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Nebraska could be No. 1, but in this case it should not want to be.

Instead, the state is tied with Indiana for 15th — still not great — in a ranking of the most-obese states.

About 34%, slightly more than one-third, of Nebraska residents weigh in as obese, according to Trust for America’s Health, a nonprofit that promotes optimal health for every person and community.

Out of every three people in the state, one of them is struggling with obesity, defined generally as abnormal or excessive fat accumulation that presents a risk to health. Nebraska's rate is slightly worse than the national rate of about 31%, according to the 16th annual State of Obesity: Better Policies for a Healthier America report released Thursday.

The report calls for policy changes such as taxing sugary drinks, expanded supplemental nutrition assistance and Women, Infant, Children nutrition support programs, and an environment that encourages physical activity.

Attempts to tax pop in Nebraska in prior years were unsuccessful. Pop and candy are exempted from taxation, but a bill (LB289) introduced in the last session would remove that exemption.

Mississippi and West Virginia came in at No. 1 in the latest ranking by the nonprofit, with the highest level of adult obesity in the nation at 39.5%. Colorado, just over Nebraska's western border, had the lowest rate at 23%.

Arkansas (37%), Louisiana (36.8%), Kentucky (36.6%), Alabama (36.2%), Iowa (35.3%), North Dakota (35.1%), Missouri (35.0%) and Oklahoma and Texas (34.8%) made up the remaining top 10. Kansas (34.4%) was 12th.

Minnesota and South Dakota (30.1%) tied for 30th.

From 2013 to 2018, the report said, 33 states had statistically significant increases in their rates of adult obesity.

The report is based in part on newly released data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor survey, and analysis by the nonprofit. It was made possible by funding from the Robert Wood Johnson Foundation.

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“These latest data shout that our national obesity crisis is getting worse,” said John Auerbach, President and CEO of Trust for America’s Health. “They tell us that almost 50 years into the upward curve of obesity rates, we haven’t yet found the right mix of programs to stop the epidemic."

Isolated programs and calls for lifestyle changes aren’t enough, Auerbach said. Fundamental changes are needed in the social and economic conditions that make it challenging for people to eat healthy foods and get sufficient exercise.

The report highlights that people with lower incomes are more at risk. People who live in neighborhoods with few options for healthy foods and physical activity, and are the target of widespread marketing of unhealthy foods, are at elevated risk.

As of 2015-2016, the latest available data, 47% of Latino and black adults were obese. Adult obesity rates among white and Asian adults were 38% and about 13%,  respectively. Incidence of childhood obesity was highest among Latino children at 26%, while 22% of black children, 14% of white children and 11% of Asian children were obese.

The report said promoting healthier food for children through revamped WIC food packages and taxing sugary drinks could help.

In 2009, the USDA updated WIC food packages to more closely meet recommended national dietary guidelines, including the addition of more fruits, vegetables and whole grains and reduced fat levels in milk and infant formula. A Los Angeles County study published this year found that 4-year-olds who had received the revised WIC food package since birth had reduced their risk for obesity.

The report includes recommendations for policy action by federal, state and local governments, across several sectors, designed to improve access to nutritious foods and provide safe opportunities for physical activity, while minimizing harmful marketing and advertising tactics.

* Strengthen and expand school nutrition programs beyond federal standards to include universal meals, flexible breakfasts and eliminate all unhealthy food marketing to students.

* Enforce existing laws that direct most health insurers to cover obesity-related preventive services at no-cost sharing to patients.

* Cover evidence-based comprehensive pediatric weight management programs and services in Medicaid.

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Reach the writer at 402-473-7228 or jyoung@journalstar.com

On Twitter @LJSLegislature.

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