Virginia data and should provide information to state officials in August that will be used to develop a kit communities can use to assess their environments, Kennedy said.

The investigation offers promise in identifying targets for intervention, said Harvard University obesity researcher Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women's Hospital.

"We know that individual lifestyles play a role in obesity," she said, "but we also know that efforts to make dietary and physical activity changes have not turned this epidemic around."

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On the Net:

www.cdc.gov/nccdphp/dnpa/obesity/state--programs/west--virginia.htm