Obesity in the Headlines

December 14, 2003 - Appleton Post-Crescent

Health problems, costs expand along with residents' waistlines
Wisconsin's culture feeds obesity trend

By Shawn Rhea
Post-Crescent staff writer

It was a dreary morning, but Ryann Goodrich, 29, was wearing a smile that beamed brightly as he took his daily walk through Fox River Mall in Grand Chute.

A year ago, walking the mall was impossible for the Appleton resident, but in December 2002 Goodrich underwent bariatric surgery (so-called gastric bypass) and has since lost 286 pounds.

Losing the weight freed Goodrich of a host of medical problems. It also forced him to come to terms with how he became so dangerously large. What he unearthed was a life filled with comfort foods, particularly the kinds for which Wisconsin is famous.

"My Mom gave me the name 'Mouse' because I ate so much cheese," he said.

By his own estimate, he typically ate a Velveeta-sized brick of whole-fat cheese every two to three days. There were also summer sausages, bologna sandwiches, whole milk, burgers and large servings of pasta and noodles.

Statistics show excess weight and obesity are growing problems for Wisconsinites, who are nurtured in a culture of beer, brats and butter.

In 2001, Wisconsin ranked as the 13th heftiest state, with 20 to 24 percent of residents qualifying as obese, according to the Centers for Disease Control and Prevention. Preliminary data being compiled by the state for a report next year ranks Appleton as the state's heaviest city, with 64.4 percent of adults categorized as overweight or obese.

The number of Wisconsinites who are morbidly obese (carrying an excess of 100 pounds or more) has increased eightfold in the past decade, with 92,000 residents fitting the definition.

Chetna Mehrotra, a state epidemiologist collecting data on weight and obesity, says Wisconsin's food culture is partly to blame for residents' expanding waistlines.

"You have to look at the diets. If (residents are) consuming the typical Wisconsin diet of a lot of beer and brats then that may explain part of it," said Mehrotra.

The added pounds are a recipe for health problems and financial costs that go with treating them.

In 2002, obesity-related health problems, such as heart disease, diabetes, hypertension, muscular-skeletal problems and sleep apnea, cost the United States roughly $93 billion, according to an analysis underwritten by the CDC.

Late last year, Goodrich's health problems became so significant he failed his state Department of Transportation physical and was laid off from his job as a truck driver. He's been on disability for a year, working to get down to a healthy weight.

A heavy history

Wisconsin is known for its rich history of foods and delicacies brought over by European settlers. With the Swiss came the art of cheese making and dairy farming, and the Germans brought their flavorful bratwurst and beer-making recipes.

Hungarians carried over their rich noodle and dumpling dishes, while the Irish and the Danish brought potato pancakes and kringle pastries, respectively.

Those and other rich, fatty foods nourished generations of Wisconsinites who performed heavy farm work, producing much of the country's dairy goods. The starch-heavy dishes were often the only option for families during the winter months, when farmland was too frozen to produce fresh vegetables and fruit.

Passing down those time-honored foods has helped keep Wisconsin's heritage alive. But in recent decades those eating traditions also have helped birth a growing population of obese and overweight residents.

"The cheese curds, the bratwurst, the things that have the high fat content are staples in this area," said Dr. Ray Georgen, co-director of Midwest Bariatric Solutions in Neenah.

"I think why we didn't see the obesity problem here (during earlier generations) was because of the labor involved in farming. The output was much higher," said Appleton city health officer Kurt Eggebrecht. "I think unless you make an effort to modify the fats in those recipes you're in trouble."

Farm raised

Maryann Schubert, 62, grew up on a farm in Fond du Lac. "It was very small - only 40 acres," said the Darboy resident of her childhood home. "(We had) a few chickens, so we had eggs, (and) a small milking herd - like eight or 10 cows."

Farming was extremely physical work, but as the oldest girl Schubert was given the responsibility of helping her mother cook for the family.

On a typical day, Schubert said, they might have had a breakfast of eggs and raw-fried potatoes. Because they lived on a tight budget, she and her siblings often were sent to school with sandwiches made of white bread, butter and sugar - staples that the family purchased or produced en masse.

Dinnertime often featured starchy foods.

"We didn't have a lot of meat. We had potatoes a lot - potatoes and sauerkraut, potato pancakes, creamed potato soup, potato dumplings," Schubert said. "Two or three times a week, we'd usually have dessert, and that would be like applesauce cake with hickory nuts."

While the high-calorie meals had little effect on her siblings, who were burning them off through farm work, Schubert says being responsible for the meals meant she got less exercise and she began to gain weight.

The weight gain escalated as Schubert got older, especially around harvest and slaughter times when her family would visit relatives to help with the farm work.

