Obesity rates in American children have risen to epidemic levels over the past few decades. Since 1980, obesity prevalence among children and adolescents has almost tripled with approximately 18.5% of children and adolescents aged 2-19 years being obese (CDC, 2017). Weight problems in childhood often continue into adulthood and the potential consequences of obesity are significant. According to the latest Centers for Disease Control data, 39.6% of American adults are obese (CDC, 2017). Obesity leads to increased risks for many chronic diseases such as type 2 diabetes, hypertension, stroke, asthma, heart disease, and kidney disease. Obesity-related illness accounts for approximately $190.2 billion, which is about 21% of annual medical spending in the United States. Childhood obesity alone is responsible for $14 billion of direct medical costs (NLC, 2018).
Another consequence for obese children is the negative psychological and social effects. These include lower self-esteem, depression, anxiety, problems with social relationships and decreased academic performance.
The American Academy of Pediatrics (AAP), American Medical Association (AMA), and the Centers for Disease Control & Prevention (CDC) endorse many key recommendations to reduce the prevalence of childhood obesity. Among those include exclusive breastfeeding for the first six months and continuing until twelve months of infant’s life, eating at least five servings of fruits and vegetables daily, limiting the consumption of sugar-sweetened beverages and consumption of high-fat and high-calorie foods, limiting eating out (especially at fast food restaurants), avoiding using food as a reward,
participating in 60 minutes of moderate to vigorous physical activity each day, and limiting television and other screen time to no more than 1 or 2 hours of quality programming a day.
Unfortunately, the dietary and activity habits in America show otherwise. Most American children do not meet the national recommendations for fruit and vegetable intake. Only 9% of high school students meet the fruit recommendation, and only 2% meet the vegetable recommendation (CDC, 2018). As for infant feeding in the U.S, exclusive breastfeeding rate at six months varies anywhere between 10.9% and 31.4% depending on the individual state (CDC, 2016).
The Issue Solution
Identifying and promoting the fundamental requirements for health in a community are of primary concern to public health. The way in which a society is structured is reflected in the health of a community (Public Health Leadership Society. 2002). In order to fulfill this statement, we need to create an environment to promote a healthy lifestyle. Nutritional food needs to be accessible to all. Parents and communities need to be educated about lifestyle changes and engage in role modeling behaviors. According to the White House “Let’s Move” campaign, the macro-level has four primary components including healthy schools, access to affordable and healthy food, raising children’s physical activity levels, and empowering families to make healthy choices. On the micro-level, the home food environment includes parent role modeling, child feeding practices and the family lifestyle.
Schools and community organizations need to eliminate fast-food fundraisers. Many chains have fundraising nights, gift cards and other programs that encourage families to spend money at fast-food restaurants, where many of the menu options can undermine children’s health.
Breastfeeding has proven to have the health benefits of decreasing the risk of childhood obesity. Breastfeeding mothers need to be supported by breastfeeding promotion programs, their employers, and policies protecting breastfeeding rights.
Positions Supporting the Issue Solution
Oddy (2012) conducted a systematic review of literature suggesting that early nutrition in infancy may influence later child health outcomes including obesity. Breastfeeding in particular is associated with a reduction in the risk of obesity. Artificial-feeding (formula feeding) stimulates a higher postnatal growth with faster adipose tissue deposit. The higher protein content of artificial baby milk compared to the lower protein content in breast milk is responsible for the increased growth rate and adiposity of formula-fed infants. The adverse long-term effect of early growth acceleration plays a role later in life contributing to overweight and obesity (Oddy, 2012).
Kanekar & Karnik (2012) studied several interventions for childhood obesity prevention. Some of the interventions used were family based, school-based, community-based, play-based, and hospital-based. The article enforces the importance of education and parent-child interaction as parents can influence children food choices and motivate them to have a healthy lifestyle. Because children spend most of their time at school, schools should be promoting healthy food choices and physical activity. Communities need to make an effort to make healthy foods accessible and affordable. In addition, promoting physical activity should be supported by the environment including safe sidewalks, bike paths, and safe parks.
“Community plays a crucial role in healthy lifestyle of children. This resource can be effectively used to promote healthy nutrition and healthy behavior. Community support is invaluable in implementing interventions and organizing social events like healthy food festivals, harvest festivals, imparting healthy messages, and educating and encouraging people to adopt a healthy lifestyle. Thus, community can help children to get affordable and accessible healthy food options and encourage healthy nutrition. Community organizations along with parents can promote nutrition and physical activity-based programs for children. Community can influence media or local entertainment to promote healthy educational programs for parents and children” (Kanekar & Karnik, 2012, p.7).
Positions that Oppose the Issue Solution
While breastfeeding has proven health benefits as well, including lowering chances for obesity, there are several barriers that prevent women from successful breastfeeding. These include cultural and community pressures, lack of maternity leave and supportive workplace policies, and aggressive marketing of breast-milk substitutes. According to the Save the Children organization, American mothers have the industrialized world’s lowest level of protection when it comes to maternity leave policy (Weinberg, 2013).
