750 words 8 hrs

The Casales family in the open-air living room of their home in Cuernavaca, Mexico, with a week's worth of food. Marco Antonio, 29, and Alma Casales Gutierrez, 30, stand with baby Arath, 1, between them. Al the table are their older chil- dren, Emmanuel, 7, and Bryan, 5. Cooking method: gas stove. Food presel"llation: refrigerator-freezer. F3vorite foods- Marco Antonio: pizza. Alma: crab. Emmanuel: pasta. Bryan: crab and candy. Arath: chicken.

111,;~tlt PIAlftr, WffAl TIit W'OIUO r,;,,rs

MEXICO

0 E WEEK'S FOOD I MAY

Grains & Other Starchy Foods: S15,76 c..,...~, n1ltrMiMfrols,J11b.Momo,whtk-ttt:, 11 lb ,or,uw,; l J •. &mN whrte bf"ud. J.iiud. I lo.ii( K,..,, s,.c,.I IC,~,., 1 1 lb M°"""1 p,mi. 11 lb, U' M~ ~,u, 141or puidul«1fs-1brc.ld) usorted,l&oz:br,6d

n•chU~°'

Dairy: S26.81 ..,,_,000Wll'holem1lk. I 9 pl,AJf"H"10Uraum, JI qt. ,..__acrt,mpops,.11qt:Yoplo1tro,urt,11qt:cfttts,

ha,,drNd,t , 1 lb, lo L.Mhel'JI condensed mill Ganncd, 14 oz,

CCMl1S(' theot-w. 13 6 CM'., Co"""'°" tvJ.por.itrd milk. 1l oz, M.11'11'.hetodlttw lloz.crnmchttse, 67oz, bontr,HOl

Meat, Fish & Eggs: S42.81 Chickrl\ pttctt 1) .. !b. ci,b, l 7 lb, ,cgs, 1!. ul1pta (fishj, 2 J lb c,rf,u,.221b.~t1U1C,66oz,-"'°"1Jfi1>A011lt~m

""1fo,IU0hlm.S6o.t

Fruits, Vegetables & Nuts: S44.21 uanp. 1µ lb, pinupples, 6 6 lb, WitcrmclOt1, 6 6 lb, or1"f". S S It, unoloupt-, +-4 lb po.vas. J l lb, qu•flCH. 2 l lb,,taow br,!'lan.is, 2 2 lb r<>ma IO!'!UIOH, 6 6 lb, 1om11,Hos,

6 6 lb com.t 4 urs, 1voudos 7, cti.,ot, squuh u lb ,.,_. bn,,s, :u. lb; whtte oniom. 21 lb. zucch.n&, 2.2 lb; I.JI ~ Pttklfd11laprfto pe~ unntd,, 6 lb; grttn tH-1ns ,11b pl~~n,frflh,111b broc.col,,11aoz..11•!<.

Uoi,dl,portt pt'p9ffl f$ff!Oked11l1Pf'ilos). 71 oz:

Condiments: s9.37 Upc,,loano/1 OIi 2 I qi, matp,,,w, '59 OJ..~ "'')'On'II/UIJIOi,ultllot S.-lic\lhJ,ot;McCom,ocJ.

bl,d.Pf'PPNJ2ot,cumlrl,07or.;b,yluw, dned.osoz

Snacks & Desserts: S6.,7 Rodokw ch.II loll.PGP', , 1 lb, R""""° pn.us <hocol.att undy. ' ' lb, C.,,m,o CtKl.f-1, 1\ 9 ot en,,,,, rnarshnullowt 11 01. Rodo/,tto d,,t, Undy S 7 ot

Prepared Food: S4.79 Dotla Mal'IO molt (UW>t) uuct made from chcxob1t and chU,j, 2 I lb, Knotrc.hlC~tn bou,llon, j: ot

Beverages: S39.07 Coca-COOi, 111 ,,qt bottles, Wll!tt bortltd, sg;1I, VJCtona bttr, 20 11 I n,oz bottlt-t..Ju.,,, .. ,u,u, , 1 q1 ~ r~c, Sid Hurnune dnnk, I , qt, Cio:ltOl'llde hmc d"nk. 1 1 qt, Nncafo. lrlSlint, d«;1f,] I OZ I~ W-.IC'f ii;,, coo'-,r11,-

$ Nol 1r1 Photo Nott Gro«ry vpend,tu~ (Of Ol'lf w,rfk. btforc the U~ales brruycloffd 1hNS,hop1i,d Marc:oMlonoo mOV'f'd iolhtUS 106ndwork

Food Expenditure for One Week: 1,862.78 Mexican pesos/S189.09

THE CASA LESES OF' CUER AVACA

Wanted: Living Wage MarcoAnron,o 1,ftM,ncoforth$ Unrttd States ,nOctobtrof 2004. afteragrwMtopaya,mw,;-

gier$3.ooo to gt1 him there. Hers now an illegal tmrntgront, prl1ngfro1tfor$5an hi,ur. r.lule his w,fe rar.sts ih.e1rthree chilclren alone Theyntvtr intended iolu-·t ,hu u.101

W HEN WE PrRST MET MARCO ANTONru .1nd lusw1fcAlma,a former

surgical ourse. they Wt"re hvrng in a rwo·story. cernent·block apart·

mem outside Cuernavaca. 50 miles south of Mexico City. and oper a111ig a changarro-a miw eonvcnience s1ore-on the ground noor. Marco Antonio bad been laid off from ht ioh at a brrwcry a few years

e:1rlier and couldn't !ind anorher one. Jfov111g no savinbrs a11d no al1crnat1ve. the cou·

pie opened t.he1r own lit1le swre. which at first carried only 10 or 15 Items-pork rind.s,

sausages. candies. Coca-Cola. and delr foods. IV,,h MarroAnronio and Alma splirtingthc

shop keeping. they increased rhc1r sclec1io11 and 111111g a telcVJs1on from the re1!1ngof the trny store 10 help pa& 1he time between customers. The family ate 1he1r meals 1ogetJwr

belund 1he counter-a common sight in Mexko's 1housands of fam,lrowned shops.

On any give11 day. the family schedule rrvolved around 1heir chango.r-ro. Se,•en·year-old E1runanuel would rend lo h.Js lit1le brother Arath \\ bi.le Uarco Antonio

tended 10 his customers-mostly neighbors and friends-through the shop window

over a glass·fron1ed case. h wasn't uncommon for Marco An1on10 to scoop up Aratb

and hold him while worlung rn the shop. If he /efr 10 run errands, Alma ~ould take

over, because 1hc key 10 rn:ikingends meet was keeping the shop open 1hrougbou11hr

day and e,·ening. At midday. AJma would cook 1be ram,ly lunch upstairs: usually nee: and bc:ins. and then rhickea soup with c1lanrro. or a S3\0I)' crab soup. or sornP111nes

tucos de carmtas (pork tacos). Like most of her neighbors. Alma bought fresh corn

tortillas every day from rbe tort,lleria nearby. Wbcn lunch was read'· shr would bring it

down to Marco Antonio in the shop, ancl 1he children would sit on rhc lloor with their

bowls in their laps to cat. In the early evening. Lhey woulJ have mencnda. a light meal served ,,ith bre.1d and fniit. Later in 1he evening, most i\•let1can fom1l1cs eat supper.

a.I though Alma said this is not her family's custom.

ih, <htldrrn &:ti'", . o d,d lht.'ir a,·<·c- lo ,rwck food lups

,:a n

rl · aRJ Mhtt paru~<l 0n tl fll'Oc.'t·'!8t><l 1n•a1s. Almost ,.,thout ru..-l II n llit-C.,saJe · m,.i.b ,.,.r,. t"T\f'd 1<1th Coca Cola. the farn

,h hr,, r nf < l><>11·t-In a ,.,·ek· Lime. •ht-v drank more lhan 20

qu n of •t \l'h u \Ima " a child. beans. paMa. nee. and tomUa C'N' •J I" main,u" of h.-r r I · I J ,am, l ~<wt. am tbt•re "as no money for

"-•l;lln nr_-.;uti t1Tat ~" only ate food that [m) motherf cooked."

