Currently browsing posts about: Obesity-in-kids

The First Lady spoke to the Grocery Manufacturers Association (GMA) yesterday about her campaign to prevent childhood obesity.  According to one witness, Marian Burros, she scolded them – politely and with humor – but told them in no uncertain terms “to stop fattening our children.”

The GMA is a tough audience for messages about childhood obesity.  It represents the makers of processed foods and beverages who have much to lose from efforts to get kids to eat less of their products.

The speech itself is a masterpiece of tact, but Mrs. Obama clearly gets the issues loud and clear.  Here are some excerpts:

• we need you not just to tweak around the edges, but 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 needs to be a serious industry-wide commitment to providing the healthier foods parents are looking for at prices they can afford.
• what it doesn’t mean is taking out one problematic ingredient, only to replace it with another. While decreasing fat is certainly a good thing, replacing it with sugar and salt isn’t.
• it doesn’t mean compensating for high amounts of problematic ingredients with small amounts of beneficial ones — for example, adding a little bit of Vitamin C to a product with lots of sugar, or a gram of fiber to a product with tons of fat doesn’t suddenly make those products good for our kids.
• This isn’t about finding creative ways to market products as healthy.
• Parents are working hard to provide a healthy diet and to teach healthy habits — and we’d like to know that our efforts won’t be undermined every time our children turn on the TV or see a flashy display in a store.
• what does it mean when so many parents are finding that their best efforts are undermined by an avalanche of advertisements aimed at their kids?
• what are these ads teaching kids about food and nutrition? That it’s good to have salty, sugary food and snacks every day — breakfast, lunch, and dinner? That dessert is an everyday food? That it’s okay to eat unhealthy foods because they’re endorsed by the cartoon characters our children love and the celebrities our teenagers look up to?
• if there is anyone here who can sell food to our kids, it’s you. You know what gets their attention. You know what makes that lasting impression. You know what gets them to drive their parents crazy in the grocery store.

Well done, Mrs. O.

Apparently, GMA members applauded her speech.  Let’s hope they act on it.

(Actually, they claim they are already fixing these problems.  More on that tomorrow).

It’s almost impossible to keep up with what’s being written about childhood obesity.  The papers and commentary pour in.  Much of this is well worth reading.  If you want to keep up on the latest thinking about the issue, here are some places to start:

1.  Health Affairs: Thanks to Matt Gruenberg for alerting me to the issue of Health Affairs devoted entirely to obesity topics.  Here’s the Table of  Contents.

The Robert Wood Johnson Foundation had a hand in this and discusses some of the papers on its website.

Even better, Health Affairs has produced a series of “issue briefs” to go with the journal articles.  These are available on the Health Affairs blog. They cover:

• Overview: The State Of Childhood Obesity In America
• The Role Of Agriculture Policy In Reducing Childhood Obesity
• Food Marketing And Distribution’s Role In The Fight Against Childhood Obesity
• Speeding Up Progress In Fighting Obesity In Schools
• Lessons From States On Fighting Childhood Obesity
• The Pervasive Effects Of Environments On Childhood Obesity

2.  FoodNavigator.com has a “special issue” on childhood obesity from the business standpoint:

Giving children the best nutritional start: With childhood obesity rates apparently sky rocketing around the world, celebrity chefs redesigning school meals, and international initiatives to influence what our children eat, now is an interesting time for child nutrition.

Kids’ food trends in the spotlight: Some major trends in children’s eating habits could change as the economy recovers – but foods marketed as natural and healthful are here to stay, according to a senior analyst at Mintel. 

How characters can help children eat healthily: From Disney to Tony the Tiger, consumer groups have been campaigning hard to break the links between childhood icons and unhealthy foods. But furry friends and super-heroes are now putting in more of an appearance on healthy products.

Kids’ TV food commercials down, but cross-promotions soar: Cross-promotions on food packaging targeted at children increased by 78 percent between 2006 and 2008, according to a study from Yale’s Rudd Center for Food Policy.

