by Marion Nestle

Currently browsing posts about: Obesity-in-kids

Dec 16 2011

Good news! Childhood obesity rates declining in NYC

Just in time for the holidays, we get some good news.   The New York City Health Department reports that rates of childhood obesity are falling.

If the rates were staying constant, I’d consider it a step forward.  But these results show rates going down, even if only by a few percentagel points.

The Bloomberg administration says the numbers are a result of its anti-obesity initiatives, some focused especially on children.  Health Commissioner Dr. Tom Farley told the New York Times that he attributes

the progress partly to the city’s aggressive advertising campaign against sugary sodas, which he said may have altered what parents were providing to their children. The city has also tried to add healthier options to school lunch menus, enacted strict rules on the calorie and sugar content of snacks and drinks in school vending machines, and even put limits on bake sales, a move that caused some grumbling.

As I explained to Bloomberg News,  if this trend continues, it will represent the first truly positive development in years.

It also suggests that the health department’s unusually aggressive efforts to address obesity may be paying off.  If so, they should inspire other communities to do the same kinds of things.  If nothing else, they raise awareness of the problem and help create an environment more conducive to healthy eating.

On the national level, Michelle Obama’s Let’s Move campaign also has raised awareness.  Could it be that we are getting to a tipping point?

It’s pretty clear by now what works.  A Cochane meta-analysis of 55 studies finds strong evidence to support beneficial effects of child obesity prevention programs on BMI, particularly for kids age 6 to 12.

The interventions showing the most promise are just like those in New York City:

  • School curriculum that includes healthy eating, physical activity and body image
  • School sessions for physical activity throughout the school week
  • Improvements in nutritional quality of the food supply in schools
  • Environments and cultural practices that support children eating healthier foods and being active throughout each day (see yesterday’s post)
  • Support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities)
  • Parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen based activities

These are showing measurable benefits.  Shouldn’t every city start doing them?

Dec 14 2011

Update on marketing to kids

I subscribe to The Lancet, and always enjoy reading its editor’s weekly Offline column.  In October, editor Richard Horton wrote about how  government obesity policy needs to be based firmly on scientific evidence.

And what is that evidence?

On this question, the evidence is utterly clear.  Thanks to the work of the best scientific minds in obesity research, the most reliable evidence shows that the government’s plan should include taxes on unhealthy foods and beverages, front-of-pack traffic-light nutrition labeling, reductions of junk food and drink advertising to children, and school-based programmes to reduce television viewing and sugar-sweetened beverage consumption (Lancet, 2011;378:1451).

If you care about public health evidence, that’s what it shows.  But doing these things goes against the business interests of food companies and they are doing everything they can to oppose such science-based measures.

In the U.S., the Sunlight Foundation has just released a report detailing the amounts of money food companies have spent on lobbying to block federal attempts to set nutritional standards for marketing foods to children (see previous posts).

Big companies such as Nestle, Kellogg, Viacom, McDonalds, General Mills, and Time Warner have indicated on official reports that they have lobbied on the controversial proposed guidelines; all together such companies have reported spending more than $37 million on lobbying this year.

The Sunlight report lists reported lobbying expenses (for example, Coca-Cola $4.7 million, General Mills $660,000).  It also points out that

…Over all public relations were handled by Anita Dunn, formerly communications director at the Obama White House, at the firm SKDKnickerbocker Consulting.

Anita Dunn is of special interest because of her previous position at the White House.  Now she’s working for the not-so-loyal opposition.  Marian Burros reported on this switch for Politico:

Dunn, who served as White House communications director, is a senior partner at SKDKnickerbocker Consulting, which is handling public relations for the food industry’s campaign. Switching sides isn’t uncommon in the incestuous world of Washington consulting and lobbying, and the food industry coalition seeking to scuttle the voluntary guidelines argues that they are actually enforceable regulations in disguise that could lead to billions in lost sales.

Dr. Horton’s comments in Lancet imply that the British government isn’t doing much better.

As for the European Union (EU),  Food Chemical News reported on December 8 that major food companies— McDonald’s, Burger King, Coca-Cola, Danone, Kellogg, Mars, Nestlé, PepsiCo, Procter & Gamble and Unilever, as well as the European Snacks Associations—have just pledged to promote only healthful products on their websites aimed at children under age 12.

