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Talking Points:

The Big, Fat American Kid Crisis . . . and 10 Things We Should Do About It

By: ELEANOR RANDOLPH

Published: May 10, 2006

The problem is all too obvious. At the mall, the movie theater or the airport, the evidence appears in the flesh — altogether too much of it. Americans are now officially supersized, overweight, obese even. This is true of almost two thirds of American adults, but what is more alarming, it is also true of millions of American children. The "little ones" aren't so little anymore.

Yes, they are gently labeled "chunky," "husky" or "plus-sized" by the clothes marketers who are adding larger and larger sizes to the children's racks. But these euphemisms can't cover up the unpleasant reality that too many of our kids are so dangerously overweight that they are spilling out of their childhood — too chubby for their car seats or too uncomfortable as they squeeze into their little desks at elementary school. But the real problem is not aesthetics or the need to save classroom space. Childhood obesity has become a national medical crisis.

Over the last 30 years, obesity rates have doubled among pre-schoolers and tripled for those age 6 to 11. For those added pounds, the young are starting to pay a terrible price. Adult diabetes has rapidly become a childhood disease. Pediatricians are seeing high cholesterol and high blood pressure and other grown-up problems in their patients. Teachers and school psychiatrists are coping with a plague of shame and distress among children whose size subjects them to hazing and other cruelties by their classmates.

Many overweight kids even suffer from sleep apnea, the snoring disease that usually afflicts middle-aged men and women with beer bellies. Adolescent apnea means that students are irritable, sleepy and ready to catch any cold germ that lands on their No. 2 pencil at school.

The National Institutes of Health estimates that Americans will take five years off our average lifespan in a few years if we don't curb obesity, especially among the young. The Centers for Disease Control and Prevention has estimated that the obesity epidemic is already costing our health care system about $79 billion a year. And that bill is expanding as fast as the national waistline.

America's culture of "personal responsibility" means that we are quick to blame fat people for their condition. Certainly, anyone overweight bears part of the responsibility for their condition, and each person whose body mass index is over 25 needs to be part of any solution to the obesity epidemic. The comedian Billy Connolly has a point when he suggests, "If you want to lose a bit of weight, don't eat anything that comes in a bucket."

But Americans are not getting fatter because of a sudden shortage of self-discipline. There are broader social forces at work that are conspiring to overload Americans — particularly American children — with calories while reducing the amount time and effort spent burning those calories away.

A good deal of the fault lies with Big Food, the name, echoing Big Tobacco, that critics have given to food companies that keep trying to foist dangerous food choices on the American public, including children. We should encourage young people — and particularly the nation's 9 million overweight children — to take responsibility for their weight and health. But we should also start to consider childhood obesity a social problem, and take action as a nation.

Here are 10 places to start:

1. Stop Bombarding Children With Junk Food Ads

It's easy to blame young people for eating badly. But this generation has been confronted with something previous generations never faced: an unprecedented wave of sophisticated, multimedia advertising designed to hook them on unhealthy food before they are old enough understand what is happening.

Children's television has become an incredibly efficient way to sell soda, candy, salty snacks, and other junk foods. Although the industry pretends there's confusion, the evidence is clear. Children younger than 8-years-old cannot tell the difference between advertising and entertainment on television. Some in the food industry have exerted at least a modicum of restraint (Kraft has put limits on ads aimed at toddlers, for example, and Coca-Cola avoids programs for those under 12), but it's too hard for the corporations to police themselves.

In the 1970's, the Federal Trade Commission proposed a rule to ban or severely restrict all television advertising to children. But guess what? The food lobbyists didn't like it, so Congress passed something it called "The Federal Trade Commission Improvements Act of 1980" (see page 11). The "improvements" in this case include stripping the agency of the authority to restrict advertising — a clear improvement from the point of view of Big Food. Instead of banning children's ads, the Congress gave us a voluntary system that is funded by the industry and doesn't really work.

