The White House Task Force on Childhood Obesity released a detailed report including 70 recommendations this week.
The action plan defines the goal of ending childhood obesity in a generation as returning to a childhood obesity rate of just 5 percent by 2030, which was the rate before childhood obesity first began to rise in the late 1970s. In total, the report presents a series of 70 specific recommendations, many of which can be implemented right away.
Pdf files containing the full report, or individual sections, can be downloaded here. After the jump I highlighted a few proposals that caught my attention in each of the five large sections: Early Childhood, Empowering Parents and Caregivers, Healthy Food in Schools, Access to Healthy, Affordable Food, and Increasing Physical Activity.
I. Early Childhood
This part of the report urges several steps to better inform women about "the importance of conceiving at a healthy weight and having a healthy weight gain during pregnancy." It also includes a wide range of recommendations to promote breastfeeding, with the goal of having half of U.S. babies breastfed for at least nine months by 2015. The recent health insurance reform bill requires workplaces with at least 50 employees to provide a private space other than a toilet stall for women to express milk during their breaks.
The report endorses Baby-Friendly hospital standards, which I suspect would be fiercely resisted by formula manufacturers. Insurers and health care providers are also encouraged to "provide information to pregnant women and new mothers on breastfeeding" and "connect pregnant women and new mothers to breastfeeding support programs." In addition, "Local health departments and community-based organizations, working with health care providers, insurance companies, and others should develop peer support programs that empower pregnant women and mothers to get the help and support they need from other mothers who have breastfed." Child care providers are also encouraged to make the setting more supportive of breastfeeding, for instance by allowing mothers to breastfeed their children on-site (when dropping off or at the pick-up time), and making sure employees "know how to store, handle, and feed breast milk."
I was surprised to see the report urge federal and state agencies to "prioritize research into the effects of possibly obesogenic chemicals." I assume this refers to endocrine disruptors like bisphenol A (BPA). The report notes, "As the research becomes clearer, reducing harmful exposures may require outreach to communities and medical providers, and could also entail regulatory action."
There are also several recommendations aimed at reducing children's "screen time," such as better informing parents and child care providers about the American Academy of Pediatrics recommendations on children's exposure to television and digital media. Many of those ideas do not require federal action, but the report asks the federal government to "provide clear, actionable guidance to states, providers, and families on how to increase physical activity, improve nutrition, and reduce screen time in early child care settings" and "look for opportunities in all early childhood programs it funds (such as the Child and Adult Care Food Program at USDA, the Child Care and Development Block Grant, Head Start, military child care, and Federal employee child care) to base policies and practices on current scientific evidence related to child nutrition and physical activity."
II. Empowering Parents and Caregivers
This part of the report discusses A. Making Nutrition Information Useful; B. Food Marketing; and C. Health Care Services. Most of the recommendations rely on private sector actions, such as better nutrition labeling on food and beverage packages, smaller portions and healthier options on restaurant children's menus, reduced marketing of unhealthy food and beverages to children, and faster implementation of the calorie count requirements the health insurance reform law imposes on restaurants and vending machines. I doubt much of this will happen, nor do I think media and entertainment companies will heed the task force's call to "limit the licensing of their popular characters to food and beverage products that are healthy and consistent with science-based nutrition standards."
The section on health care services includes recommendations on encouraging doctors and dentists to better inform families about achieving a healthy weight. It also recommends, "Federally-funded and private insurance plans should cover services necessary to prevent, assess, and provide care to overweight and obese children."
III. Healthy Food in Schools
Many of the recommendations in this section can be accomplished through federal action, especially by the U.S. Department of Agriculture, such as: "Update Federal nutritional standards for school meals and improve the nutritional quality of USDA commodities provided to schools"; "USDA should work with all stakeholders to develop innovative ways to encourage students to make healthier choices"; "USDA should work to connect school meals programs to local growers, and use farm-to-school programs, where possible, to incorporate more fresh, appealing food in school meals." Schools are encouraged to consider changes to the nutrition curriculum, upgrade equipment to make it easier to prepare healthful foods, have school gardens if possible as an educational tool and to "ensure that choosing a healthy school meal does not have a social cost for a child."
The task force also asks food manufacturers to "develop new products and reformulate existing products so they meet nutritional standards based on the Dietary Guidelines and appeal to children."
Jamie Oliver's Food Revolution series has made the conversation about school food much more mainstream, but I suspect cost factors and institutional inertia will deter many school districts from following the task force recommendations.
By the way, if you are concerned about school lunch nutrition, I recommend bookmarking and occasionally checking the sites La Vida Locavore and School Lunch Talk (which originally had the brilliant blog name "F is for French Fry").
IV. Access to Healthy, Affordable Food
It's been well-documented that Americans in many urban and rural communities have limited access to affordable, nutritious whole foods. This section of the report was full of good ideas, such as increasing the number of farmers' markets and other direct-to-consumer options for farmers. However, I feel pessimistic about prospects for the task force's recommendations in this area. It would be wonderful to "Provide economic incentives to increase production of healthy foods such as fruits, vegetables, and whole grains," and to "evaluate the effect of targeted subsidies on purchases of healthy food through nutrition assistance programs." But in times of budget scarcity, I can't see local governments funding "incentives to attract supermarkets and grocery stores to underserved neighborhoods and improve transportation routes to healthy food retailers." I am skeptical that the "food, beverage, and restaurant industries" will "use their creativity and resources to develop or reformulate more healthful foods for children and young people."
V. Increasing Physical Activity
Several of the 17 recommendations in this section are aimed at increasing children's physical activity during the school day, at recess as well as in physical education classes. I would love to see more frequent and higher-quality P.E. in all schools, to cite one example. Unfortunately, P.E. is often one of the first things cut when budgets are strained, as they are in many parts of the country now. My children's school district considered big cuts to P.E. at elementary schools in the coming academic year. Most of the that funding was restored after the state legislature adopted a relatively generous education budget, but if money is tight next year, I expect P.E. to be on the chopping block again in my area and across the country.
The task force asks state and local educational agencies to make physical activity more accessible for kids in after-school programs too, and to make it less expensive for kids to participate in sports teams (that is, limit the use of "pay to play" for extracurricular sports).
Several of the recommendations deal with broader issues of transportation and land-use planning, such as adopting a new Surface Transportation Act "that enhances livability and physical activity," and EPA guidelines for new schools that emphasize ways to make it possible for students to walk or bike to school. Local governments and the business sector are asked to devote resources to making more parks, playgrounds, fields, gyms and other indoor recreation centers accessible to children, "particularly in underserved and low-income communities." This kind of thing should be a no-brainer, but I know many cities are having trouble maintaining their park systems, let alone expanding or upgrading them.
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