Road map on obesity tough path

Judith Graham
October 1, 2004

The National Academy of Sciences proposed an ambitious action plan Thursday to prevent childhood obesity, calling on schools, parents, health professionals, community organizations, industry and government agencies to play a stronger role in reversing this escalating epidemic.

The 482-page report provides a road map for what should be done, including that companies adopt voluntary guidelines for advertising aimed at children, schools stop letting companies market to students, restaurants expand healthy offerings, food labels provide better information about calories and nutrition, and parents limit kids' TV watching.

Health insurers should make obesity prevention a priority, and health professionals should routinely counsel families about children's weight, advises the report, produced by the academy's Institute of Medicine.

Every student should get an annual school check of body-mass index--a ratio of height to weight--and 30 minutes of physical activity a day, the study suggests. Schools also should develop new nutrition guidelines for all foods and beverages they sell. Similar proposals, many of them controversial, have been debated for several years. But this is the first time an independent, national panel of experts has endorsed such an extensive set of recommendations.

Cost of future illnesses

The cost of inaction would be a growing burden of obesity-related illnesses such as heart disease, arthritis, hypertension and diabetes for growing numbers of young people, who will become disabled earlier in their lives than previous generations, experts warned.

"This is a collective responsibility, and we as a nation need to move toward a healthier environment in which our children and youth can grow up," said Dr. Jeffrey Koplan, former head of the federal Centers for Disease Control and Prevention, who chaired the institute's 19-member panel.

Some 9 million American youth are now considered obese, and those at the highest end of the scale are heavier than in the past, the report found.

Parents often blame themselves when their children become obese, not realizing that many other factors can influence young people's weight.

"This report says we need a national response, that parents can't do it alone," said Margo Wootan, director of nutrition policy for the Center for Science in the Public Interest.

"That's a very important message."

Not aggressive enough

Many obesity researchers praised the institute's comprehensive approach to tackling childhood obesity and said it was sure to be influential. But critics faulted the study's emphasis on voluntary strategies, arguing that a more aggressive approach--like the one used to target cigarette smoking--was needed.

"The evidence in the report is strong enough to support much stronger actions," said Marion Nestle, professor in the Department of Nutrition, Food Studies & Public Health at New York University. "As it stands, the recommendations are weak. There is nothing here with any teeth in it."

Particularly disappointing, she said, was the institute's failure to call for strict guidelines for companies marketing to children on TV or in schools. "These companies aren't going to do anything voluntarily that stands the chance of hurting their business. It won't work," Nestle said.

Under the institute's proposals, the Federal Trade Commission would get new power to monitor voluntary industry guidelines and impose penalties if they aren't followed. If that doesn't work, stricter actions may be taken, Koplan suggested.

The average child sees more than 40,000 TV commercials a year; a large percentage promote soft drinks, fast food, snacks, candy and sweetened breakfast cereal, the institute reported.

Food and beverage companies spend $10 billion to $12 billion annually on marketing to children.

A statement released by Mary C. Sophos, senior vice president of the Grocery Manufacturers of America, argued there is no need for new industry guidelines.

"The recommendations ... describe a system that sounds very much like the one that is in place," Sophos said. "The Children's Advertising Review Unit guidelines and review system, backed by the Federal Trade Commission's present authority to investigate non-compliance, provide a mechanism that is perfectly suited to the task."

In its call for communities to mobilize around childhood obesity, the national panel has embraced an approach already adopted in Chicago.

Chicago has a plan

For the last 18 months, the Consortium to Lower Obesity in Chicago Children has brought together health professionals, businesses, government officials, university researchers, community organizations and schools to develop strategies for preventing and reducing obesity. Committees are compiling education materials on obesity for parents and examining how prevention initiatives can be tailored to African-Americans, Hispanics and various ethnic communities in the city. Data about overweight and obese children have been collected for the first time in the Chicago Public Schools.

With a push from the consortium, the Illinois legislature last year enacted a bill calling for the state Health Department to track students' body-mass index scores, using data already collected during school physicals.

On Wednesday, the consortium sponsored a childhood obesity policy summit in Chicago, asking a wide range of organizations to propose policies that would help the state deal with this epidemic. By December the group plans to cull the leading proposals and present them to state lawmakers, hoping to garner support for major obesity-related legislation in the next session.