So, kid's television is a Pinocchio's Land of Toys — a sugary world where all the candy one can eat eventually turns children into junk-food donkeys. Extra-large donkeys. The Center for Science in the Public Interest recently announced plans to file a lawsuit in Massachusetts against the Kellogg Company and Viacom (which owns Nickelodeon) after determining that 88 percent of the ads on children's television were for cookies, pastries, sugary cereals, candy and other junk food. The center, allied with a Boston-based group called Campaign for a Commercial-Free Childhood, argues that the advertising aimed at toddlers as young as two years old is "creepy" and "predatory."

They're right. Those ads — including an ad for Apple Jacks cereal that made an apple look menacing and grumpy — can launch a lifetime of bad eating habits. Congress should give the F.T.C. back its authority to regulate children's television commercials, and the F.T.C. should start protecting children from junk food propaganda.

2. Proselytize for Healthy Eating

It's time for elected officials, and other prominent people, especially young people, to use their bully pulpits, and the powers of their office or their fame, to send a message to kids about how to eat right. One excellent model in this regard is Gov. Mike Huckabee of Arkansas, who has made healthy living a personal crusade.

Huckabee was diagnosed with Type 2 diabetes, and his doctors told him that if he didn't lose weight, he wasn't likely to live much longer. Huckabee, who used to joke that he weighed almost as much as a cement truck, dropped more than 100 pounds, and began such an intense exercise regime that he now runs marathons.

As a missionary for healthier living, the Arkansas governor speaks publicly, often, about the importance of healthy eating and exercise. And he has launched a program called "Healthy Arkansas," which encourages people to exercise and eat well. Among other things, the state allows workers a half hour off each day to exercise and free pedometers are available to help measure how many miles they cover per workday.

Since his heart surgery, Bill Clinton has also taken his turn speaking out against childhood obesity. Earlier this year, he and the Robert Wood Johnson Foundation announced an $8 million initiative to encourage children to eat better and exercise more. He has also joined with the American Heart Association to start the Alliance for a Healthier Generation, which offers an obesity newsletter and tips for combating childhood obesity. The alliance has also entered into a partnership with Nickelodeon to foster healthier lifestyles for children.

These initiatives are great, but they are easily drowned out by the massive advertising campaigns of Big Food. More elected officials, celebrities and foundations need to speak out. Athletes and movie and television stars and the music crowd idealized by the young could be particularly influential. They could beam this message into every young head: eating junk food and staring at a computer or television screen all day is simply not cool. Dancing is cool. Carrots are cool. Fruit, which does not naturally come in loops, is cool.

3. Ban the Junk Food in Schools

Another reason this generation is fatter than its predecessors is that junk food has never been as easily accessible as it is right now. Food in school used to be limited to the mystery meats and limp vegetables served up in the cafeteria. But the soda, fast food and junk food industries have fought hard to get a foothold in schools, and they have been extraordinarily successful.

Big food has been remarkably strategic about plotting its assault on the schools. It has promised woefully under-funded school systems a share of the take from vending machines, or outright cash gifts. Many school systems have caved.

According to a 2005 report by the Government Accountability Office, 83 percent of elementary schools, 97 percent of middle schools and 99 percent of high schools sell junk food from vending machines or school stores. Parents' groups, and other civically minded people, are beginning to fight back, trying to extricate junk food from the schools. But many states (including New York) seem to be circling the issue while they let the sweet, sugar and bad fat industry continue adding to the adolescent waistline.

A bipartisan amendment (pdf) offered recently to the National School Lunch Act in Congress would prohibit the sale in schools of any foods that are too high in fat, sodium and sugar. The law currently permits the sale of many unhealthy foods in the cafeteria if they contain at least five percent of certain vitamins and minerals. That means candy bars (think peanuts) and ice cream (cream) and chips (corn). You don't have to be a registered dietician to know that a Snickers bar or a bag of Cheetos should not meet anyone's definition of healthy eating. The biggest benefit from this amendment would be to stop the sale of drinks and snacks from vending machines anywhere in a public school during school hours.

The U.S. Department of Agriculture should be able to regulate all food being served in schools, and states and local school districts should also uphold higher standards. Children are required by law to attend school, where they become a captive audience for whatever food and beverages are available. We should not allow the soft drink and junk food industries to push their products on children on school property.