.,},,. aa, If I "-i111led cand1 or N'frcsro I of1 dnn.ksf" she say . "my mNhn u,m)d •eJI me. 'If f grve )OU monev for &naclcs. we 110

11 '1 have

m<,D('\ for toniJJa~. ·- r,en as c-a h strapped adults. Alma and Marco

uom,1 had arc.-e to a w1d,-n·a.riel)' of foods. intludmg a substan11al

... mou1,1 ofproc-r,,ed h.i~1 fat. high caJone nnch.

Trad111on.1l \1et1can cooking-tamale . huevos rancheros wi1h

fr~!ili rorn 10n1lla~. c-hee f' f'nc.-h!ladas, quesadillas. beans and rice 11f'• '1<1th fard-1s great fut>l for thr phjs1c-all acuve. 11b1ch the \fex1ran populauon. increas,ngl . 1s not. The popu.lation has been

~"irtg alann1ngly heavy. Ac-cording lo stat, lies released by the

~orld HC"alth Organiz<111un in 2005. 65 pcrcenl of Mexico's popu-

Jarion is no" obese or o,erweigh1-a tremendously high number

(thouf!h. nll, 5 percent less than th equl\Jlent U . populauon).

Likl' rhe Unitf'd !ates. Mexi o JS overeating and underexer-

c, rng Alma and Marco Antonio's family are no exc-eption: "My

mother. anrl my mother- and father-in-law are overweight.·· Alma

sa.id. -And they all have diabetes . ., Alma. Marco Antonio, and their ddebl on are also oven.eight. She worries 1bat they. 100. w1JI

become diabetic. but thar worry hasn ·1 yet been tran lated 11110

acuon. Asl..ed i,be,her he got any phy ical exerci e. Marco Antonio

aid no: -1 used to play football and run around. but when the boys

were born there was a ·c any time for sports.·· Did he ever go out and

run around wi1h hi children?·· or really ... he said. Sitting behind

th.e changarro counter for long hours each day waiting on custom-

er urely wasn't burning any calories. Going to a health club-the

solution to inactivity in postagricultural. post-industriaJ coun-

tries-wasn't an economic or logistical possibility for him.

Over time. more and more small stores opened up in Alma and

k as1goilic-an1 b,teoutoftheir farro Anton1o's neighborhood. ra ·,ng d

1 , nlo the cornmun11y an profits. Big upermarkets. too. were mov 11 !I

I b

•r ('tung enoug 1 us, dra,,ing c-u tomers away. The couple wasn I{

1 b

M Antonio had oo ot 1er JO ness to JU t,fy taying open. bur arco k h

. ndo umcn1ed wor erw. o op11ons.J\.f1erourv1s1t.Nma sfalher.anu .d d

h - h,m ·n1e couple dee, e

picks fruit 111 the U.S .. sugge$red e J0 111 · 1 . ril They made ar-th1s rmght be rhe only way to wJn f1nanc-1a secu Y·

.k MarcoAntolllO acros raogement w11h a corote-a smuggler-to snea .

· f Tl , Jidn'I have 10 pay 1I the border in exchange for a $3.ooo e. 1 t'} c

d , . 1 and pronused LO all at once-1he1 gave 1hc coxote a own pa} men ' · . ' . 1 f I M· . 0 Anronio left bis pay 1he rest la1er. Both fearlu.1 and 10pe u, a,c

family behind.

R1sKY Busr E s

So far. the risk has not paid off. Marco An101110 11·orks onJy 20 or 30

hours a week. at $5 an hour. He sends ht mea •er paychecks to Mex- ico. where Alma make the monthly payment lo the COJ'Ote and uses

the li11lc that remains lo buy food and pay expense . "\Ve don't eat the

way we u ed to ... says Nma. bu, 1J1ey aren ·r eaun, any healthier either.

They eat fewer fresh frujts and vegetables. but the snack food and 0£1

drinks 10 which they've grown accustomed have become a permanent

part of their diet-though they're down to four quarts of Coke a week.

Dcsp!le the financial belt-tighrening. the children till manage to eat

many nacks, even when Alma doesn"t pay for 1hem. "They do little

JObs and favors for people.·· she says. "and pend the mone I theyeam 1 on candie and rchipsl. And if I give them money for lunch at school.

sometimes rbeyspend i1 on snacks. "Nma ha moved the children into

her mother·s house. Her sister Estella. who owns a tiny lunch counter

nearby. takes care of the boys while Nma work part-time at a nearby

market. Is Alma concerned about Marc0Anto1110? .. Yes. I worry ... she

says. "but he worries loo-rhat he's not ma.king enough money for us ...

Might he t1y to find a different job? He's afraid. she says. ''As he gets

more familiarwilh the system fin the U.S. I I think he will move on. but it's difficult because he doesn't lrnow the language.'' They talk on the

phone once a month, and hang on to their hopes and dreams.

In Cuernavaca's Colonial-era central square-the zocalo found in every Mexican town-<ity dwellers and visitors take their traditional late-afternoon weekend stroll among the balloon vendors while a band plays on the bandstand. Similar scenes have been replicated in Mexican towns for more than a century. But here, as elsewhere in the nation, is a sign of sweeping change: a banner protesting the imminent arrival of Costco, a U.S. big-box store fat right).

no HUl'l'Cll'I' Pl"~ET 't.'!IAT 111£ WORLD £ATS

Shopping for 1he week's worth offood at a big supermarket, Alma marches 10 the cash register, chomping on an apple and laughing at the absurdity of buying so much bread at once. Her order of tortillas al the tortillerio across the street from her convenience store (above right) is just as irrational-she never buys tortillas, which don't keep well, in bulk. Afterward, she cooks crab soup .;it her sister's restaurant (bottom right) for both the patrons and her family.

\([\JCO

• Pol"''' .._ to+9S9.S9'1 , ~ of {utmaV11CJI 70S,4oS

.,. ,,_. ;,61,404 (slighdy less

• :: ~ b,nes the sae of Texas) , p.,pJ,,~ drt1s typer square mile 1}8

. _. 1"'9"~- 76" , ~s popu~t,on '◄" , L'<""°"'""' mal</f..,,.I• 72/77 , .. ,. , L !It~ gap b,etwttn 1nd1genous

,.,cl,.,,, ~ g,rnous population. --6" • ~ JV rilt (births prr woman): 2..5

• I.M"IC'f' ro1te rmle/fenule, 15 yurs and

_.9419 1" • CJio'1C -,uke ava lable da1fy prr person:

~ 141..ic,,;.s , A_-r~ alc.ohof consump1Ion per person

1 ,~ coo tent onty): 4-2 quarts

, GDP ptr person in PPP S (Purchasmg ~ Pilnty an ad1ustmen1 for what equ,¥,~nt local goods would cost m the

us) sa,9;,o , Toul annual health expenditure per person

1 n Sand u a percent of GOP· S370/6.1

, ~cht population, male/female: 6sJ66'14

• Obese population, male/female 20/32%

• PopubtlOfl age 20 and older with d,ab<tM3.9'14

• Toru!~ c.onsumptt<>f'I per person per year: u.Jpounds

• lite.at consumption per person per year:

12.9 pounds

• McOono1lch r~taurants 261

• B,1 Mac puce S2.12

• NumMr of restaurants/reta,I stern ,un by Walrnt,: (Walmart Mexico, SA). 285/411

• C,prttte consumption per person per yt4r 754

• Wo(ld rank for per-person consumption of Coca-Cola No. ,

• Popula110n living on less than S2 aday: 26"

FICLO ',QTF.

