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MAY 2008

U.S. Surgeon General’s Perspectives
Childhood Overweight And Obesity Prevention
By RADM Steven K. Galson, MD, MPH

Our children are our future; let’s help make their future healthy through efforts to prevent overweight and obesity. Between 1980 and 2002, the number of overweight children has tripled in the United States, making this a very serious public health epidemic. Data show that 13% of our nation’s 2- to 5-year olds and 18% of 6- to 11-year olds were overweight in 2003–2004, and the prevalence of overweight adolescents aged 12–19 years increased from 5% in 1980 to 17% in 2004. This trend is alarming because overweight children are at increased risk for multiple health problems such as heart disease, diabetes, high blood pressure, and high cholesterol. Equally disturbing health risks for overweight children include poor self-esteem and depression due to social discrimination. Because of this rising prevalence of overweight children, it is imperative that we promote a healthy lifestyle change for our youth.

The increase in childhood obesity is partly attributable to an increasingly sedentary lifestyle and poor nutrition. Sedentary behaviors such as television viewing, computer use, and video game playing often replace vigorous physical activity in children. At the same time, more fast foods, convenience store snacks, and sweetened beverages are available now than in past generations. Our youth’s lack of physical activity and poor eating choices need to be addressed by everyone so that we can combat this major public health dilemma.

There are many ways parents, teachers, and community leaders can get involved to mitigate this epidemic and prevent childhood obesity. First and foremost, we need to make sure that an adequate amount of physical activity is introduced into a child’s everyday life, with at least 60 minutes of physical activity recommended per day as well as 30 minutes of vigorous activity three times per week. Parents, other caregivers, and community members can impact the physical activity tendencies of children in a positive way by promoting outdoor family activities that meet these recommendations, as well as limiting the amount of time children spend in front of the television or computer, or playing video games. Teachers can also play an important role in encouraging children to be physically active by incorporating health-oriented messages into their lesson plans. Increasing the amount of physical activity at school each day can lay the foundation for children to have a positive view on physical fitness.

It is also vital to make sure children maintain healthful eating patterns. Parents should refer to nutritional food labels to help select foods that are low in calories and saturated fat. It is also important to limit the intake of sweetened beverages such as soft drinks, sports drinks, and fruit juices, whose consumption has skyrocketed during the same time period that obesity has spiraled out of control. We must encourage children to limit the size of the meals they eat and include at least five servings of fruits and vegetables in their diet each day. Furthermore, school administrators and teachers should establish a plan to increase the nutritional value of school meals and limit the number of nutritionally inferior food choices that tempt children. By putting forth a conscious effort to evaluate the food our children are presented with at school each day, we will favorably impact child health.

As part of this renewed focus on prevention of childhood overweight and obesity, Michael O. Leavitt, the Secretary of Health and Human Services, has asked me to chair a council of senior leaders across the Department of Health and Human Services (DHHS) to identify and assess evidence-based programs for local communities that demonstrate promise in combating this serious health crisis. The Childhood Overweight and Obesity Prevention Council will focus on bringing the many different DHHS programs together to engage in an effective collaborative effort. The council will identify ways for the numerous DHHS programs to exchange ideas about how to more effectively address childhood obesity. Some of the programs include the President’s Council for Physical Fitness and Sports, which encourages all Americans to be physically active in their everyday lives, and the Food and Drug Administration’s program, Using the Nutrition Fact Label to Make Healthy Food Choices—Spot the Block, Get Your Food Facts First—which helps children identify nutrition fact labels on food to help them make healthful food choices. Using the integration of these programs and advice garnered through the new council, I hope that all Americans will work together to reduce the prevalence of overweight children in the U.S. To learn more about DHHS childhood obesity prevention programs and what you can do, please visit http://www.surgeongeneral.gov/obesityprevention.html.

As parents, caregivers, teachers, mentors, public health leaders, and other concerned citizens, it is our responsibility to take immediate action to mitigate this serious and growing public health epidemic. We can and must work collaboratively, using available science and evidence of effective programs to ensure that our children receive encouragement and guidance to make healthful choices for physical activity and good nutrition. Optimally, we act as role models, with our own health behaviors promoting a healthful lifestyle by example. This will result in a public health movement that will not only help reduce the burden of childhood overweight and obesity, but also lessen the occurrence of other chronic diseases such as diabetes, high blood pressure, and high cholesterol.#

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