With heart disease having now surpassed tobacco use as the number-one cause of premature deaths in North America, Katz argued that it does little good to discuss heart disease without acknowledging the modifiable behaviors capable of preventing it. It is estimated in the US alone there 300000 premature deaths attributable to obesity.

"I'm a preventable-medicine specialist so I must acknowledge that death is not preventable, but it is deferrable, and premature death is an unwelcome thing," said Katz. "These deferrable deaths are attributable to modifiable behavior, and obesity is an important part of the reason for premature death that could be deferred."

Trends projected into the future, said Katz, indicate that the prevalence of obesity and type 2 diabetes is getting worse, not better, and threatens to undo decades of progress in cardiovascular advances. He added that obesity also threatens developing countries such as China and India, nations not equipped to deal with the epidemic levels of obesity.

What is particularly disheartening about all of this is how well we had been doing....I fear the potential for an out-and-out reversal.

"What is particularly disheartening about all of this is how well we had been doing," said Katz. "In fact, cardiovascular medicine is perhaps the area of medicine where advances that are clinically relevant are seen at the briskest pace. And yet all of this threatens to be arrested by the epidemic of obesity, insulin resistance, and diabetes....I fear the potential for an out-and-out reversal."

During his presentation, Katz said human beings today are simply out of their environment, not unlike a polar bear in the desert. Since the human body was built for a time when food was scarce and sustenance required securing sufficient calories to survive extensive physical activity, it is not surprising that in the modern environmentwith high-fat, high-calorie food available at very turnobesity has increased, he said.

"We live in a toxic nutritional environment of our own devising," said Katz, adding that human beings have no natural defenses against dietary excess. The US agricultural industry currently produces more than 3800 kcal of food per dayafter exportsfor each US citizen, and as a result, there is a strong push to consume to more food.

"Unless you play professional hockey or are in the National Football League, you don't need 3800 calories a day, and certainly your kids don't," said Katz. "This is an egregious excess, it is a sea of calories in which we are drowning."

Katz argued that there are no easy solutions to the obesity pandemic and that physicians and other healthcare professionals must extend beyond evidence-based medicine in treating patients at risk for future cardiovascular disease.

"In the case of obesity management, what we need to do must be predicated as much on judgment and intuition as evidence, because the evidence isn't there," he said. "If we look at the evidence we see nothing but failureobesity is getting worse and worse. The things we have done have not worked."

Katz discussed eating plans such as the Atkins diet as well as the Barry Sears and South Beach diet. Two Atkins study resultspreviously reported by heartwirewere published in the New England Journal of Medicine this year and received a tremendous amount of media attention.

"The public is desperate for magic," said Katz. "The problem with that is as long as they remain diverted in the quest for magic they will never find, they fail to attend to the difficult job at hand."

While diets such as Atkins do produce short-term results, the effects are incompatible with long-term health, he said.

These damn experts can't agree on anythingto hell with them, I'm going to Burger King.

"Why are we studying a dietary pattern at odds with everything we know about human health and simply seeming to care only about whether it produces short-term weight loss?" asked Katz.

"It is critical that we rally around the notion that we really do know something about the basic care and feeding of Homo sapiens," he continued. "We are not clueless. Until parents understand this, they will not adopt to the effort required to maintaining a healthy diet for themselves and their children."

Katz called on healthcare professionalsphysicians, nurses, and dieticiansto unite in the fight against obesity with the hope of providing a simple message to consumers bombarded with health claims.

"We agree on all of the major points, but does the public know that?" Katz asked the audience. "No. All they hear is my [food] pyramid can beat your pyramid and what they say is, 'These damn experts can't agree on anythingto hell with them, I'm going to Burger King.' "

"We know what health is and we know what dietary patterns are associated with it," added Katz.