If you want to bKomc 1m!'Mfs.ed ,n tout Mc, and death, tMrc s no plKc l•kr the SptaNhn& mun,c1pal mafvt ,n Cuerna...xa-a c.ollcc11on of half a dozen brgc okf bl.,,kttngs stacked on a h1Us1dc overlook1n1 the c,t)' Wh,lc wa1t1n& for loot vendors and 1hoppas to get 1n gear, I en)Oycd freshly 5quttzed orange and ca,rot ,u,c.c and ttw!-n a tropteal fresh-fruit salad This market has sC"#Cl'al fascmatmg ,~ of stall<\ selling pg and chic.ken heads and fttt In our country. p,g heads would n~er be d1splaytd bcuuse death, a fact o(hfe, ,s deemed ur;savory off-putting, unappctmng To avoid rem1nd,ng us that the meat we consume was once connected lo heads and feet, we Amrcnuns cut 11 into anonymous chunks and wr.1p 1t ,n piastre. In Mexico. ,r's hard to shy ,w.y from the fact 1hat an animal hn bccn lul!ed so that you can eat tlS Resh. As a fOfmer bttf rancher, I advocate facing faas-we should be required to be real1st,c and honest 1f ~ cat meal - Pe.Ur

FAM I LY RECIPE

Alma Casales' Sopo de Jaibo (Crab Soup) 2 oz margarine

2 lb red tomatoes, chopped

1/2 lb white onions, slrccd

S doves garlic

5 olwe l~ves

5 T salt

4-1/2 lb Ctib pieces, thoroughly rinsed

1-1/2 lb UJ CcmtAo ch1potl~ ~ppen,

1 lb carrot, sliced

10 qt Wiler

• In a large pan, melt margarine Add 1omatoes, onions, garlic, olive leaves, and salt Fry unttl onions soften

• Add crab and a1101her 1ngrcd1cnts to pot

• Pour m water, cover. and s1mme1 for 8o minutes

=

In what may be a disappearing custom, shoppers throng Cuernavaca's daily public market, inspecting the alarmingly fresh meat (above, hogs' heads, signaling the prtstnce of a butcher) and picking up snacks at the many small restaurants inside (at right). The crowds are large, but not as large as they used to be. Increasingly, Mexicans are choosing to shop at big chain supermarkets; indeed, Walmex, a Walmart subsidiary, is already Mexico's biggest private employer.

u.. ttON'CaY J'LANtr 'S'IIAT Tur. ..-o""' 'ATS

ESSAY FRANCJ NE KAUFMAN

Diabesity

H UMAN BEINGS A Rt OMNJVOl\£S. and there is an e.x- lTaordin.ary variety of fruits. vegetables. grains, and

meats for people fo eat. Food preferences may have

varied across tbe globe. but they have also conformed

10 some uoi,,ersal patlerns. In .ilmost every country.

d1t-ls h..we I rad.1tfonally been low in simple carbohydrates, especially

processed sugars. and low in trans fats and satl1ra1ed fats. like paJm

and coconut 01I. ow, though. 1he world is changing. Everywhere

people are eating more :ind more simple c,,rbohydrates ;md satu-

ra1ed and trans fats. From place 10 place. meals still look different.

but they are increasingly likely to be the packaged products of a large

company-and decreasingly li.kely 10 be good for you.

Tbe resu.Jt is 1ha.1 we are beginning to experience a global epi-

demic of wl_HH has been called "diabcsity.'· a potent mixture of dia-

beles and obesity. Its epicenter is the United States. where nearly

60 percent of adults-and 3o percent of children-:ire overweight or obese. Because obesity is tighliy linked to diabetes. the Centers for

Disease Control and Prevention esrimates that one in every three

children born in the United States i.n 1he year 2000 will have diabe-

tes some time in their life. As a result of diabesity. this generation of

American children wiJl likely live less long than their parents.

Diabetes is a disease characterized by abnormally hjgh sugar lev-

els in the blood. It occurs because a key hormone. insulin. is either

absent or uoable to work normally in some of the body's cells. There

are two main forms of diabetes. type I and type 2. Type I diabetes,

wh.ich used to be called juvenile-onsel diabetes. occurs when the

immune system malfuoctions and destroys the cells in the pancreas

that produce the body's insulin. Typically appearing in childhood

and progressing rapidly, type, diabetes is relatively rare. Nine out of

HUl'lCIIT l'LAl'lt'T: 'll"HATTIII! ••O ■ LIJ IIA'fS

• which used 10 be called aduh- rcn people with diabetes have type . . ,

I c ·e:1s continues 1'0 make msultn,

onsel diaberes. In type 2. t 1e pan , • . . . . d 1 ·t Eitherw·ay. rhe insulin deft ,ency bul the body doesa t rcspon o t • • •

h b d , cells from ob1a1111ng 1he sugars

or resistance prevents I e O Y s b d

. llssiarve unusedsugaraccumulatcs rhcy use as fuel. As 1.he o Y 5 ce ' · _ in the blood and spills oul iLllO the urine. creating _1he symptoms ~f diabetes, including excessive urination. thirst. fatigue. blurred vi-

sion. and sores that do not heal normally. Diabetes. already the si.,.1 h leading cause of death in the United

States. is responsible for almost 200.000 deaths in I he United States

each year. most of them from diabetes-linked cardiovascular dis-

ease. DialJetes increases the risk of hea,1 disease sixfold and mul-

tiplies the risk of stroke by four. fl is the leading c~1use of acquired

blindness. kidney failure. and oontraumatic ampu1a1ion (limb loss

that is not due to accidents or violence). Jn 2002. diabetes cos1 the

United States $132 billion in direcr medical costs. lost wages. and lost

work productivity.

Type 2 diabetes occurs in those who nre genetically suscep1ible

when they overconsume calories. particularly from saturated fats

and simple sugars, physical inactivity also plays a role. Ir usually

comes on 1,,radually. with such subtle symptoms that aJmosl a third

of those, ith the disease-more 1han 5 million people in the United

States-do not know !hey have it. 1 n the past, it typically made its ap-

pearance in the r,f1h or sL<th decade of life (hence the previous name

adult-onset diabetes). but that is no longer true. Today. younger

adul!s and even children are developing type 2 diabetes.

1Ype I diabetes is incurable and unpreventable. 1·hough ii can be

treated. Type 2 is different. Many people can prevent it simply by 111am-

taininga healthy weight.And even if theyclevelopcliabe1es. losingwcigbt

can help many people cure th d e •scase. if it is s, JI ·

Unfortunately. ever-larg .b 1 111 its early stages.

er num ers of peo 1 1· attend schools. and mhabu nei hb h P e ive in families.

g or oods where ·1 ficull to maintain a healihy d t Th 1 •s extremelydif- ,c · ey are the t f

docs 1101 seem to care of an ec . vic ims o a society that . onom,cstructurethat k . I

toeatfriesthanfl11it.ofthefo d I

ma es,1c1eaper o inc us, ry and them· d' I

them to consume what they sho Id . S ass me ia ur,ug u n 1· chools are becomin f

the worst environments of all s II' gone o . e 1ng sugar-comai ning soft d . ks

candy. and fast food to children. r1n · ·

ln my work at the Obesity Center of Childrens Hospital Los An- geles. I see children every day who h b d .

. ave een ma e sick by their en- vironment. One of my patients, ,6-year-old Max wh h d I

3 · o we1g e c ose to oo pounds. told me that he drank a suc· - k f pac o sweetened soda

every day. 1 was appalled, he was consuming more ,ban a thousand

empty calones every day just in soda. And I was puzzled. too. Max

was on his high school's junior varsity football team. which meant he

arrived at school early in the morning and left late in the afternoon,

after practice. How. I asked. did he manage to drink six cans of soda in the remaining hours of the day?

