Preventing Obesity in Children. Americans are the fattest people on the planet and continue to expand. According to

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1 Walker 1 Ashley Walker Professor Avalos English December 2003 Preventing Obesity in Children Americans are the fattest people on the planet and continue to expand. According to a survey of adult men and women in the United States during , published in JAMA: The Journal of the American Medical Association, 30.5% of Americans are obese, up from 22.9% ten years earlier, and nearly two-thirds (64.5%) are overweight (Flegal et al.). Excess weight isn t just a matter of looks. Obesity magnifies the risk of heart disease, diabetes, high blood pressure, and other ailments already overtaking tobacco as the leading cause of chronic illness (Brownell and Horgen 4). An especially disturbing aspect of this trend is that children are increasingly obese. The Center for Disease Control and Prevention reports that the percentage of obese children aged 6 to 11 almost quadrupled from 4% in 1974 to 15% in 2000, and the percentage of obese children aged 12 to 19 increased from 6% in 1974 to 15% in 2000 (United States; see Fig. 1). Obese children have a 70% chance of becoming obese adults with a much higher risk of serious illness than those of normal weight (Brownell and Horgen 46). Furthermore, obese children suffer many serious health problems today. Pediatricians now routinely treat atherosclerosis and type II diabetes, diseases that used to be frequent only among older people (Tyre 38). Today s children are among the first generation in American history who may die at earlier ages than their parents.

2 Walker 2 Fig. 1. Prevalence of overweight among children and adolescents ages 6-19 years, chart from United States, Department of Health and Human Services, Centers for Disease Control and Prevention, Prevalence of Overweight Among Children and Adolescents: United States, (24 Oct < pubs/pubd/hestats/overwght99.htm>). For most people in the United States, obesity is a matter of individual choice and old-fashioned will power (Lee and Oliver). The usual advice for overweight people is to eat less and exercise more, but how applicable is this advice for children unless they have strong guidance from adults? How can children make intelligent choices about eating in an environment where overeating is normal and where few adults know what s in the food they eat? The United States has been successful in addressing teenage health problems: drug use has dropped, teenage pregnancy has been reduced, and teen smoking has declined. We need to take a similar proactive response by taking concrete steps to

3 Walker 3 reverse the trend toward more obese children. Many have blamed the rise in obesity on a more sedentary life style, including the move to the suburbs, where people drive instead of walk, and increased viewing of television. One study of children watching television found a significant drop in the average metabolic rate during viewing (Klesges, Shelton, and Klesges). Another study reports that reducing children s television viewing also affects their eating behavior (Robinson and Killen). No doubt that children who exercise less tend to weigh more, but the couch potato argument does not explain why the enormous weight gains have occurred over the past twenty-five years. The move to the suburbs and the widespread viewing of television began in the 1950s. Furthermore, the couch potato argument neglects the extraordinary rise of female participation in athletics. The number of young women playing a sport in high school has risen from 294,015 in to 2,856,358 in , almost a ten-fold increase ( Participation ). Yet girls, like boys, have gained weight. The simple answer to why Americans of all ages have steadily gained weight over the past three decades is that we re consuming more calories about 500 more per person per day in 2000 than in Marion Nestle, the chair of the Department of Nutrition and Food Studies at New York University, observes that food is so overproduced in the U.S. that there are 3,800 calories per person per day, and we only need about half of that" (qtd. in Spake and Marcus 43). We re eating more food high in calories and high in fat than ever before. Patterns of eating in America have changed over the past three decades. With more people working longer hours and fewer staying at home, annual spending in adjusted

4 Walker 4 dollars at restaurants increased nearly by a factor of ten between 1970 and 2003, from $42.8 billion to $426.1 billion ( Industry ). The growth was most rapid among fast-food chains, which by 1999 were opening a new restaurant every two hours (Schlosser, Bitter ). According to Eric Schlosser, In 1970, Americans spent about $6 billion on fast food; in 2001, they spent more than $110 billion. Americans now spend more money on fast food than on higher education, personal computers, computer software, or new cars. They spend more money on fast food than on movies, books, magazines, newspapers, videos, and recorded music combined. (Fast 3) As the restaurant business became more competitive, fast-food chains realized that the cost of the food they served was small in comparison to the costs of buildings, labor, packaging, and advertising, so they began increasing the size of portions. Amanda Spake and Mary Brophy Marcus note: When McDonald's opened, its original burger, fries, and 12-ounce Coke provided 590 calories. Today, a supersize Extra Value Meal with a Quarter Pounder With Cheese, supersize fries, and a supersize drink is 1,550 calories (44). Large portions may represent good value for the dollar, but they are not good value for overall health. Another significant change in the American diet beginning in the 1970s has been the introduction of high-fructose corn syrup into many foods. Look at food labels today, and you will find fructose, dextrose, maltrose, or a similar name all corn syrup products high on the list of ingredients in foods like peanut butter, crackers, and ketchup that you might not expect to contain such high levels of sugar. Food producers found that sweetness is an important component of taste, and they have been dumping in

