US launches plan to tackle childhood obesityBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7274.1432/d (Published 09 December 2000) Cite this as: BMJ 2000;321:1432
The US Department of Health and Human Services, the Centers for Disease Control and Prevention (CDC), and the Department of Education have drafted a report outlining a comprehensive plan to promote physical activity and decrease obesity in the nation's young people.
The interagency report was requested by President Clinton after the CDC found that youth obesity had reached epidemic proportions in the United States. It noted a doubling in the percentage of overweight young people since 1980. The trend is alarming because childhood obesity leads to adult obesity, and the extra weight reduces life expectancy and contributes to heart disease, diabetes, hypertension, colon cancer, and depression.
Among overweight children aged 5-15, 61% already have one or more cardiovascular risk factors and 27% have two or more such factors, according to the report. Moreover, type 2 diabetes mellitus—so rare in youth that it was used to be known as adult onset diabetes mellitus—rose dramatically in adolescents.
Obesity and poor nutrition together account for over 300 000 deaths in the United States annually, an amount exceeded only by tobacco related deaths, according to agency experts. Obesity is also expensive and consumes 8% of the national healthcare budget and an estimated $100bn (£71.4bn) in direct and indirect costs.
Additionally, a study in the October issue of the journal Physician and Sportsmedicine found that physically active people had lower annual direct medical costs than did inactive people. The cost difference was $330 per person, based on 1987 dollars.
The interagency report focused on physical activity to combat childhood obesity and called for a multipronged approach which would involve families, schools, communities, sports and recreational centres, the media, and local and national healthcare departments.
The report emphasised the importance of daily physical exercise for all children, including those who are disabled, and called for participation in quality physical education classes in every school day as well as in after-school programmes.
The agencies found that 35% of all young people lack regular vigorous physical activity and that participation in such activities drops from 73% in the 9th grade (13-14 year olds) to 61% by 12th grade(17-18 year olds).
Forty five per cent of youngsters do not play sports, and 44% are not enrolled in physical education classes. Enrolment in such classes drops to 37% in 12th grade from 79% in 9th grade. Only one state, Illinois, mandates daily physical education classes for all students, from kindergarten to 12th grade, and even Illinois commonly allows exemptions.
The agencies suggested that an increase in sedentary activity may be secondary to an over-reliance on electronic media, such as televisions, computers, and electronic games, for entertainment and play.
Among the recommendations outlined by the report are changes in the infrastructure of communities, such as the designing of more parks, playgrounds, and bicycle friendly pavements, and a call to make public transport free for youngsters travelling to public swimming pools and physical recreational activities.
The agencies also called for increased monitoring of childhood physical education classes by local and national health departments and coordination between the departments of education and health or the department agencies.
Commenting on the plan, Donna Shalala, secretary of the Department of Health and Human Services, said that the report “lays out an important agenda for action to promote physical activity among our young people. It provides a comprehensive vision to encourage lifelong fitness, and it offers concrete steps to make that vision a reality.”
Promoting Health for Young People through Physical Activity and Sports can be accessed at www.cdc.gov/nccdphp/dash/