The answer floored me, Max explained that he bought ~ve ca11sof

sugared soda from school vending machines every day, one each be-

fore his first class. his second class. and lunch. Before football prac-

tice he downed a fourth can. and he topped it off with a fifth can of

soda when practice was over. That left one for home. I asked why he

didn't drillk water. He told me the water that came out of the foun-

tains was brown and smelly and the vending machines didn't sell it.

The rest of his diet was equally bad. In the mid-morning he bought

a candy bar at the student store. at lunch he had the high-calorie. high-fat burrito and fries or cheese nachos. and after football prac-

flee there were boxes of doughnuts. I asked about fru1t1 and veg, tables. Max told me they were u,ually soft wd brown. or wvered in

butter or sauce. There was literally nothing in hlS dai.ly environment

that was both nuir111ous and appealing.

Max is but one of a gro~·,og number of children at mk. In 2001,

the Lanc,i published a study of sixth- and seventh-grarl, children 111 Boston 1hat found the odds of becoming obese increased by 60 per-

cent for each 12-ounct can of sweelcned soda consumed da1ly. Given such figures. which have been shown to be accurate in 1tudy after

study. schools must no longer sell candy. sugar-coniarnrng drinks.

and fast foods loaded with calories and fat.

We must begin put11ng children's health and welfare above the

financial benefits of selling1unk food. fast food, and sodas in school.

A year af1er1he Loncel study. I joined a coalition worlong to ban the

sale of soda in the Los Angeles Urufied School Distnct. the second

biggest in the United States. Ulttmately. the district banned the 1ale

of sodas and then vending-machine junk food to students. 1 hope

this move 1s just the beginning.

We stand al a crossroads. now in the United Slates and soon in the

rest of the world. People must change scbools. commuuities. health-

care systems. workplaces. governments. and their own ramifies. Only

then can we return to living our lives with appropriate nurntion and physical activity. In this way we can live and grow old with a normal

weight. a normal blood sugar. and the chance to be healthy.

Francine R. Kaufman. M.D .. ,s the author of Diabesity, a call to action against the dangers of diabetes and obesity. A professor al USC, she also heads the Center for Diabetes and EndocriMlogy at Cluldrens Hospital

Las Angeles.

"They are the victims of a society that does not seem to care, of an economic

structure that makes it cheaper to eat fries than fruit, of the food

industry and the mass media luring them to consume what they shouldn't."

C1NNA¥()N IREMFAST ROlL CHEESE, M[AT • BARCHH(lDE GERMANY

SURANO HAM, CRlll[O V[C[TABLES, rRulT. PARIS. rRANCE BBQ PORK. WARSAW. POLAND PQll:I( ANO ONIONS• 811:ISIA"/l AUS1'.A,..1.l

lll'1'Clr 1'1AStt Tll,1.l THI! 'l'ORIO CATS

Meals .h t'H'I) tra\eler !rams. human beings ea1 :m extraordinary vane!} of foods. aU prepared in s1unn1ngly di\erse \,ays. )ct.as Franrrne K:iufman poimson11n heraccompan)ing tssa), the:.e p1ct11res or mt-als around rhc \1u1 IJ. ,1pp,1reoll) so d1ss1m1.lar. 1llusm11e a trrnd. As soc1e11es around the v.orldgrov. morcafn11t"nt. their members r:u more sugar. more refrnecl carboh)dra1cs. more d1Cllll) fac. Nutrnioms1s d•~'TI'eon the cHee1sof each one. but most bcl1c\f' that the colle<."tl\t' imract of 1h1s 1 rans111on 1~ d1sas1rous-

produc1nga glohal onslaught of obes11y. d1abctcs, and nrd10\ascular disease.

PLASTIC fOOO RESTAURANT WINDOW. J.06[. V.,AN

CHICKEN A.ND RK[. OU9AI UNIT(O AltA.8 EMIRATES

The Caven (amily in the kitchen ohheir home in American Canyon, California, with a week's worth oHood. Craig Caven, 38, and Regan Ronayne, 42 (holding Ryan, 3), stand behind the kitchen island; in the foreground is Andrea, S· Cooking methods: electric stove, microwave, outdoor BBQ. Food preservation: refrigerator-fr«:zer, freezer. Favorite foods-Craig: beef stew. Regan: berry yogurt sundae (from Costco). Andrea: clam chowder. Ryan: ice cream.

UN !TED STATES

ONE WEEK'S POOD APR! L

Dairy: S6.22 S-,,,,, s,kl {SIOIT b,;;ii,d} n"lilk,t I pl. chtt~,.t shrcdd~, I o:, Xte{t ,._,~n cheese. g.r11N,} oz

Meal, Fish & Eggs: $22.87 FoSW"""" ct,,dtn t,,eut 1eoders ,t l't>. Sun~,r egas. 12, t,tef' J'Ol',w:l• 1 S lb, 1un1 fi,h.J c.1nncd, 1 lb

Fruits, Vegetables & Nuts: S21.30 o,i Mo,!U ~llow tM,nanu, S lb Br:r.eburn v,r1ety apple,. l S t, (.olde,t C)fboouS v11ief)' apples. l S lb, t.inJennn, 2 lb,

~rapn 1slb. 1>abyu1rot1, 2 lb· bro«oh. 1 lb. c:mots,, 11,. s.u,,,,, Stlect mil!~ ~qet1bltt frozen, 8 oz, Scm,iy ~ct ~ ffoztf,,!oz

Condiments: $9-43 ~~ttd HOM)' Nul ponllt butter, 1 1 lb: c&H W'hne a,_MIJ'' 1oz. Morr EIJU1 aprkot Jam. ◄ 02, &s1 Foods m,,o,,na1n,l J oz: Frrr,ch's yellow munard.t , oz, H,mz 1rr,,c11o;p,J1ot,ull.16oz

Snacks & Desserts: S11.54 ~-...dough ru~ preuds, 1 lb; Si-n"t' ¼Cl ,a1s11u, 11oz SorMyS.-leavan,hwafrrs, 12oz;Si,n"11xl«t8l~be•r, frv,1 & G,a1n a-<eil ba.rs. 10-4 oz; S..,n,ry Xlta llnpbe•')' F~it & c;,,._n (tfC~ ~1'3., 10-4 OZ.

..... ···- ····· Prepared Food: 519_33 ~~~~7!::: ffJ; ham Wbmtfine S~hn, Fann, COin dogs, 1 J lb ,,.,. 8:,:~:~" w,cd:. '-"' RQ II Ro ... thocb!n llho,, 6.9 O.t. ~. •a Ol,

Fast Food: s7.50 M(Oo,u,ld 1. 2 H,1PF, Mt.11,, {tlth con11,n,t1&

1 6.pi«e

chitktn Mclllugg,u. ' S"1•11 Frtnch fno, , low f11 m~k) chocolate chip cook,n. 1 pka '

Restaurants: s4.50 F,nh Chotu Rnt,1.1r.1nt 1/tc fom,~ ,,, 11 ~"' onu II monih, :i::::;:.,~{;,::i:· ~ ilioi<,,, rrf1«t1ontfo.,rll! Beverages: $22.89 Alh11mbro w.ue,. S g~I. Coca,CQ/Q f ~ 6 qt, d,tt UIC/l,Co/11

2 l

q1, c,,e /ountom dn11k pu~d ~/M do,fydnw IO ..-orl,;; Cop,, Si,,n 11.1,ct dnnt 10 6 &.11,o,z: pleas-•l>P~ f\llU. 1 qt, 7,op,u,,o homeSl)"lt or,mge !UICt. 2 qt, Sufi")' 5dttl lflSl;ml coll'et 12 oz,1.1pw.Uefforcoolcin1

Miscellaneous: S3.49 Whfsbs Sl'o'OI)' Nun~, Cill food. J 3 lb.

f:NotmPhoto

Food Expenditure for One Weck: $159.18

-My mothtr didn't hovt ou;ess lo the nutntion information now required by the FDA, .. says Regan. ~she tl'Usltd that if the market carried a food iltm. it must be okay to tot i1. So we att 11101 of lime• stwmgfood-pockoged and canned-rarely onyihingfresh. I, on the other hand, rarely feed my family conned foods.~ She prefers seryingfrtsh fruits and vegetables.

