By Mabel Ponce-Koch, Health Consumer Alliance Director
There is a growing consensus that the life expectancy of many of today?s children will be less than their parents? because of early and continuing obesity. This sobering and growing problem is the focus of a recent report from the Institute of Medicine (IOM), Local Government Actions to Prevent Childhood Obesity.
According to the Report, obese children and adolescents are more likely to have hypertension, high cholesterol, and Type 2 diabetes when they are young. The Report also emphasizes that much can and is being done in all sectors of our society to reverse this dangerous trend and focuses on what local government can do.
The Report?s introduction explains that although the causes of childhood obesity are complex, the simple explanation is that too many calories are ingested (through consumption of food and beverages) and too few calories are expended (through physical activity). Importantly, calorie consumption is more than a matter of individual willpower or personal responsibility. Living in an environment that lacks healthy food choices and encourages unhealthy ones is a challenge to overcome. An environment that offers no place to play and nowhere safe to walk is likely to discourage optimum physical activity. The Report finds that real solutions to obesity must take into consideration the environments in which children live, learn, and play. Indeed, the IOM highlights the need to understand the local context and community conditions when making decisions on childhood obesity prevention efforts. Community conditions, such as unequal access to opportunities for healthy foods and physical activity, can contribute significantly to the obesity problem.
Because food and physical activity choices made every day affect short-and long-term health and are directly related to weight outcomes, the IOM?s report underlines the importance of local governments in creating healthy eating environments and healthy environments for physical activity. The Report notes that local governments are more likely to increase their chances of success if their efforts are combined with those underway in other sectors, including schools. Indeed, as noted in the Report, evidence points to multisectoral community initiatives as effective in achieving and sustaining prevention of childhood obesity. A multi-sectoral plan can include clear roles, responsibilities, and policies that encourage healthy choices to be easier choices by giving communities, schools, businesses, and families the tools they need to follow national recommendations for healthy eating and physical activity.
Healthy eating. A healthy eating environment is one in which families have access to supermarkets or other places where they can obtain affordable, healthy foods like fruits and vegetables with minimal or no added sugar, fat, or salt; fat-free or low-fat dairy products; whole grains; and lean meats. Research suggests that neighborhood residents who have better access to supermarkets and limited access to convenience stores tend to have healthier diets and lower levels of obesity. The IOM report emphasizes that local governments can provide strategic leadership, such as using zoning laws to change local food environments, serving as a catalyst for community change by offering healthier foods at government facilities, and communicating the importance of healthy eating and obesity prevention to community members. The IOM recommends developing healthy eating strategies and action steps around three goals: First, improve access to and consumption of healthy, safe, and affordable foods; second, reduce access to and consumption of calorie-dense, nutrient-poor foods; and lastly, raise awareness about the importance of healthy eating to prevent childhood obesity.
Physical activity. The IOM report stresses that a sedentary lifestyle is a predictor of overweight and obesity; therefore, physical activity is critical not only for optimal weight but also for physical and cognitive development. Moreover, there are man-made elements of the physical environment including buildings, infrastructure, and other physical elements created or modified by people (sidewalks, streets, trails, bicycle lanes, parks, playgrounds) called the ?built environment? that play an important role in promoting physical activity for both children and adults. The built environment includes two important elements: land use and transportation systems. Social factors like family, friends, place of employment, home, neighborhood reputation (defined by perceived safety and social nuisances) are equally important. According to the Report, local governments can promote physical activity by helping make available good sidewalks, low-speed streets, attractive green spaces, nearby trails, easily accessible recreation centers, and low crime rates. The IOM developed recommendations for physical activity strategies and action steps that local government can take around three goals. First, encourage physical activity; second, decrease sedentary behavior; third, raise awareness about the importance of increasing physical activity.
In addition to encouraging implementation of healthy eating and promotion of physical activity strategies and action steps, the IOM report emphasizes the need to evaluate any obesity prevention actions performed in a community. Identifying what local governments can contribute and what does and does not work can assist a community in making better decisions about future actions.
For a full copy of the report Local Government Actions to Prevent Childhood Obesity go to: http://www.nap.edu/catalog/12674.html.
