The Last Lean Americans

Colorado’s obesity rates are the lowest in the country—but are we really as healthy as we think? Plus: We surveyed 400 Coloradans about their everyday health habits to see how—and why—our state has stayed on the good side of skinny.

October 2010

This article won a 2011 Top of the Rockies Excellence in Journalism Award.

Walk down just about any street in Denver or Boulder and you’ll see the evidence: Skinny people are everywhere. Young, slender women in yoga pants. Athletic-looking men in form-fitting T-shirts. Retirees out for a morning jog in Wash Park. It’s long been known—and proven time and again—that Coloradans (especially in the Denver metro area and the mountain counties) tread more lightly on the scale than almost any other American population. It’s true that on other streets in other cities in other states, time and again—that Coloradans tread more lightly on the scale than the residents of almost any other American state. On other streets in other cities in other states, the battle that Americans are losing with obesity is much more evident—and dire. The muffin-tops, the beer bellies, the thunder thighs: All are ubiquitous signs that Americans are facing an epidemic of flab. So why are Coloradans faring better?

The answer to that question is more complicated than one might think. When Washington, D.C.–based nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation released their “F as in Fat” report in June of this year, the fact that Colorado’s obesity rates were the lowest in the country was big news. “I think some people see a report like that and think it’s cause for celebration,” says Maren Stewart, the president and CEO of LiveWell Colorado, a nonprofit focused on reducing obesity. “But if you dig deeper, I see it as a cause for concern.”

It’s difficult not to agree with her. Although the study ranked Colorado as the leanest state, the report plainly showed that 19.1 percent of Coloradans are considered obese. Not chubby. Not carrying 10 extra pounds. Obese. Which means that excess fat has built up in the body to the point that it can negatively affect one’s health and shorten one’s life expectancy. Diabetes, heart disease, and cancer can result from a body mass index (BMI)—a measurement that compares height and weight—of more than 30, which is diagnostic for obesity. In fact, the Centennial State’s obesity rates have nearly doubled since 1995, which means our state is actually getting fat faster than the rest of the country. To make matters worse, our childhood obesity rates are startlingly bad: According to the Colorado Health Foundation, in the past handful of years our children have gone from the third leanest to the 23rd leanest in the nation.

Of course, that we are still comparatively trim is a good thing. “Colorado is uniquely positioned to look at these rising rates—and stop them,” Stewart says. “We are not too far gone at this point.” But obesity is a complex issue. Not only do we not know for certain why Coloradans are leaner (see the “High Altitude, Low Weight” sidebar on page 79 for possible explanations), but there is also no foolproof method to combat this complicated health matter. “It’s not fixed with a drug, and it’s not fixed with a good ‘Don’t Smoke’ message like tobacco,” Stewart says. “You can’t tell people not to eat. And that’s the real challenge.”

Instead, organizations like LiveWell Colorado, the Tri-County Health Department, the Colorado Health Foundation, and the Colorado Department of Health and Environment are trying to find ways—through funding, policy changes, and legislation—to help Coloradans make healthier choices and to provide access to healthier food. “It’s not hard to determine the reasons why and how Americans are becoming obese,” says Eric Aakko, director of the physical activity and nutrition program at the Colorado Department of Public Health and Environment. “But it’s difficult to change those reasons.” For decades America has been building itself to be reliant on cars. People moved away from cities. And they didn’t want their suburban homes nestled next door to commercial buildings. Walking to, well, anywhere became impossible. “Essentially, we engineered activity out of our lives,” Aakko says. Add to that the proliferation of inexpensive, high-calorie, processed foods, and you have a recipe for a fat population.

Now, experts say we have to swing back the other direction. We need to decrease our intake of processed foods, a step that involves more than just choosing a salad over a frozen dinner for many people. “Where there are high rates of poverty, there will be high rates of obesity,” Aakko says. “There is often a lack of access to grocery stores in impoverished areas, which means a lack of access to fresh foods. People often end up shopping at the corner store, where the best thing they have is an old brown banana.”

We also have to focus on what experts call the “built environment,” a principle of community design that encourages physical activity. “It’s not enough to have trails,” Stewart says. “Those trails must connect to each other, and to sidewalks and to bike lanes, and ultimately to places people need to go so that people can get around without a car.” Tista Ghosh, a medical epidemiologist with the Tri-County Health Department who’s researching obesity, agrees. “The grocery store could be right across the street, but if that street is an eight-lane highway and there’s no other way to go, people will not make that walk,” she says. But redesigning our environment to fit these specifications can (and will) take many years—years that some Coloradans in particular, and Americans in general, may not have in the fight to counteract obesity.

Which is why we wanted to find out how healthy Coloradans—the ones who seem to be keeping our obesity rates lower than normal—stay that way. Earlier this year, we partnered with Resolution Research, a Denver market research firm, to survey 400 Coloradans about their health habits. We asked these Coloradans about everything from how much they exercise to what they snack on. We also administered a survey at 5280.com to 412 of our readers to see how their answers differed. Then we, along with the help of some of this year’s Top Doctors (our annual list begins on page 80), examined their answers. The results were insightful, surprising, sometimes mystifying, and, we hope, ultimately helpful to anyone who needs a nudge in a healthier direction.

The Lean Coloradan

Hoping to delve into the mystery of why our state has stayed on the good end of skinny, we surveyed 400 residents about their health habits. Here’s what they said.

To participate in the survey, respondents had to consider themselves either moderately or very healthy; they must have never experienced obesity-related illnesses or obesity-related symptoms; and they had to agree that they exercised at least one time per week.

Methodology: To participate in the survey, respondents had to consider themselves either moderately or very healthy; they must have never experienced obesity-related illnesses or obesity-related symptoms; and they had to agree that they exercised at least one time per week.

Resolution Research administered this survey in collaboration with 5280’s editors. Resolution Research is a full-service market research firm specializing in qualitative and quantitative research designed to gather market intelligence and opinions. Resolution hosts www.resolutionpanel.com, a market research panel, and invites your participation to help influence the policies, products, and services offered by organizations across every industry. Resolution Research conducts online surveys, telephone surveys, focus groups, product tests, taste tests, clinical trials, mock juries, bulletin boards, and more. Client industries include the medical community, media, technology, utilities, higher education, retail, service businesses, and government institutions. For more information, visit www.resolutionresearch.com, e-mail [email protected], or call 1-800-800-0905.