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Healthy Habits in Norway leads the women to be lean
– Reported, February 04, 2012
Anne Karen’s family did not own a car, so she walked to school and back home a distance of four miles each way. When it was snowing, she used a sled. And although her father occasionally provided money for the commuter train, she and her sister got around in the summers by bike.
Anne Karen’s Norwegian healthy lifestyle was typical, and its long-term health effects are striking. According to data gathered by the World Health Organization, in 2007 just 5.8 percent of Norwegian women were significantly overweight making Norway’s people among the slimmest in the developed world. Tor Claudi, project director in the Norwegian Directory for Health Affairs, believes that the country’s location and comparatively slow economic development sheltered it from changes in the availability of food, attitudes about transportation technology, and the subsequent decline in daily exercise that transformed life in the United States and Europe in the second half of the 20th century. Until recently, fast food wasn’t available, so the traditional Norwegian diet consisted of fish, meat, potatoes, and vegetables. Even now, he notes, dining out is relatively uncommon.
Another difference: The portion sizes at restaurants are smaller than those typically found in the States. Cathrine Halverson, a 26-year-old insurance advisor who works in Oslo, spent the past year living with her boyfriend in Kansas. She was astounded by the meals served in American restaurants. “The first time we went out to eat, I asked, ‘Is this a plate for two?'” she recalls. “They said, ‘No, just for one.’ I thought, oh my God in Norway it would be for three!”
Norwegians have been equally slow to adopt Americans’ more sedentary lifestyle, brought about by cars, freeways, and suburban sprawl. While the number of automobiles in the country has grown by 30 percent since 1985, many people still walk or bike to work. Gro Holstad, 46, the vice general secretary of the Norwegian Diabetes Foundation, also spent a year in the U. S. and was baffled by its car culture. “I’m used to walking or jogging to get where I’m going,” she says. “When I did that in America, drivers would lean out the window to ask, ‘Why are you walking? Can I drive you anyplace?'” Gro grew up hiking and skiing, and her teenage children adhere to that tradition. “We’re proud of our outdoor culture,” she says. “I’ve got it in my blood to be active, and they’ve got it, too.”
When you compare rates of type 2 diabetes one of the diseases most closely associated with being overweight in Norway against those in the U. S., the differences are just as startling. In the past two years alone, the number of Americans with the disease has increased by almost 15 percent, to 23.6 million people, 7.8 percent of the population. Norway, by contrast, has one of the lowest rates of any Western nation 3.6 percent. Five years ago, a survey found only 15 cases of underage type 2 diabetes in all of Norway and all but one of those were in immigrants.
But despite the country’s low rates of obesity and diabetes, there are small but unmistakable signs that Norway’s traditionally healthy lifestyle may be in jeopardy. Knut Dahl-Jorgensen, M.D., D.M.Sc., a researcher who studies diabetes and weight at the University of Oslo, says that many Norwegians used to spend their summers boating or hiking and their winters skiing. But the tradition of activity has waned a bit with changes in lifestyle. Now people work longer hours to compete in the global marketplace, and they spend more of their leisure time at the computer or in front of a TV. So far, the shift has been gradual, but experts worry it’s a harbinger of worse to come.
Norway’s modern story is familiar. The country’s economy boomed in the 1970s and ’80s, and mimicking what happened in the U. S. after World War II families began moving into the suburbs. That migration brought tighter schedules and longer commutes, usually by car. Other habits also changed. With extra money to spend on food, Norwegians enjoyed more imported goods produce like citrus was exotic next to the staples of cabbage, carrots, onions, and cauliflower. But soon, soft drinks and fast food started to edge out the traditional diet of fish and homemade bread. Anne Karen says that her two eldest daughters, who are in their early thirties, eat well, but that her youngest, 19, has to be prompted to get outside and eats candy frequently. “We’re hoping she’ll grow out of it,” she says wearily.
It’s this anecdotal evidence about Norway’s adolescents that troubles epidemiologist Haakon Meyer, M.D., Ph.D., of the Norwegian Institute of Public Health and the University of Oslo. “It doesn’t take much to shift the population’s weight as a whole,” he says. Because lifestyle changes are gradual, a country’s increasing collective waistline can go unnoticed for years especially since health problems associated with obesity can take time to manifest.
Dahl-Jorgensen points out that the weight and health crisis in the U. S. had been brewing for several decades before type 2 diabetes became an epidemic. American researchers began noticing signs in the late 1980s, when the first cases in children under 12 turned up. By the mid-1990s, one in five children were overweight twice as many as in 1970 and the current figure is closer to 30 percent.