THE CAVENS OF CAUFOHNIA

I(ick the Can

T IIIBE ARP MORf SOFT-DllllOt MACHINES than water fountains 1n the

Nonhern California bigh school where Craig Caven 1eacbce-a fact th.lt angers. but doesn't surpn.sr bUJ1. Lucrative contracts with soft-dnnk courparne. and

snack vendors provide cash-strapped school dtstncts with needed l\mdmg.

And what better place rhan a school to flnd captive consnmers ~1tb money lO

hLtrn? .. CafeLena meals have improved. - says Craig ... but they" re sull offenng fatly a.Jrerru-

tives. •· He says be s111J sees many students v1sinng the vending macluoes and eatmg p1xza.

"What proof do I have?· Craig asks. -All the cans and wrappers ou the clusroom floor.·

He believes stude11ts are renecring lessons lhey·re leam1og at home: -,r 1bc1r parents had taught them good eating hab11s. then the s1uden1s would make hea.l1h1er choices at.school. ..

Craig and his wife Regan. a counselor al U1e Unjversi1y of CaJ1forrua_ Berkeley. try to find a balance between whal their own two chiJdren. Andrea. 5. and Ryan. 3, want and what they

actually need. Part of her own balancmg act includes Regan's hour·long commute from the

city to their home in the grassy suburbs.-, don't mind cooking. but I often get borne with DD time to thmk abou1 wha1 to cook.~ says Regan. 1l1ough they have been known to eat. a frozen

com dog or two, she doesn't regularly serve conveoience food. Despite the ume pressure.

Regan manages to make a nutritious meal. thanks ro her cuJina,y sidelo.ck the m1cro\\a\e

oven. And exercise? Craig says l11ere isn·t much ti.me for It. 'Tve never been on a Wet-

although somegeotle hints have been made in my direction with ID Lhc paS1 ycarorw. H

Although Reg-.in a.ml Craig have the same nulr1t:1onal goals ar the grocery store. their

approach to shopping differs. Regan JS a self-proclaimed label reader. ·1 save my reading for home." says Craig. He tries to get mto and out of the grocc,y store as cruickly as possible.

and lo buy store brands. because "they're generally cheaper than narionaJ brands. H Regan LS

looking for .. foods low in sodiwn. low in fat. not too processed. fresh. and organic. if they" re

not too expensive.~ They generally eal at borne. t.ry1ng to set.,. good example----tbougJ1 a few

times a month they 1ake the children out for Happy Meals. TI1ey've found th.ti doing wh:,(s

right is no, always that easy. "There are jusl too manycbocolate holidays.· says Regan. alluding

10 her own personal vice. ~l gf't through the Chris1mas candy just in time for Valeotine·s Day.

Next. ir's Easier. TI1en. maybe I can keep away from sweers until Halloween.~

4tu,y,,,.d,.,d

J Ii• ~ PQbton. ~lli ,~101, cut ,nto e1ahths

I an-on. Clll 11\lO b1t~s1ze pita\

' "• ,.....,. chopped com,ly

• ln a l,rp pol brown beef and onions in otl

• Add w1te-r, tomato sauce, garlic, parsley, ind •" tp<es. Bnng to boil, then lower hfn C'O'l't'f. and ,1m~r for 1 hour

• Add pot.tot-s, canots. and celery S,mmer c.°""rf'CI unt•I tendN {)o-6o minutes).

• StTw w th 1ood. crusty brtad

•As an adult, I'm not as physically active as I was when I wu younger," says Craig, "and this has rubbed off on my kids. I don't think they consider the option of going outside to play as much as they ought to. When I was their age I lived on quiet residential streets and my parents felt secure in letting me run around. Nowadays, we live on a street that can be quite busy, so our kids' ability to play in the neighborhood is limited. When I was young I rode my bike to school. Andrea and Ryan have to be driven to their school because it's in the next town, so another opportunity for exercise is lost•

Fl ELD \OH

Beuus, Ct,og h>d Om< all &o,,, WO<\ on E,si,r wttk, h, d,d tho shopo.,,g >t 11>1,y- su~marlcet Clvtch1!'lg the det.iil!cl p

5

list th,i R,g,n had cornp,/ed, "' dut,r,':;" performed h1, lardtr-stod:mg chore w,th a• the enthusiasm of a man sptnding hl'S d off m lht supermarke1 Bef°'' bq,n"'ri'i,.ay he pul Andrea and Ryan into the cMdc.re room at the superm,1rtri After pushrng the overflowing urt through the che-ckout sund, he picked up the kids stopping to let them buy gum from one of the kKl-entic,ng vending machines by 1he door.

Right after that. <n1g "'-'tnt to the dnve. through window at tht McDonald sat 1~ other end of th" p,ukmg lot and bought the children Happy Meals and httle c.nons of milk Sometime bttwttn slugging down his milk and tearing into his McNuggets young Ryan stuck his gum up his nose.

Back at their ranch-well, '41nch•style housr-Cra,g put the grocenes awar wtiilt Ryan and Andrea watched cartoons and fimshtd offthe1t Happy Meals Cra1gumc 1rHo the living room when he was done and started to wrestle with Ryan on the Aoor, Occasionally, when Ryan needed lo utch his breath, or got Involved ma cartoon, they called a time-out. II seemed 10 me that Craig, who said that he was 1ust as ovtractive as Ryan when he was the same-age. wu en1oytng the physical mteract,on on a purei't nostalgic ch1ldl1ke level It brought back memones of wrestltng with own my sons and even a few bouts W1th my father as wdl. Maybt 1he-se memories are-htmlly sWttt, as father-son sparring ,s probably triggeml by fructose as much as by le-<.tosterone

-Prla

Momentarily suspending the wrestling match with his son, Craig tilts his head back to sha~ a cartoon momenL Thq ue surrounded by debris from the Happy Meals they purchased at the drive--thru window of a McDonald's (bottom left} in Napa, California, on the way home from the weekly shopping expedition to R1ley's (top lq!J, a California grocery chaitL The high school where Craig teaches is on break this w~k, so the child~n are out of daytal'1! and~ ith Dad.

Jumping for joy, Andrea (above, second from left) works through the routines in her ballet class at the American Canyon Community Center. Parents (Regan on right, in UCSD sweatshirt) benevolently supervise from chairs along the wall. The next day, Easter Sunday, both kids (at left, Andrea.foreground, in pink; Ryan.foreground, holding egg/ join Craig's family in Santa Rosa, 45 minutes away, for their annual Easter egg hunt, complete with a man in an Easter Bunny suit.

I lil1'f,D STAT I'S l~S

The Fernandez family in the kitchen of their San Antonio, Texas home with a week's worth offood-Lawrence, 31, and wife Diana, 35, standing, and Diana's mother, Alejandrina Cepeda, 58, sitting with her grandchildren Brian, 5, and Brianna, 4. Cooking methods: electric stove, microwave, toaster oven, outdoor BBQ. Food preservation: refrigerator-freezer. Favorite foods-Diana: shrimp with Alfredo sauce. Lawrence: barbecue ribs. Brian and Brianna: pizza. Alejandrina: chicken mole.

