March 24, 2011 -- Americans who are religious are more likely to be happy, healthy ... and hefty?
According to research from Northwestern University, youths of a healthy weight who frequently participated in religious activities were twice as likely to become obese by middle age than their less-religious peers.
Even when controlling for race, sex, education and income -- several factors that could independently be affecting likelihood of obesity, this affect remained. Researchers drew on data from the Coronary Artery Risk Development in Young Adults study, which tracked weight and a number of physical and behavioral variables, including religious involvement, in more than 2,000 men and women over the past two decades.
"We had previously found that those with high religious involvement were more likely to be obese [as middle-aged or older adults], but we wanted to follow people over time to make sure that people who are religious are more likely to become obese, not that people who weigh more are more likely to turn to religion," said Mathew Feinstein, lead author of the study and an M.D. candidate at Northwestern University.
Several studies, including some of Feinstein's past work, have found an association between high religious involvement and obesity, but the studies didn't necessarily find an association between religiosity and negative health outcomes, such as markers of cardiovascular disease. Indeed, several studies link faith to an increased lifespan, more positive mood, and avoidance of unhealthy behaviors like drinking and smoking.
In the current study, for instance, the more frequently participants attended religious services, the less likely they were to smoke. The avoidance of such unhealthy behaviors may explain, in part, why religious people live longer, said Feinstein. But why they tend to put on more weight than their less-religious peers remains a bit of a mystery.
Faith and Fat: Why Religiosity May Tip the Scales
Feinstein posits that one possible explanation for the link between religiosity and weight may be that religious gatherings may center on unhealthy or high-calorie meals, thus creating a habitual association with religious works and overeating.
"Social aspects of religion almost invariably involve food and feasting," said Dr. David Katz, director and founder of Yale University's Prevention Research Center.
Many diet experts thought that an attitude shift among people of faith may also be behind the link.
"Another possible explanation is that religion encourages a focus on the afterlife and might thus distract a bit from focusing on the health goals in this one," said Katz.
Another possibility is that religious people take a fatalistic attitude towards their health, which Katz has seen in his own work.
"It's in God's hands, so I will just let come what may" is the attitude some take, he said.
Carla Wolper, a registered nurse at the Obesity Research Center at St. Luke's-Roosevelt Hospital in New York, agreed with that possibility, saying that believing that God is control of one's life may reduce the likelihood that those of faith take matters into their own hands and make changes.
A sociological study on the topic posited that associations between obesity and faith may have to do with a prioritization of certain sins over others. Sociologists Krista Cline and Kenneth Ferraro noted that, in America, religions tend to focus on constraining sins such as smoking, drinking and promiscuity, while gluttony became a more acceptable vice to indulge in.
Dr. Keith Ayoob, director of the Nutrition Clinic at Albert Einstein College of Medicine, added that amid the atmosphere of restriction, food can also become "a legitimate, socially acceptable drug."
Bible Belt vs. Obesity Belt and Towards a Religious Solution
While the association between religiosity and obesity was strong in the study, both Feinstein and diet experts warned against concluding that religious affiliation definitely causes obesity. More likely, there are other factors, such as the health attitudes and lifestyle choices discussed above, that are associated with both religious faith and the tendency to overeat.
One such mediating factor may have been where participants were living. The southeastern part of the United States, often referred to as the Bible Belt, has the highest concentration of religious populations and also contains some of the states with the highest prevalence of obesity.
While Feinstein's study draws on populations from around the country (Alabama, Minnesota, Illinois, and California), researchers did not control for location and, hence, it may have been that the Alabama participants skewed the association by having large populations of overweight and highly religious participants.
Whether religious faith was predisposing church-goers towards mid-life obesity or other factors associated with religious involvement were controlling the association, Feinstein pointed out that anti-obesity initiatives may do well to have specific outreach to religious populations.
Anecdotally, "faith-based" exercise programs have had success in religious communities heavily burdened with obesity and co-morbid conditions such as diabetes and heart disease. For instance, one Los Angeles-based program had elderly black women pair scripture readings, group prayer and exercise education with much success.
"Religion can be a tool we can use for those at risk," said Ayoob. "This study may be a wake-up call that we need to use religious ideas to convey health messages that mean something to people [of faith]. Make diet and exercise an extension of their religious dedication."