Until the law changes, we're stuck with voluntary measures.

President Clinton recently brokered such a deal in which the nation's largest soda companies agreed to keep non-diet soda out of elementary and middle schools. It is an important step, though it does not go as far as it should. The ban does not cover sports drinks or diet sodas, both of which present health risks for young people. It also does not cover all of the many non-beverage products that continue to be dangled before children at school. And it does not cover high school, where the need for better nutrition is every bit as great as in the lower grades.

4. Upgrade the School Snack

It is not enough to keep unhealthy snacks away from children. We need to provide them with healthy alternatives.

Senator Tom Harkin, a Democrat from Iowa who has been active in the fight against childhood obesity, has a smart idea about snacking. He has started a pilot program that allows the government to give away fresh fruits and vegetables as snacks at over 100 schools and two Indian tribal organizations, mostly in the Midwest.

The "Harkin Snack," as we'd like to call it, should be offered at schools across the country. On an average day, less than half of American children (45 percent) eat any fruit at all, according to the Center for Science in the Public Interest. Part of giving away these fresh fruits and vegetables at school may be a way of introducing it to the many young people who think corn is a kind of Halloween candy.

5. Tax the Fatteners

America has a long tradition of "sin taxes" aimed at products like cigarettes and alcohol, partly to discourage their use, and partly to recoup some of the costs that these products impose on society. Junk food should be subject to such a tax. There should be an especially high tax on trans fats, a test-tube food product that is present in a lot of processed foods and is believed to be a leading contributor to heart disease.

Just as federal gas taxes are earmarked for highway construction, fat taxes could be earmarked for special programs that could help counter the problems caused by junk food — helping to pay for after-school athletic programs or the rising medical costs of fighting diabetes among the young. Another good use of the money would be an advertising campaign, modeled on the anti-smoking campaigns, that counteracts the messages Big Food is sending out about junk food.

Expect Big Food to fight back — and hard. As the movie "Thank You For Smoking" recently reminded us, corporations spend a lot of time and money getting out a positive message about their products — even if those products are tobacco, firearms and alcohol.

For a taste of what Big Food is already doing, check out The Center for Consumer Freedom, a collection of anti-public-service messages funded by the restaurant and junk food industries.

6. Stop Subsidizing Junk Food

Agricultural subsidies got their start during the Great Depression, to help starving farmers to survive. Today, they are largely a form of corporate welfare for large farmers. In addition to costing taxpayers dearly, these subsidies are creating some unhealthy incentives for big agriculture.

A prime example is the roughly $40 billion in corn subsidies government has handed out over the last decade. They've encouraged farmers, not surprisingly, to raise a lot of corn. Too much of this taxpayer-subsidized corn is being used to produce high-fructose corn syrup, which is now so cheap that it has practically replaced sugar in many processed foods.

Nutritionists suggest that high-fructose corn syrup, which is showing up in foods of all kinds, is a stealth reason why Americans are getting fat. An American Journal of Clinical Nutrition study shows how Type 2 diabetes and sweetener use have soared together over the last 25 years. There needs to be a broad-based attack on the overuse of high-fructose corn syrup, including better labeling requirements, and public education. But an obvious place to start is removing the taxpayer subsidy on corn converted to sweeteners.

Nobody wants to get rid of sweets altogether, but the American sweet tooth has been recklessly over-indulged in recent decades. Sweeteners should be a rare treat, not a staple of the Western diet.

7. Start Subsidizing Healthy Food for Poor People

Another key reason children are eating badly is that junk food is cheap. It is often a lot cheaper than fresh fruits and vegetables. "If you tell a family, you really ought to be eating more salads and fresh fruit, and this is a low-income family, we're essentially encouraging them to spend more money," Adam Drenowski, professor of epidemiology at the University of Michigan, told the Associated Press last year. The most effective way to help poor people to eat better is to help them pay the bills. Governor Huckabee of Arkansas has been trying to change his state's food stamps program to give a bonus to people when they spend money on fruits and vegetables, and reducing the value of the food stamps when they are spent on junk food. It is a great idea, but sadly the federal government has been resisting granting permission — and it is hard to believe the political influence of Big Food isn't part of the reason.

