Breaded pork tenderloins, Maid Rites, and Snickers salad. All staples of Iowan culture, but these classics are part of an issue, as Iowans place seventh in the Trust for America’s Health nationwide obesity rating released in September of 2024.

Alongside obesity, Iowans face many health obstacles, including high cancer rates placing the state second on the CDC’s list and high alcohol use across the state and at the University of Iowa.

According to a study done by the College of Public Health, 22 percent of adults in Iowa reported binge drinking, compared with 17 percent in the U.S. This places Iowa fourth in the nation for adult binge drinking.

Alcohol use, drug use, and poor dieting can be detrimental to health and lead to much more serious problems down the road for Iowans.

“Obesity and health problems in general tend to be complex issues. There tend to be a lot of deep ties to social, economic, and environmental factors. One of the goals of our state health department is to remove barriers and create sustainable changes,” State Medical Director Robert Kruse said.

Kruse touched on some of the social barriers that can be in place across the state. With much of Iowa’s land being rural, Kruse said many populations in Iowa lack access to healthy foods.

“Some of the rural areas may not have access to certain healthy choices to have, whether it’s supermarkets or a lot of different kinds of traditional grocery stores that are just not available,” Kruse said.

Many Iowans may have to rely on fast food or gas stations for their meals, which aren’t always stocked with the plethora of fresh produce, meat, and dairy that Hyvee might carry, he said.

Karen Grajczyk-Haddad, who is a senior behavioral health consultant at UI Student Wellness, said all of this contributes to poor nutrition, which can lead to a domino effect fueling obesity, diabetes, poor mental health, cancer, and other diseases.

“Nutrition and diet impact overall wellness because food is our main energy source. By eating nutritionally balanced food, we can feel the positive effects on our body while also reducing the likelihood of chronic disease over time,” Grajczyk-Haddad wrote in an email to The Daily Iowan.

Some of Grajczyk-Haddad’s work surrounds the external factors and behaviors that can lead to poor health in a person, specifically in students.

“Substance use and mental health concerns are often co-occurring disorders, meaning it is common that someone that has challenges with one also has challenges with the other,” Grajczk-Haddad wrote. “It’s important for students to realize if either their mental health or substance use is impacting their relationships, academics, or health.”

Substance use and poor eating go hand in hand with obesity, which can be deadly.

“In terms of obesity in particular, a lot of times people are concerned about that equation, the balance of calories in and calories spent. The clearest connection here is that alcohol is just empty calories. There aren’t any nutrients in alcohol,” Paul Gilbert, UI professor of Community and Behavioral Health, said.

Many alcohol-related behaviors are not good for overall health and can lead to empty calories, which leads to obesity. All of these combined can lead to cancer.

“Obesity is a significant risk factor for several types of cancer. That excessive body weight is linked to increased inflammation, sometimes hormonal imbalances, sometimes different metabolic changes that contribute to cancer development,” Kruse said.

Kruse said the most common types of cancer with increased risks linked to obesity are breast cancer, colorectal, endometrial, esophageal, renal, and kidney cancer.

Kruse said the state is working to combat not only obesity rates but also the rising cancer rates across the state.

“We’re making progress in improving the lives of all Iowans, particularly those who may be disproportionately affected by obesity, including those who may be lower income, families or individuals with disabilities, and certainly rural communities,” Kruse said.

RELATED: ‘It’s about rural Iowa’: UIHC looks to address high cancer rates across the state

One way the state is doing this is by increasing the presence of healthy eating and nutrition programs in schools throughout the state.

Iowa is currently ranked 15th in the country for childhood obesity, according to the same Trust for America’s Health. Programs at the state level are looking to bring that number up.

Pick a Better Snack is one program the state has implemented, according to the Health and Human Services website. “Pick a Better Snack aims to help children eat more fruits and vegetables.”

The goal of this program is to introduce children to different foods, which will, in turn, help them lead a better and more nutritious lifestyle.

Another program the state is working on is called the 5210 program. Kruse said the program’s goal is to encourage kids to eat five servings of fruits and vegetables, limit screen tome to two hours, engage in an hour of physical activity, and consume zero sugary drinks each day.

However, education doesn’t stop at the elementary school level. The UI Division of Student Wellness has many programs to help students have better wellness.

This includes a program that aids in substance abuse prevention and recovery.

“Success, Not Excess support groups through the Collegiate Recovery Program. These meetings meet twice a week and offer students a space to generate ideas on how to change their [substance] use, develop goals on how to achieve these changes, and share successes,” Grajczyk-Haddad wrote.

Gilbert touched on other ways to reduce alcohol to help with diet.

“I think taking a break periodically is a good idea. The other thing is just knowing that the balance of benefits and harms is kind of out of whack. The main benefit of drinking alcohol is the social realm. That is such an important social and cultural practice. But it’s not required. It’s not mandatory,” Gilbert said.

Substance use and poor diet are not the only factors leading to obesity. However, Kruse said reducing obesity will be a long process for entities across the state.

“We know that these are kind of key areas we want to focus a lot of our kinds of activities. I think our goal is to reduce the trend. I think it’s going to take some time,” Kruse said.