By “healthful,” they mean products that meet “better-for-you” criteria.  Food Chemical News cites a study suggesting that European children now see 79% less advertising of really bad junk foods on kids’ TV than they did in 2005, and 29% less across all TV programs.

The study did not say whether sales of those products were down too. If not, this could explain the willingness of companies to extend the voluntary restriction to websites aimed at very young children.

All of this would be much simpler for parents if governments paid attention to the research.  If they did, they would:

  • Tax unhealthy foods and beverages
  • Require traffic-light front-of-pack labels
  • Stop junk food and drink advertising to children
  • Institute programs to reduce television viewing
  • Institute programs to reduce sugar-sweetened beverage consumption

Taken together, these might actually make some progress in reducing childhood obesity.

Dec 7 2011

White House insists “eat better” is still part of Let’s Move

I got a call yesterday from Sam Kass, the senior policy adviser on Michelle Obama’s Let’s Move staff, objecting strongly (an understatement) to my post about her new physical activity initiatives.

I interpreted her speech as a pullback from healthy eating initiatives.  “Eating better” is demonstrably bad for business.  The food industry much prefers “move more.”

Mr. Kass says no pullback was intended.  Instead, he said, this is an expansion of Let’s Move into another one of the program’s five essential “pillars.”

Pillars?

I did not recall anything about pillars.  I went to the Let’s Move website. Sure enough, there they are:

At the launch of the initiative, President Barack Obama signed a Presidential Memorandum creating the first-ever Task Force on Childhood Obesity….[Its] recommendations focus on the five pillars of the First Lady’s Let’s Move! initiative.

  1. Creating a healthy start for children
  2. Empowering parents and caregivers
  3. Providing healthy food in schools
  4. Improving access to healthy, affordable foods
  5. Increasing physical activity

In February 2010, Mrs. Obama discussed these elements in her speech launching Let’s Move, although without using the word “pillars.”  The word also did not pop up in her speech discussing the new activity initiatives.

When I need help with this sort of thing, I consult Obama Foodorama,  a treasure trove of information about food at the White House.  Here’s what Let’s Move has done and is doing about the pillars:

  1. Creating a healthy start for children: encouraging breastfeeding, Let’s Move Child Care, and other such programs
  2. Empowering parents and caregivers: MyPlate and MiPlato, front-of-package labeling
  3. Providing healthy food in schools: child nutrition legislation, Healthier US Challenge , salad bars in schools
  4. Improving access to healthy, affordable foods: combating food deserts, reducing the price of fruits and vegetables, encouraging gardening, and green markets
  5. Increasing physical activity: Presidential Active Lifestyle Award challenge (PALA) and the new initiatives

In the broader context of the Let’s Move pillars, a focus on physical activity makes sense.  It is an addition, not a substitution.

But Mrs. Obama’s speech did not frame it like that.  Instead, her speech implied that she had given up on healthy eating because it is too difficult (kids have to be forced to eat vegetables), leaving open the possibility that “eating better” is too hard to promote in an election year.

I wish her speech had placed the initiative in context.   Had it done so, it would not have been open to this kind of interpretation.

Dec 5 2011

Let’s Move Campaign gives up on healthy diets for kids?

In what Obama Foodorama calls “a fundamental shift in the Let’s Move campaign” Michelle Obama announced in a speech last week that she will now focus on getting kids to be more active.

Apparently, she has given up on encouraging food companies to make healthier products and stop marketing junk foods to kids.

This shift is troubling.  Here’s why:

1.  The shift is based on faulty biology.

To lose weight, most people have to eat less whether or not they move more.   For example, it takes about three miles of walking to compensate for the calories in one 20-ounce soda.

Activity is important for health, but to lose or maintain weight, kids also need to eat less.  Sometimes they need to eat much less.  And discouraging them from drinking sugary sodas is a good first step in controlling body weight.

But eating and drinking less are very bad for business.  Food companies do all they can to oppose this advice.

