The Specter of Obesity

April 7, 2010

Michelle Obama's Let's Move campaign brings in sharp focus the insidious obesity trend among children and teens. Report after report warns of the consequences: obese children are more likely to become obese adults, who in turn are more likely to develop diabetes, cardiovascular disease, depression, and perhaps pancreatic cancer, among other diseases.

Michelle Obama's Let's Move campaign brings in sharp focus the insidious obesity trend among children and teens. Report after report warns of the consequences: obese children are more likely to become obese adults, who in turn are more likely to develop diabetes, cardiovascular disease, depression, and perhaps pancreatic cancer, among other diseases.

The data are plentiful, and, unfortunately, trend in one direction. Delving into the 2007 National Survey of Children's Health, a team from the Oregon Health and Science University found that while the number of overweight children ages 10 to 17 hasn't increased, the percentage of obese children rose to 16.4% in 2007. Equally significant, the percentage of children who remained obese hovered around 15%.

A meta-analysis from the University of North Carolina of 31,337 children ages two to 18 uncovered that caloric intake from snacks today is 113 calories per day more than it was in 1977. Snacks account for nearly 30% of daily calories. That's an amazing statistic: for most children and teens, nearly every third calorie comes from salty snacks, candy, desserts, and sweetened beverages.

The cost of the problem could be in the billions. An estimate published in the Journal of Health Affairs pegged the direct costs of childhood obesity at $14.1 billion, not including $237.6 million for in-patient costs.

Given these and dozens of other indicators, the First Lady's campaign is both welcome and important. Her effort brings attention to a situation that must be reversed. Whether Let's Move can accomplish the goal is another matter. The obstacles are high and formidable. For one, dietary habits are ingrained early, and the snack genie will not go willingly back into the bottle.

There's also the free-market issue. Ours is an entrepreneurial society. Can mainstream food giants realistically be expected to part with decades of marketing and product development in an effort to sweep snacks off the shelf in favor of carrot sticks and bottled water? Consumption can be discouraged, healthier alternatives promoted, and parents and children educated-but less-than-healthy foods and beverages will be on the market for those who want them.

QUOTE OF THE MONTH

"The physical and emotional health of an entire generation and the economic health and security of our nation is at stake." - First Lady Michelle Obama

Recognizing this dilemma, many cities and states are attempting to modify behavior-and fatten coffers-with sweetness taxes. Philadelphia recently enacted a two-cent-per-ounce tax on sweetened sodas, sport drinks, juices, and similar beverages. Non- or artificially sweetened beverages are exempt, which is another discussion for another time. The tax alone on a two-liter bottle of soda is estimated to be $1.36, while the tax on a 12-pack would be $2.88.

Frugal Philadelphians face three choices. They can drink fewer sweetened beverages, switch to diet products, or smuggle in their favorites from New Jersey or Delaware. All three are likely to happen; only one will help reverse obesity.

Some critics say the link between sweetened beverages and obesity is tenuous at best. Forbes recently quoted a study from Jason Fletcher, a public health expert at Yale; David Frisvold, an Emory economist; and Nathan Tefft, a fellow economist at Bates. In an effort to correlate taxation rates with obesity, the team looked at changes in body mass index (BMI) in states with sweetness taxes. They discovered that a one-percentage-point increase in the tax rate decreased BMI by a mere 0.003 points. They found similar patterns among children and teens. One theory holds that BMI stayed the same because sweetened beverages were replaced with more-nutritious, but higher-fat, alternatives.

The biggest obesity hurdle is, was, and always will be that there is no magic bullet, no sweeping generalization that applies to every individual. Doctors can tell every patient that one cigarette a day is dangerous. They can't tell every patient that a daily can of soda will make them obese. The Let's Move initiative acknowledged these complexities by attacking obesity on four fronts: school meal choice, parental education, healthy alternatives, and physical activity. To vilify food choices, including soda, is not the answer. As proven by other campaigns that demonized fats, salt, white sugar, alcohol, caffeine, white bread, and a supermarket shelf of other products, the strategy never works.