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IOM report examines the national obesity epidemic

Tuesday May 8, 2012
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Americaís progress in arresting its obesity epidemic has been too slow, and the condition continues to erode productivity and cause millions to suffer from potentially debilitating and deadly chronic illnesses, according to a new report from the Institute of Medicine.

Solving the problem requires a comprehensive set of solutions that work together to spur across-the-board societal change, wrote the report committee. The report identifies strategies with the greatest potential to accelerate success by making healthy foods and beverages and opportunities for physical activity easy, routine and appealing aspects of daily life.

The report, released May 8 at the Centers for Disease Control and Preventionís "Weight of the Nation" conference in Washington, D.C., focuses on five critical goals for preventing obesity: integrating physical activity into peopleís daily lives, making healthy food and beverage options available everywhere, transforming marketing and messages about nutrition and activity, making schools a gateway to achieving a healthy weight, and galvanizing employers and healthcare professionals to support healthy lifestyles.

The committee assessed more than 800 obesity prevention recommendations to identify those that would be most effective in a large-scale effort.

Specific strategies include requiring at least 60 minutes per day of physical education and activity in schools, industry-wide guidelines on which foods and beverages can be marketed to children and how, expansion of workplace wellness programs, taking full advantage of cliniciansí roles to advocate for obesity prevention with patients and in the community, and increasing the availability of lower-calorie, healthier childrenís meals in restaurants.

"As the trends show, people have a very tough time achieving healthy weights when inactive lifestyles are the norm and inexpensive, high-calorie foods and drinks are readily available 24 hours a day," committee chairman Dan Glickman, executive director of congressional programs at the Aspen Institute in Washington, D.C., and former secretary of the U.S. Department of Agriculture, said in a news release.

"Individuals and groups canít solve this complex problem alone, and thatís why we recommend changes that can work together at the societal level and reinforce one anotherís impact to speed our progress."

Clinical approaches

In the section regarding strategies for healthcare providers, the committee wrote that all providers "should adopt standards of practice (evidence-based consensus guidelines) for prevention, screening, diagnosis and treatment of overweight and obesity to help children, adolescents and adults achieve and maintain a healthy weight, avoid obesity-related complications and reduce the psychosocial consequences of obesity.

"Healthcare providers also should advocate, on behalf of their patients, for improved physical activity and diet opportunities in their patientsí communities."

Standards of practice should include routine screening of body mass index, counseling and behavioral interventions for children, adolescents and adults to improve physical-activity behaviors and dietary choices, the committee wrote.

Nursing schools and other medical training schools should include instruction in prevention, screening, diagnosis and treatment of overweight and obesity in children, adolescents and adults.

Providers should serve as role models for their patients and provide leadership for obesity prevention efforts in their communities by advocating for institutional, community and state-level strategies that can improve physical activity and nutrition resources for their patients and communities.

Providers also should work to ensure coverage of, access to and incentives for routine obesity prevention, screening, diagnosis and treatment; and encourage healthy weight gain during pregnancy and breast-feeding, and promote environments that are "friendly" to breast-feeding (more details about these strategies are available in the PDF of the IOMís recommendations at http://bit.ly/JUIrtM).

A comprehensive effort

Among the strategies for other sectors, healthy food and beverage options should be available at competitive prices everywhere that food is offered, and efforts should be made to reduce unhealthy products. The food, beverage, restaurant and media industries should increase voluntary efforts to develop and implement common nutritional standards for marketing aimed at children and adolescents up to age 17. Government agencies should consider setting mandatory rules if a majority of these industries have not adopted suitable standards within two years.

Healthcare providers could perform "routine screening regarding overconsumption of sugar-sweetened beverages and counseling on the health risks associated with consumption of these beverages," the committee wrote.

Schools should be given the resources and support to implement federal nutrition standards for meals and for products served in vending machines, concession stands and other venues. Students in every grade should have opportunities to engage in at least 60 minutes of physical activity daily through quality physical education and active classroom activities. Schools could make food literacy part of their curricula, supported by the USDA through the development of age-appropriate nutrition information for lesson guides.

Sponsored by the Robert Wood Johnson Foundation, the report was released in conjunction with the "Weight of the Nation" initiative, which includes an HBO documentary series presented in collaboration with IOM, in association with the CDC and the National Institutes of Health, and in partnership with Kaiser Permanente and the Michael and Susan Dell Foundation. The initiative seeks to spur individuals and groups to get involved in local efforts to promote healthy eating and activity. More information is available at http://theweightofthenation.hbo.com.


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