It is more than four years since Jamie Oliver embarked on one of his most audacious challenges by taking his Food Revolution series to the most unhealthy city in the US - Huntington, West Virginia - and trying to convince its children to eat their greens.
The show was sad: slack-jawed, jowly kids who ate pizza for breakfast and couldn't tell the difference between a potato and a tomato when it was dangled in front of their upturned noses.
The result, predictably perhaps, was a revolt, not a revolution. "We don't want to sit around and eat lettuce all day," said the local shock-jock radio host, predicting that "Jamie's not got anything that will change this town." Jamie was soon weeping tears of frustration.
Nearly five years on, Huntington - where some 40% of people are clinically obese - was this month again named the fattest place in the US in Gallup's annual survey.
There was a time not so long ago - before I moved to the US - when I'd have let rip all my prejudices at such news. Once someone who looked at a fat person and instinctively thought "get it together", I'd have poured scorn on these waddling grotesques.
It is true that a trip into Middle America feels like a Gary Larson Far Side cartoon suddenly brought to life, as lumpen figures haul themselves wheezing from their pick-ups, barely able to make it from car park to diner.
But, as The New Yorker's George Packer observed in his book The Unwinding, a brilliant account of economic collapse in places like Huntington, this is a world partly of our own making, yes - but also of the food conglomerates, lobbyists and PR machines that protect and promote their sugary, processed wares.
This is a world where people trundle up supermarket aisles in electric scooters because they are too fat to walk, filling their baskets with super-sized, force-fed chickens that often collapse under their own weight before slaughter.
As a former smoker, I know all too well what it is to choose today's pleasure over tomorrow's pain. And imagine a world - as it was in the 1950s - where cigarettes were endlessly advertised and consumption was not only acceptable, but encouraged.
It is hard to be healthy and a kid in the US. Whatever reductions in sugar, fat and salt content are shamed out of food companies are more than compensated for by the relentless expansion of serving sizes.
There are threats of new laws, but the companies that bankroll the politicians always manage to lobby for industry "self-regulation".
Too often, particularly in poorer areas, there is nothing else to choose from. Urging children to make "good choices" is heavy going in the face of a $140-million (R1.47-billion ) "Big Food" lobby. We in the US are breeding our children to be fat - just like the supermarket chickens. - © The Daily Telegraph
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