Book Review: Fat Land

Fat Land, by Greg Critser

This book is the author's attempt at explaining how Americans became the fattest people in the world. This is one of the best non-fiction books I've read in a long time. In this review, I go chapter to chapter with my own notes. These notes, although pretty thorough, give the book no justice, because it's just that good. I like how he takes a very long look at the history of obesity, exercise, food and other related issues of this country. Highly recommended.

Some general comments on the book:

• It's short - without index and additional material, it's only 176 pages.
• Fast read - it's so well written, that even medical mumbo jumbo is really interesting, shocking and REAL.
• Knowledge, knowledge, knowledge - plenty of information on history, social class, race, health, biology, research, habits of children, etc.
• Sound journalism - from what I can tell, anyway. Great notes (with additional comments on each chapter), sources, quotes, and observations.
• Book focuses mainly on California and Texas. I wonder about if kids in colder parts of the country have a harder time getting out more in frigid weather. Does it matter at all?
• I liked the idea of "European-sized" foods because it provides an amusing visual when put next to our "Super-sized foods".
• Great closing with a Dante mention. So good.

Chapter by Chapter Notes

Ch 1

Critser argued that globalization in form of free trade created cheap and abundant food supply in 1970s, starting with Malaysia and its palm oil. Palm oil was the high fructose corn syrup of the fat world. Its chemical makeup is closer to that of beef tallow than vegetable oil and its fat is more saturated than pork lard. The reason this was all important was because with palm oil, stuff could be made way cheaper - which people liked. It didn't break down easily at all, but that didn't seem to be a problem in that era.

Ch 2

Before mega-huge movie popcorn, there were actually NORMAL sized ones. It's true. Critser talked about how people didn't want to be the fatso buying 2 popcorns (or french fries, etc) back then. It was almost like the shame of holding two popcorns, indicating you're gorging on popcorn, was like a check and balance for people to control themselves. One of the hugest marketing wonders was to make ONE popcorn bigger and tricking the consumer into thinking they're getting more for less, minus shame of two containers. I know, pretty absurd. This chapter also focused on the decrease of family dinners due to allegedly people's lives getting busier and the increase of constant snacking as a daily routine.

p. 28 Fun fact - A serving of McDonald's fries went from 200 calories (1960) to 320 calories (late 70s) to 450 calories (mid 90s) to 540 calories (late 90s) to the present day total: 610 calories.

Ch 3

All about kids' nutrition: how school fund cuts leads to nasty/cheap food production. Cuts in Los Angeles school district made the school turn to Pizza Hut for their lunches. In 1977 Americans got 18% of their calories away from home. In 1994 it was 34% calories away from home. USDA: "We calculate that if food away from home had the same nutritional densities as food at home . . . Americans would have consumed 197 fewer calories per day." That equals about an extra pound worth of energy every 20 days.

First the parents let the kids down with not helping them develop good eating habits and then the public schools follow suit. Great.

Ch 4

This chapter is where we witness Physical Education's doom. In California there have been PE requirements since the 19th century. It's where physical fitness used to be king, in and outside of school. This starts changing in the 1970s. There was a fitness boom, but people were focused on the individual and medical purposes instead of group participation and peak performance.

Critser says that baby boomers with bad memories from their old gym days (i.e. being last to be picked) would later help crush PE, because they didn't want to expose their child to that type of PE experience. But the baby boomers accepted private fitness solutions for their kids (i.e. travel leagues) where everyone plays. By the 1990s, the author said, the message was clear: "In America, fitness was to be purchased even if you were a child."

There's discussion of how various organizations, including Center for Disease Control kept lowering the standards for the exercise prescription, meaning they were under mining the importance of vigorous exercise. The standard basically went from "adequate exercise means vigorous exercise" to "take the stairs instead of the elevator". Basically, CDC and others exaggerated that moderate exercise was good enough and that vigorous exercise didn't help that much. And the science was far from sound.

p. 94 Dose response effect. Williams of Lawrence Berkeley National Laboratory. In a 1993 study of 8,283 male recreational runners he said, "Our data suggest that substantial health benefits occur at exercise levels that exceed current minimum guidelines and do not exhibit a point of diminishing return." 2001 American College of Sports Medicine findings note that dose-response relationship holds true for prevention of type 2 diabetes, colon cancer and obesity.

p. 114 By 1993 41% of Saturday morning ads that accompanied cartoons were for high fat food.

Ch 5

Author talks about how tweens are fatter, about how poverty, race, class can increase/decrease chance of obesity. Anorexia is found in wealthier white teens, while black teens feel more comfortable with themselves even though they're generally more overweight.

p. 125 Insurance companies pay for anorexia prescription for adolescents but won't cover effective obesity drugs for kids. Not that kids in the hood have insurance to begin with, but still...

p. 126

The last phrase in chapter 5: Diabetes - the growth industry for an ever expanding nation.

Ch 6

Thrifty gene theory. Groop said "The insulin-resistance gene has protected individuals during long periods of starving by storing energy as fat rather than as glycogen in muscle. The abundance of food in Western society has made this once protective gene a deleterious one, suggesting that these individuals are not equipped with the metabolic machinery to handle overeating."

Utero programming holds that pregnant women that face starvation during term are more likely to have child metabolically disposed to retain fat.

There's lots of science in chapter 6. Sometimes a little tough to follow, but generally pretty clear. Talks about genes, enzymes, fructose, metabolic breakdowns, artery walls, gallstones, and of course diabetes - which I never realized quite how awful it is. Talks about every part of the body effected by obesity: skeletal system, blood stream, pancreas, brain, feet, etc.

Chapter 6 ends with a hypothetical situation where most people fall into the categories of obese and not so obese. Talks about the woes of every day life for fat families.

Ch 7

Talks about San Antonio school district and Dr. Robert Trevino's aggressive and unconventional tactics that in the end helped the elementary kids get better.

p. 155 - A great story about PE teacher from West Middle School in Downey, CA. He came up with a video game health club which became VERY popular.

Author also emphasized the point that soda pop companies contribute not only millions of dollars, but millions of calories in exchange. No doubt kids' pop consumption has a lot to do with their increasing obesity numbers.