Though Norway remains slimmer than many other developed countries, the most recent data show that its obesity rate has more than doubled in the past 10 years, alarming officials who fear that the country is headed for an Americansized epidemic of weight-related health problems. Public-health officials tend to place Norway roughly 20 years behind the U. S. on the obesity curve; the question that obsesses doctors and politicians in Norway is whether an American-style health crisis can be averted, and the question of how to keep the country thin has become a matter of public debate. Last year, the U. S. spent $174 billion 10 percent of its health-care expenditures on diabetes-related illnesses, and fear that Norway could one day face a comparable bill has prompted a wide range of interventions there. The government recently began mulling a “fat tax” on sugar and junk food (it already taxes soft drinks), hoping that higher prices might discourage mindless snacking. And the CEO of one of the country’s largest supermarket chains has removed the value-added tax from the price of vegetables and fruits in his stores in a voluntary effort to steer people toward more healthy eating.
Still, Norway’s war against obesity has been slow to gain momentum. Within the government, the proposed fat tax has generated debate over whether it’s an appropriate measure for a thickening population or if it would turn Norway into a nanny state that regards its citizens as incapable of making intelligent health decisions on their own. Another bill that mandates fresh fruit and vegetables in schools has come under attack for diverting money that could be spent on science labs and music programs.
Likewise, while many Norwegians support school programs to teach children nutrition and promote healthy behavior, the impact modern life has had on the country’s youth is hard to dismiss. Compared with the myriad candy bars and supersize soft drinks available, the fruit compote and three-ounce soda of Anne Karen Jenum’s childhood are a hard sell. “Nowadays, kids in Norway are surrounded by temptation,” Meyer says.
Still, if any country stands a chance of avoiding America’s fate, it’s Norway. Interventions have begun well before obesity becomes widespread a step that endocrinologist Larry C. Deeb, M. D., past president of the American Diabetes Association and a consultant to the International Diabetes Federation, says could be crucial to keeping the population slim. So far, roughly 360,000 Norwegian workers almost 10 percent of the country’s population have enrolled in a program overseen by the newly established Company Sport Association, which creates individually tailored workout plans for corporate employees (Microsoft Norway is a client). And the culture of outdoor recreation has not vanished. Municipal authorities in Oslo recently purchased 3,000 bicycles for public use, only to be swamped by a demand for more. The capital city is also surrounded by forests accessible to hikers and cyclists, and whereas American cities are built for cars, Oslo’s streets remain heavily pedestrian.
The country hopes to keep it that way. Preserving the traditional walk to school, Anne Karen says, “has been part of Oslo’s planning policy for decades.” In her district, close to the forest on the north side of the city, parents are explicitly asked not to drive their children to school in order to promote an active lifestyle. (Typically, one parent escorts a group of the youngest children to school each morning.) And in order to keep walking routes safe, legislation has been passed to minimize traffic, even in the city center.
Norwegian families also put an emphasis on family meals, Claudi says. (Americans spend 174 times as much money as Norwegians on fast food each year.) “Cooking and eating together forces you to slow down and think about what you’re putting into your body,” says Peter Fraenkel, Ph.D., director of the Center for Work and Family at the Ackerman Institute for the Family in New York City. And eating more slowly has another benefit: It doesn’t trigger the pancreas to pump out extra insulin (which could encourage diabetes) the way speed-feeding does.
The notion of strolling school kids and Leave It to Beaver-style dinners is unlikely to catch on widely in the States. But one thing the U.S. could learn from Norway is its emphasis on early intervention. Because adult habits are harder to change, the country is focusing the bulk of its efforts on the young, requiring nutrition classes at two different grade levels, extending mandatory exercise programs, and providing students with water rather than soda, says Ellen Pedersen, the State Secretary of Norway. In the U. S., meanwhile, school health-education programs are haphazard and soda machines are still permitted on many campuses, even as experts here have long said that programs similar to those in Norway are needed to help curtail childhood obesity and diabetes.
So what has motivated the Nordic nation to successfully implement such large-scale reforms? It’s simple, Pedersen says: “We fear becoming like you.”
Credits: JENNIFER KAHN,Women Health
Read more at Women’s Health: http://www.womenshealthmag.com/health/why-norwegians-are-thin#ixzz1lKTsqVCG
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