Currently browsing posts about: Obesity-in-kids

My monthly Food Matters column for the San Francisco Chronicle:

Q: I forced myself to watch all four hours of HBO’s “Weight of the Nation.” I get it that obesity is a scary problem and I’m supposed to be eating less. What I don’t get is how I’m supposed to do that when food companies can do what they want and the government lets them.

A: I am with you on this one. I also looked at the website (theweightofthenation.hbo.com) and a report from the Institute of Medicine, “Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation.” These all are components of a public-private partnership campaign to bring the personal and economic costs of obesity to national attention.

As The Chronicle’s David Wiegand put it in his Datebook review (see: sfg.ly/KO2vgI), the show “pulls no punches, spares neither the multibillion-dollar food and advertising industries nor public officials for not only failing to fix the problem but actually making it worse.”

I thought the series focused too much on what you have to do on your own to manage your weight: take small steps, set realistic goals, focus on portion control, monitor your calorie intake.

I wish it had spent as much time on countering the actions of the food industry, called by Kelly Brownell of Yale’s Rudd Center as “powerful, pernicious and predatory.”

I also wish it had been more courageous in demanding that government help check the excesses of food industry marketing to make it easier for Americans to cope with the social, economic and business drivers of obesity that the series documented so well.

I saw that courage in an accompanying video for kids, which won’t be shown nationally until the fall. Watch for it. School kids in a Rethinkers club in New Orleans wanted to improve the lunches in their school. They went into action and figured out how to make the system work for them. They succeeded by learning to “speak truth to power” and “hold feet to the fire.”

Why aren’t adults doing the same? For an explanation, take a look at the institute’s report. Its recommendations do speak some truth to power. Although its No. 1 goal promotes physical activity (a thoroughly uncontroversial recommendation), its No. 2 is to fix the environment to make healthier food options routine and easy, especially by discouraging consumption of soft drinks.

As for holding feet to fire, the report warns that if companies don’t adopt nutrition standards for kids’ marketing within two years, policymakers should consider making them mandatory.

Consider? “Weight of the Nation” showed how the food industry reacted when the Federal Trade Commission tried to propose voluntary standards.

In two years? The institute already gave the food industry two years to act – six years ago. Its 2006 “Food Marketing to Children and Youth” report stated that if the industry didn’t stop advertising junk foods on children’s television programs within two years, Congress should legislate marketing standards.

In 1968, the CBS television documentary “Hunger in America” shocked the nation and galvanized Congress to pass legislation to reduce poverty and malnutrition.

“Weight of the Nation” is equally shocking. It impressively and compellingly defines the problem of obesity, its consequences and its causes, personal and societal.

But I wish the series – and the Institute of Medicine – had been able to rise above the politics and say more about how we as a society could do better to improve school food, limit the relentless marketing of sodas and junk foods, and make it easier for everyone to afford and have access to healthier foods.

Food companies are businesses. In today’s investment economy, they must not only make a profit but must increase the profit every 90 days. Business imperatives mean that they could help make healthier choices easier, but won’t unless forced to. That’s what New York Mayor Michael Bloomberg’s proposed ban on big sodas is trying to do (see: sfg.ly/L45K0t).

At the very least, I’m hoping the HBO program will encourage viewers to press for political action to prevent obesity. If it does, history will judge this documentary to be as important a democratizing influence on our society as was “Hunger in America.”

I’m catching up on some reading over the long weekend.  Here are some selections from the latest issue of Childhood Obesity (Click here for the complete Table of Contents).

I’ve been asked to comment on the HBO series, Weight of the Nation and everything that comes with it: the accompanying book, the auxiliary videos, the distribution plan to schools and other institutions, and the Institute of Medicine’s report, Accelerating Progress in Obesity Prevention.

Because I wanted to look at all of it before commenting, plenty of others have beaten me to it, among them FoodandTechConnect’s infographic summary,   Kerry Trueman on AlterNet and Michele Simon on Grist.

I don’t have HBO but got sent the press kit, the Weight of the Nation book, the disks, and the IOM report.  I watched all four hours of the HBO series, plus the “Rethinkers” video of kids working on a school lunch project in New Orleans (air dates), plus the IOM and HBO books, plus the website.

Overall, Weight of the Nation makes the size, scope, causes, and consequences of obesity alarmingly clear.

The talking heads—many of them my friends, colleagues, and former students—all had plenty to say about what obesity means on a day-to-day basis for individuals and its personal and economic cost to society.

The programs ought to convince anyone that obesity is a big problem and that something big needs to be done to prevent it.

But doing something big, the series makes clear, will be very difficult.

This may be realistic, but it is not inspiring.

We need inspiration.   That’s why I wish the programs had focused as much on social responsibility as they did on personal responsibility.