3.  Michelle Obama’s campaign:USA Today reports on Mrs. Obama’s talk to the school nutrition association, the organization of people who work in school lunchrooms – those who Jamie Oliver refers to as “lunch ladies.”  Check out the coverage and see the video.

What is one to make of all this?  Childhood obesity is a huge public health issue and deserves the attention it is getting.  Let’s hope some of it works.

Jamie Oliver, the British celebrity chef who has taken on school food as a personal crusade against childhood obesity – and with some success in Great Britain – wants to do the same for us.  He is starting with a school in Huntington, West Virginia, a community that gives itself credit for being the unhealthiest in America.

Thanks to NYU student Jessica Watkins for forwarding this video of his plans. The reactions of people in the community to Jamie’s ideas are especially interesting.

This is the start of a TV series.  Is his campaign about theater or is this real public health?  I guess we’ll have to watch and decide.

Update March 7: Here’s Jamie Oliver’s famous TED video.

Mrs. Obama’s campaign to prevent childhood obesity did not mention food marketing to kids.  But check the latest research.

Researchers at UCLA took a careful look at the correlation between watching commercials on TV and childhood obesity (Their paper is in the February 2010 American Journal of Public Health).  Kids who watch commercials on TV are more likely to be obese than kids who watch non-commercial TV.  Commercials, of course, are largely for junk food and kids see a lot of them.  The authors conclude:

steering children away from commercial television may have a meaningful effect in reducing childhood obesity…The existence of many high-quality, enjoyable, and educational programs available on DVD for all ages should make it relatively easy for health educators and care providers to nudge children’s viewing toward less obesogenic television content [my emphasis].

Relatively easy?  They have to be kidding.  Food commercials are ubiquitous in kids’ lives.

For example, Lisa Sutherland and her colleagues at Dartmouth took a look at the prevalence of food brands (mostly junk foods) in movies from 1996 to 2005 (Pediatrics, February 2010).  There are loads of such placements, and movies aimed at younger kids tend to have the most.

As for industry self-regulation, Kelly Brownell and his colleagues at Yale have plenty to say about how it’s not working and what would be needed to make it work (also in the February American Journal of Public Health).

Michelle Obama may not be able to touch this one, but Congress can.  And it should.

I had best comment on this before anyone asks.   First Lady Michelle Obama wants to do something about childhood obesity and has gone into action.  She announced her “Let’s Move” initiatives accompanied by much fanfare.  Check out:

• The USDA Secretary’s promise to ask Congress to get junk food out of schools and provide breakfast and lunch to more kids (the New York Times discusses some of the reactions)
• The President’s appointment of a task force on childhood obesity
• The Ad Council’s public service announcements
• USA Today’s neat graphics on rising rates of childhood obesity
• USA Today’s maps of the environment of childhood obesity
• The USDA’s website atlas of the environment of food choice
• The American Beverage Association’s promise to put calories on the front of soft drink packages
• The American Academy of Pediatrics commitment to aid the White House effort
• And the Surgeon General’s Vision that I commented on two days ago

This is big news.  I see much to admire here.  The campaign focuses on kids.  It is sensitive to political realities (it’s called the uncontroversial “Let’s Move,” not the inflammatory “Let’s Eat Less” or “Let’s Eat Better”).  It’s brought a large number of groups on board (the New York Times account emphasizes this point).  It aims to do something useful about school food and food “deserts” (areas without grocery stores).  And it derives directly and explicitly from the White House garden.

I wasn’t able to watch the press conference but I hear that Will Allen was an invited speaker.  Allen is the charismatic and highly effective head of Growing Power, which runs urban farms in Milwaukee and Chicago.  I’m told he said:

• It’s a social justice issue.
• Every child in this country should have access to good food.
• We have to grow farmers.

Yes!

Before the announcement, Marian Burros wrote in Politico.com about the barriers this effort will face (I’m quoted in her article).   And the Los Angeles Times discussed the enormous and enormously successful lobbying effort undertaken by the soft drink industry against soda taxes.  It predicted that the First Lady would not mention soda taxes when she announced her obesity campaign.  Indeed, she did not.

