Moving Policymakers To Tip Scales On Childhood Obesity

The seemingly intractable problem of childhood obesity in the U.S shows few signs of abating.  But it’s not for a lack of effort. Major initiatives from such high-profile entities ranging from the NFL to First Lady Michelle Obama have pounded the message of exercising and healthy eating.  Still, 17% of U.S. children weigh in at an unhealthy Body Mass Index (BMI), according to the most recent CDC statistics.

States have passed laws limiting access to sugar sweetened drinks at school and/or requiring a certain amount of recess time each day.  Some have even mandated that schools measure a student’s BMI (Here is a list of these state laws).

But the overall childhood obesity curve remains untamed.  At best it is leveling off; at worst, pockets of increases remain. This graphic from the CDC’s National Health and Nutrition Examination Survey illustrates how the problem has grown in the last few decades.

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Racial, ethnic and income factors play a significant role in a child’s obesity risk. Close to one-third of low-income children between the ages of 2 and 4 in the U.S. are overweight or obese, according to the CDC.

Decades old government guidelines for school lunches that had no limit on the calorie count of each meal were revamped in 2010. Widely seen as a triumph for the first lady and advocates who have long toiled on this issue, school lunches got a makeover this fall. But students around the country complained of grumbling stomachs. Three high schoolers went so far as to compose a song for the first lady asking for enough calories to sustain them during the day, as reported by WDAY’s Becky Parker. 

A new collaborative aiming to further influence policy has entered the mix. A couple weeks ago the Robert Wood Johnson Foundation (RWJF) and the American Heart Association (AHA) joined forces with the goal of reversing the childhood obesity epidemic by 2015. 

Jill Birnbaum, Vice President of State Advocacy and Public Health with the AHA, says what makes this ambitious new initiative different is its focus on policy. 

“There are a lot of existing programs to combat childhood obesity, but there have been very limited resources to change the policy,” Birnbaum explains.

The RWJF and AHA anti-obesity collaboration will take from lessons learned in tobacco control efforts, which effectively changed behavior and social norms through laws, taxes and access to smoking cessation programs.

“What we learned from tobacco is we needed to continue to put more pressure on multiple points,” Birnbaum says, adding that the obesity problem is even more complex.

“There’s so many different places that we have to influence.  The amount of work that we have to do here is incredibly big,” she adds.

This work will largely focus on improving nutritional intake, but enacting policies that get kids to exercise is part of the strategy as well. Birnbaum cites prior policy successes working with schools and vendors to enact nutritional standards in the lunchroom.  These have effectively taken away unhealthy options for children to consume at lunch, but before- and after-school programs as well as fundraisers are not covered by the guidelines.

Reducing food and drink marketing to children and setting price points that might disuade people from buying certain items (read: taxes) grounds the strategy as well. Birnbaum says some industry players have stepped up to the plate with voluntary initiatives - like the American Beverage Association's work with the Alliance for a Healthier Generation that has limited student's access to sugar-sweetened drinks in school. It will also be important to assure comprehensive change in the school food and beverage environment through local, state and federal laws, she says.

The question with any effort to combat obesity remains: Even if access to healthy food and exercise improves and the choice of eating unhealthy food is limited, will overall habits change?  Students might not be able to drink a soda at school, but what is served at their kitchen table?

In a blog post last year, Barbara Feder Ostrov cited a USDA/Economic Research Service study that examined whether or not offering healthy food and grocery stores in underserved areas would actually boost their consumption. The answer illustrates the age-old expression, “You can lead a horse to water, but you can’t make him drink.”

Even if supermarkets are accessible to all, it's not clear consumers will significantly improve their diets by shopping at them – supermarkets carry all the unhealthy foods that convenience stores do, and usually offer them at lower prices. (June 2009) 

Here are some related story ideas:

• Have students in your school system gotten used to the new food choices at lunch after the federal guidelines were updated this year? Or are there still movements afoot to change the menu?
• Pending regulations from the USDA that govern food sold outside of the lunch program (called "competitive food") are expect soon. How will they be rolled out in your school districts?
• As some state legislatures begin their sessions next year, are they considering any relevant legislation?
• Explore local efforts to banish what are know as "food deserts" -- places where it is difficult to find fresh fruits and vegetables. A variety of players are working in this arena, from state and local governments to farmers markets and Wal-Mart. The Food Trust is also a good resource on the issue.
• Chefs have joined the healthier eating effort. The Chefs Move to School element of the Let's Move campaign enlists chefs that have volunteered to help with nutrition at their local schools.

Image by SodexoUSA via Flickr