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Fall/Winter 2004 Vol. 4 No. 3

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©Jim Dandy/Corbis The Battle of the Bulge

National Campaign Needed to Curb Childhood Obesity

The key to avoiding obesity is elementary: consume no more calories than your body needs to fuel itself. But if that simple prescription was so easy to follow, rates of obesity among U.S. children and youth would not have tripled over the past three decades, inciting America's public health leaders to dub childhood obesity a national epidemic.

Debate rages over what factors are to blame for the increase in childhood obesity, with fingers pointing to everything from the abundance of fast food and soft drink ads to the dwindling of physical education in schools to the changing lifestyles and wavering willpower of kids and parents. Several recommendations have been made for steps that would curb the rise in obesity. But unhealthy eating and inactivity are too ingrained in today's culture to be solved by actions undertaken by one or a few segments of society, says a recent report from the Institute of Medicine. It will take a concerted, far-reaching campaign similar to national efforts to curb tobacco use to begin reversing the obesity trend, the report says. Families, schools, the food and entertainment industries, communities, and governments all share the burdens of -- and blame for -- childhood obesity, and so all have roles to play.

"We've drifted into the current situation over the past 30 years because of gradual changes in society, but we're not going to just drift back out," said Jeffrey Koplan, chair of the committee that wrote the report, and vice president for academic health affairs, Emory University, Atlanta. "We need to launch a multilevel assault on obesity in kids, and this report offers the blueprint for a comprehensive campaign."

Several of the report's recommendations challenge entrenched aspects of American life. But preventing childhood obesity will require tough choices and a significant shift in many social norms, Kaplan noted.

The report calls for schools to apply nutritional standards developed at the national level to all foods and beverages served on school grounds, including vending machine products. The standards might entail setting upper limits on particular nutrients, such as fat and sugar. To counter downward trends in activity levels, schools should ensure that students engage in at least 30 minutes of physical activity each day and should expand opportunities for exercise beyond gym classes.

Because research suggests that exposure to food, beverage, and entertainment advertisements may adversely affect kids' eating habits and activity levels, these industries should develop and implement guidelines for advertising directed at kids. Congress should give the Federal Trade Commission the authority to monitor compliance and take action against ads that fail to comply. The restaurant industry should continue to expand offerings of nutritious foods and beverages, and restaurants should provide calorie content and other nutrition information.

The report also outlines several specific measures that parents should take, including providing healthy foods in the home, actively discussing their children's weight with health care providers, and limiting their children's TV, video game, and recreational computer time to less than two hours daily. It calls on community groups and state and local governments to support zoning ordinances and plans to enhance sidewalks, bike paths, playgrounds, and other recreational facilities.

While some might say that these and other aspects of the report's ambitious plan will be too hard to execute, the committee points to other national public health efforts that have proved successful over time, such as the campaigns to reduce tobacco use and to promote auto safety. People used to shun seat belts and even laugh at those who wore them, the committee members noted. Now, the vast majority of people buckle up automatically.   -- Christine Stencel

Preventing Childhood Obesity: Health in the Balance. Committee on Prevention of Obesity in Children and Youth, Food and Nutrition Board, Institute of Medicine (2004, approx. 482 pp.; ISBN 0-309-09196-9; available from the National Academies Press, tel. 1-800-624-6242; $44.95 plus $4.50 shipping for single copies).

The committee was chaired by Jeffrey Koplan, vice president for academic health affairs, Emory University, Atlanta. The study was funded by the U.S. Department of Health and Human Services' Office of Disease Prevention and Health Promotion; Centers for Disease Control and Prevention; National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Child Health and Human Development; National Heart, Lung, and Blood Institute; National Institutes of Health's Division of Nutrition Research Coordination; and the Robert Wood Johnson Foundation.

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Copyright 2005 by the National Academy of Sciences