Members of Congress should amend the food stamps law to build in an express reward for spending directed at healthy food, and a penalty for buying junk. Other states should also follow Governor Huckabee's lead and push for state-level changes.

8. Label Food in Chain Restaurants

Labeling of food in restaurants lags far behind labeling in supermarkets. Consumers who eat out but want to eat right are mostly dining in the dark. At one time, that didn't matter. But in today's hurried world, most Americans spend about half their food budget outside the home. Many products that are served in fast-food restaurants — like Chicken McNuggets — are not found in nature, and a consumer would have no way of knowing exactly what they are getting nutritionally without more data provided by the restaurant. (McDonald's does provide nutritional information, though not as prominently as it could.) At the very least, consumers at chain restaurants have a right to know the data — calories, fat, saturated fat, trans fat, salt, sugar and high-fructose corn syrup — in every dish.

The restaurant industry managed to win an exemption from the 1990 law that requires nutrition labeling on most foods and drinks we buy at the store. It's time to close that loophole for the chains that have standard fare and standard menus. So far, power brokers in Congress and the White House have been listening more to the restaurateurs than to the customers. If we want to hold people responsible for their food choices — a common refrain of Big Food — we have to give them the information they need to make informed choices.

9. Educate Parents and Teachers

Parents have a key role to play in combating childhood obesity. They have enormous influence (though certainly nowhere near as much as they would like) over what their children eat, and how much exercise they get. Unfortunately, many parents are themselves not very knowledgeable about obesity and healthy living.

With nearly half of New York City's elementary school students either overweight or obese, Dr. Thomas Frieden, New York City's health commissioner, launched an effort last fall to educate parents, make healthier food available and press schools for more physical fitness. Some other cities are energized as well. Philadelphia's Food Trust found little healthy food options in many inner-city stores (only one store offer individual-sized low-fat milk and none had fresh fruit). So they began pushing the stores, snack food distributors and even food companies to make better choices available.

California has been a pioneer, launching a rigorous anti-obesity program in schools two years ago. In Arkansas, for the past three years, the state has been weighing children in school, and sending home confidential notes to parents whose children are overweight. Since the program began, the state's childhood obesity rate has inched down slightly.

Other states should quickly follow the lead of California and Arkansas. Along with information about their children's weight, parents need educational materials that explain how to help their children eat right, the recommended intake for nutrition and calories for children of different ages and the amount of time they should be active every day.

10. Exercise for Everybody

As any nutritionist can attest, controlling food intake is only half of the battle in keeping thin. The other half is exercise. It is no secret that too many children are not running, jumping or moving around enough. There are many reasons, from the rise of video games to the carpooling culture, which means that many children scarcely do more than walk across the parking lot on an average day.

An important part of the solution should be organized athletic activity in the schools. Unfortunately, too many physical education classes are mired in the distant past. They should be re-imagined to use their limited time in the most efficient way.

One experiment by researchers at the University of Wisconsin found that in old-fashioned gym classes, by the time clothing is changed and attendance taken, only about 25 minutes is left for actual exercise. The study showed that fitness classes that focused on simply keeping kids moving allowed children an average of 42 minutes of exercise per class, and did more to help them lose weight and keep fit.

In this age of high-consequence testing, schools are understandably focused on reading and math scores, and ultimately, on college placement rates. But physical fitness is important for its own sake as a means of keeping children healthy, relaxed and energetic enough to learn well. Schools should devote more of their self-improvement efforts toward making more energetic play time in the earlier years and more inventive physical education programs for adolescents.

No one favors childhood obesity. But too many companies and their stockholders are more concerned about profit than products. And too few adults, from elected officials to school principals, are giving the problem the attention it deserves. This is not an issue that can be solved with a few narrow fixes — by shifting to diet drinks and going for cookies that are labeled low-fat. With more than a majority of Americans overweight, obesity and near-obesity are now society's problems. And the oversized American now requires a change in the national culture, starting in the high chair.

Lela Moore contributed research for this article.

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