The Tribune Democrat, Johnstown, PA

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July 14, 2013

The fat of the land

Cambria County men face one of the nation’s fastest-growing rates of obesity

JOHNSTOWN — An episode of “The Sopranos” came over the TV. The episode saw mob boss Tony Soprano worrying aloud – in Italian – about his weight and the ramifications it could have on his health.

It was an Italian broadcast that Dr. Matthew G. Masiello was musing over while vacationing in Europe – Masiello has been studying the effects of obesity for most of his professional career and this episode stuck out to him.

That episode aired on Italian TV in June, just two days before “Sopranos” star James Gandolfini died of a massive heart attack – also while vacationing with his family in Italy.

Masiello, the chief wellness officer at Windber Research Institute for more than 15 years, said someone should have said, “Cut!” when the actor’s weight could have spiraled into health problems. He said Gandolfini should have “gotten his act together.”

“We have the ability as a parent or physician to ‘stop production,’ ” he said, drawing a Hollywood parallel.

“At some point, responsible people have to say, ‘You are too big – you need to lose weight.’ ”

County’s disturbing trend

A recent study conducted at the University of Washington appears to show that responsibility has been in decline in Cambria County for quite some time. The study measured metrics as they correlate to obesity by U.S. county and the prevalence of physical activity.

Males age 20 and older in Cambria County ranked as some of the worst in the country in obesity prevalence, with the number of heavily overweight men jumping by 13.2 percent from 2001 to 2011 – the 10th worst metric result in the nation.

Joy Portella, spokeswoman for The Institute for Health, Metrics and Evaluation, said the study surveyed roughly 3.3 million people through state-based, random-digit phone calls. When adjusted for reporting bias through the National Health and Nutrition Examination Survey, which has a sample size of about 30,000 adults age 20 and older, a relationship between physical activity, diet and obesity began to take shape.

Why it’s happening

“We’ve found in our research that the No. 1 risk factor related to preventive ailments in Americans that cause death and disability is a poor diet,” Portella said, but said that doesn’t discount the importance of regular exercise in staving off cardiovascular disease and diabetes. “Physical activity is obviously an issue related to obesity. ... (But) diet is disproportionate to physical activity in regards to obesity.

“It’s a lot less of a correlation than anyone would think.”

According to Portella, measuring that poor diet – as per the study’s results – boils down to 14 different factors, which include too many salty foods and not getting enough vegetables and whole grains in the daily mix. Some could argue that simply cutting out the unhealthy meals is a matter of willpower or desire to maintain health.

Masiello has supervised programs that target obesity from the top down – educating parents and their children on best practices and working with psychologists and fitness experts, not to instill “healthy habits” but change mentalities. He said he’s encountered external factors that can affect a family’s diet.

“One, it’s the economy. Certainly there are families now that can’t afford the vegetables and fruits and other good, wholesome foods that may cost more than fast food,” he said. “It’s not a matter of stepping out for fast food because we’re busy – it’s what we can afford.

The second factor, Masiello said, is the media’s reinforcement of a tasty yet fattening diet in advertisements that are often targeted toward youths. He said he thinks all these elements are simply distractions from the meals that are the most positive and healthy – physically and mentally – those spent around the dinner table with family.

How to combat it

He said several studies have shown set dinner times that include the family simply make children better – better learners, more physically active and more mentally and emotionally fit.

“They’re spending time throughout the day talking about themselves and life,” he said. “Parents can offer sound advice to their children at least once a day over the dinner table.”

Masiello said the study’s findings don’t surprise him. He said what’s happening in Cambria County represents the greater national epidemic. Education about the dangers of obesity is not as strong a priority as it should be.

“It’s likely you’re going to die at an early age.  It’s likely you will have heart disease. It’s likely you will have diabetes,” he said, also explaining the weakening effect obesity can have on human bone, called demarrowization. “We don’t teach this to our mothers. We don’t teach this in our medical schools to the degree that we should.”

In the latest Community Needs Assessment, Masiello said national health statistic databases provided information to community leaders, stressing the effect obesity has on the county.

“We presented this data to them. We told them what we were doing to address obesity,” he said. “They agreed obesity was an issue. But there’s been a failure on multiple levels to address the issue of obesity. It’s at every level: the business level, the legislative level, the health care level, the educational level, the media level.”

Masiello said there is hope, however. It rests in leadership to address the issue on a larger scale.

“It just can’t be public health folks like us. We need the education leaders and the political leaders to take the advice that we give them. They need to lead the effort,” he said. “We know there are folks out there that can do this. We at Windber Research Institute will provide as much support and encouragement as we can.

“But those folks need to step forward.”

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