Currently browsing posts about: Obesity-in-kids

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).

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: 

• Food marketing to children: U.S. Businesses Show Mixed Progress on Marketing a Healthy Diet to Children and Adolescents
• Industry self-regulation: Self-Regulation by Food and Beverage Industry Does Little to Reduce Kids’ Exposure to Unhealthy TV Ads
• New York City’s menu labeling regulation: Customers Who Use Menu-Labeling Information Order Fewer Calories
• The ban on sugar-sweetened drinks in Boston schools: Boston High School Students Drinking Fewer Sugary Beverages

From the Campaign to End Obesity:

Obesity Rates Projected to Soar, ABC News, 8.25.11: Will 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, 8.26.11: The 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.

The professional journal, Childhood Obesity, has just published several new reports online.  Three are research reports of various kinds of interventions.  The one about food and beverage marketing is a conversation among people with different perspectives on the issue.

Effect of Secular Trends on a Primary Prevention Trial: The HEALTHY Study Experience
Authors: F. Kaufman, K. Hirst, J. Buse, G.D. Foster, L. Goldberg, M. Schneider, M. Staten, E.M. Venditti, M. White, and Z. Yin, for the HEALTHY Study Group

Behavioral Self-Regulation and Weight-Related Behaviors in Inner-City Adolescents: A Model of Direct and Indirect Effects
Authors: C.R. Isasi and T.A. Wills

The Role of Food and Beverage Companies in Shaping Family Food Choices
Authors: D. Lubetzky, S. Goldman, G. Mateljan, and J. Posner

Bridging the Gap between Family-Based Treatment and Family-Based Research in Childhood Obesity
Authors: J.A. Skelton, M.B. Irby, and B.M. Beech

Imagine this.  A professional journal, Preventing Chronic Disease: Public Health Research, Practice and Policy (Vol 8, Issue 5, Sep 2011) has published a series of papers on the ethics of childhood obesity interventions. 

It is about time that these kinds of ethical issues are getting focused attention.  Applause for the journal’s editors and authors!

Ethical Issues In Interventions For Childhood Obesity

A92: Protecting Children From Harmful Food Marketing: Options for Local Government to Make a Difference
  Jennifer L. Harris, Samantha K. Graff

A93: Childhood Obesity: A Framework for Policy Approaches and Ethical Considerations
  Rogan Kersh, Donna F. Stroup, Wendell C. Taylor

A94: Childhood Obesity: Issues of Weight Bias
  Reginald L. Washington

A95: Children With Special Health Care Needs: Acknowledging the Dilemma of Difference in Policy Responses to Obesity
  Paula M. Minihan, Aviva Must, Betsy Anderson, Barbara Popper, Beth Dworetzky

A96: Public Policy Versus Individual Rights in Childhood Obesity Interventions: Perspectives From the Arkansas Experience With Act 1220 of 2003
  Martha M. Phillips, Kevin Ryan, James M. Raczynski

A97: A Question of Competing Rights, Priorities, and Principles: A Postscript to the Robert Wood Johnson Foundation Symposium on the Ethics of Childhood Obesity Policy
  Shiriki K. Kumanyika

A98: The Ethical Basis for Promoting Nutritional Health in Public Schools in the United States
  Patricia B. Crawford, Wendi Gosliner, Harvey Kayman

A99: Ethical Family Interventions for Childhood Obesity
  Mandy L. Perryman

A100: Public Policy Versus Individual Rights and Responsibility: An Economist’s Perspective
  Frank J. Chaloupka

A101: State Requirements and Recommendations for School-Based Screenings for Body Mass Index or Body Composition, 2010
  Jennifer Linchey, Kristine A. Madsen

A91: Ethical Concerns Regarding Interventions to Prevent and Control Childhood Obesity
  John Govea

The Institute of Medicine released a report today on how to prevent obesity in children from birth to age 5: Early Childhood Obesity Prevention Policies.

