Commentary: The Kids Are Not All Right

With child obesity a fast-growing problem, schools are leading the fight

It ought to make parents cringe. A major study released on Sept. 30 reports that 9 million school-age children are obese. That's 15% of all kids in the classroom. It gets worse. The study, conducted by the independent Institute of Medicine (IOM), goes on to report that the prevalence of obese children age 6 to 11 is three times as high as 30 years ago, while obesity rates among preschoolers and teenagers have doubled. An estimated 80% of these children will go on to be obese adults, with all the attendant health problems.

Congress has taken note. It asked the IOM, part of the National Academy of Sciences, to prepare the report, which carries the proactive title Preventing Childhood Obesity: Health in the Balance. But don't expect Washington to take concrete action against this epidemic anytime soon. The feds are doing almost nothing to rein in food advertising to children, require better nutritional labeling, or fund physical education. And the IOM pulled its punches, calling on the President to seek "a high-level task force" -- usually a recipe for inaction.

In an ideal world it would be up to parents to see to it that their kids eat properly. But given that some 30% of U.S. adults are also obese, parents are part of the problem. What's more, even parents who are striving to instill good eating habits at home are fighting an uphill battle against the food industry's TV-marketing juggernaut. That's why if change is to occur, it will more likely start in the place where kids spend most of their time -- in school. Says Kelly D. Brownell, director of Yale University's Center for Eating & Weight Disorders: "Legislators tend to be on the side of the food industry on this one. But there are local actions all around the country that are making a difference."

U.S. Surgeon General Richard H. Carmona is pushing local solutions. On Sept. 29 he released a survey of some 2,000 organizations around the country that are tackling childhood obesity, so parents and community leaders will know where to turn for solutions. Several regions are taking the lead: Last year, Arkansas banned all vending machines from its schools and now requires that every student have their weight evaluated and reported to parents. Los Angeles and Philadelphia have barred sales of junk food and soda in all public schools, and New Jersey is proposing a similar ban.

New York City, with the nation's largest school system, is using its clout to extract concessions from the food industry. "We serve 860,000 meals a day," says David Berkowitz, who runs the school food program. "Because we're so large, we can ask manufacturers to reduce the fat and sodium content." In 2003, New York cut the fat content of lunches served at school by 30% and started offering free breakfasts to every student, ensuring they start the day right.

Schools still need to do far more to ensure kids work off those lunches. The IOM reports that budget cutbacks have fallen heavily on physical education, with only 8% of elementary schools, 6.4% of middle schools, and 5.8% of high schools providing daily physical education. Yet a Rand Corp. study released in September found that providing five hours of PE a week to kindergartners would cut the prevalence of obesity in girls in that grade -- currently 10% -- by nearly half.

Communities can also demand that PE be treated as more than a marginal school pursuit. The light has already dawned in Mississippi, which has the highest rate of obesity in the nation -- 26% of all adults. Starting this year, all public schools in the state are required to offer physical education; it hadn't been mandatory for over a decade.

The obesity problem is a time bomb that needs to be defused. According to the IOM report, an estimated 30% of boys and 40% of girls are at risk to develop Type 2 diabetes at some point in their lives. "Kids don't make decisions on their own," says Dr. Jeffrey P. Koplan of Emory University, chair of the IOM team that produced the obesity report. "We have to provide an environment that allows families to choose a healthier lifestyle." That's a message that cannot wait for a White House task force.

By Catherine Arnst, with David Kiley in New York

— With assistance by David Kiley

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