by Marion Nestle
Jun 23 2011

IOM advice for preventing childhood obesity focuses on personal responsibility

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.


  • Anthro

    I imagine that most members of the IOM are shareholders in food and beverage companies.

  • I’m delighted there are no rigid rules, “eat this, not that” style for preventing obesity, because that’s the last thing we need! Labeling foods good and bad, setting up food rewards, all or nothing approaches to food selection contributes to an unhealthy relationship with food; I’ve seen it for 25 years in practice. Learning appropriate parenting skills, including limit setting, teaching delayed gratification, learning emotional regulation, and yes, teaching parents, and kids what reasonable portions are is essential. Teaching parents how to juggle the demands of working and parenting, including convenient, yet healthy, meal prep works too. But banning “junk” foods? Think again!

  • I agree that every parent needs to learn to set limits and teach delayed gratification; this does not only apply to food. However, “Teaching parents how to juggle the demands of working and parenting” comes across as a bit patronizing. I don’t think lack of knowledge about prioritizing is what stops a single mom working two or three part time jobs in order to get by from purchasing and preparing fresh vegetables for a daily meal. Acknowledge it or not, there are societal trends that make is difficult for people to eat healthily, and these trends are not necessarily affected by an individual’s personal choice or actions. Americans work much more than citizens of many other countries. Many live far from food vendors. Many do not realize the extent to which junk food can harm growing bodies, and yes, there is a large, well-funded array of forces working to tell them that junk food is not so bad.

    Personal responsibility – yes, there should be more of it in many situations. But I’d rather help people to make good decisions when the outcomes of those decisions, such as increasing healthcare costs and lost productivity due to ill health, affect me and my society as well as the individual making the decisions.

  • Charlie L

    You see, we don’t have no stinkin’ obesity problem in American; what we have is a lack of personal responsibility epidemic! And because of that, all the intervention needed is just to offer gentle reminders to be more responsible next time, and exercise more. =)

  • Suzanne

    Heaven forbid junk food would be forbidden, because then, what household name, heavily-marketed-to-children food product manufacturers would fund the lion’s share of the American Dietetic Association budget?

  • ckc

    Am I correct that it seems that the IOM often comes out with reports that conflict each other? Is this a result of silos within the IOM? Study sponsorship? The make up of the committee? Is the IOM really the best place to get unbiased, independent reviews of current science?

  • Cathy Richards

    @Charlie L — too funny. You are exactly ‘right’!
    Now everybody stop reading this blog and get outside and exercise! That’s all we need to do.

    Haven’t read the report, but did they make any suggestions about mandatory maternity leave in order to enhance duration of exclusive breastfeeding? Because the US is woefully behind on that score.

    Oh, and if parents have all that responsibility for their kids (which they do) doesn’t the IOM have a responsibility to society? They are pointing a finger at parents, with 3 fingers pointing back at themselves.

  • Liv

    Coming from a country in Europe, I find it shockingly difficult to eat well in the US. Due to the amount of sugar (mostly HFCS, but that doesn’t really matter) and salt/preservatives in everything, I find most foods sold in supermarkets unpalatable. I make my own bread (flour, yeast, salt and water).

    But the scary thing is: visiting home after three years of uninterrupted stay in the US, I was shocked at finding that at home, processed food is incredibly expensive. A kilogram (~2 pounds) of fresh peaches, peppers, tomatoes, potatoes…pretty much any vegetable or fruit that was in season was between 50-75 cents. A kilogram of meat, the cheapest chicken I could find, was $6. The pre-sliced, 1 pound sandwich breads were $2 per loaf, a freshly baked 1kg wheat loaf was $1.

    And perhaps the most crucial point: a 2-liter bottle of soda is $2-3…so guess what people give their kids on the weekends for a ‘fancy drink’? Fruit syrups with seltzer water, lemonade…etc. Only once or twice a week though. Otherwise you get teas, milk and mostly water or seltzer water (50-cents per two liters).

    Anyway, people don’t have to make difficult parenting decisions, or wonder whether they can afford the fresh fruits from the farmers market. Eating healthy is cheaper than eating junk-food. McDonalds is a luxury. The street food people get are gyros stuffed with fresh tomatoes, onions and lettuce (and I’m not from Greece). It requires a lot more conscious effort to eat healthy in the US compared to eating healthy in my home country.

    And I fear what will happen if my children go to a school that has vending machines. Kids should not be responsible for resisting sugary or MSG-rich temptations.

  • Anthro

    How is setting out rough guidelines and discouraging direct marketing to children avoiding personal responsibility? NO ONE has advocated “banning” junk food–only encouraging and supporting parents to do exactly as the trolls say, which is to exercise personal responsibility.

    @Sebastian Nosense

    I am surprised that you hold the IOM in such high esteem.

  • Missi

    The main way to help the child is to teach them how to eat. If the child knows when they have had to much junk food it will be easy for the child to say no to the junk food and yes to the healthy foods this is how I did my four children they all like the junk food but they do not over eat on the junk food and they always are out side playing and exerciseing. A person just needs to use their head when they are feeding themselves and their child.

  • Couldn’t agree more! It is self responsibility and the parents job to help monitor and teach there kids at a young age what is good and what is bad. It doesn’t hurt to play with your kids either to promote exercise! There are things parents can do at an early age for their children to prevent all this!