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House Subcommittee Discusses Obesity Epidemic; Panelists Discuss Implications of Obesity in Childhood

On March 26, the House Agriculture Subcommittee on Operations, Oversight, Nutrition, and Forestry held a hearing on the state of obesity in the United States.

William H. Dietz, director of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention (CDC), described the status of childhood obesity, saying, “There are disparities by race, ethnicity and socioeconomic status in the prevalence of obesity among youth. In 2004, 14.8 percent of children [age] five and under from low-income families were obese compared to 10.4 percent of those from moderate to high-income families. Among males aged 12 to 19, more than 25 percent of Mexican Americans were obese, compared with 15.5 percent of non-Hispanic whites. Among females aged 12 to 19 years, the obesity prevalence was higher among non-Hispanic Blacks (27.7 percent) and Mexican Americans (19.9 percent) compared to non-Hispanic whites (14.5 percent)… [R]ecent trends reveal that among all youth, the rate of obesity appears to have leveled; there has been no statistically significant increase or decrease for either boys or girls 2-19 years of age between survey years 1999-2000 and 2005-2006. Recent data also show a plateau of obesity rates among U.S. children and adolescents that participate in the Women, Infants and Children (WIC) Supplemental Nutrition Program. We cannot, however, become complacent about this plateau. Sixteen percent of our youth remain obese, and we have not achieved a reduction in obesity among this population group.”

Exploring CDC’s current programs and goals, Dr. Dietz explained, “Currently, CDC’s efforts to address the obesity epidemic are focused on policy and environmental strategies that can improve the health of all U.S. children and adults by making the places in which we live, learn, work, play, and pray more supportive of healthy eating and physical activity. Through innovative partnerships and funded state programs, we are identifying, implementing, and evaluating a variety of policy and environmental strategies in order to prioritize best and promising practices at the community, state, and national level. Our efforts revolve around six target areas, prioritized because they address a significant disease burden, are supported by reasonable or logical evidence, and can prevent and control obesity at the population-level. These six strategies include: increasing physical activity; increasing fruit and vegetable consumption; increasing breastfeeding initiation, duration, and exclusivity; decreasing television viewing; decreasing consumption of sugar-sweetened beverages; and decreasing consumption of foods high in calories and low in nutritional value.” Dr. Dietz also cited as additional CDC priorities: “proper breastfeeding practices” and the recent “[update of] WIC program requirements to be more consistent with the Dietary Guidelines for America.”

Donna Mazyck, president of the Board of the National Association for School Nurses (NASN), said, “We know first-hand that school nurses are performing duties today that go well beyond what school nursing was like 30-40 years ago when health care costs were affordable, and school children with complex health needs did not come to school. School nurses do not simply wait in their offices for a sick child to appear; rather they provide health services for all the students, but especially for the uninsured. They also provide health education, with special attention to nutrition and obesity. They serve children with chronic conditions, which previously were extremely rare in children, such as type-2 diabetes, heart disease, high blood pressure, and food allergy. School nurses have knowledge and expertise in the areas of nutrition, weight maintenance, and exercise. This knowledge can be applied to intervention and prevention programs that help students live healthy and active lifestyles. The school nurse collaborates with students, parents, school personnel, health care providers and members of the community to identify students who are overweight and obese. In addition, the school nurse is involved with support programs, counseling services, referrals, and follow-up activities.

She continued, “Critical to helping students break the cycle and develop good decision-making skills related to nutrition, is the modeling [that] occurs in the school meals program. Currently, the National School Lunch Program is serving nutritious meals to more than 28 million children and the School Breakfast Program is reaching more than 8 million children daily. The meals eaten at school are meals that they can count on. In contrast to the students who pay full price for lunches, students on assistance are generally so hungry that their plates are clean when they finish. We have to ask ourselves, what would our schools be like if these children did not receive these vitally important meals? In addition, if the Department of Agriculture nutrition standards for school foods sold outside of meals would be updated, our nation’s schools (not just the meals program) could become a place where children’s nutritional health is taken seriously…Since the Child Nutrition and WIC Reauthorization Act of 2004 [P.L. 108-265], all school districts are required to have local school wellness policies. School nurses have a critical role in teaching about and providing healthy food choices and teaching skills and knowledge to motivate participation in lifelong physical activity. Many school nurses throughout the country are the lead person in the school for development and implementation of the wellness policy. NASN recommends that school nurses serve on every school and district wellness policy committee. With the help of the Congress, this could become a reality.”

Richard Hamburg, director of government relations at Trust for America’s Health, summarized the economic costs of obesity: “These health impacts come at a great cost to our nation. According to the Department of Health and Human Services, obese and overweight adults cost the U.S. anywhere from $69 billion to $117 billion per year. One study found that obese Medicare patients’ annual expenditures were 15 percent higher than those of normal or overweight patients. The cost of childhood obesity is also growing. Between 1979 and 1999, obesity-associated hospital costs for children (ages six to 17 years) more than tripled, from $35 million to $127 million. The poor health of Americans of all ages is putting the nation’s economic security in jeopardy. More than a quarter of U.S. health care costs are related to physical inactivity, overweight and obesity. Health care costs of obese workers are up to 21 percent higher than non-obese workers. Obese and physically inactive workers also suffer from lower worker productivity, increased absenteeism, and higher workers’ compensation claims.”

Also testifying were Anne Wolf, research instructor at the University of Virginia Health System, and Martin Yadrick, president of the American Dietetic Association.

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