June 7, 2004
Call them the obesity warriors. Restaurant-and food-industry
lobbyists have called them "nutrition nannies" and the "food
police." But Brownell, Nestle, Ludwig, Sallis and a few other
scientists have stepped out of the ivory tower of academe to
challenge communities, industry and government to do more to
fight obesity and especially to prevent it from afflicting more
children. Taking cues from the battle against smoking, these
scientists write books, they lecture at meetings—including
food-industry gatherings—they dash off op-ed pieces and they
spend generous amounts of time talking with reporters from major
networks, newspapers and magazines like this one. What Brownell,
author of Food Fight (Contemporary Books; 356 pages), and
like-minded researchers advocate is change at every level of
society—from local communities and schools to the Federal
Government.
They are fully aware of how difficult it will be to engineer this
kind of change. Nestle, who served in the Reagan Administration
as senior nutritional-policy adviser and editor of the first—and
only—Surgeon General's Report on Nutrition and Health, knows
that health messages are politically dicey when they concern the
mighty food industry. Her 2002 book, Food Politics (University of
California Press; 469 pages), documents how those messages get
distorted. Still, that doesn't stop her and her fellow warriors
from campaigning for action.
A look at their ideas for cleaning up our fattening environment:
START WITH THE SCHOOLS
Nothing infuriates the obesity warriors more than dietary
conditions in public schools. "We as a society have really
abdicated responsibility for teaching kids how to eat right and
how to have an active lifestyle," charges Ludwig, who wants to
eliminate "junk food, fast food and soft drinks" from schools.
"Students are a captive audience," he says. "Promoting their
physical well-being should be part of the school's educational
mission." The first step is getting rid of soft drinks, which
"are basically candy," says Nestle. "Get 'em out of the schools."
Tackling soft drinks alone could make a remarkable difference.
Ludwig's research shows that for every additional daily serving
of a soft drink, a child's risk of becoming obese rises 60%. The
typical adolescent, he says, gets a whopping 10% to 15% of his or
her daily calories from soft drinks. If those drinks were
replaced by water, far fewer kids might become overweight.
Increasingly, school officials across the country are coming
around to this point of view. Los Angeles, Philadelphia, San
Francisco, Chicago, New York City and numerous smaller districts
have taken steps to ban the sale of soft drinks during the school
day (although New York has made the dubious decision to replace
soda with sugary Snapple beverages). California and Texas have
issued statewide bans on soft-drink sales in elementary and
middle schools.
The next step, say Ludwig and Brownell, is to restrict the sale
of potato chips, candy and other junk food in schools. Texas, Los
Angeles and New York City are leading the way. After that, says
Brownell, cafeteria menus should be revised to replace foods high
in empty calories with more nutritious fare. Ludwig is eager to
eliminate fast-food-type meals from school cafeterias, some of
which sell food supplied by McDonald's, Pizza Hut, Burger King
and other franchisers. On days when kids eat fast food, they
consume an average of 187 more calories than on days without fast
food, Ludwig and collaborators reported in a large study
published in the January issue of Pediatrics. Since, on average,
the American kid eats a fast-food meal 1 out of every 3 days,
"this would account for an extra 6 pounds of weight gained a
year," says Ludwig. "It's a poor return on investment to fund
education by selling this kind of food to kids."
Besides reforms in the cafeteria, obesity experts would like to
see changes in what kids learn about fitness and diet. Studies
have shown that teaching kids to eat smarter, be more active and
watch less TV can have lasting results. The largest school-based
health-intervention study ever done was a mid-1990s trial,
involving 5,000 children in four states, called CATCH (Child and
Adolescent Trial for Cardiovascular Health). Aimed at preventing
heart disease rather than obesity, it showed that improvements in
the lunchroom, gym class and health instruction could change
kids' eating habits and activity levels at school and at home.
And the lessons stuck. A follow-up study three years later found
that kids who had been through CATCH from third grade through
fifth grade still had a healthier diet and were more physically
active when they reached middle school than control-group kids.
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