2.  It undercuts healthy eating messages.

On the one hand, Mrs. Obama says that she disagrees with this assumption: “kids don’t like healthy food, so why should we bother trying to feed it to them.”

But her speech implies that kids won’t eat healthfully unless forced to:

I want to emphasize that last point — the importance of really promoting physical activity to our kids…This isn’t forcing them to eat their vegetables. (Laughter.) It’s getting them to go out there and have fun.

3.  It declares victory, prematurely.

Mrs. Obama says:

Major food manufacturers are cutting sugar, salt and fat from their products. Restaurants are revamping kids’ menus and loading them with healthier, fresher options. Companies like Walgreens, SuperValu, Walmart, Calhoun’s Grocery are committing to build new stores and to sell fresh food in underserved communities all across this country.

Congress passed historic legislation to provide more nutritious school meals to millions of American children. Our schools are growing gardens all over the place. Cities and towns are opening farmers markets. Congregations are holding summer nutrition programs for their kids. Parents are reading those food labels, and they’re rethinking the meals and the snacks that they serve their kids.

So while we still have a long way to go, we have seen so much good progress. We’ve begun to have an impact on how, and what, our kids are eating every single day.  And that is so important. It’s so important.

Really?  I’d say we’ve seen promises from food companies but remarkably little action.

Mrs. Obama’s speech fails to mention what I’m guessing is the real reason for the shift: “Move more” is not politically loaded.  “Eat less” is.

Everyone loves to promote physical activity.  Trying to get the food industry to budge on product formulations and marketing to kids is an uphill battle that confronts intense, highly paid lobbying.

You don’t believe this?  Consider recent examples of food industry opposition to anti-obesity efforts:

  • Soda companies successfully defeated efforts to impose taxes on soft drinks.
  • Food companies successfully defeated efforts by four federal agencies to set voluntary standards for marketing foods to children.
  • Food companies successfully lobbied Congress to pass a law forbidding the USDA from setting standards for school meals regarding potatoes, tomato sauce, and whole grains.  The result?  Pizza tomato sauce now counts as a vegetable serving.
  • McDonald’s and  Burger King evaded San Francisco’s new rules restricting toys with kids meals by selling the toys separately for ten cents each.

The political cost of fighting the food industry is surely the reason for the change in Mrs. Obama’s rhetoric.  Now, she agrees that kids won’t eat vegetables unless forced to.

But in March 2010 Mrs. Obama warned Grocery Manufacturers Association:

We need you…to entirely rethink the products that you’re offering…, the information that you provide about these products, and how you market those products to our children….This isn’t about finding creative ways to market products as healthy.

The food industry understood those as fighting words.  It fought back with weapons at its disposal, one of which is to deflect attention from food by focusing on physical activity.   It now has White House endorsement of this deflection.

I’m all for promoting physical activity but the refocusing is a loss, not a win, in the fight against childhood obesity.

Nov 2 2011

IASO’s news feed

Oct 4 2011

Food marketing gets plenty of attention, and about time!

Here are some of the latest reports on how food marketing influences eating patterns and obesity.

American University’s Kogod School of Business publishes a business magazine, Kogod Now.  It latest CoverStory takes a tough look at at how targeted marketing of foods and beverages contributes to the obesity crisis, especially among minority children and adolescents.

Cornell University’s Pierre Chandon and Brian Wansink ask the question, “is food marketing making us fat?”  Their review of the research leads them to conclude that a “small steps” approach ought to help reverse obesity.   Recent analyses, however, suggest that reversing overweight is likely to take a lot more than small steps, but it’s worth reading what they have to say about marketing practices.

Two reports from Canada indicate that industry self regulation has little effect on actual food industry marketing practices.  Instead, banning the marketing of junk foods, as has been accomplished in Quebec, works somewhat better.

The American Academy of Pediatrics takes a look at how television watching affects obesity in children.  If kids watch a lot of TV–and they have a TV set in their bedrooms—they are at high risk of becoming obese.  The obvious conclusion?  Get rid of the TV!

It is heartening that so much of the research on obesity these days focuses on changing the food marketing environment.  Now if policymakers would just pay some attention!