Once again, Schubert's job was to help prepare food for the rest of the family.

"There were these spreads and you had to eat or it was insulting," she explained.

Following her family's German cooking tradition, Schubert cooked by taste and rarely measured things. "It was a skosh of this, a dash of that."

Taste testing only added to Schubert's weight problems, and she carried her habit of cooking for large groups of people into her adult life.

"I don't think I ever got cooking for four (people). I was cooking for 10. I never got the (large) portions out of my mind."

New day, old habits

Obesity experts say the tradition of cooking in large quantities - which decades ago served farming families well - is still informing the eating habits of many Wisconsinites.

"When I go to the grocery store and see somebody who has four gallons of milk in their cart, even if they have a very big family, they're really overdoing it," said Shawn Boogaard, University of Wisconsin-Fox Valley Family Practice health educator. "The serving size of cheese is the size of a domino, (but) people look at it and laugh, and say, 'That's just the testing.'"

Added to the problem of over-consumption is the fact that too few people exercise their option to purchase healthier versions of their favorite foods.

"Dairy products are really wonderful products when you look at the protein, but a lot of the people I see are drinking the full fat (milk)," Boogaard added.

The demand for quantity also is driving what area restaurant owners are placing on diners' plates, said Kimberly Swanson, coordinator of the state's nutrition and physical activity programs.

"It's those super-sizing of portions," she said of what's adding to the waistlines of Wisconsin residents.

Swanson was quick to note, however, that super-sizing is not a practice that's unique to Wisconsin. "We're not that different from what's happening elsewhere."

Terence Broxterman, 32, said he experienced a definite shift in food culture when he and his wife moved to the Fox Valley from California six years ago.

"When you go to a restaurant like Victoria's or La Bamba the portions are out of control," said Broxterman, who was used to eating lighter fare and smaller portions when he dined at restaurants in California.

A visit to any number of Fox Cities restaurants shows eateries have plenty of competition when it comes to large portions and all-you-can-eat menus.

The Machine Shed in Grand Chute has a menu that features sizable servings of "Farm Style Favorites" such as baked ham, fried chicken, biscuits and gravy throughout the week, while Paretti's in Appleton offers up pasta-heavy, all-you-can-eat buffets.

On Friday evenings, popular fish fries like the one held at the Veterans of Foreign Wars Hall in Appleton draw diners from all over the Fox Valley.

Broxterman, who moved to Appleton to accept a marketing job, said that between the frequent potlucks at work and dinners and drinks with coworkers and clients he gained 20 pounds during the first six months of his relocation.

"In California, you'd go out for a beer and it was quite literally a beer. Here, you'd run into people who thought nothing of going out for five or six beers during the week."

According to state epidemiologist Mehrotra, during the same 10-year span that more and more Wisconsinites were becoming morbidly obese, a study found that serving sizes in restaurants increased by as much 30 percent.

Earlier this year, researchers at the University of North Carolina at Chapel Hill published findings that said the size of the average fast-food hamburger increased from 5.7 ounces in 1977 to 8.4 ounces in 1996. Consuming a burger, fry and soft drink today will pack on 214 more calories per meal than it did 25 years ago.

The blame game

While dietitians and public health officials agree that super-sizing is a main contributing factor to Wisconsinites' expanding waistlines, most are reluctant to blame the restaurant industry for the weight gain epidemic. "I think (restaurants) are a key partner (to addressing the problem). I don't think it needs to be adversarial," said Wisconsin public health officer Julie Hladky.

Two years ago, Hladky chaired the Overweight/ Obesity Subcommittee for Wisconsin's implementation of the federal government's 2010 health initiative. Some of the committee's recommendations for addressing portion distortion among residents and dining establishments was for the state to consider giving financial incentives, such as tax write-offs and subsidies, to schools and worksite cafeterias that offer well-balanced, properly sized cuisine.

"We did talk about encouraging restaurants to provide healthier food options, but as an option, not a mandate," Hladky said.

Wisconsin Restaurant Association President Ed Lump believes that restaurants already offer reasonable portions and healthier fare as options.

"Twenty years ago, Wisconsin's white linen restaurants used to be steak and potatoes," he said.

"Now you have more fish and salads. You do see more restaurants offering smaller portions and substitutes."

But Lump said these options are rarely among the popular menu items.

"There's no question that a lot of consumers look at value. That's one of the appeals of the buffet. They say, 'OK, how much can I get for my money.' That's not something the restaurant owner dreams up. That's driven by consumer demand."

Shawn Rhea can be reached at 920-993-1000, ext. 526, or by e-mail at srhea@postcrescent.com.