As we approach the end of the year and we start to contemplate New Year’s resolutions we must remember that nothing is as important as preserving our health.

It is a foregone conclusion that despite important clinical and surgical developments offered by modern medicine most of what we can do to remain healthy are individual decisions related to our lifestyle.

Avoidance of disorders relating to our lifestyle and behavior are extremely important to health preservation. The avoidance of tobacco, illegal drugs, and excessive alcohol consumption in addition to keeping an adequate diet and a suitable exercise program are the main elements for the maintenance of health.

In contrast to previous centuries when infectious diseases predominated, chronic diseases are now the most common causes of death in the U.S.

Obesity, which is now a major health concern, is responsible for or aggravates the most common chronic diseases such as diabetes, arthritis, heart disease, stroke and even cancer.

The frequency of diabetes is at an all-time high. This condition is the most common reason for kidney failure, responsible for most of the lower limb amputations and remains the leading cause of blindness in adults.

Under normal circumstances, body weight varies according to many factors but the most important is our height. That is the reason why in most instances we use Body Mass Index (BMI), a combination of weight and height, to identify individuals overweight or at risk for becoming obese.

We have placed on the Town Crier web site a BMI calculator for those readers interested in knowing their BMI.

There are lots of misconceptions about obesity. Some of my favorites are:

“Why should I bother, I’m grossly overweight, I will never be skinny.” The reality is that even a small weight loss of five to ten percent will benefit the obese person and lower the risk for chronic diseases.

“I can have that slice of pie tonight because I will take an extra walk tomorrow.” Well, plan for a very long walk. The classic portion of apple pie is about 415 calories. If you go “a la mode” you are adding 260 calories for a small scoop (1⁄2 cup) of vanilla ice cream. This brings that dessert to a grand total of 675 calories. You will have to jog almost six miles to burn those calories.

“I don’t have to worry about calories because I eat ‘good food.’” Although it is important to make healthy choices, incorporating fruits, vegetables, grains and meats in our daily diet, how much we eat is as important, or more important, than what we eat.

“My child is overweight but the excess fat will go away as he gets older.” Obese children very often continue to gain weight and become obese adults. Appropriate diet with positive reinforcement is important at all ages. No child (or for that matter, no adult) should be chastised because of his or her weight.

“I just heard of this terrific diet on the radio, you take a smoothie and the appetite goes away, people cannot stop losing weight.” Three Day Diet, Berry Diet, Cabbage Soup Diet, Hollywood Diet, Beverly Hills Diet and all the rest do not work. Fad Diets don’t work. At best they are a very temporary improvement and sometimes may be expensive and dangerous.

For most people, the most sensible way to diet is to eat a balanced meal incorporating all basic food groups and perhaps even more important to get accustomed to smaller portions. Portion control is the key to success.

In addition we should all (but critical for overweight individuals) adopt a practical exercise schedule. It is very difficult to maintain extreme efforts or actions, in either dieting or exercising.

Is weight control a case of individual or personal responsibility? Is obesity a case of personal irresponsibility or there are other contributing factors?

Most experts agree that although the individual must be an active participant to control his or her weight, corporate and societal factors played a very important role. There is little doubt that the food environment has changed dramatically over the last few decades.

Just the increase in portion size in restaurants and cafeterias, dramatic increase in the size and availability of sweet drinks coupled with very sophisticated advertisements especially targeting children has changed the environment dramatically from the experience of previous generations.

It is difficult to make a case that people have become more “irresponsible” and thus became obese. The answer is certainly more complicated than that. In many other areas, society has become more responsible, it is hard to make a case that the opposite is the case in food consumption.

The most notable examples of increased responsibility are a lower incidence of alcohol consumption, intercourse outside stable relationships without condoms, tobacco consumption and the dramatic increase in the use of seat belts. Why would the consumption of food be an exception?

However, it is noteworthy that changes in public policy and public health campaigns helped to decrease unhealthful and dangerous behaviors, indicating that there is a role for government in this area.

The most conservative segment of society believes that this is not an area for government intervention; it is an area of “personal responsibility.” It is important to remember that this was the defense of the tobacco industry during the 1940s and 1950s while attempting to increase the number of nicotine addicts in the country.

Most likely a balanced approach of educating people about smart food choices in conjunction with sensible regulatory changes is the best course of action. It is hard to predict given the massive influence of the food and beverage industry if this will become a reality.

If you have a suggestion for a future topic for Dr. Manetta to address, send an email to [email protected].