Despite increased research and public health efforts, the prevalence of obesity in the United States has increased dramatically during the past three decades, more than fourfold among children 6–11 years of age. Today, nearly one-third of children and adolescents are overweight or obese.1
As a result, public policy approaches have emerged as a solution and raised ethical questions. Are children a vulnerable population? Policy proponents believe they are. Children are dependent on adults for the foods they have available, their opportunities to play actively, and the information they receive. Now more than ever, children in the United States are at an increased risk of being harmed both physically and emotionally as a result of the childhood obesity epidemic.
The solution is complex, and the health care system, public health community, industrial sector, and policy makers have not determined how to most effectively address and reverse the childhood obesity epidemic. There are many factors contributing to this epidemic, and no single villain emerges. Unlike national efforts to decrease tobacco use, food is necessary for life, and we rely on industry for that food. Although personal choice is important, we know that eating and physical activity choices are often limited and influenced by the environment in which we live and raise our children. The good news is that, if everyone works together (individuals, organizations, legislators, and communities), a combination of efforts could lead to environmental and societal changes that could make healthy choices easier.
The Institute of Medicine (IOM) has published several evidence-informed reports with recommendations to improve the environment in which children live, learn, and play.2–5 These recommendations remind us of the importance of ensuring healthy practices in our child care settings, schools, and underserved neighborhoods.
The goal of a recent summit held in Washington, D.C., was “to save our nation” by building a healthier future for our children through a multilevel collaborative effort. The mantra of the summit was, if we don't take action, “our country is looking at the first generation of youth who could have a shorter lifespan than the generation that came before them.”
In this spirit, the Partnership for a Healthier America (PHA), an organization devoted to working with the private sector to solve the obesity crisis, brought together public, private, and nonprofit leaders in Washington, D.C., to make a commitment, take action, and work together to find solutions.
PHA is a nonpartisan, nonprofit group created just more than 1 year ago in conjunction with the Let's Move initiative (www.letsmove.gov). U.S. First Lady Michelle Obama is the honorary chair, and she provided an inspirational keynote presentation as a parent and as the leader of the campaign. Throughout this conference, the need for meaningful change, clear commitment, and accountability was emphasized.
Numerous announcements by private sector leaders as they publicly committed to changing how they do business to address the childhood obesity epidemic were a highlight of the summit. PHA expected these actions to be substantive, not superficial. As health professionals working in the community to improve health, we believe they achieved this goal because many of these commitments coincided with recommendations made by the IOM about how to address childhood obesity. Changing the course of childhood obesity will take just such bold moves, leadership, and collaboration.
One of the organizations committing to a bold move was the national YMCA, which made specific commitments to improving the health of the 700,000 children it serves through school-aged child care programs. These commitments included establishing minimum time allotments for physical activity and maximum time allotments for screen time; providing fruits and vegetables as snack options and offering water as the primary beverage during snack times; encouraging breastfeeding; and conducting parent education to encourage healthy behaviors at home.
Another organization committing to bold changes was the New Horizon Academy, which provides child care for 7,500 children in Minnesota and Idaho. Its commitments included following family-style eating practices; serving fruits and vegetables with every meal; eliminating all fried foods and sugar-sweetened beverages; providing access to water during meals and throughout the day; serving low- and nonfat milk to all children over the age of 2 years; serving a maximum of one 4- to 6-oz serving of 100% juice per day; accommodating mothers who breastfeed; providing a minimum of 1–2 hours of physical activity per day; eliminating or reducing screen time; and encouraging parents and caregivers to limit screen time to no more than 1–2 hours per day at home.
Other national organizations also came to the table with commitments that will improve the environment for parents and families to aid in curbing the childhood obesity trend. Walmart committed to reformulating thousands of everyday food products to make them healthier and to offering more affordable options. It will also address “food deserts” (communities whose residents lack access to fresh produce and other healthy foods) by building stores in such areas. Darden Restaurants, the world's largest full-service restaurant company, committed to offering 1% milk and a fruit or vegetable as the default side dish for its children's meals. Important commitments were also made by Fresh Grocer, a Philadelphia-area company, to build five grocery stores in food deserts; by Kaiser Permanente to support breastfeeding; by Hyatt Hotels to provide children's meals that meet healthy guidelines; and by Walgreens to offer a wider selection of fresh foods in some neighborhoods deemed food deserts. Readers can learn more about these commitments and others and how progress will be monitored by going to the PHA website at http://www.ahealthieramerica.org.
It is often debated just whose job it is to ensure that children have a healthy life: parents, caregivers, schools, communities, states, businesses, or industry. The time has come to end the debate and take action on all fronts to protect future generations.