The report is remarkable for its focus on policies for parents and child care providers, and its almost complete lack of attention to policies for improving the food environment in which parents and caregivers operate.

The report’s key recommendations for children from birth to age 5:

• Promote breastfeeding
• Monitor growth
• Increase physical activity
• Provide healthy foods in age-appropriate portions
• Ensure access to affordable healthy foods; educate caregivers and parents
• Limit screen time (all media) to less than 2 hours a day

That’s all? Nothing about keeping sodas and junk foods out of the house?  Only this about food marketing to kids?

The Federal Trade Commission, the U.S. Department of Agriculture, Centers for Disease Control and Prevention, and the Food and Drug Administration should continue their work to establish and monitor the implementation of uniform voluntary national nutrition and marketing standards for food and beverage products marketed to children.

As the IOM well knows from its 2005 report on Food Marketing to Children and Youth, parents and caregivers cannot do this on their own.  They need help, and that means policies to improve the food environment.  The report does say a little about farmers’ markets and green carts as a means to improve access, but that’s it.

It’s time for a follow-up to the 2005 report.  This doesn’t do it, alas.

http://www.iom.edu/Reports/2011/Early-Childhood-Obesity-Prevention-Policies.aspx

Several recent articles highlight concerns about food marketing to children.  Yesterday’s New York Times, for example, explained why obesity experts are increasingly concerned about advertising through new electronic media:

Like many marketers, General Mills and other food companies are rewriting the rules for reaching children in the Internet age. These companies, often selling sugar cereals and junk food, are using multimedia games, online quizzes and cellphone apps to build deep ties with young consumers. And children…are sharing their messages through e-mail and social networks, effectively acting as marketers.

…The sites can attract substantial audiences. HappyMeal.com and McWorld.com, sites from McDonald’s, received a total of 700,000 visitors in February, around half of whom were under 12, according to comScore, a market research firm. The firm says 549,000 people visited the Apple Jacks site from Kellogg’s, which offers games and promotes an iPhone application called “Race to the Bowl Rally.” General Mills’s Lucky Charms site, with virtual adventures starring Lucky the Leprechaun, had 227,000 visitors in February.

Advertising Age notes the use of cell phones, ipods, and ipads by younger and younger children:

Over half the parents in the survey say their children should be able to go online on their own by age 6, and by 5 should be able to play games on a cellphone or on a console or listen to a portable music player on their own.

And the Public Health Law Network explains takes up the question of parental responsibility vs. food industry responsibility.  It asks whether it is:

reasonable for food and beverage companies to spend hundreds of millions of dollars targeting children with marketing, mostly for obesogenic foods, placed literally everywhere and anywhere a child might eat, study, or play, and then demand that parents run interference against them?

Food companies think marketing to kids is plenty reasonable.

Here’s a situation in which some policy changes would be most helpful.  How about some restrictions on what food companies can do in order to make it easier for parents to manage what their kids eat?

Just a thought.  Happy weekend!

I keep telling you.   You can’t make this stuff up.  Try these for food politics–in this case, soda politics–in action.

Beverage Association gives $10 million to Children’s Hospital of Philadelphia (CHOP)

From the Philadelphia Inquirer blog (March 16):

In keeping with a controversial pledge to made last year to City Council as part of an effort to ward off Mayor Nutter’s steep tax on sugar-sweetened beverages, the soft-drink industry will donate $10 million to the Children’s Hospital of Philadelphia to fund research into and prevention of childhood obesity.

The three-year grant is funded by a new organization, the Foundation for a Healthy America, created by the American Beverage Association, the national trade group representing manufacturers and bottlers. The ABA was instrumental in lobbying Philadelphia City Council to reject Nutter’s proposal to tax sugary drinks at 2-cents per ounce as a way to cut consumption and raise money for the general fund.

In a press release Wednesday, CHOP insisted that it will “retain absolute clinical and research independence,” as the source of its funding for the research is likely to come under attack from those wary of the beverage industry’s influence. That includes funding for clinical studies to be submitted to peer-reviewed publications.