. ,'j. Other surchy Foods: S19.28 Gr~un . 1-,c:JtMrft# IDttll•s. 1.6 lb; Kdlogg's Special ~ !t lb;., bemff, 1 5 lb: Nowrw·s Own honey wheat ~-- rn1uh¥il'll,l,jlb,GoldM«Joli1II- ~ 1 ::~H-f-8 (store bnincl) French-style bread, F"""" nce. , h ~ c{Whtat cereal, 14 oz, Qvo.l:tr ,._~J!to:;Oltlfltl"rolk.1302: PostCocoil Pebbles cereal,

~ ftttl,c.Ol'll!',S-)OZ:Q&Q~lcell,,50z. ,,oz.i+-C-1

oairy:S'7-P- ".1 ~ mA. 1,i; low-fat, h1g~-calc1um. 1 gal: Oak

~ Skim Orlint milk. 1 pl; BIIH Ek/I ice c~a~, 1 qt; Donon r..ffll Swln8"' Str~rTY Ban,1na and Rockin' Raspberry :=-,oprt. 2µ fl oz: 'lt,p/oll p1i'li1 co1ada yogurt, 1.5 lb;

~,ocurt. 11oz: Kraft Colby& Monterey Jack = 1 oz; Frff10 Chrest Ht ads strmg cheese, 6 oL Mea~ Fish & Eggs: S42.10 l.fl(Mltl/1 f11ll ch1den drumsticks, 3 lb; H,11 Country Hlre p,rbo egp. 1&, H,E-B rotisserie chicken, original flavor, 2.5 lb; s,,drtRJl1 fomn ducken thigh fillets, boneless & skinless. 1.5 l;Gorkl'ISOriginallenders fish sticks, frozen, 1.1 lb; H-E-8 eittMan btef. ground, 1 lb, H-f.8 turkey breast, ground, 1 ti, OW;a, ~ 1\111("1 cono s.ilami, 1 lb; shrimp, frozen, , lb; &UnWwrbyvanetypac.k, sliced, 12 oz; H•f.Bbeer, top

101111d~ uoz; TyM,,,fun nuggets. frozen chicken. 12 oz; HICownrr f.ott smoktd ducken, sliced, 5 oz.

Fruits, Veg.Ubles & Nuts: $33.05 Graprfrurt, 51b; DoM biinan.as, 2.5 lb. Granny Smith ;ipples, 1.3 ti: II"" gr.iptS, 1 3 lb; Coastal stnwbtrritS, 1 lb; Key limes, 1 lb: ltd 11pplrs, 12.8 oz: Hiss avoc1dos, 4; Hunts tomilto sauct, 2,S Ir, G,Ee,i G,,m1 gret"n ~.ans, c.anncd, 2 lb; Grun Ciont com. &ozm, 1.6 lb; tomatoes. 1.3 lb: La Simo refried pinto ~o11s.. 15 oi; 1ttbtrg lettuce, 1 heild; Frnh Exprns Italian sat.ad ma. U oz: yellow onions, 8.6 oz; Fresh &preu colesl1w, 8 oz; m1111 urrots, 11 oz: mushrooms, sliced, 8 oz; jal11peno peppers, ◄ oz;go1r1k, 2 oz; Pfarrlds honey-roasted pearruts, 12 oz.

Condiments: $16.05 Grrot\lolue~et.ible oil, 2.1 qt; f,lifl Country Fore 8BQ s.iuce, 1·1 ~;lnkmationo/ Ddigh1 cofftt c~amer, 16 ff oz; I Corr't llt/ia.oi: 11'1 No4 B1d1trsprei1d. 15.8 oz; Alinljtmimo Butter Lite f)l'Up, 11oz: HI/I Country Fort ketchup. 9 oz; C#Ji,cr Burleson·s hooey. 3 oz; H.f.e roastfd pepper salsa picante, 8 oz; Season

UNITED STATES I T} IE FERNANDEZ ES OP TEXAS

All s~uoned salt. 8 oz; Wish Bone 0i1SSIC 6 oz. peinut butter 4 oz: pe Ruich Up! dressing,

, pper, ground, ' oz; sill o 5 oz.

Snacks & Desserts: S23.33 H·f•B Tens-shaped corn ch, s lb· whole-fruit bu P<>Psides, 16.: ,i :z, 6retzels. '. lb; Orq,11 Rifzwhole wheat crackers, 7,S oz· ~e rco_cookies, 9 oz,

Colors crackers, 6.6 oz, Ritz Sticks ci:::~:e Mimi Goldfish pot.ito chips, 6 oz; Centro/ Mills F,u,t Gu • 6.3 oz; Prmglts Kc//ogg·1 Special K blueberry bars _shers snacks. S-4 oz;

peaches & berry bars. 4,9 oz, 0~,:/R:;::t:f s;:ial~ microwave popcorn, J.7 oz; Bomum'$ iln1m.il et•ckeri,a2~1 o:

Prepared Food: Si8.l6 Prcgo. spighetti sauce. I lb; Lo Swra ref11ed be.ins with chttse. '5 oz, Ro11ch Style b,ans With j11tapeno peppers. is oz; l'i,onm Brond buttermilk pancake mix, 10 _7 oz; ikrl-OJli cr,.imy alfredo sauc~8 o_z; Zotomm's black be.ins & net, 7 oz: Zatarain'i gum m,x, 7 oz; Pionur brown g111vy m,x, nonfat. 2.8 oz; Pionur Country gravy mix. nonfat, z 8 oz: Knorr Suizo chicken broth, 2 oz; Diarro 01 work, S cojeler,a meols, ~onny of mam courses oval/able. Lowrenu grobs o salod or $Ike af praa at 11-'0rl

Fast Food: $11.81 McDonald's: 3 Happy Meals; 4 Mountilin Blasr ice cre.tm drinks: I vanilla ice cre11m cone.

Restaurants: $42.11 Fire Mountain 81,,ffet.: dinner for S, assorttd items. sold by the pound, 3.8 lb; Cici's Pizzo: t.arge bttf pizza, large white piua, l.arg, meat lover's pizza, 3 salads.

Beverages: $18.87 Hill Co1m1ry Fore natural sprmg water, 8 gal: Tm: Top apple juice, 1 gal; Ccpri Sun Mountain Cooler, 10 6.8-ff.oz pkgs; Capri Sun orange drink, 10 6.8,fl•oz pkgs, Dole p1nupple,om1gt· banana juice, 8 6.ff.oz urtorrs; Hill Country F-/Jre ictd te.i m,x, 1.7 lb; Wykrs Light pink lemoniilde. powdc~d m,~ 1.2 lb; H·E·B Caft Ole coffee. 3 oz; Ovohine mahed instant dimk m,x, 3 oz: Kool-Aid, sugar.free grape, powdered mix, u oz.

Food Expenditure for One Week: $242.48

Tejas Texas

A LEJANDRINA CEPEDA WOllKS AS A NAlfNT on the weekdays . .but for an

hour on Saturday afternoons she transformB the home she shares with

her daughter's family into a Mex.ican tortuluia. Her grandchi.ldren stand

on ~hairs with their own kid-size tonilla p-resses and watch her mix masa

hanna (corn-flour mix) and water Ytith her hands_ Brianna. 4. leans over th e bowl inquisitively, speaking with her grandmother in English. Alejandrina. who

speaks English. answers in her native Spanish. Brian. 5, loudly flings hi.s press open and

closed several times ... Remember. Brian.~ warns his mother. Diana Pe.maadei. a school

librarian. "your grandmother likes you to be serious when you're cooking witb her."

Brian is more interested in eating the tortillas than making them. but with the just-add-

water tonil.la mix from the supermarket. the process is quick. Diana-who was raised

by Alejandrina in the Mex.ican city of Nuevo Llredo. on the U.S. -Mexico border-flows

between the two languages seamlessly. helping her children understand words they don't

know. The conversation is wide-ranging. "What is limOn?" Brianna asks at one point.

as her grandmother hands her a ball of dough. "Lemon ... says Diana. as she watches

Brian pummel the dough in h.is press."[ s th.is pancake okay?' Brianna asks. "Bueno." says Alejandrina. who's expertly pressing most of the tortillas in her own large press. "But it's not a pancake-it's a tortilla,·· she says in Spanish. Diana translates. Alejand.ri.na will

forgo cooking the tortillas on a comal. a traditional griddle. Shell cook them on the stove

and turn them into the kids· favorite-cheese quesadillas.