5 Walker 5 sweet corn syrup ever since. High-fructose corn syrup is cheap to produce and enjoys government subsidies, enabling soft drink manufacturers to increase size without increasing cost. The 8-ounce soft drink bottle of the 1950s has been replaced with the 12- ounce can, 20-ounce bottle, or 32-ounce fountain drink. Harvard researcher David Ludwig has found that food high in sugar makes you hungrier in a short time because it creates a spike in blood sugar followed by a crash, triggering overeating (Uhlenhuth). In other words, one cookie does lead to another. Also contributing to the rise of obesity is widespread availability of food. Stores that formerly did not sell food such as drug stores now have aisles of food. Gas stations have been replaced by mini-marts. Vending machines are found nearly everywhere, particularly in cash-strapped schools. And food companies have produced an endless line of good-tasting snack foods for consumption at home and at work. When we eat food high in sugar and feel hungry two hours later, usually food is close by. These factors have contributed to a general rise in obesity, but they do not explain why the rate of obesity among children has skyrocketed. One prominent cause is the huge increase in marketing food to children, which has not only doubled since 1992 but also become increasingly sophisticated. An average child in the United States who watches television now sees a food ad on Saturday morning every 5 minutes and a total of over 10,000 a year, overwhelmingly ads for high-sugar and high-fat food (Brownell and Horgen ). Restaurant and food companies spend fifteen billion dollars in marketing to children each year with sophisticated advertising campaigns that include product tie-ins (Barboza C1). Even children of parents who limit or ban television watching are exposed to a massive amount of food advertising in movies, video games,

6 Walker 6 the Internet, and even in schools. Walter Willett, a Harvard professor of nutrition, observes The vast majority of what [food companies] sell is junk.... How often do you see fruits and vegetables marketed? (qtd. in Barboza C1). Obesity in children is a health crisis comparable to the illnesses causes by smoking. Defenders of the food industry argue that smoking is voluntary, but everyone has to eat. The crisis for children is more analogous to second-hand smoke, which has been proven to be harmful to children. To blame children for choosing to be fat is like blaming a baby to be born to parents who smoke. Most children lack knowledge to make intelligent food choices, and they often have no access to healthy food. Parents of course can make a difference, but parents do not control much of the environment where children eat, including school lunch programs and vending machines in schools. Furthermore, the majority of adults have inadequate skills for controlling their weight. Some changes have begun to occur. West Virginia has eliminated junk food in vending machines in schools (Tyre 40). McDonald s and other fast-food companies have been begun to offer healthier alternatives to their fat-laden foods. Kraft Foods, the largest food company in the United States, has begun an anti-obesity initiative by reducing portions of popular snacks and providing more nutritional information (Walker). But these are small steps in addressing the biggest health crisis of the twenty-first century. The first major step in reducing obesity in children is to restrict marketing of junk food to children. When the American public realized how effective Joe Camel ads were in reaching children, their outrage led to a ban on many forms of cigarette advertising. The food industry has no such restrictions and uses popular cartoon characters and actors to pitch their products. According to advertising professor Vijay Netaji, children under

7 Walker 7 age eight cannot distinguish programs from advertising, particularly when the same characters are participating in both. Other countries including Belgium, Greece, Norway, and Sweden now limit advertising directed toward children (Brownell and Horgen 121). The United States should join these nations. The second major step is to develop a campaign to educate children and parents about healthy and unhealthy food. Children and their parents need to know more about the health risks of obesity and how to follow healthier eating habits. Parents play an important role in selecting what children eat, but children also need to be able to make good choices about eating on their own. The third major step is to promote a healthy life style though more exercise. Exercise, like eating, is not simply a matter of personal choice. Many schools cannot afford to provide physical education programs and activities that encourage exercise, and many communities lack public space and facilities where people can exercise. More exercise for children needs to be made a priority in schools and communities. Step one can be accomplished by either voluntary restriction of marketing to children or by legislation, but steps two and three will require major funding sources. Margo Wootan of the consumer advocacy group, Center for Science in the Public Interest, proposes that food companies support a public service campaign to promote healthier eating and more exercise ( Generation ). Wootan s proposal may be too idealistic for the highly competitive food industry where profits mean survival. Advocates for children s health have proposed instead taxes on unhealthy food and soft drinks similar to taxes on tobacco products that fund the campaign to reduce teenage smoking (e.g., Brownell). Food tax proposals have been extremely controversial. The

