Major Assault Sought on Childhood Obesity

Reversing problem will require multi-tiered attack, report urges

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By
HealthDay Reporter

THURSDAY, Sept. 30, 2004 (HealthDayNews) -- Stemming the obesity epidemic in children will require an all-out assault not dissimilar to the antismoking campaign of the last four decades, a U.S. expert panel said Thursday.

Such a war would require a multi-level approach that would harness the efforts of families, schools, communities, the food industry, and government, according to a new report from the Institute of Medicine (IOM).

The report, Preventing Childhood Obesity: Health in the Balance, which was commissioned by Congress, calls for making the prevention of childhood obesity a national public health priority.

"This report provides the first comprehensive, evidence-based action plan for tackling the epidemic of childhood obesity on multiple fronts," said IOM committee chairman Dr. Jeffrey Koplan, vice president for health affairs at Emory University and former director of the U.S. Centers for Disease Control and Prevention.

"It contains recommendations for actions that should be taken concurrently by all who have a stake in reversing this problem. No single sector bears all of the blame, and no single sector acting alone can solve it. It will require a sustained commitment of effort and resources spanning many years, possibly decades, to effectively tackle the problem," Koplan said.

Among other proposals, the report recommended that the food industry change its packaging and advertising practices. Industry officials responded that they were already ahead of the game.

"We're trying very hard to give consumers -- and especially students -- a choice," said Kathleen Dezio, spokeswoman for the American Beverage Association. "In vending machines and everywhere, soft drink companies are providing juice, bottled water, teas, sports drinks, and diet drinks as well as full-calorie soft drinks. A lot of the efforts are under way."

The epidemic of obesity has experts in a variety of disciplines fearful for the future of the nation's health. According to the report, the rate of obesity over the past 30 years has more than doubled for preschool children aged 2 to 5, and adolescents aged 12 to 19, and more than tripled for children 6 to 11. The condition carries with it a number of serious health implications, including an increased risk for developing diabetes and other chronic conditions.

"Many of us are extremely scared about what's going to happen in the future," said Dr. Tom Robinson, a member of the committee and associate professor of pediatrics and medicine at Stanford University School of Medicine. "Obesity affects just about every organ system in the body. As a result, we're looking at adult chronic diseases starting to enter into the teen years and childhood. In many ways, we're not equipped to address morbidity in the population as a whole."

While generally calling for healthy eating behaviors and regular physical activity, the report also had a number of specific recommendations:

  • The food industry should develop and adhere to marketing and advertising guidelines that minimize the risk of obesity. This would include reconsidering branding that involves cartoon and other characters geared to children. "The current system is not working because of the amount and effects of advertising on children," Robinson said. "What we recommend is not more of the same current review system for industry, [but] to define new standards for what is appropriate advertising to children and marketing to children." Compliance should be voluntary, but the Federal Trade Commission should have enough power to monitor this, he added.
  • The U.S. Food and Drug Administration should revise the nutrition facts panel on products to prominently display total calorie content for items usually consumed at one time. This would reduce confusion about serving size.
  • Restaurants, both full-service and fast-food, should continue to expand healthy food menu options.
  • Communities should develop programs to promote healthy eating and more physical activity. This should include changes in the built environment, such as adding recreational facilities, playgrounds, sidewalks, and bike paths.
  • Health-care professionals should get involved by routinely tracking body mass index (BMI). Insurers and accrediting organizations should provide incentives for maintaining a healthy body weight.
  • Schools should adopt nutritional standards for all foods and beverages served on school grounds, including those from vending machines. They should also include opportunities to exercise at least 30 minutes a day.
  • The government should explore pilot programs to increase access to nutritious foods for participants in the Food Stamp Program and Special Supplemental Nutrition Program for women, infants and children.
  • School health services should keep track of each student's BMI, and discuss results with them and their families. "We felt strongly that we not stigmatize children who may be overweight," said Russell Pate, a committee member and associate dean for research and public health at the University of South Carolina. "Measures should be administered in a private, confidential manner and fed back to the parents in a very carefully planned manner."
  • At home, parents should promote healthy lifestyle choices. This includes exclusive breast-feeding for the first four to six months of an infant's life and limiting children's television viewing and other recreational screen time to less than two hours a day.

"We have drifted into this. We're not going to drift out of it," Koplan said. "It's going to take work and leadership and resources, but those resources are really a pittance compared to the price we're going to pay if we don't take this seriously."

More information

View the report by visiting the Institute of Medicine.

SOURCES: Sept. 30, 2004 news conference with Jeffrey Koplan, M.D., vice president for health affairs, Emory University, Atlanta; Tom Robinson, M.D., associate professor of pediatrics and medicine, Stanford University School of Medicine, Palo Alto, Calif.; Russell Pate, Ph.D., associate dean for research and professor of public health, Norman J. Arnold School of Public Health, University of South Carolina, Columbia; Kathleen Dezio, spokeswoman, American Beverage Association, Washington, D.C.; Institute of Medicine report, Preventing Childhood Obesity: Health in the Balance

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