Progress Slow in Fight Against Childhood Obesity

Report calls for concerted push, from U.S. government to individual families

WEDNESDAY, Sept. 13, 2006 (HealthDay News) -- While there's more recognition of the obesity epidemic plaguing American children and many new programs to fight it, the effectiveness of these efforts is not clear, a new federal report warns.

In addition, the fight lacks national leadership, according to the Institute of Medicine report, Progress in Preventing Childhood Obesity: How Do We Measure Up?, released Wednesday.

"The very health of the country hangs in the balance until we reverse the childhood obesity epidemic," Dr. Risa Lavizzo-Mourey, president of the Princeton, N.J.-based Robert Wood Johnson Foundation, which funded the report, said at a press conference.

"Leaders in Washington, in our home states and towns need to accept this cold hard fact: That if we do not reverse the epidemic of childhood obesity, millions of kids and our society will be robbed of a healthy and hopeful future," Lavizzo-Mourey said.

U.S. rates of childhood and adolescent obesity are rising at an alarming pace. Currently, one-third of American children are obese or at risk of becoming obese, according to the report. In 2002, the obesity rate for children and teens was 16 percent; by 2004 it had risen to 17.1 percent; it's expected to climb to 20 percent by 2010.

Obesity is known to cause a variety of diseases and health problems, including diabetes, heart disease, stroke, gallbladder disease, osteoarthritis, and certain cancers.

According to the IOM report, short-term gains are being made. There are several federal policies that have been instituted to encourage better nutrition and physical activity in schools. Many communities have built sidewalks and bike paths to encourage exercise, and national awareness of the obesity problem is increasing.

But positive changes in the health of children will require years of sustained effort, evaluation, and resources, the report said.

The report provides a framework to evaluate programs and calls for greater leadership in preventing childhood obesity, Dr. Jeffrey P. Koplan, lead author of the paper and vice president for academic health affairs at Emory University's Woodruff Health Sciences Center, said at the press briefing.

"The nation is beginning to grasp the severity of the epidemic," Koplan said. "But despite some encouraging efforts, many of them remain fragmented and small in scale. We are still not doing enough to prevent childhood obesity and the problem is getting worse."

Koplan said inconsistent monitoring of programs has hindered experts' ability to identify those that work.

"We also observed that many environments do not support healthy behaviors for our children and youth," Koplan said. "In some communities, fruits and vegetables are not readily available, especially for families on limited household budgets. Certain neighborhoods don't offer safe places for children to play," he added.

In addition, public and private spending is not enough to deal with the extent of the problem. "There is need for collective responsibility and actions among all who have a stake in reversing this problem. No single sector of society should bear the responsibility of the problem, and no single sector, acting alone, can effectively halt and reverse it," Koplan said.

The report calls upon federal, state and local government to provide leadership in creating and evaluating effective programs, and upon the food industry to develop and promote healthful products and monitor product portion sizes.

In addition, the food industry should convey consistent information to consumers that support a healthy lifestyle. Industry should also partner with public institutions to support childhood obesity-prevention efforts, the report recommends.

Communities should share their successful programs with others and schools should increase their physical-education requirements and standards, Koplan said. In addition, families need to be sure that meals, snacks and beverages support a healthful diet and are served and eaten in reasonable portion sizes. Families should also make physical activity a priority, he said.

One expert found the report helpful, but believes that no one approach will reverse the obesity epidemic.

"With its usual careful and comprehensive methods, the IOM has characterized the state of childhood obesity and control efforts in the United States very accurately," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine.

There is more attention focused on the problem, and more recognition that the dual epidemics of obesity and diabetes in children are a real public-health crisis, Katz said. However, it isn't clear which programs work. What's needed are innovative programs, carefully evaluated to see which are most effective, he said.

Moreover, children's daily environment promotes obesity, Katz said. This makes it impossible for any one approach to solve the problem.

"Factors that favor obesity assault us daily, from calorie-dense fast food to deceptive advertising, to labor-saving technology. No single factor created the obesity epidemic, and no single program will fix it," he said.

More information

The U.S. Centers for Disease Control and Prevention can tell you more about childhood obesity.

SOURCES: Risa Lavizzo-Mourey, M.D., M.B.A., president, Robert Wood Johnson Foundation, Princeton, N.J.; Jeffrey P. Koplan, M.D., M.P.H., vice president for academic health affairs, Woodruff Health Sciences Center, Emory University, Atlanta; David L. Katz, M.D., M.P.H., associate professor of public health, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Sept. 13, 2006, Institute of Medicine report, Progress in Preventing Childhood Obesity: How Do We Measure Up?
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