But she did say:

The truth is our kids didn’t do this to themselves.  Our kids didn’t choose to make food products with tons of fat and sugar and supersize portions, and then to have those foods marketed to them wherever they turn.

So let’s call this campaign a good first step and give it a big round of applause.  I hoping everyone will give it a chance, help move it forward in every way possible, and keep fingers crossed that Mrs. Obama can pull it off.

I recently received this request from Daniel posted to Feedback:

Would you mind writing a blog post on the new surgeon general’s obesity report? …Is there a food politic element to why this has gone under the radar? …I find it ironic that Michael Pollan’s Food Rules generated substantially more press than a report by the United States Surgeon General.

I’m not surprised.  Pollan’s book is a hot best seller (it’s #1 on Amazon books, and for good reason, in my opinion).   The need to prevent obesity and how to do it is not exactly front-page news.  And the new Surgeon General, Dr. Regina Benjamin, is still relatively unknown as a political force.

But let’s give Dr. Benjamin credit for taking on obesity in one of her first public actions: the release of “Vision for a Healthy and Fit Nation.”   The Vision, which comes with a press release and a fact sheet, recommends these actions to prevent obesity:

1. Reduce consumption of sodas and juices with added sugars.
2. Reduce consumption of energy dense foods that primarily contain added sugars or solid fats.
3. Eat more fruits, vegetables, whole grains, and lean proteins.
4. Control your portions.
5. Drink more water.
6. Choose low-fat or non-fat dairy products.
7. Limit television viewing time and consider keeping televisions out of children’s rooms.
8. Become more physically active throughout the day.
9. Breastfeed exclusively to 6 months.

These are all useful suggestions but we have heard them before.  The real issue is how to achieve them.  Here, the report disappoints.

The first two items should have grabbed attention: targeting soda reduction as as the first line of defense against obesity, and eating less junk food (my translation) as the second.

But Dr. Benjamin assigns parents the responsibility for feeding kids healthfully.  Fine, but what about about public health approaches to reducing soda consumption?  To pick a non-random example, soda  taxes are under intense debate right now.  Does Dr. Benjamin weigh in on such approaches?  Alas, no.  Only on the second-to-last page does she summarize suggestions from the Centers for Disease Control and Promotion (CDC), among them:

• Increase availability of healthy, affordable food and beverage choices in public service venues.
• Improve geographic availability of supermarkets in underserved areas.
• Improve access to fresh fruits and vegetables by providing incentives for the production, distribution, and procurement of foods from local farms.
• Limit advertisements of less-healthy foods and beverages.

I wish the report had focused on such ideas, instead of leaving them to an afterthought and personal responsibility. It’s great that the nation’s doctor cares about obesity but her Vision isn’t nearly as tough or realistic as it needs to be.  For that, we need the CDC or the report on food marketing to kids that the Institute of Medicine produced in 2005.

In 2001, Surgeon General David Satcher released the first government report on preventing obesity.  It got press. If this one didn’t, it could well be because it doesn’t break enough new ground.  Surely, it’s high time we got beyond blaming parents and instead started focusing on the need to create a food environment that makes it easier for parents and everyone else to make better food choices and be more active.

I hear that Michelle Obama will soon announce (tomorrow?) a new program to address childhood obesity.  I’m hoping that her program will take on some of the factors in the food environment that make it so difficult for everyone to eat healthfully.

I keep saying that you don’t need complicated theories to explain childhood obesity.  Just read the newspapers!  Yesterday’s New York Times carried two stories that fully account for kids’ caloric balance these days.

The first (front page) describes a Kaiser Family Foundation study that counted the number of hours kids spend online each day.  The bottom line: “practically every waking minute.”  Here’s the link to the actual study.

The second is a food section story documenting the astonishing rise in snacking among kids to the point where parents are harassed beyond belief  about having to supply snacks for every activity.  And you should see what goes on in schools.   The bottom line: also practically every waking minute.

No wonder kids are gaining weight.

The question, of course, is what to do about it.   Dealing with the snacks will be easier and that’s a great place to start, no?

Tomorrow: I will comment on the new study on salt, discussed in today’s paper.

My San Francisco Chronicle column, now appearing in print on the first Sunday of the month, is also online.

