Medical report calls for focus on children to tackle America's bulging waistlines

Two in three American adults are too fat, medical experts say, calling for a renewed focus on schools as the place where eating habits take hold for life.

North Carolina school children enjoy a workout in support of the US first lady, Michelle Obama's Let's Move! initiative to fight childhood obesity.

WASHINGTON // Two in three  American adults are too fat, and a major overhaul of US policies - from schools to restaurants to urban planning - is needed to stem the epidemic, medical experts said yesterday.

In a 400-plus page report, the Institute of Medicine (IOM) called for urgent action to reverse national obesity trends that are costing the US $190.2 billion (Dh697) a year in illness-related costs.

Peppered with terms such as "synergies", "empower" and "systems approach", the report called for a renewed focus on schools as the place where eating habits take hold for life, noting that 17 per cent of US children are obese, a figure that has trebled in 30 years.

Offering lunches packed with vegetables and whole grains and limiting access to sugar-sweetened drinks were among the recommendations for people from the age of six to 18.

States and local schools should also ensure that all children and teenagers have the opportunity for 60 minutes of exercise a day, said the report titled "Accelerating Progress in Obesity Prevention: Solving the Weight of a Nation".

Other top goals for all ages include making physical activity a daily routine, making healthy food and drink choices widely available, and expanding the role of doctors, insurers and employers.

"Because obesity is such a complex and stubborn problem, a bold, sustained and comprehensive approach is needed," said the report.

"Action must occur at all levels - individual, family, community, and the broader society."

The IOM report reviewed past strategies for obesity prevention to come up with new recommendations to speed progress, it said.

"Left unchecked, obesity's effects on health, health care costs, and our productivity as a nation could become catastrophic," added the report.

People who belong to ethnic minorities, who have lower incomes and less education are more susceptible to obesity, partly due to policy decisions that result in limited access to healthy foods and places to enjoy exercise.

For instance, one third of children born today - and half of Hispanic and black children - will develop type 2 diabetes in their lifetime, according to projections cited by the IOM.

"Some communities may have no safe place to walk or play, no shops offering affordable healthy food, and widespread advertisements of unhealthy food and beverages," said the report.

Community planners could work harder to make sure there are safe places for exercise, for example by converting an unused railway bed into a running and biking trail, said the report.

"People only have a certain, limited ability to control their weight in an environment where there is a lot of food available," said the IOM committee member, Shiriki Kumanyika, professor of epidemiology at the University of Pennsylvania.

"One of the main reasons (for obesity) has to do with people being presented with large quantities of food - tasty food - in a culture where more is better, portion sizes are getting larger and heavily advertised," she said.

Separate research presented on Monday at a related conference on obesity in Washington, DC, warned that 42 per cent of US adults could be obese by 2030, and the number of severely obese people could more than double from five to 11 per cent.

Michael Jacobson, executive director of the Centre for Science in the Public Interest, a consumer-advocacy group, urged governments, the food and health care industries and schools to implement the IOM's recommendations, calling it an "excellent blueprint for solving America's costly obesity problem."

He added: "But policymakers will have to invest both money and political capital to convert the advice into reality."

Despite the report's repeated urging of more institutional measures to make sure healthy foods are readily available, Prof Kumanyika said the report's authors were not seeking new laws or mandates.

"We can't rely on mandatory solutions where they are not likely to be put into place. There a lot of things that government can do voluntarily," she said.

"Many of the things we recommend are in the control of people. They just require energy, focus and leadership to get things done."