by Marion Nestle

Currently browsing posts about: Obesity-in-kids

May 24 2019

Weekend Spanish lesson: a book about obesity for teenagers

Simón Barquera.  ¿Hasta que los kilos nos alcancen? Una introducción desde la ciencia sobre el aumento de la obesidad y la forma de enfrentar esta epidemia [My and Google’s translation: Until the kilos reach us?  A scientific introduction to the increase in obesity and how to confront this epidemic]. Instituto Nacional de Salud Publica and SPM Ediciones, 2019 (119 pages, hard cover).

I did a blurb for this book (it’s in Spanish on the back cover):

I can’t think of a better target audience for a book about the social, economic, and political causes of obesity than the young people who will be tomorrow’s leaders and policymakers.  Simón Barquera gives them–and readers of any age—the skills to recognize how food and beverage companies promote corporate profits over public health, and to act on this knowledge through advocacy for regulating conflicts of interests.  These skills are essential for preventing obesity and creating healthier food systems.

I’ve wrote about Barquera’s work a couple of years ago; he is one of the Mexican soda-tax advocates who had spyware installed on his phone, and is a researcher at the public health institute in Cuernavaca where I went on a Fulbright in February 2017.

I hadn’t seen the book’s illustrations when I did the blurb.  If I had, it would have been hard to talk about anything else because they are beyond charming.  It’s hard to pick a favorite, but I especially like this one.

This book needs an English translation!  I hope someone is doing one.

If you want a copy, try this link.

Dec 10 2018

Letter to The Nation about Michelle Obama’s “Becoming”

Michelle Obama’s new book, Becoming, may be a blockbuster, but The Nation wishes she were more political.  An interview of Nation-contributor Amy Wilentz by Nation-contributing editor Jon Wiener about Becoming induced me to fire off this letter:

The Edible Is Political

As a longtime subscriber to The Nation and the author of Food Politics and other books on this topic, I was dismayed to read the following exchange in Jon Wiener’s interview with Amy Wilentz [“Michelle Obama’s Carefully Scrubbed Memoir,” online Nov. 30]:

JW: I wonder if it’s possible that Michelle Obama actually is not a political person. Maybe the things she cares most about really are childhood obesity and healthy eating. We would like her to be more political, more of a progressive Democrat—but maybe she isn’t.

AW: But remember that, for her, those issues—childhood obesity and the “Let’s Move” idea—are political issues. It’s not like decorating the White House.

Childhood obesity most definitely is a political issue and for everyone, not just Michelle Obama. Childhood obesity is directly linked to the corporatization of America; to discrimination based on race or gender; to income inequalities; to the increasing privatization of what used to be public goods; to depressed wages; to immigration policies; to lack of a decent health-care system; and, not least, to current divisions in Americans’ views of what our society should look like.

If “Let’s Move” seems apolitical in retrospect, it’s because of the intense opposition it faced from those who understood perfectly well that taking on childhood obesity meant, in essence, taking on the entire trillion-dollar-a-year food industry and everything else that backs up our current food system.

I’ve always wondered whether Michelle Obama knew just how political childhood obesity would be when she took it on, or whether she thought it was something that would easily attract widespread bipartisan support. I suspect the latter and am not convinced by assurances that she knew it would be a fight. The White House Task Force Report on Childhood Obesity produced a mixed bag of objectives for “Let’s Move,” out of which she picked two that appeared especially supportable: access to healthy food in low-income communities and healthier school food. But the pushback, especially on school food, was ferocious. That’s why the new school-food rules, compromised and unfunded as they were, seemed like a political triumph.

Marion Nestle
Professor of nutrition, food studies, and public health, emerita, at NYU
New York City

Jon Wiener Replies

Marion Nestle is, of course, right about this. I should have said something like, “Childhood obesity is a political issue, but that’s not the way Michelle Obama presents it in the book.” Sadly, in listing her accomplishments, “Let’s Move” and the White House garden come after commissioning new china for the newly redecorated dining room.

Jon Wiener
los angeles

Jon Wiener, as it turns out, is spot on.  I had not read Becoming at the time I wrote the letter but this exchange sent me right to the book.  Mrs. Obama focuses on the personal and indeed presents herself as uninvolved in the political.  But during the Let’s Move era, she gave a couple of decidedly political speeches about the role of the food industry in childhood obesity (here’s my summary of one of them).

Postscripts

  • The Obama’s date at Blue Hill. Indeed, Michelle Obama doesn’t say much in Becoming about Let’s Move. She devotes more pages to her date with the President at Blue Hill, which I found riveting because I witnessed that date.  My partner and I were taking Sidney Mintz and his wife to dinner that night and that’s where we had made reservations.  The staff seated us directly across from the Obamas but, alas, did not introduce us.  Cool New Yorkers as we are, we left them in peace.
  • The Nation’s previous comments on Let’s Move: The Natiohas long been critical of the way Let’s Move partnered with food companies (I’m quoted in this article).
Dec 7 2018

Weekend reading: the 2018 Global Nutrition Report

If you want an overview of the current status of nutrition problems in the world, what is being done about them, and what needs to be done about them, this report is required reading (to get to the download button for the entire report, scroll to the end of the page).