8 Walker 8 Center for Consumer Freedom, a group supported by the restaurant and food industry, has launched ads against fat taxes and legal actions against junk food, arguing that healthy food is a choice ( CCF ). The choice argument, however, is more difficult to make for children. If food taxes are the best way to promote healthier eating and more exercise among children, would Americans support such a tax? A 2003 opinion poll sponsored by the Harvard Forums on Health found that Americans are overwhelmingly in favor of measures to fight obesity in children including banning vending machines that sell unhealthy foods in schools and providing healthier school lunches ( Obesity ). Over three quarters of the people sampled in the poll support a government-sponsored advertising campaign for healthier eating and the creation of more public spaces for exercise. The poll indicates that Americans are willing to pay higher taxes for these programs, although the majority opposed specific taxes on junk food. Just as Americans eventually woke up to the risks of smoking among young people and took decisive action, they are gradually becoming aware of the threat of obesity to their children s future and, more important, starting to do something about it.

9 Walker 9 Works Cited Barboza, David. If You Pitch It, They Will Eat. New York Times 3 Aug. 2003, final ed., sec. 3: 1+. Brownell, Kelly D. Get Slim with Higher Taxes. New York Times 15 Dec. 1994, final ed.: A29. Brownell, Kelly D., and Katherine Battle Horgen. Food Fight: The Inside Story of the Food Industry, America s Obesity Crisis, and What We Can Do about It. Chicago: Contemporary, CCF Ad Campaigns. ConsumerFreedom.com Center for Consumer Freedom. 18 Nov < Flegal, Katherine M., et al. Prevalence and Trends in Obesity among US Adults, JAMA 188 (2002): Generation XL; Middle Ground on Obesity. Editorial. Boston Globe 11 Oct. 2003, 3rd ed.: A18. Industry at a Glance. Restaurant.org National Restaurant Association. 18 Nov < Klesges, Robert C., Mary L. Shelton, and Lisa M. Klesges. Effects of Television on Metabolic Rate: Potential Implications for Childhood Obesity. Pediatrics 91 (1993): Expanded Academic ASAP. Thompson Gale. Perry-Casteñeda Lib., U of Texas at Austin. 20 Nov < Lee, Taeku, and J. Eric Oliver. Public Opinion and the Politics of America s Obesity Epidemic. May John F. Kennedy School of Government, Harvard U. 12

10 Walker 10 Nov <ksgnotes1.harvard.edu/research/wpaper.nsf/rwp/rwp02-017/$file/rwp02_017_lee.pdf>. Netaji, Vijay. Telephone interview. 20 Nov Obesity as a Public Health Issue: A Look at Solutions. Harvard University Program for Health Systems Improvement Harvard Forums on Health. 18 Nov < Participation Summary Make a Difference National Federation of State High School Associations. 14 Nov < Robinson, Thomas N., and Joel D. Killen. Obesity Prevention for Children and Adolescents. Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. Ed. J. Kevin Thompson and Linda Smolak. Washington, DC: APA, Schlosser, Eric. The Bitter Truth about Fast Food. Guardian 7 Apr. 2001, weekend sec.: Fast Food Nation: The Dark Side of the All-American Meal. New York: Perennial, Spake, Amanda, and Mary Brophy Marcus. A Fat Nation. U.S. News & World Report 19 Aug. 2002: Tyre, Peg. Fighting Big Fat. Newsweek 5 Aug. 2002: Uhlenhuth, Karen. Spoonful of Sugar Makes Appetites Go Up. Advertiser 19 Jan. 2003: 39. LexisNexis Academic. LexisNexis. Perry-Casteñeda Lib., U of Texas at Austin. 20 Nov <

11 Walker 11 United States. Department of Health and Human Services. Centers for Disease Control and Prevention. Prevalence of Overweight Among Children and Adolescents: United States, Oct Nov < Walker, Andrea K. Chipping Away at Fat. Baltimore Sun 26 Sept. 2003, final ed.: C1. LexisNexis Academic. LexisNexis. Perry-Casteñeda Lib., U of Texas at Austin. 20 Nov <