Obesity is a major problem worldwide. And with an obesity rate of 36% in the United States—the 12th worst in the world—we desperately need to make changes in our country, not just for the young adult age group (20-44), but starting with our youth.

In an article published in the Journal of the American Medical Association (JAMA) this past March, researchers noted that declines in cardiovascular mortality have stagnated in the U.S. over the past decade, in part related to worsening risk factor control in older adults (including high blood pressure, diabetes, elevated blood lipids, obesity and tobacco use). 

Also, it was noted that American life expectancy is now its lowest since 1996 (76.4 years). But surprisingly, among 12,924 U.S. young adults (50.6% of whom were women) referenced in this study, the prevalence of high blood pressure had risen from 9.3% in 2009-2020 to 11.5% in 2017-2020. The percentage of diabetes had risen from 3% to 4.1% during the same period. The greatest change in this younger age group was their obesity, increasing from 32.7% to 40.9% by 2017-2020.

The researchers go on to recommend promoting focused prevention programs early in adulthood and the need for innovative and effective strategies to address them. The time is now to embrace more aggressive measures in young adults and adolescents.

Sound familiar? You probably recall that I have been emphasizing prevention as primary care medicine—as practiced here at Cooper Clinic in Dallas—for nearly 53 years. During that time, I have said many times to all types of audiences that it is cheaper and more effective to prevent disease than it is to find a cure!

There are many medical problems associated with obesity. In addition to heart disease, diabetes and cancer, obesity can also cause liver damage. For years we have known of damage to the liver that readily occurs with excess alcohol consumption, resulting in life-threatening cirrhosis. But did you know there is a condition called non-alcoholic fatty liver disease (NAFLD) which also can cause cirrhosis of the liver? This has been referred to as the “quiet liver disease.” 

This disease affects between a quarter and a third of the U.S. population according to estimates, and rates are rising in adults in their 20s—as well as in children! Non-alcoholic fatty liver disease is also the leading cause for liver transplants in women, research shows.

Experts say patients often lack symptoms and that raising awareness is essential to help them get the care they need to manage progression. But if symptoms occur due to advanced disease, they are typically fatigue, aching in the upper right abdomen, yellowing of the skin and eyes (jaundice) and unexplained weight loss.

Among patients with NAFLD, Hispanic Americans display the most cases, and we are seeing this in Hispanic children along the Rio Grande Valley. In fact, NAFLD is the most prevalent liver disease in children according to the Liver Disease Foundation—with estimates of 5-10% of American children diagnosed. Remember, children and young people are at a greater risk if they are overweight, have Type 2 diabetes (which is related to obesity), a poor diet and lack of exercise.

So, if you can’t practice prevention by following our eight healthy steps to Get Cooperized (accessible at CooperAerobics.com), at least eliminate obesity and inactivity, and certainly control alcohol. And don’t believe that preventive medicine is the “Cinderella (or poor sister) of the medical specialties,” as I was taught in medical school. It is the key to good health care. Unfortunately, there are more profits to be made in treating disease than in promoting prevention. 

And since I mentioned the role of alcohol in causing the cirrhosis of the liver, let me conclude by sharing with you what Paul says in Ephesians 5:18: “Don’t be drunk with wine, because that will ruin your life. Instead, be filled with the Holy Spirit.” ©2023 Kenneth H. Cooper

Kenneth H. Cooper, M.D., MPH, known worldwide as “the father of aerobics,” is the founder and chairman of Cooper Aerobics in Dallas and chairman emeritus of The Cooper Institute.

The Scripture is taken from the Holy Bible, New Living Translation, ©1996, 2004, 2015, by Tyndale House Foundation. Used by permission of Tyndale House Publishers, Carol Stream, Illinois. All rights reserved.

Exercise & Diabetes

Since obesity is commonly associated with Type 2 diabetes (formerly called adult onset diabetes, now known as Type 2, because it is commonly seen in obese children), is there any value in exercise? 

A study conducted in China more than 10 years ago consisted of a clinical trial of a 12-month intervention with three groups of people. The control groups included those involved in vigorous aerobic exercise, moderate aerobic exercise and non-exercise. At the end of the 12-month active intervention, all participants were encouraged to continue with healthy lifestyle and moderate intensity aerobic exercise.

At the 10-year follow-up to this study, the result in the vigorous aerobic exercise group was a 49% reduction in the risk of diabetes, compared to the non-exercise group. In the moderate aerobic exercise group, that reduction was 53%, compared to the non-exercise group. Bonus: moderate exercise also trimmed liver fat in the initial one-year study, because the participants lost weight!