Sharing Solutions for Childhood Obesity
Hood, Ernie, Environmental Health Perspectives
According to a 2004 report by the Institute of Medicine Committee on Prevention of Obesity in Children and Youth, approximately 9 million American children over 6 years of age are considered obese--that is, they have a body mass index (BMI) equal to or greater than the 95th percentile as calculated by the Centers for Disease Control and Prevention (CDC). Yet most experts believe the 9 million figure is minimal. Rates of obesity also are much higher among some populations and in certain geographic areas. And the prevalence of childhood obesity is growing exponentially. In the past three decades, it has more than doubled in children aged 2-5 and 12-19, and more than tripled in children aged 6-11.
There is currently a wide variety of activity at all levels aimed at reducing the epidemic of childhood obesity, as shown by the gathering of more than 700 experts from many fields in early June 2005 for Environmental Solutions to Obesity in America's Youth, a conference sponsored by the NIEHS. The meeting followed up on the success of a similar event held in 2004, which was aimed primarily at identifying research opportunities and needs to help design a research agenda related to environment and obesity. This year, the focus was on solutions.
"The goal of the conference was to try to identify the successful environmental interventions that have been developed across the country, and then to disseminate them more broadly," said primary organizer Allen Dearry, NIEHS associate director for research coordination, planning, and translation. "The major accomplishment was to bring together a very interdisciplinary group of experts in environmental health sciences, and in fields like planning and transportation, and policy makers to work together and think collaboratively, and to be able to define what makes one of these successful environmental interventions work."
The conference was supported in part by the Robert Wood Johnson Foundation. The planning committee included representatives from the NIH, the CDC, and the U.S. Department of Transportation, as well as from state and local health departments, academia, and the American Planning Association. Keynote speakers included NIEHS director David Schwartz, U.S. surgeon general Richard Carmona, CDC director Julie Gerberding, former National Football League star Lynn Swann (who is now the chairman of the President's Council on Physical Fitness and Sports), U.S. Department of Health and Human Services secretary Michael Leavitt, and Arkansas governor Mike Huckabee.
Pinpointing the Factors
As several participants pointed out, human genetics and biology don't change quickly enough to account for spiking obesity rates of the past 30 years, so a complex array of environmental factors that influence individual behavior is clearly at the root of the epidemic, in both children and adults. At a press conference announcing the forthcoming awarding of $5 million in NIH/CDC research grants addressing obesity and the environment, Schwartz said that defining the interface between environmental components and individual choices will be crucial to building a solid evidence base to support and refine efforts to stem the obesity tide.
"There's a fine balance between the environment and the individual that allows some people to make the choice for a more active and healthier life, and others to continue to eat the wrong types of foods or not be involved in physical fitness programs," Schwartz said. "That balance is very difficult to understand, and that's the focus of this research program and this conference."
The stakes involved are high. Obesity greatly increases a child's risk in adulthood of developing and dying from serious chronic conditions such as cardiovascular disease, type 2 diabetes mellitus, and certain cancers. Further, many children already suffer from adverse health effects related to their obesity.
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