The U.S. end-of-year reflections came and went, as usual events-as-they-occur stories, such as shootings and storms, trumped slow-to-develop issue stories. One issue story that fails to make end-of-year lists is the obesity pandemic.

Americans on the whole sure seem willing to acknowledge the issue of obesity but are unwilling the address the problem outside of buying fad diet books. This despite worldwide warnings from health experts, most notably in September 2006 at the International Congress on Obesity in Sidney, Australia.

Cardiovascular disease remains the leading cause of death in the United States &8212; though, it should be noted, the figure looked a little better for the most recent year in which data is available, 2004 &8212; yet reducing the risk factors for heart disease remains a low priority for many people. Obesity also can lead to diabetes, increased risk of cancer, sleep apnea and stroke.

Why don&8217;t people take action? Part of the problem is Americans are bombarded with mixed messages. There&8217;s Oprah, Rachael Ray, Dr.Clay.com, South Beach Diet, Atkins, Scarsdale, Slim Fast, Hoodia, Weight Watchers, the U.S. government food pyramid, the revised food pyramid, Fen-phen, studies that contradict previous studies, on and on and on.

Step back for a moment and take it all in. There are loads of people hoping to make loads of money on fad diets, pills and advice. What gets left out of the messages is the most important aspect to stemming the obesity problem:

Exercise.

There is too much focus on diet. While diet is important, people should focus on health in general. That means the food you eat, the exercise you do, the pressure you face, the risks you take, the hygiene you practice, even the interactions you have with other people. It is your physical, mental and social well-being.

There is a simple message out there, and you&8217;ve heard it before because it gets repeated so often: &8220;A balanced diet with exercise.&8221;

It is hard to say whether Americans will ever grasp this concept. Though rates for cardiovascular disease looked better for 2004, the obesity rate for 2007 was worse than 2006 in every state except California (which didn&8217;t get better, only stayed the same). Mississippi remains the fattest state; Colorado the leanest. West Virgina replaced Alabama as the second-fattest.

Minnesotans, of course, are thinner than the average American, but still not looking good as folks in the Western and New England states. In Minnesota, 23.1 percent of its residents were obese in 2006. In 2007, the figure rose to 23.7 percent.

In comparison, 17.6 percent of Colorado residents are obese. The national median for 2006 was 25.1 percent.

The obesity database is maintained by the Centers for Disease Control in Atlanta.