Population-wide approach needed to curb obesity

NEW YORK (Reuters Health) - A broad range of policy and environmental initiatives at the local, state and federal levels aimed at increasing physical activity and healthful eating is needed to reduce rates of obesity in the United States, according to an American Heart Association (AHA) scientific statement in the Association's journal Circulation, published Monday.

In an AHA-issued press release, Dr. Shiriki Kumanyika, chair of the working group that wrote the scientific statement "Population-Based Prevention of Obesity," noted that "almost all of our current eating or activity patterns are those that promote weight gain -- using the least possible amount of energy or maximizing quantity rather than quality in terms of food."

Kumanyika added, "People haven't just made the decision to eat more and move less; the social structure has played into people's tendencies to go for convenience foods and labor-saving devices."

Referring to the panel's recommendations, Kumanyika, a professor of epidemiology at the University of Pennsylvania School of Medicine in Philadelphia, said: "We're not talking about creating a dieting society, but looking at choices people make in day-to-day living that affect their ability to manage their weight and then trying to change the environment to facilitate healthier choices,"

Key areas to explore to effect change, according to Kumanyika and colleagues, include modifying the environment in which people live, like creating more walkable neighborhoods with sidewalks and areas for physical activities; decreasing restaurant portion sizes; and making sweetened drinks, high-fat foods and low-fiber foods less readily available.

"Changes in these areas can eventually become 'normal' and displace the current 'normal' ways of doing things," she said. "Right now, you have to be pretty single-minded to make some of these choices, such as walking or riding a bike instead of driving. We advocate changes that will move the social norm to where physical activity is the custom."

It's currently estimated that roughly 67 million American adults are obese, and an additional 75 million are overweight. About 4.2 million children 6 to 11 years old and 5.7 million adolescents 12 to 19 years old are also overweight.

The latest national survey data, released in May 2008, reported no significant increase in the proportion of children and adolescents who are overweight or obese compared with surveys conducted in 2003-04 and 2005-06.

"This could be good news -- a sign that recent public health efforts in raising awareness of childhood obesity are working -- but it's really too soon to tell," Kumanyika said. "Regardless, childhood obesity must remain on the population health agenda for years to come. We need much more than a plateau. We need a reversal."

SOURCE: Circulation: Journal of the American Heart Association, July 22, 2008.