Sep 16 2011

Michele Obama gets Darden’s to promise healthier meals

Yesterday, Michele Obama announced  that as part of her Let’s Move! initiative Darden’s, the restaurant chain that owns Olive Garden, Red Lobster, LongHorn Steakhouse, The Capital Grille, Bahama Breeze, and Seasons 52, would be making its meals a bit healthier.

As I explain below, I have a personal interest in this announcement.

According to the White House press release, the Darden’s commitment includes:

Kids’ Menus – changes starting now and to be fully implemented by July 2012.  Darden’s will:

  • Add a fruit or vegetable as the default side for every kids’ menu item at those restaurants offering a default side on the children’s menu: Bahama Breeze, LongHorn Steakhouse and Red Lobster.
  • Make 1% milk the default beverage.
  • Make milk prominently promoted on the menu and available with free refills.
  • Illustrate healthy choices for meals and drinks on menus.
  • Display healthier menu options more prominently, when possible.
  • Not display carbonated beverages on children’s menus.
  • Improve the nutritional content of one or more children’s menu items to provide equal or less than 600 calories, 30% of total calories from fat, 10% of total calories from saturated fat, and 600 mg of sodium.

Calories/Sodium Footprint Reduction – changes to be implemented by 2016 and 2021

  • By 2016, reduce calories by 10% and over a ten-year period by 20%.
  • By 2016, reduce sodium by 10% and over a ten-year period by 20%.

My personal interest: In 2005, I was invited to Amelia Island, Florida, to give a talk to the CEO’s of popular restaurant chains, among them Clarence Otis, Jr., the CEO of Darden’s.  I was specifically asked to discuss what restaurant chains could do to lessen the impact of childhood obesity.

In my talk, I told the group that they could help alleviate childhood obesity by:

  • Making healthy kids’ meals the default.  Parents could still order junk food, but the default meal should be healthy.
  • Providing a price incentive for choosing smaller portions.
  • Stopping any funding of the Center for Consumer Freedom and hiding behind its tactics.

The reaction?  The CEOs went ballistic: “you are trying to put us out of business!”

No, I simply hoped they would consider making it easier for customers to make healthier choices.

Seven years later, Mrs. Obama has put these chains on notice that they are part of the problem of childhood obesity and must change their practices.  Darden’s has admitted that it bears some responsibility for contributing to childhood obesity and is making some grudging changes.  Others are likely to follow.

It’s a step.  Now let’s make sure they follow through.   

For more details, see the AP story.   For many more details, see what Obamafoodorama has to say (I’m quoted).

Sep 1 2011

Obesity research and commentary: today’s roundup

My mailbox is overflowing with new reports and commentary about obesity.  Here are some examples:

State medical expenses: The journal, Obesity, has an analysis of the cost of obesity to states.  Obesity costs states an additional 7 to 11% in medical expenses. Between 22% (Virginia) and 55% (Rhode Island) of state costs of obesity are paid by taxpayers through Medicare and Medicaid.

Robert Wood Johnson Foundation series on preventing childhood obesity: 

From the Campaign to End Obesity:

Obesity Rates Projected to Soar, ABC News, 8.25.11Will half the U.S. population be obese by 2030? The current trajectory would see 65 million more obese adults, raising the national total to 164 million. Roughly one-third of the U.S. population is currently obese.

In U.S., Obesity Rates Remain Higher Than 20% in All States, Gallup, 8.25.11: Colorado continues to be the state with the lowest obesity rate in the country, at 20.1% in the first half of 2011. West Virginia has the highest obesity rate in January through June 2011, at 34.3%, which is also the highest Gallup has measured for any state since it began tracking obesity rates in 2008.

Reversing the obesity epidemic will take time, LA Times, 8.26.11The old rule that cutting out or burning 500 calories a day will result in a steady, 1-pound-per-week weight loss doesn’t reflect real people, researchers say. For the typical overweight adult, every 10-calorie-per-day reduction will result in the loss of about 1 pound over three years.

I’ve commented on some of these in previous posts.  If you find the avalanche of studies overwhelming, you are in good company.  I do too, but will summarize my take on the literature in my forthcoming book with Malden Nesheim, Why Calories Count: From Science to Politics, due out from University of California Press in March 2012.  Stay tuned.

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