On Tuesday, Trust for America's Health and the Robert Wood Johnson Foundation (RWJF) released their annual 'F as in Fat: How Obesity Threatens America's Future' report on national obesity prevalence, which for the first time forecasts adult obesity rates through the year 2030. RWJF is a founding member of Partnership for a Healthier America, the foundation that supports First Lady Michelle Obama's Let's Move! campaign, and the report's final policy recommendations are a handbook for how to prosecute the goals of the initiative. Let's Move! is designed to achieve its ultimate goal by 2030, and coordinates the anti-obesity efforts of more than 13 federal agencies, as well as schools, communities, states, and the private sector.The report uses previously published federal data that relies on self-reporting by individuals to show the consequences by state for an uptick in obesity rates without aggressive interventions (a note on this is below). All 50 states could have obesity rates above 44% by 2030, the report predicts, with 39 states with rates above 50%, and 13 states with adult obesity rates above 60%. For instance Mississippi, America's fattest state, currently has an obesity rate of 34.9%. That could rise to 66.7% by 2030, the report says.
The report also predicts that "the number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension, and arthritis could increase 10 times between 2010 and 2020—and double again by 2030." Medical costs associated with treating preventable obesity-related diseases "could increase by up to $66 billion per year by 2030, and the loss in economic productivity could be as high as $580 billion annually."
But: The report maintains that "states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index of their residents by just 5 percent by 2030." Yet that still leaves a statistically high level of obesity if the report's other predictions are true.
Supporting Let's Move!...
The report encourages support for all the sub-components of the Let's Move! campaign, including healthier school meals and the full implementation of the Healthy, Hunger-Free Kids Act 20120; the Let's Move Salad Bars to Schools project; supporting breastfeeding and maternal and early childhood interventions; promoting school fitness initiatives; boosting farm to school programs; promoting school and community gardens; making streets safer for play; labeling foods, introducing coordinated federal advertising standards; making restaurant meals and processed foods healthier, etc. A strong new Farm Bill with full funding for nutrition programs is encouraged. Each component is detailed and promoted in the report, which spotlights case studies of success stories, such as Walmart's pledge to put a "healthy seal" on the front of food packages that contain nutritious foods. Walmart, America's largest grocer, is a partner in Let's Move!.
*Download the full F as in Fat 2012 report [PDF]
The Let's Move! campaign is based on an action plan created by the White House Task Force on Childhood Obesity. Download the Report to the President [PDF], which contains all policy recommendations.
Predicting obesity trends is tricky...
It should be noted that predicting obesity trends is an inexact science, with experts in the field often disputing government data, which is gleaned from surveys that rely on self-reporting. 'F as in Fat' uses a peer-reviewed model that was used in an analysis of obesity trends published in a 2011 article in British medical journal The Lancet, which used data from the National Health and Nutrition Examination Survey. But the report uses 2011 data from the Centers for Disease Control and Prevention. In 2011, CDC gathered its data with a different methodology than in past years, using cell phones to quiz participants for the first time. Those participating in the survey were neither weighed nor had their body mass measured; they merely reported their own statistics. That means they could be giving false statements, whether upward or downward.
Previous CDC surveys also relied on self reporting, but it is not possible to compare 2011 results with results from past surveys thanks to the introduction of cell phone use. For instance, the report's authors note that in 1995, Mississippi's obesity rate was also #1 in the nation at the time, but it was only 19.4%, compared to the 2011 rate of 34.9%. And they point out that that 20 years ago, no state was above 15% for obesity. But these statistics were not determined the same way as the 2011 data, which shows a dramatic, across-the-board spike.
The report's final policy recommendations include:
*Fully implement the Healthy, Hunger-Free Kids Act, by implementing the new school meal standards and updating nutrition standards for snack foods and beverages in schools.
While healthier school lunch standards went into effect in US schools this Fall, the Department of Agriculture has failed to issue even preliminary guidelines for competitive foods, those potentially unhealthy foods sold on campus in a la carte lines and vending machines. This rule is mandated under the school meal legislation, signed into law in December of 2010. The report notes that 40% of children purchase competitive foods on a daily basis.
*Fully support healthy nutrition in federal food programs
The report suggests fully funding the federal nutrition programs, a subject of debate in the current Farm Bill that is under consideration by Congress. But it does not address the massive elephant in the room, which is that those who receive Food Stamps can purchase obesogenic foods such as soda, chips, cake and ice cream with their benefits. Food Stamps, formally known as the Supplemental Nutrition Assistance Program, is the largest federal nutrition program, with an average of 46 million Americans enrolled monthly, at a cost of more than $6.2 billion.
*Finalize the Interagency Working Group on Food Marketed to Children Guidelines
These guidelines have led to an ongoing smack-down between the federal government and the food and beverage industry, with the private sector sidestepping any federal intervention by coming up with their own self-imposed guidelines. The Walt Disney Company has stepped up to the plate for Let's Move!, offering its own version of standards for marketing and nutrition. The effort does not begin for another three years, however.
*Protect the Prevention and Public Health Fund.
*Increase investments in effective, evidence-based obesity-prevention programs.
*Fully implement the National Prevention Strategy and Action Plan.
*Make physical education and physical activity a priority in the reauthorization of the Elementary and Secondary Education Act.
*Encourage full use of preventive health care services and provide support beyond the doctor’s office.
*Photo by Eddie Gehman Kohan/Obama Foodorama