The report is chock full of useful facts, figures, case studies, and recommendations.  A massive undertaking, it

was produced by the Independent Expert Group of the Global Nutrition Report, supported by the Global Nutrition Report Stakeholder Group and the Secretariat at Development Initiatives. The writing was led by the co-chairs Jessica Fanzo and Corinna Hawkes, supported by group members and supplemented by additional analysts and contributors.

For a quick overview, go right to the slide deck and then to the graphics in the executive summary.

The report deals both with problems of malnutrition (undernutrition) and obesity (overnutrition), especially in children.

It also deals with adult obesity:

It identifies measurable nutrition indicators that can be used to track progress:

It recommends actions to reduce the prevalence of malnutrition and obesity.

What stands in the way of implementing these steps?  Political will, alas.

These reports have come out annually since 2014.  Let’s hope this one gets the attention it deserves.

Oct 3 2017

The state of obesity, U.S. 2017

Where are we in obesity prevalence?  The Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health (TFAH), are keeping score for us.   Their report gives figures state by state.  Since I live in New York, I’m highlighting its figures.

ADULT OBESITY PREVALENCE

This looks like good news.  The increase is slowing down and maybe trends are leveling off at long last.

 

CHILDREN’S PREVALENCE OF OVERWEIGHT AND OBESITY

 

This also looks hopeful.  The prevalence is level or declining in most states.

But, as Richard Besser of the Robert Wood Johnson Foundation and John Auerbach of Trust For America’s Health explain in an editorial in The Hill,

One of the best ways to bring down those adult obesity rates in every state is to prevent children from becoming overweight or obese in the first place…Unfortunately, there are signs that we are moving in the wrong direction—and not just on school meals…These kinds of threats put at grave risk the progress our nation has achieved. To accelerate progress in addressing obesity, we urge policymakers to support proven programs like school meals and SNAP that put kids on a healthier track for their entire lives, and maintain full funding for agencies like the Centers for Disease Control and Prevention that are responsible for protecting the health of kids and adults nationwide.

Nov 22 2016

Some good news: childhood obesity declines in low-income children–a bit

The CDC and USDA are collaborating to track the prevalence of obesity in children ages 2 – 4 who participate in the Special Supplemental Program for Women, Infants, and Children (WIC).

In a new report, the agencies find obesity prevalence to have increased from 14% in 2000 to 15.9% in 2010.   But here’s the good news:  it dropped to 14.5% in 2014.

More good news: it decreased significantly among toddlers in these groups:

  • Non-Hispanic whites
  • Non-Hispanic blacks
  • Hispanics
  • American Indian/Alaska Natives and Asians/Pacific Islanders
  • 61% of the 56 agencies in states, DC, and US territories

The not-so-good news is that obesity in WIC kids is still higher than the national average among kids 2 – 5 years (8.9%), but this trend is in the right direction.

What accounts for it?  The report lists several possibilities:

Let’s keep doing more of the same and keep that trend heading downward.

Sep 7 2016

The well deserved fuss over the UK’s childhood obesity plan

The much delayed UK government’s plan for dealing with childhood obesity has finally been released to virtually universal dismay over the missed opportunity.

The strategy is now a Plan, and says it is “the start of a conversation.” It reconfirms the government’s intentions to implement a soft drink tax, subject to consultation, but does not include a range of measures recommended by its own Public Health England and by last year’s House of Commons Health Committee, such as reduce food marketing and controls on retail promotions. It relies on voluntary sugar reduction by the food industry and encouraging parents to help increase children’s physical activity to meet the recommended 1 hour per day.

It’s fun to read the criticisms: nobody minces words.

An editorial in The Lancet

The UK Government’s long-anticipated response to the childhood obesity crisis disappointed everyone. From doctors, health charities, and celebrities to the very industry it seeks to propitiate, the Childhood Obesity Plan, published with as little noise as possible in the summer recess, has met with resounding criticism. As a Comment in today’s Lancet highlights, the strategy has been delayed for a year, and in that time it has been watered down to a vague Plan with no teeth.  Reading the report from start to finish gives the impression that its authors haven’t.

The Lancet editorial continues

The absence of curbs on industry practices that contribute to childhood obesity—promotions of unhealthy food in supermarkets and restaurants; advertising of junk food through family TV programmes and social media—seems like a gift to industry.

The Lancet is especially miffed because it ran a series on obesity last year that made it clear what kinds of policies needed to be enacted.

Also in The Lancet, World Obesity’s Tim Lobstein and Klim McPherson say

What we read in the government’s Plan is nothing particularly new, nothing bold, and very little that can actually be measured to assess the Plan’s success. It is a document that is not only a disappointment to public health professionals, but also evidence of a government walking away from its moral duty to protect the health of children, and its fiscal duty to protect the NHS from the consequent costs.

