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Health Report: Obesity Becomes A Problem; New Freedoms Pose Risks; AIDS In Uzbekistan On The Increase

U.S. officials plan to focus resources in the coming year on what experts call an epidemic of obesity and its attendant adverse health effects. Obesity is rapidly becoming a major public health concern in Europe and parts of the former Soviet Union as well. In this week's RFE/RL Health Report, Correspondent K.P. Foley interviews a U.S. expert about the scope of the problem. The report also includes a look at a recent United Nations survey on the health and well-being of children and young people in the former communist countries, and concerns over an increase in HIV infections in Uzbekistan.

********** U.S. To Develop Plan To Combat Obesity And Overweight

Washington, 11 January 2001 (RFE/RL) -- U.S. Surgeon General David Satcher says overweight and obesity have reached epidemic proportions in the United States, nearly doubling since 1980.

Satcher is the nation's chief public health officer and he says it is imperative that the U.S. develop a national strategy to "implement obesity prevention efforts that focus on the family and community, schools, work sites, the health care delivery system, and the media."

In an RFE/RL interview, the director of the Division of Nutrition and Physical Activity at the U.S. Centers for Disease Control, Dr. William Dietz, described the extent of the problem in the United States.

"Over 50 percent of our population have a Body Mass Index greater than 25, which indicates that they are overweight, and about 25 percent of the U.S. population has a Body Mass Index greater than or equal to 30, which classifies them as obese."

The Body Mass Index (BMI) is a ratio of weight to height. It is obtained by dividing weight in kilograms by height in meters squared.

Dietz says research has led public health experts to believe that obesity is linked to a range of debilitating and often fatal conditions.

"The concern that we have about this problem is that obesity is associated with a variety of chronic diseases such as heart disease, stroke, cancer, and diabetes; and already we're beginning to see an increase in diabetes that reflects the increase in obesity."

Dietz says obesity and obesity-related illnesses account for 5 percent of the annual U.S. medical bill. Obesity's total economic burden, including medical and lost work productivity, is an estimated $99 billion annually.

Dietz says obesity is a relatively new phenomenon and experts have not yet settled on a cause. However, he says changes in the way Americans live -- changes mirrored in many other industrialized societies as well -- may play an important role.

"We know that the epidemic of obesity in the United States has occurred coincident with a variety of other changes in the way we live, so that, for example we're much more reliant on fast food today than we were 20 years ago, and in general fast food tends to be high in calories and high in fat. We're consuming twice as much soda today as we consumed 20 years ago. We're considerably less active than we were 20 years ago."

The physician says obesity also has a genetic component, but he says that, in his view, "that makes people susceptible to obesity, it doesn't cause obesity."

Experts assert that it is essential for Americans to increase their levels of physical activity. Dietz says activity is a preventive measure.

"We believe that increases in physical activity are essential not only to prevent obesity but we know that people who are more physically active are less likely to suffer the complications of obesity."

********** Experts Recommend Body Measurements As Predictive Tool

In a related story, experts at the U.S. Centers for Disease Control (CDC) -- along with experts in 10 other countries -- recommend the use of body measurements, such as Body Mass Index (BMI) and waist circumference, to predict the likelihood of death and disease.

Dr. Frank Vinicor of the CDC's diabetes program said the use of the BMI and the waist circumference measurement "consistently identify the health risks of excess weight." He said these are simple, inexpensive and reliable tools for doctors to use to assess the state of their patients' health.

The Body Mass Index (BMI) is calculated by dividing weight in kilograms by height in meters squared. Waist circumference, experts say, adds more health risk information by pointing at body fat distribution around the abdominal area.

The CDC believes that because many adults visit their family doctor at least once a year, routine monitoring of BMI and waist measurement may help doctors practice prevention. The CDC says changes in weight or other body measurements could signal a potential health hazard, such as the type of diabetes that develops in adulthood. Timely information could help a family doctor devise treatments that might reduce risks.

A recent study by CDC found a 33 percent increase in diabetes in the U.S. The study said the increase was strongly linked to increases in obesity.

********** UNICEF Publishes New Report On East European Youth

The United Nations Children's Fund (UNICEF) says the transition from communist systems to market economies has opened up social and economic opportunities for young people in the former communist countries of Eastern and Central Europe and the former Soviet Union, but UNICEF also says that school dropouts and unemployment are on the rise.

The report entitled "Young People in Changing Societies," was published by UNICEF's Innocenti Research Center in Florence, Italy. UNICEF says the report looks for the first time at the what has happened over the past decade to the estimate 65 million people aged 16-24 who live in the 27 countries of the region.

UNICEF Executive Director Carol Bellamy says: "This generation is often portrayed as the natural winners of the transition, and they are. But we are concerned for the thousands of young people who are falling through the cracks: the drug addicts, street children, young prostitutes, long-term unemployed, and those who are HIV-positive. Their numbers are growing."

The UNICEF report says the countries that have made the most progress offer young people greater opportunities in education, business, and politics. However, the report also warns that new freedoms have meant new risks including hazards almost unknown to earlier generations: unemployment, drugs and other substance abuse, and HIV infection.

UNICEF says the health of this young generation is under threat from what the World Health Organization fears is an impending explosion of HIV and AIDS in a region which was one of the least affected parts of the world just a few years ago. International health experts say that In most Central and Eastern European countries the number of new cases registered each year is low but rising. But, in some former Soviet states, particularly Ukraine and Russia, infections are increasing significantly. There were an estimated 360,000 cases in the region at the end of 1999.

The report also says alcohol, drug and tobacco use are also on the rise in many countries in the region as is the suicide rate. UNICEF says that in 16 countries, youth mortality rates stood at lower levels in 1998 than in 1989. That list includes the Baltic states and all countries of Central Europe. In 11 countries, youth mortality rates were higher than a decade ago, largely in former Soviet states such as Russia, Ukraine, Belarus, Azerbaijan, Kazakhstan, and Turkmenistan.

********** UN Concerned About HIV In Uzbekistan

Islamabad -- A United Nations expert on HIV and AIDS fears Uzbekistan could see an increase in HIV infections unless the nation takes action to counter the threat.

The report comes from the Integrated Regional Information Networks, a UN news agency. The report quotes Rudick Adamian, the Uzbek adviser for the UNAIDS program, as saying that 228 HIV cases had been detected to date. He said that is twice as many as last year. The infections were reported mainly in the town of Yangiyol near Tashkent and in the capital itself.

HIV is the English acronym for Human Immune Deficiency Virus. It is a communicable infection that weakens the body's natural system of defense against disease. HIV is transmitted from person to person via contact with contaminated bodily fluids such as blood and semen. Unprotected sex with infected partners and the sharing of contaminated syringes by drug users are blamed for the spread of the infection.

There is no preventive vaccine for HIV. It can lead to the condition known as Acquired Immune Deficiency Syndrome (AIDS), which is fatal and for which there is no known cure.

The UN official cautioned further that the number of cases in Uzbekistan does not reflect the real danger.

Adamian told the news service that: "You can not look at just these figures as there is an extremely high prevalence of HIV amongst drug users in Uzbekistan -- 80 percent to be exact. Given this dangerous prevalence I would describe this situation as serious. If proper measures are not taken, within a couple of days or months, this could get out of hand."

Adamian said the government's response to the crisis has been positive so far. He said the authorities are taking the situation seriously, expanding their own efforts and asking for more international help.

According to a UN report issued in December, 21.8 million people worldwide have died from AIDS and 36.1 million are currently living with HIV-AIDS infections.