Their love for pork rinds, super-size soft drinks and ice cream isn't helping adult Kings County residents get any leaner, prompting health officials to warn more urgently: eat less and exercise. Even as California as a whole scored a low adult obesity rate in a recently released nationwide obesity study, Kings County and other Valley counties are still wrestling with some of the state's highest adult obesity rates -- ones that could rival those of America's fattest states, such as Mississippi, Alabama and West Virginia.

"As far as risk factors for disabilities and early deaths, it's probably the No. 1 issue that faces Kings County as a cause," said Dr. Mac Lean, Kings County's health officer.

California has the 10th lowest rate of adult obesity in the nation, with 23.6 percent of adult residents classified as obese by the U.S. Center for Disease Control and Prevention, according to the annual ranking of obesity rates in U.S. states released this week by the Trust for America's Health and the Robert Wood Johnson Foundation.

The report said the rate of obese adults stayed steady over the past year. Nationwide, obesity rates among adults increased in 23 states and didn't decline anywhere, the report said.

Mississippi topped the list for the fifth year with 32.5 percent, while Colorado had the lowest rate at 18.9 percent, followed by Massachusetts with 21.2 percent. Three other states -- West Virginia, Alabama and Tennessee -- now have obese rates above 30 percent, the report said.

Reliable scientific data for local obesity trends are limited, but at least one survey shows that local statistics aren't any better.

The obesity rate for adults in Kings County is 29.4 percent, and it's 30 percent Valley-wide, according to the 2007 California Health Interview Survey, a phone survey conducted by the University of California Los Angeles Center for Health Policy Research.

Obesity is twice as common in Kings County as in the Bay Area, and so is the prevalence of diabetes, data show.

In April, the Kings County Department of Public Health issued a landmark health report that put greater emphasis on urging residents to eat less, eat better and drop some weight.

Obesity increases the risk of many diseases, such as diabetes, heart disease and stroke. And according to the county report, about three out of five Kings County residents are overweight or obese.

"In Kings County, one of the primary adverse outcomes of being obese is type 2 diabetes," Mac Lean said. "You may have a genetic predisposition, but if you stay lean and physically active, you can really overcome that, at least until you're at advanced age."

Designed to encourage individuals to take control of their health, the county health report provided some simple formulas for figuring out how many calories to eat in a day to either maintain or lose weight.

How many calories should be eaten depends on the person's gender, physique and physical activity patterns, but it generally falls between 10-15 times the person's weight, according to the report.

For example, those who weigh 150 pounds and are happy with their weight need about 2,250 calories a day to maintain it. But those who weigh 180 pounds and want to weigh less should keep their daily calorie intake at around 1,800 calories as a general guideline.

Mac Lean feels strongly about environmental factors that are making healthy choices harder, anything from lack of safe walking paths to unhealthy treats often available at work places. He says what is perceived as a "normal diet" has also been distorted by consumerism and food industry.

"For the last few decades, the portion sizes of calorie-dense foods have just gone berserk," he said. "The fundamental problem is what we expect of our meals and snacks and what we consider normal have gone haywire. That's why we're having such a problem with obesity in our society."

While the nation has long been bracing for a surge in Medicare as baby boomers start turning 65, the new report makes clear that fat, not just age, will fuel much of those bills. In every state, the rate of obesity is higher among 55- to 64-year-olds -- the oldest boomers -- than among today's 65-and-beyond adults.

Medicare already spends anywhere from $1,400 to $6,000 or more annually on health care for an obese senior than for the non-obese, said Jeff Levi, executive director of the Trust, a nonprofit public health group that released the report "F as in Fat: How Obesity Policies Are Failing in America 2009."

"There isn't a magic bullet. We don't have a pill for it," Levi said. "It's not going to be solved in the doctor's office but in the community, where we change norms."

His group is pushing for health-reform legislation to include community-level programs that help people make healthier choices -- like building sidewalks so people can walk their neighborhoods instead of drive them, and providing healthier school lunches to help fight the childhood obesity that turns into adult obesity.

Many states have begun tackling obesity, and there are hints of improvements, said Robert Wood Johnson vice president Dr. James Marks.

"We're still getting fatter, but maybe a little more slowly than before," he said. Last year's report found obesity rates rising in 37 states compared with 23 this time around.

He's encouraged that 19 states have implemented nutritional standards for school meals that are stricter than the federal government's; in 2004, just four states did. Some are requiring nutritional information for restaurant food, he added.

On July 1, a historic menu labeling bill took effect in California, making it the first state in the nation to have its restaurant chains post calorie information on menus and indoor menu boards for consumers.

Mac Lean called it an important step toward a paradigm change in the way people eat.

"I think it's something that makes the information more available to people, and the second step is that we have to get people to understand what they should be taking so that they can use that information," Mac Lean said.

Associated Press Medical Writer Lauran Neergaard contributed to this report.

This reporter can be reached at 583-2429.

(July 2, 2009)