Its title:  “Hot food issues ready to boil over this year.”

Q: What do you think will happen with food and nutrition in 2010?

A: I wish I could read the leaves while I drink tea, but the best I can do is tell you which issues I’m going to be watching closely this year.

Hunter Public Relations recently asked 1,000 Americans which food-related issues they thought were most important in 2009. The top three? Food safety, hunger and food prices. For the decade, the winner was childhood obesity.

I have my own top 10 list of hot-button issues for 2010, and here they are:

• Hunger: More than 35 million Americans get benefits to which they are entitled under the Supplemental Nutrition Assistance Program (formerly, food stamps). The economy may be improving, but not quickly enough for millions who have lost jobs, health care and housing. Will Congress do anything this year to strengthen the safety net for the poor? It needs to.
• Childhood obesity: Rates of childhood obesity may have stabilized, but we all want to figure out how to prevent kids from gaining so much weight that they develop adult chronic diseases. I expect to see more efforts to improve school food and make neighborhoods more conducive to walking to school, riding bikes and playing outside.
• Food safety regulation: Congress is sitting on a bill to give the Food and Drug Administration some real authority for food safety. The bill does not do what is most needed – establish a single food-safety agency – but is a reasonable step in the right direction. Let’s hope Congress gets to it soon.
• Food advertising and labels: The long-dormant FDA and Federal Trade Commission are getting busy at last. In the wake of the Smart Choices fiasco, the FDA is working to make package labels less misleading and easier to understand. The agencies have proposed nutrition standards for products marketed to children. These voluntary standards fall far short of my preference – an outright ban on marketing junk foods to kids – but puts food companies on notice that their products are under scrutiny. The FDA is also working on designs for front-of-package labels. I’m hoping it chooses a “traffic-light” system that marks foods with a green (any time), yellow (sometimes) or red (hardly ever) dot. Expect plenty of opposition from the makers of red-dotted products.
• Meat: The meat industry has been under fire for raising food animals under inhumane conditions, using unnecessary hormones and antibiotics, mistreating immigrant labor, and polluting soil and water. Now it is also under fire for contributing to climate change. Recent films like “Food, Inc.” and “Fresh” and books such as Jonathan Safran Foer’s “Eating Animals” are encouraging people to become vegetarians or to eat less meat to promote the health of people and the planet. I’ll bet the meat industry pushes back hard on this one.
• Sustainable agriculture: The back-to-the land movement has loads of people buying local food, choosing foods produced under more sustainable conditions and growing their own food. The number of small farms in America increased last year for the first time in a century. Seed companies cannot keep up with the demand. It will be fun to follow what happens with this trend.
• Genetically modified (GM) foods: My book, “Safe Food,” comes out in a new edition this year, so I am paying especially close attention to debates about GM foods. The FDA’s 1994 decision to prohibit labeling of GM foods continues to haunt the food biotechnology industry. By now, nearly all American soybeans and sugar beets (95 percent) are GM, as is most corn (60 percent). But when the U.S. Department of Agriculture approved GM sugar beets in 2005, it neglected to perform the required environmental impact assessment. On that basis, environmental groups want to ban further planting of GM sugar beets. The dispute is now in the courts.
• Chemical contaminants: The FDA has yet to release its report on the safety of bisphenol A, the plastic chemical that acts as an endocrine disrupter. Shouldn’t it be banned? The bottling industry says no. Watch for fierce arguments over this one.
• Salt: Nutrition standards allow 480 mg sodium (the equivalent of more than 1 gram of salt) per serving. A half cup of canned soup provides that much. A whole cup gives you 4 grams and the whole can gives you 8 grams – much more than anyone needs. Nearly 80 percent of salt in American diets comes from processed and restaurant foods. Companies are under pressure to cut down on salt. Will they? Only if they have to.
• Dietary advice: The new edition of Dietary Guidelines for Americans, which the government publishes every five years, is due this year. What will it say? I can’t wait to find out.

Those are the issues I am tracking these days. My one crystal-ball prediction? We will be hearing a lot more about them this year.

Happy new year!