Posted on Sun, Apr. 18, 2004
U.S. obesity epidemic prompts changes in public policy, industries
BY SUMANA CHATTERJEE
WASHINGTON - As the American waistline disappears amid growing girth, public-health advocates are struggling over how to slim down a nation that loves fast food, soft drinks and sitting on the couch.
"We're just too darn fat, ladies and gentlemen, and we're going to do something about it," Health and Human Services Secretary Tommy Thompson said recently. He unveiled a multimillion-dollar ad campaign that encourages people to take "small steps" toward governing their children's diets and encouraging more physical activity, such as climbing stairs instead of taking the elevator.
Thompson's announcement was the latest in a flurry of federal measures to address obesity. Critics say the government could do more, but they recognize that the politics of obesity is complex and will take time to fight.
Obesity is defined as a body-mass index of fat greater than 30 percent. The problem is reaching epidemic proportions. In the last decade, America's obesity rate has doubled. An estimated 64 percent of U.S. adults are overweight or obese. And 15 percent of children and adolescents between ages 6 and 19 are overweight. In 1992 only six states had adult obesity rates of 15 to 19 percent; 10 years later, 18 states did.
Obesity promotes many chronic diseases, including cardiovascular disease, several types of cancer, musculo-skeletal disorders, sleep apnea and gallbladder disease, according to Dr. Julie Gerberding, the director of the
Centers for Disease Control and Prevention. Obesity and a sedentary lifestyle also strongly increase the risk of diabetes, the sixth-leading cause of death.
If current trends continue, being fat could overtake smoking as the nation's No. 1 cause of preventable death, the CDC warned last month. The problem "is becoming too significant for the life insurance industry to ignore," according to Swiss Re, a risk-management firm that specializes in insurance. Its analysts say companies might increase life insurance premiums for obese consumers.
Three in five U.S. health-care dollars are spent on obesity-related illnesses, according to the HHS. An estimated $95 billion is spent annually on federal medical costs related to obesity, and state governments spend another $75 billion. "The long-term effects of obesity on our nation's health and on our economy" shouldn't be underestimated, the CDC's
Gerberding said.
McDonald's announced that it's launching an anti-obesity education campaign to promote exercise and a balanced diet. The world's largest fast-food chain will offer a "Go Active" Happy Meal for adults that includes a salad, water and a pedometer.
The move follows a number of lawsuits against the company from people who blame their obesity on McDonald's food. It's the latest of many restaurants that have begun offering more healthy choices in reaction to lawsuits and consumer demand.
Last month the House of Representatives passed the "Personal Responsibility in Food Consumption Act" to protect the food and beverage industry from civil lawsuits. Under the measure, known as the "Cheeseburger Bill," people who buy food or drinks couldn't sue the companies that made them, the stores that sold them or the restaurants that served them if they got fat from the products, so long as the products met existing laws. The Senate is expected to take up a similar bill later this year.
Congress hasn't developed a comprehensive plan to address the obesity epidemic, but some lawmakers are trying to take small steps in that direction. A national highway-construction bill included money for local governments to build sidewalks and bike paths, to encourage children to walk or ride bikes to school. The Senate unanimously passed legislation to study how the National School Lunch Program and other government food assistance can address obesity. The measure also established a grant program for communities to promote physical activities for children.
Nutrition advocates are pushing for legislation that would require better nutrition labeling at chain restaurants where menus are uniform. For example, fast food menu boards would list calories per item and a restaurant chain's sit-down menus would list calories, saturated fat and sodium content.
"Some fast food places and chain restaurants already give nutrition information for the healthy options. That shows it is possible. So why not on all the items?" said Margo Wootam, the director of nutrition policy at the Center for Science in the Public Interest, an advocacy group based in
Washington.
The Food and Drug Administration has asked the food industry to voluntarily revise nutrition labels by putting the calorie count in larger type and providing a percentage of daily value for calories, similar to the scores now given for fats.
But the Bush administration has proposed cutting funding for a CDC project to promote physical activity among 9- to 13-year-olds, from $36 million this year to $5 million in 2005. In fiscal 2000, its first year, the program, known as the VERB campaign, received $125 million, but its funding has declined steadily despite the CDC's assertions that targeted children exercised 30 percent more.
Obesity is a global problem, having an impact on developing countries as well as rich ones, as societies change from people working on farms to standing in factories to sitting at desks, said David Porter, a spokesman for the World Health Organization.
The WHO will release recommendations before a meeting May 17 of its 192 member countries to adopt a global strategy for reducing obesity. The WHO is expected to propose that governments help reduce obesity by changing tax and subsidy programs to encourage healthy diets instead of those high in processed foods, sugars and fat.
The trade group for the U.S. food and beverage industry opposes that approach. "Food taxes have been shown not to work" and they penalize the poor, said Richard Martin, a spokesman for the Grocery Manufacturers of
America.
He added that "what constitutes a healthy diet differs for every individual, and prescriptions on what one person should or should not eat does not work."
Washington influences food choices by its trade and subsidy policies on corn, soybeans and sugar, the three main ingredients in processed foods, countered Marion Nestle, the author of the book "Food Politics." Nestle is a nutrition professor and the director of New York University's Public
Health Initiatives.
So why not harness government power to promote good health? she asked.
Advocates are bracing for a long fight, but they think the epidemic already is changing minds. For example, in the 1990s, school districts across the country were installing snack and beverage vending machines to raise money for athletic equipment, band uniforms and library books.
Now many are having second thoughts and developing ways "to raise money in ways that don't undermine children's health," Wootam said. Last year
California banned selling soda in elementary and middle schools. A dozen other states are considering similar legislation.
"The rising obesity rates have caused people to rethink practices that were acceptable in the past," Wootam said.
ON THE WEB
National Center for Chronic Disease Prevention and Health Promotion's page on overweight and obesity,
www.cdc.gov/nccdphp/dnpa/obesity
Center for Science in the Public Interest's guide to improving school foods and beverages,
http://cspinet.org/schoolfood/index.html
World Health Organization's global strategy on diet, physical activity and health,
www.who.int/hpr/global.strategy.shtml
Grocery Manufacturers of America,
www.gmabrands.com
The U.S. government's nutrition site,
www.nutrition.gov 
more posts...