Atkins Obesity Center publishes review of effects of soft drinks on obesity

In a delicious irony, the latest review of this topic comes from the Atkins Center at Berkeley.  Yes, the Atkins Diet Atkins, the one that promotes high-fat, low-carbohydrates, and has everything to gain from proving that sugars are bad for you.

With that duly noted, set the irony aside.  The review was funded by independent agencies and organizations.  Let’s take its results at face value.

The reviewers looked at five kinds of evidence: secular trends, mechanisms, observational studies, intervention trials and meta-analyses.  All supported the idea that

The currently available evidence is extensive and consistently supports the hypothesis that sweetened beverage intake is a risk factor for the development of obesity and has made a substantive contribution to the obesity epidemic experienced in the USA in recent decades.

Sweetened beverages are an especially promising focus for efforts to prevent and reduce obesity for two reasons: (i) the evidence supporting the association between sweetened beverage intake and excess weight is stronger than for any other single type of food or beverage; and (ii) sweetened beverages provide no nutritional benefit other than energy and water.

Coca-Cola funds North Carolina School of Public Health campaign against Childhood Obesity

Isn’t that nice of them?  The apparently unironical slogan of the campaign : “Everything in moderation.”

Robert Wood Johnson Foundation report, “F as in Fat”, features piece by PepsiCo’s CEO

Melanie Warner, writing on bNET, explains that the RWJ Foundation is usually scrupulously independent but that putting Pepsi’s PR piece into its document makes no sense.

A third of the way into the report, up pops a bizarre “personal perspective” from PepsiCo’s (PEP) CEO Indra Nooyi in which she details the many ways her company is working to make America healthier. “Helping consumers by building on our portfolio of wholesome and enjoyable foods is not just good business for PepsiCo -– it’s the right thing to do for people everywhere,” Nooyi chirps in a two-page soliloquy that reads like a press release and touts everything from Pepsi’s pledge to reduce the sodium in its products by 25% by 2015 to its reduced sugar drinks like Trop50 and G2. No other food company is mentioned, just Pepsi.

[This inclusion]…also ties into the ongoing debate about what role the food industry should play in helping Americans slim down. Are food companies trusted partners who are committed to fundamental changes, or is getting people to eat healthier versions of processed food really a whole lot of Titanic deck chairs?

As the research linking soft drinks to obesity gets stronger and stronger, it is no wonder that the Beverage Association is buying off city councils, and soft drink companies are eager to position themselves as helping to solve the problem of childhood obesity, not cause it.

Do these actions remind you of any other industry’s behavior?  Cigarette companies, anyone?

Mrs. Obama’s Let’s Move campaign is one year old and people are asking me whether it has accomplished anything.  I think it has.

• It has brought childhood obesity to public attention, as never before.
• The choice of action areas—fixing school food and getting supermarkets into inner city food deserts—makes excellent sense.  Both are doable and both can make a real difference to kids and their families.
• Encouraging the makers of packaged foods to reduce salt and sugar and to stop blatant marketing to kids brings attention to their worst practices.
• And now, according to the New York Times, Mrs. Obama is talking to restaurant companies about serving healthier foods, especially to kids.

This last one warms my heart.  Six or seven years ago, I was invited to speak to a small group of owners of restaurant chains, Applebee’s, Darden’s, and the like.  I went with a three-point agenda:

• Make healthy kids’ meals the default.
• Give a price break to encourage people to order smaller portions (charge 70% for a 50% portion, for example).
• And stop funding the Center for Consumer Freedom (an aggressive PR firm that does the dirty work for restaurant and other industries).

The response?  Ballistic. “What are you trying to do, put us out of business?”

Well, times have changed.  Some of those chains are actually doing some of these things.  And now the First Lady is urging them to do the first two points on my agenda, at least.

Mrs. Obama has no legislated power.  She only has the power of leadership and persuasion.  I’m glad she’s using it to promote action on childhood obesity, challenging as that is.

Happy birthday!