The Fernandezes eat from the global dinner t.able most of the time. "We go from mullet

to menudo to egg rolls ... says Diana's husband Lawrence. an accomplished cook who grew up

in Louisiana. He credits his upbringing there with sparking his love of food: .. When someone

invites you to dinner in Louisiana. you never say no. lt's going to be a big deal-a big pot of'

something." says Llwrence. "Especially if they've got a [-Creole name like] Breaux or Mouton.··

Lawrence. who manages a Cici's Pi;,.zeria. also cooks with the children. On Lhose occasions he,

too. helps them prepare balls of dough. though ones that are much bigger thanh.is mother-in·

law's. "I'll bring raw dough and sauce home," he says. "and the kids and I will btLi.ld pizzas.And

that's a big treat." Any dessert? "Ice cream at midnight. when t.he kids are asleep."

After the Saturday soccer game, Diana (abo1,1t,far right), and Alejandrina perform a family ritual: making fresh tortillas (in background) for cheese quesadiltas (see recipe). The next day, though, it's back to less less-than-traditional fare: takeout chicken and soda pop (bottom.far right). The Fernandczes begin their Sunday grocery trip after lunch. Clutching their spending money, Brianna and Brian (above} head for the bakery case, where they settle on giant pan dulces.

Ji~l,~-T,Jlfo 75(1,o )'UIS

rth, ~ woman): 2..1

kt av.I .iblt dil ly pe-t prrson

JJ74'"'°""' • c., or,c • ~ .. •"• abl~ from animal

p,oduC>d••ftP"'P"'°" 1,047caloriH • A~ ,k ti...! consumption per person

(,kohal ,,,.,,.,,, orly) 9,6 quarts

• GO" Pf' .,.,,on SJ5,7So • TDe-,.,in.,.• ~, th et"Pf'nd,ture ~ person

n s ,nd u, p,,c,nt of CDP: $4,887/13.9 • "'1J, .ans~, 100,000 populauon. 279

. c •-ttf> con,umpt,on per person per yu, 2,255

• S"'i'' ,.nd swttteners available per person fl" y,,r 158 pound•

• 5oft,drink eon1umpt1on/Coca-Cola product consumption per person per year 54-8 vllons/21-7 gallons

• M~at consumpt,on per person per year:

271 pounds • McDonald's rtsuurants: 13,491

, Bttf/potat<><' purchased annually by McDonald's: 1 billion pounds/1 billion

pounds • Manure from all 1ntens1ve an,mal.farm,ng

prad,cn per year. 2 billion tons

• Human w,ntc per year; 200 million tons

• Household food wutc per yta.r: ◄8 million ton,

• Cot,t or household food wasted per year. S43 blmon

• Hov5chold rood waste per year as a percent of rood purcha1es: t◄

• Percent of processed roods with some gcnellc1lly modified ingredients 75

• Perccnl o( soy/corn roused that is a gtnc11ully mod1Red v;wety. 8o/40

FAMILY RECIPE

[);ana Fernanda's Quesadillas m>m Fresh Com Tortillas 2 cup,; mau har1na (dnt:d lime-treated fine c.ommea~

1-1/2 wps warm'tlrt.iter

◄ cups Colby jack chttse (on substitute any kind of Chedd.ir chene), coar!>tly grated

1/◄ tuh

• Kne:ad warm waw and utt into masa horrno and c:ombne ur,t,I dough rs warm and only sl,gtn)J ,toy Cut douit, rnu> about 18 Lttle balls, tac.h of ..+,id, will ro,m one tottilla

• Flanen the l1tde dou&h b.ills with a iorulltra (tOftllla press) until they .ire very thin {TM)' un be rolled With a rolling pin, but th,s ts much more d,fficult.)

• Place flattened dough cirde on a seasoned comat (a flat cooling pan rmde spec1i1lly to cook tort1lln) on med,um-h,gh heal

• Once tortilla yellows and becomes harder, put chttse ,n mtddle and fold tort.Illa over Keep folded tortilla on coma/ 1ust long enough to melt chttSc, turning 11 over when necessary (abouts mrnutcs).

• Serve 1mmed1atety

SUPEIISIZED U.S.A

• Overwetght population, male/female.

72/70'1/,

• Obese populat10n. male/(emale 32/33"

• Population age 20 and older with diabetes. 8.8'1/,

• Liposuction surgenes per ~ar- 400,000

• Gastric bypass surgeries per ,e.ar 150,000

• Percent paid by taxpayers for obts1ty· related medical costs 50

• Percent of dieting men/wo~n on any given day: 25/45

• Annual spending on dieting and diet• related products S40 billion

• Percent or all d1tms who will ,~am t~r lost wt1ght w1th1n I to s yean gs

l'l'l11:D •t4Tl4 zn

l !

Fl ELD 1 0TE

Lawrence Fernandez is a food professional: he has managed several all-you-can-eat cafeterias, including a Luby's, and now runs a Cici's p,zza franchise with a $3,99 all-you-can-eat buffet in suburban San Antonio, Texas. The Fernandez family 1s not supers,zed, but that 1s not true of their city. San Antonio went from 13th fattest city in the U.S. to 4th between 2003 and 2004, says Men's Fitness magazine. According to the Centers for Disease Control, more than one in four adult Texans 1s clinically obese.

Texas itself is supers,zed; it's a huge state with a wide body and a pretty thick neck-also called the panhandle-and judging by the size of the meals and people here, a thick panhandle is necessary to pick up the skillet. couldn't help noticing restaurants named The Pig Stand, Fat Tuesday, and Fat Boys Faptas in San Antonio. But besides the wide streets lined with such honestly named eateries, the city does have an incredible gem: the Riverwalk, a beautiful downtown stretch of the San Antonio River lined with restaurants, shops, hotels, and more restaurants. Tour boats entice visitors as they shuffie along the landscaped pedestrian walks flanking the river. Riverwalk visitors don't usually get to walk very far before they succumb to the food. Don't want to walk and eat? Another option is to float and bloat (dining on boats as you watch other people eating along the riverbanks).

There is a widening consensus, though, that being big is natural, normal, and even noble. During our visit, I photographed the Ms Plus America Woman for 2004, Nanette Watts, a truly beautiful woman decked out in a pink top, satin banner, and sparkling crown. She was huge, but against the backdrop of the supersized Alamodome she looked fittingly in scale. - Peter

Trying to contain the children in the giant shopping cart, Diana and her mother (at left) prowl the local H-E-B supermarket. Brian, who repeatedly self-ejects from the cart, must be constantly reminded that the impulse items hung in every aisle are not on the shopping list. Al home, he polishes off a cheeseburger (at right) from Whataburger.

