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Young Lives at Risk Our Overweight Children

Inertia at the Top

Noah Horn, Age 12
"I didn't really care so much because I didn't really know that he was going to die one day so suddenly." (Video By Jennifer Crandall-- The Washington Post)

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Jayonni Doy is a quiet 10-year-old with an effervescent smile. Like many children, she is struggling with her weight. View Gallery »
By Susan Levine and Lori Aratani
Washington Post Staff Writers
Monday, May 19, 2008

The problem at first was that the problem was ignored: For almost two decades, young people in the United States got fatter and fatter -- ate more, sat more -- and nobody seemed to notice. Not parents or schools, not medical groups or the government.

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But since the alarm was finally sounded in the late 1990s, the problem has been the country's reaction: a fragmented, inchoate response that critics say has suffered particularly from inadequate direction and dollars at the federal level.

"The sense of this as a national health priority just doesn't come through," said Jeffrey P. Koplan of Emory University, a former director of the Centers for Disease Control and Prevention and chairman of the Institute of Medicine's 2004 study of childhood obesity. The top recommendation of that seminal report was for the government to convene a high-level, interdepartmental task force to guide a coordinated response. No such body has been assembled.

Contrast that with the offensive mounted in European countries: France mandated health warnings on televised food ads. Spanish officials reached agreement with industry leaders on tighter product labeling and marketing as well as reducing fat, salt and sugar in processed foods.

Britain has gone the farthest, restricting food ads on TV programs catering predominantly to children and pulling sweets and sweetened drinks from schools. Eighty-five percent of all grades have at least two hours of physical education a week. The 2011 goal is five hours.

"The whole of the government has signed up," Will Cavendish, director of health and well-being, said at a conference in Washington last month. Britain's Healthy Weight, Healthy Lives program is backed by $600 million in funding over three years.

There's no question that the U.S. epidemic won't be reversed by federal fiat alone; responsibility lies also with individuals, the health community, corporations, local governments and others. Still, health experts insist that strong leadership from the top is crucial. They see the Bush administration falling short of expectations and few real champions in Congress.

"This probably will contribute more to our health-care bill than anything else over the next 50 years," Koplan said.

The first signs of trouble appeared in the late 1970s as rates of overweight that had been relatively stable for years started to rise. In retrospect, they were reflecting societal, technological and policy shifts that would turn the youngest generation into the heaviest to date.

For starters, with more women working outside the home, families were eating more takeout or processed food. Spurred by the profit margins of volume production, fast-food restaurants pushed larger portions. Gadgets such as remote TV controls and video games meant children were planted for longer periods in front of televisions and computers. And on and on.

Through the 1990s, the waistline expansion accelerated. On campuses, once-rare vending machines multiplied as administrators signed exclusive contracts giving their schools a share of sales; the money was considered essential for band uniforms, sports equipment and other unfunded extras.

Soon, soda and chips were a ubiquitous part of millions of students' days. That it happened as many school systems minimized recess and physical education proved disastrous.


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