I wanted to see the programs take leadership on how government can help citizens reduce the social, economic, and business drivers of obesity.

That kind of leadership exists.  To see it in action, watch the video of the New Orleans school “rethinkers.”  Those kids wanted to improve their school lunches.  They got busy, dealt with setbacks, and learned how to make the system work for them.  They “spoke truth to power” and “held feet to the fire.”

Why aren’t adults doing the same?   Politics, the IOM report explains.  Although one of its principal recommendations is critical—Create food and beverage environments that ensure that healthy food and beverage options are the routine, easy choice—its recommendations speak some truth to power but do little to hold feet to the fire.

The IOM report explains the political realities:

The committee’s vision takes into account the need for strategies to be realistic, as well as consistent with fundamental values and principles.  At the same time, however, having a diversity of values and priorities among them is itself a principle of U.S. society.

Potentially competing values and principles must be reconciled, for example, in considering protections needed for individuals versus the community at large or for the public versus the private sector.

Vigilance regarding unintended adverse effects of changes undertaken to address the obesity epidemic is also needed.

“Americans,” the report says, are accustomed to the current obesogenic environment, one “driven by powerful economic and social forces that cannot easily be redirected.”

It may not be easy to redirect such forces, but shouldn’t we be trying?

In 1968 the CBS documentary Hunger in America galvanized the nation to take action to reduce poverty and malnutrition.

The HBO series was equally shocking but I wish it had focused more on how we—as a society—could mobilize public distress about the poor quality of food in schools and the relentless and misleading marketing of sodas and junk foods that it so well documented.

But dealing with the need to address the social and economic forces that promote obesity would, I’m told, be considered lobbying, which the private-public sponsors of the series are not permitted to do.

Mobilizing public support for health is considered lobbying.  Food industry marketing is not.

FoodNavigator-USA.com columnist Caroline Scott-Thomas wrote about the HBO series:

As an industry journalist, I’ll be among the first to admit that industry is stuck in a very hard position here: On the one hand, it wants to be seen to be doing the right things – but on the other, what people say they want to eat, and what they actually do eat are often very different, and after all, food companies are in the business of making money.

But honestly, could industry do more to make healthy choices routine, easy choices? I think so.

Yes it could, but won’t unless forced to.

Without leadership, we are stuck doing what the food industry needs, not what the public needs.

Weight of the Nation did an impressive and compelling job of defining the problem and its causes and consequences.  I wish it—and the IOM—could have risen above the politics and pressed harder for strategies that might help people make healthier choices.

But—if the HBO programs really do help mobilize viewers to become a political force for obesity prevention, they will have been well worth the effort that went into making and watching them.

I am in Brazil at meetings of World Nutrition Rio 2012 but was deluged yesterday by links to a lengthy Reuters’ Special Report: How Washington went soft on childhood obesity.

In an e-mail, Reuters explains that its report is about how food and beverage companies dominate policymaking in Washington, doubled lobbying expenditures during the past three years, and defeated government proposals aimed at changing the nation’s diet.

• The White House, despite First Lady Michelle Obama’s child obesity campaign, kept silent as Congress killed a plan by four federal agencies to recommend reductions to sugar, salt and fat in food marketed to children.
• Corporate lobbying last year led Congress to declare pizza a vegetable to protect it from a nutritional overhaul in the school lunch program.
• The Center for Science in the Public Interest, widely regarded as the lead lobbying force for healthier food, spent about $70,000 lobbying– roughly what companies opposing stricter food guidelines spent every 13 hours.
• The food and beverage industry has a near-perfect record in political battle even while health authorities link unhealthy food to the child obesity epidemic.
• During the past two years, each of the 24 states and five cities that considered “soda taxes” has seen the efforts dropped or defeated.

Reuters Investigates also has a video about how the food industry fought back when the White House sought healthier school lunches and Congress directed federal agencies to set nutrition standards.

Readers of this blog may recall my post last December fretting about the White House pullback, and the vigorous denial the next day by White House senior food policy advisor Sam Kass.

I attributed White House caution to the upcoming election.  Reuters does too, apparently, and so does the New York Times. 

If the First Lady is to make real progress on Let’s Move, she needs all the support she can get.  This might be a good time to send a note to the White House strongly encouraging more vigorous action on methods to address childhood obesity.

I’m getting caught up on my journal reading and didn’t want to miss this one.

The journal Childhood Obesity has a special issue of articles related to Michelle Obama’s Let’s Move! campaign.  Mrs. Obama wrote the foreword.