The Association for the Study of Obesity (ASO) issued a statement:

the plan is a lost opportunity to provide leadership and commitment in tackling childhood obesity as part of a whole systems approach. It lacks bold actions that are needed to reverse the current high levels of child obesity such as: a ban on junk food advertising before the 9pm watershed; reduction in portion sizes; reformulation targets for industry that address high energy density foods; curbing the promotion of unhealthy foods in supermarket; investment to increase and extend evidence-based child weight management services. All of these would be robust, evidence-based actions and would start to tackle the root causes of obesity in this country.

Again in The Lancet, Yoni Freedhoff and Kevin Hall point out the need for more sensible weight loss studies:

Over the past several decades, dozens of randomised controlled trials have compared various diets for the treatment of obesity. Ideally, such studies should have provided strong evidence for clear clinical recommendations and also put a stop to society’s endless parade of fad diets. Unfortunately, the evidence base remains contested and the “diet wars” continue unabated…What is especially striking is the similarity of the long-term pattern of mean bodyweight change, irrespective of diet prescription.5 …Fewer resources should be invested in studying whether or not a low-carbohydrate diet is marginally better than a low-fat diet, or whether intermittent fasting provides marginally better short-term outcomes than a so-called Paleo diet.

Their study provides further evidence why we need stronger policies for preventing obesity.  It’s too bad the UK couldn’t do better.

And if you think things are any better in New Zealand

The food industry has hit out at claims in a leading journal that New Zealand’s childhood obesity plan was flawed and that the government valued corporate profit over public good. The Food and Grocery Council said that an editorial in the New Zealand Medical Journal, which claimed that the government’s strategy did not address excess sugar intake, was “flawed on many fronts.  Moreover, the FGC complained that its response to the article, solicited by Fairfax Media, was not run.

Addition, September 14

Nov 10 2015

Two reports: Who is Obese? How to Curb Global Sugar?

The first report is from the UK.   Fat Chance? Exploring the Evidence on Who Becomes Obese is a curious example of what happens when a sugar company (AB Sugar) partners with a health organization (2020 Health) to produce a policy document.

The report examines the role of age, gender, socioeconomic factors, the built environment, mental health and disability, sleep, bullying and child abuse, smoking, ethnicity, and religion as factors in obesity—everything except diet and activity levels.

The press release for the report gives key findings, among them:

  • Obesity rates are rising rapidly among the poor as well as other groups who experience social instability.
  • Uncertainty seems to be a significant factor for weight gain.
  • Fast food outlets near working environments have a significant impact on the BMI of men; the lack of green space has an impact on obesity rates particularly among girls.
  • Half of all people suffering with psychosis are obese.
  • Parental obesity, especially in mothers, is a far more predictive factor in childhood obesity than is ethnicity.

Its authors write:

What is particularly highlighted in recent research, though rarely explicitly stated, is that obesity rates seem to be deeply influenced by social change (not just influences within static social categories). The studies we have compiled for this review show a subtle trend that has become increasingly evident over the last decade. It is highlighted in economic mobility, rising rates of mental illness, technological habits and engagements, and rapidly shifting urban ground. Argued here, broadly speaking, is that many of these categories strongly hint to a meta-structure that remains profoundly under-researched and largely ignored. This is the structure of uncertainty, a type of habitus that influences the terms of emotional engagement between an individual and their daily life. Insidiously, it undermines health seeking behaviour by making daily decision processes cognitively intolerable and emotionally taxing.

They conclude:

…approaches to obesity that recognise and incorporate complexity might impact a host of rising health problems that affect communities across Britain. The same interventions that encourage healthy BMI may improve energy levels through metabolic process and sleeping habits, while reducing risk of mental health problems, diabetes and a range of other comorbidities not discussed in this report.

But they don’t say what those interventions might be.

Could they possibly have something to do with removing sugary drinks and foods from local environments?

For doing just that, the World Cancer Research Fund International has produced Curbing Global Sugar Consumption: Effective Food Policy Actions to Help Promote Healthy Diets & Tackle Obesity.

Examples of actions which have had these effects include school nutrition standards in Queensland, Australia; a vending machine ban in France; a front-of-package symbol that led to product reformulation in the Netherlands; soda taxes in France and Mexico; a programme targeting retail environments in New York City, USA; a programme promoting increased water consumption in schools in Hungary; school fruit and vegetable programmes in Netherlands and Norway; a healthy marketing campaign in Los Angeles County, USA and a comprehensive nutrition and health programme in France.

The first report asks us to solve problems of poverty, instability, and mental health before taking action to prevent obesity, even when actions are known to be effective.  The second calls for such actions now.

Could AB Sugar’s sponsorship possibly have something to do with this difference?

Jun 9 2015

The Lancet series on obesity policy (in case you missed it)

Some time ago, I posted the terrific Lancet infographic on obesity policy.

Here are the series articles (or at least the abstracts) that go with it.