The Institute of Medicine has released a new report, Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. The committee behind it assessed nearly 800 recommendations that had been previously published, and prioritized those that could have a big impact when undertaken together. They identified five critical areas for change:
- environments for physical activity
- food and beverage environments
- message environments
- health care and work environments
- school environments
Their goals and corresponding recommendations focus on these environments:
Goal 1: Make physical activity an integral and routine part of life.
Communities, transportation officials, community planners, health professionals, and governments should make promotion of physical activity a priority by substantailly increasing access to place and opportunities for such activity.
Goal 2: Create food and beverage environments that ensure that healthy food and beverage options are the routine, easy choice.
Governments and decision makers in the community/private sector should make a concerted effort to reduce unhealthy food and beverage options and substantially increase healthier food and beverage options at affordable, competitive prices.
Goal 3: Transform messages about physical activity and nutrition.
Industry, educators, and governments should act quickly, aggressively, and in a sustained manner on many levels to transform the environment that surrounds Americans with messages about physical activity, food, and nutrition.
Goal 4: Expand the role of health care providers, insurers, and employers in obesity prevention.
Health care and health services providers, employers, and insurers should increase the support structure for achieving better population health and obesity prevention.
Goal 5: Make schools a national focal point for obesity prevention.
Federal, state, and local government and education authorities, with support from parents, teachers, and the business community and the private sector, should make schools a focal point for obesity prevention.
I appreciate the fact that the first three goals focus on physical activity and nutrition, rather than just obesity. Physical activity and healthy eating are important, and anyone who becomes more active or adds more fruits and vegetables to her diet is doing something positive for her health even if she doesn't lose weight.
The IOM's list of goals is ambitious -- especially since it involves getting food and beverage companies to alter strategies they've found profitable -- but they're right to emphasize that population-wide improvements to eating habits are unlikely to happen in today's food (and food message) environment. As the report notes, "Taking a population approach to obesity prevention ... [is] to recognize the difficulty of maintianing energy balance when sedentary lives are the norm and high-calorie foods are ubiquitous."
The report is available as a free download here.
Glad to see some changes coming. So many schools have cut back on recess and gym class, filled the lunch rooms with vending machines and high-Calorie fast foods (thanks to the "generous donations" of the large corporate Fast Food Fiends.
I agree that changing the environment, both built and food, is key to decreasing obesity. Goals 1 and 2 are spot on. That being said, I feel we've oversaturated the American psyche with health messaging - and we haven't done enough to eliminate stressors. Folks know proper diet and exercise are the best ways to stay fit; however, it's much easier to rely on the instant gratification of a Twinkie and a TV after a hard day than it is to gear up for a run.
We know what's healthy, but we do what's easy and makes us feel good. No new PSA, poster, or provider chastisement will change that. Make it easy to make the healthy choice. Soda should cost more than juice. Potato chips should be a luxury, not the first thing to go into your child's lunchbag. Build more transit, not more parking garages. Fix the sidewalks, but also the crime, and the litter, and all the other little things that drive people inside.