Here are some selections:

Let’s Move! Raising a Healthier Generation of Kids
First Lady Michelle Obama
Childhood Obesity. February 2012, 8(1): 1-1.
First Page | Full Text PDF|

Let’s Move! Progress, Promise, and the Miles Left To Go
David L. Katz
Childhood Obesity. February 2012, 8(1): 2-3.
First Page | Full Text PDF |

On the occasion of the two-year anniversary of Michelle Obama’s Let’s Move! campaign, it’s time to reflect again on what the campaign means for the White House, for childhood obesity, and for the food movement.

A year later, I summarized some of the campaign’s accomplishments.  From the beginning, I’ve been impressed with its smart choice of targets: to reduce childhood obesity by improving school food and inner city access to healthy foods.

I’m reminded of the political savvy that went into the campaign by an editorial in The Nation (February 6), “America’s First Lady Blues.”  In it, Ilyse Hogue writes about Michelle Obama’s careful treading of the fine line between marital independence and submission, using Let’s Move! as an example.

Hogue praises Mrs. Obama’s choice of a target that looks “soft,” but is anything but:

In an effort to fit Michelle’s role into a traditional profile, the media constantly reminds us that her work is on presumably soft subjects, primarily her hallmark cause to end childhood obesity…Slurs aside, what critics miss is that this campaign is not aimed at soft targets.

The food and beverage industry is a powerful lobbying force, spending nearly $16.3 million in the 2008 cycle to defeat initiatives—like a “soda tax” and limits on aggressive advertising aimed at kids—that would encourage a healthier diet and thus cut into its massive profits.

To tackle childhood obesity, we’ll have to confront complicated issues of race, class, entrenched corporate power, and access to healthy food.

Indeed we will.  Childhood obesity is a focal point for issues of social justice.

Happy birthday Let’s Move!  And many more.

The latest obesity statistics from the Centers for Disease Control and Prevention show no change over the last several years in either adults or children.  No change is good news.

For adults in 2009-2010 the prevalence of obesity was 35.5% among men and 35.8% among women.  Obesity, in these surveys is defined as a Body Mass Index (BMI) at or greater than 30.

This represents no significant overall change compared to rates in 2003-2008.  

Going back to 1999, however, obesity rates increased significantly among men in general, and among black (non-Hispanic) and Mexican-American women in particular.  In more recent years, the rates among these groups leveled off.

 For children and adolescents in 2009-2010 the prevalence of obesity was 16.9%.  For this group, obesity is defined as a BMI at or greater than the 95th percentile of weight for height.

This represents no significant change compared to rates in 2007-2008, but with one exception: the rate of obesity among adolescent males aged 12 through 19 increased.

For decades, rates of overweight and obesity in the United States stayed about the same. But in the early 1980s, rates increased sharply and continued to increase through the 1990s.

The increases correlated closely with deregulatory policies that encouraged greater farm production and loosened restrictions on food marketing.  These led to an increase in the number of calories available in the food supply, pressures on food companies to sell those calories, a proliferation of fast food places, and marketing strategies that made it normal to drink sodas all day long, and to eat everywhere, at all times of day, and in larger portions.

Why are obesity rates leveling off now except among boys?  Nobody seems to know.

I can make up several reasons, all speculative (and I have my doubts about most of them).

• People have gained all the weight they can and are in equilibrium
• People are more careful about what they are eating
• The poor economy is encouraging people to eat less
• Junk food marketing is targeted more to boys
• Girls are more careful about their weight
• Boys are particularly susceptible to “eat more” marketing pressures
• Boys are under greater psychological tension and eat to relieve it

Anyone have any better ideas?  It would be good to figure out the reason(s) as a basis for more sensible public policy.

Yes, I know getting kids to eat their veggies can be challenging. 

Cornell researchers wondered this is because kids like different ways of presenting foods than adults.  They tested this idea in a study just published in Acta Pædiatrica.   

Contrary to the default assumption that parents and children share preferences for the ways in which food is presented on plates, we find that children have notably different preferences than adults. 

Most remarkably, we show that children tended to prefer seven different items and six different colours on their ideal plates, while adults tended to prefer three different colours and three different items….Given that adults often prepare plates of food for children to eat, these findings suggest new windows for encouraging diverse childhood nutrition.

I suppose this is the rationale behind the latest approach to getting kids to eat better diets: My Fruity Faces.  These are edible stickers that kids can stick on whatever fruits, vegetables and, presumably, any other food that happens to be handy.

The stickers are less interactive and creative than the old Mr. Potato Head toy, but kids can eat them.

And they ought to like eating them: Sugar is the first ingredient. 

Sugar is followed by Hydroxypropyl methylcellulose(Modified Cellulose), Water, Natural flavor, Modified corn starch, Glycerin, Polyglycerol esters of fatty acids, Citric acid, Red beet concentrate, Turmeric, Red cabbage extract, Caramel color, Sodium Bicarbonate.

Yum.

Will something like this reallyget kids to eat more fruits and vegetables?  Cornell researchers: get to work.