A recent New York Times article highlighted some of the first reports indicating that the prevalence of childhood obesity has decreased in several U.S. cities and states. A recent Health Policy Snapshot on Childhood Obesity from the Robert Wood Johnson Foundation presented the latest statistics, which show that the prevalence of obesity in Philadelphia and New York City students decreased by 4.5 and 5.5 percent, respectively, over several school years, while the prevalence of overweight/obesity in California and Mississippi students also declined. These changes come on the heels of a variety of policies that have been implemented to combat weight gain among school-age children in these locales, including:

• Removing sugar-sweetened beverages from school vending machines and replacing whole milk with skim or one percent in the cafeteria;
• Creating guidelines to limit fat grams and total calories in snack foods sold at school; and
• Using non-food rewards in the classroom and selling healthy treats at fundraisers.

In addition, legislative and community efforts have also paved the way for change, such as:

• The Food Trust working to bring fresh foods to corner stores and supermarkets to underserved areas of Philadelphia;
• New York City’s Green Cart and Healthy Bucks programs helping low-income families afford local produce; and
• Laws in California requiring support for walking/bicycling in transportation plans and posting of nutrition information in large chain restaurants.

Despite these promising developments, fighting childhood obesity remains an uphill battle, and the prevalence remains far too high even in places where recent declines have been seen. More than 20 percent of Philadelphia and New York City students are obese, and more than 37 percent in Mississippi and California are overweight/obese. In addition, except in Philadelphia, those highest at risk, such as low-income minority children, appear to have benefited least. The national statistics are also sobering, as:

• One-in-three children are overweight or obese, and 17 percent of children under age 20 years are obese (which is the equivalent of 12.5 million young Americans);
• On any given day, 30-40 percent of children and adolescents will eat fast food, and 87 percent of food/beverage ads on television seen by young children are for foods high in saturated fat, sugar, and/or sodium; and
• Obese children are more likely to become obese adults, putting them at higher risk for a number of negative health outcomes, including cardiovascular disease, high blood pressure, stroke, cancer, Type 2 diabetes, sleep apnea, and depression.

While any evidence that rates of childhood obesity are in decline is worth celebrating, the piecemeal efforts that have been driving these modest improvements are no match in the long run for powerful food and beverage companies and the obesogenic environment they’ve helped create. Hopefully these glimpses of improvement will propel the introduction of broad policy changes recommended by the Institute of Medicine to:

• Integrate physical activity every day in every way;
• Market what matters for a healthy life;
• Make healthy foods and beverages available everywhere;
• Activate employers and health care professionals; and
• Strengthen schools as the heart of health.

By: Susan Kleiman