II 'i I r I' n "TA r I 'I; l';)

STATISTICS

Measuring Table Health Care Expenditure

""""L,tion (annual

Physicians Access lo Life Fertility Rate Literacy Income

per c.ip1ta Access to Dfflsity Population in

1n USDS/ (per 100,000 Safe Water Safe Sanit.a1ion (~i,e, Total Area Urban Areu Expectancy (total births (percen1, (annual per c.1p1ta rn %of GDP) people) (percent) (percent) ..,...._ sq moi.) (sq miles) (percent) (male/female) per woman) male/female) USDS/PPP) - 19.913.1"'4 2.%7,124 92 77.9/83.0 l.7 l 00.0/100.0 S20,822/28,260 Sl,741/9.2 247 100 100 ........ 2131.569 121 18,142 60.2/62.4 50 56.2/28.1 5695/1,300 $9/3.9 62 70 - 4 007,601 203 19,736 45 69.3/76.4 1.3 98.4/91.l Sl,362/6,100 S85/7.5 145 N/A N/A Chad 9 531 s« 19 495,624 25 46.1/49.3 6.7 56.0/39.J 5240/1,020 $5/2.6 27 29 ~ 1.i,1'47624 351 3,704,427 38 69.6/72.7 1.8 95.1 /86.5 5989/4,580 $49/5.5 164 75 40

Cuba 11.308. 76< 264 42,792 76 75 0/79.l 1.6 97.2/96.9 NA/2,900 $185/7.2 596 91 98 - ll 212.742 121 109,454 62 67.9/73.5 2.8 94.0/91.0 Sl ,897 /3,580 S76/4.5 145 85 86 E&)'PI 76 117,421 197 386,560 42 65.3/69.0 ).) 68.3/46.9 $1,354/3.810 $46/3.9 218 97 9! Fnnce 60.424,213 286 211,154 76 75.9/83.5 1.9 99.0/99.0 $24,061 /26,920 $2,109/9.6 330 N/A •I• Gonnan7 82 424,609 598 137,810 88 75.6/81.6 1.4 99.0/99.0 $24,051/27,JOO $2,412/10.8 363 N/A •I• c.-llnlain 60,270,708 638 94,500 89 75.8/80.5 1.6 99.0/99.0 $26,444/26, 150 Sl ,835/7.6 164 100 100 C,-enland 56.384 0 l 836,109 83 64.0/70.0 2.45 N/A N/A $2,622 146 JOO >90

c.. ........ 14,280,596 340 42,032 47 63.1/69.0 4.4 78.0/63.) Sl ,941 /4,080 $86/4.8 109 92 81

Inda l .065,070 607 839 1,269,010 28 60.1 /62.0 3.0 70.2/48.J $487/2,670 $24/5.l 51 84 28

Italy 58,057,477 499 116,275 67 76.8/82.5 1.2 99.0/98.3 $20,528/26,4)0 Sl ,584/8.4 607 N/A N/A

Japan 127 333.002 873 145,844 66 78.4/85.J 1.3 99.0/99.0 SJ 1,407 /26,940 $2,627/8.0 202 N/A N/A

Kuwait 2.257,549" 328 6,879 96 75.8/76.9 2.7 85.1 /81.7 Sl5,193/J6,240 $537/3.9 160 N/A N/A

Mali 11,956,788 25 478,640 33 43.9/45.7 7.0 53.5/39.6 $296/930 Sll/4.J 65 69

Mexico 104.959,594 138 761,404 76 71.7/77.0 2.5 94.0/90.5 $6,320/8,970 $370/6.l 156 88 74

Mong~ia 2,751.314 603,749 57 60.1/65.9 2.4 98.0/97.5 $457/1,710 $25/6.4 278 60 JO

Phillpp;nu 86,241,697 745 115,800 62 65.1/71.7 3.2 92.5/92.7 $975/4,170 $30/3.J 115 86 u Pol1nd 38,626,349 320 120,696 62 70.6/78.7 1.3 99.8/99.7 $4,894/10,560 $289/6.l 220 •I• •I• Turkey 68,893,918 229 301,304 67 67.9/72.2 2.4 94.3/78.7 $2,638/6,390 $109/5.0 123 82 90

USA 293,027,571 79 3,717,727 80 74.6/79.8 2.1 97.0/97.0 $36.006/35,750 $4,887/ll.9 279 100 100

•~•,,.,>t_..,.._. f~•i->n,n"w,1hOM1ypt1 '°" tonUS N,vybne um/f101e1he1 "'°" ll("lt(;IT Pl..t.MrT W'KA'f THI! YOSI D tAfl

Caloric Uloric Suppty Sugar and Alcohol Intake from Animal Under- Diabetics Meat Sweetener Consumplion Cigarette Smokers

fdlJy. p,, Pn>dudS nourished Overweight Obese (percenl, age Human c(a":~:e~~~ (ann~~r:~~ (annual per Consumption (precent, .ige upita, fdlOly,p« (percent, (percent, (percent, 20 years Development Number of capita total, (annual per 18 .ind older, ... ~ capiu. k'CIQ 2001) mile/female) male/female) and older) Report Index McDonald's capita, lbs.) capita, lbs.) qts.) capita total) male/female) 3,05◄ 1,032 N/A 69.7/60.2 21.2/22.S 6.8 94.6 726 207.00 106.04 10.87 1,907 30.7/23.1 Australia ,,. N/A N/A 34.0/44.7 S.3/13.1 3.S S3.6 0 6.60 N/A 0.60 N/A N/A Bhutan 2.19◄ 391 8 56.6/51 .0 13.8/21.5 3.8 78.l 0 47.08 73.04 6.70 N/A 54.6/31.5 Bosnia

2.11, 140 34 10.4/17,l 0.3/1.3 2.8 37.9 0 31.46 17.60 0.21 160 19.7/3.l Chad

2.951 618 11 27.5/22.7 1.0/1.5 2.4 74.5 S46 115.28 1S.84 5.45 1,791 58.9/3.6 China

3,152 387 11 55.2/57.0 12.3/20.7 6.0 80.9 l:J: 70.84 137.06 3.61 ll43 48.8/28.5 Cuba

2.75-4 502 40.2/50.9 6.1/15.4 4.8 73.5 10 99.00 105.82 1.73 232 31.9/7.4 Ecuador

3,338 255 64.5/69.7 22.0/39.3 7.2 65.3 40 49.50 65.78 0.47 1,275 47.9/1.8 Egypt

3 65-4 1,357 N/A 44. l /33.4 7.2/6.l 3.9 93.2 973 222.42 88.00 14.07 2,058 42.6/33.9 France

l,O6 1,070 N/A 63.7/53.6 19.7/19.2 4.1 92.5 1,211 180.62 97.24 ll.17 1,702 39.0/30.9 Germany

l.•12 1,043 N/A 62.5/58.8 18.7/21.l 3.9 93.6 1,110 175.12 96.14 10.19 1,748 34.6/34.4 Great Britain

N/A N/A N/A 35.0/33.0 16.0/22.0 N/A•j• N/A 0 250.36 80.74 12.89 N/A N/Att Greenland

2.219 204 25 53.2/61.1 ll. l /25.0 2.7 64.9 38 52.36 90.64 2.02 609 24.5/3.7 Guatemala

2,459 189 21 15.0/ll.7 0.9/1.l 5.5 59.5 46 11.44 54.34 1.07 129 34.6/3.4 India

3,671 952 N/A 51.9/37.8 12.2/12.2 9.2 92.0 329 198.88 68.64 9.67 1,901 37.9/29.7 Italy

2.761 572 N/A 25.3/18.6 1.5/1.5 6.7 93.8 3,891 96.58 64.68 5.83 3,023 52.5/12.4 Japan

l.010 525 69.5/76.6 29.6/49.2 9.8 83.8 37 ll2.44 77.88 0.11 3,026 35.7/2.7 Kuwait

2,174 208 21 12.8/26. l 0.4/3.4 2.9 32.6 0 41.80 22.44 0.29 233 26.9/4.7 Molli

3 1,5 611 64.6/65.6 20.3/31.6 3.9 80.2 261 128.92 109.12 4.24 7S4 36.5/14.3 Mexico

2.2◄9 894 38 46.0/65.8 5.2/24.6 2.5 66.8 0 239.36 28.38 2.40 N/A 46.2/7.3 Mongolia

2.)79 373 22 21.7/25.4 1.1/2.8 7.1 75.3 236 68.42 61.82 3.50 1,849 59.6/13.8 Philippines

3,374 882 N/A 50.7/44.3 12.9/18.0 4.1 85.0 200 171.82 99.44 8.74 2,061 51.5/27.9 Poland

l,J57 318 47.9/65.4 10.8/32. l 7.3 75.l 81 42.46 56.76 1.66 2,394 5 l.l /18.5 Turkey

3,m 1,047 N/A 72.2/69.8 32.0/37.8 8.8 93.9 ll,491 274.56 158.18 9.58 2,255 27.8/22.3 USA