The International Code of Marketing of Breast-milk Substitutes is an international health policy framework adopted by the World Health Assembly of the WHO in 1981 regarding infant formula marketing, including strict restrictions on advertising. Its implementation depends on the laws of different countries and the behavior of infant formula manufacturers; however, the Code has no power itself. While at least 65 countries have enacted national legislation implementing all or many of the provisions of the Code, in the United States, neither the Code nor its principles are followed by governments or formula manufacturers. Manufacturers state that the composition of infant formula is designed to be roughly based on a human mother’s milk; however, there are significant differences in the nutrient content of these products. The most commonly used infant formulas contain purified cow’s milk, a blend of vegetable oils, lactose, vitamin-mineral mix, and other ingredients depending on the manufacturer.
The United States also ranks last on the Breastfeeding Policy Scorecard. It is the only economically advanced country where by law employers are not required to provide any paid maternity leave after a woman gives birth. Research has shown that many factors contribute to the low rate of breastfeeding in the United States. These include a lack of breastfeeding support, aggressive marketing by infant formula companies, short maternity leaves, employers who do not make accommodations to enable nursing mothers to pump and store breast milk during working hours, and negative social attitudes about breastfeeding (Perry, 2013).
Food industry advertising that targets children and youth has been linked to the increase in childhood obesity. Food and beverage advertising targeted at children influences their product preferences, requests, and diet. Today’s children spend more time in front of computers, television and game screens than any other activity in their lives except sleeping. “Food ads on television make up 50% of all the ad time on children’s shows. These ads are almost completely dominated by unhealthy food products: 34% for candy and snacks, 28% for cereal, 10% for fast food, 4% for dairy products, 1% for fruit juices, and 0% for fruits or vegetables. Children are rarely exposed to public service announcements or advertising for healthier foods (American Psychological Association, 2018). The majority of food brands advertised to children on TV are also promoted on the internet. Unfortunately, there is also an increase of commercialism in schools. For example school fundraisers through fast food chain restaurants such as McDonald’s support the current trend of America’s unhealthy eating habits.
The influence of media and unhealthy fundraising marketing has a powerful impact in public health. Fundraising events are often targeted directly at PTA members and teachers. “Have fun knowing that 15% of all sign-up sales generated from your participating families, teachers and community will be donated back to your school. Teachers and staff are important to the success of this program. Those attending will receive a FREE meal and a trip into the Ticket Blaster the night of the event” (Chuck E. Cheese, 2013). “A fundraising event that anyone who has gone to McDonald’s will love! McDonalds will have a teacher night for your school. The class who has the most attendance gets an ice cream party!” Those are some of the messages children often bring from their schools and are pressured to feel engaged to support their class and school. Childhood obesity is a huge problem in this country and these unhealthy fundraising ideas send wrong messages to our children. Children see their teachers and principals who are supposed to be their role models selling and cooking hamburgers and French fries which might encourage them that dinning in fast food places is more acceptable. Fast food chain restaurants such as McDonalds, Burger King, Pizza Hut, and Chuck E. Cheese’s are common fundraising places supported by school PTA. Food companies and restaurants are using children and schools as a tool to make more profit which is opposing the ideas of promoting healthy schools and empowering families to make healthy choices. Other unhealthy fundraisers like candy sales should also be avoided because they contradict the mission to support healthy students. They shouldn’t even be used to pay for healthy activities because that can be misleading to children and community members.
We can argue that we are setting ourselves for obesity from the very beginning. While research clearly associates breastfeeding with lower risk of developing childhood obesity, American mothers have the industrialized world’s lowest level of protection when it comes to maternity leave policy. Formula manufacturers freely advertise their products to healthy mothers who are able to breastfeed right from the beginning of their pregnancy by sending flyers, emails, and coupons. We are facing a similar issue regarding advertising unhealthy foods in media, communities, and school systems. Currently there is no law prohibiting unhealthy food advertisement and fundraisers.
Schools and child care facilities, workplaces, and primary care are important settings for implementation of policies and programmatic initiatives. State, community, and health care agencies need to raise awareness of the importance of undertaking population-based initiatives geared to the prevention of obesity in children. We need to focus on population approaches that go “upstream” to focus on environmental and policy change. We need to have policy that will ban junk food advertisements targeted to children and prohibit schools and community organizations promoting fast-food and junk food fund-raisers. Other countries, such as Australia, Canada, Sweden, and Great Britain, have already adopted regulations prohibiting advertising on programs targeting audiences of young children (AAP, 2018). The United States also need to implement and adhere to the International Code of Marketing of Breast-milk Substitutes regarding infant formula marketing. Let’s give our children the future they deserve right from the start!
American Academy of Pediatrics (2011). Children, Adolescents, Obesity and the Media.
Retrieved from http://pediatrics.aappublications.org/content/early/2011/06/23/peds.2011-1066
American Psychological Association (2018). The Impact of Food Advertising on Childhood
Obesity. Retrieved from http://www.apa.org/topics/kids-media/food.aspx#
Centers for Disease Control and Prevention (2017). Prevalence of Obesity among Adults and Youth: United States, 2015–2016. NCHS Data Brief, No. 288.
Centers for Disease Control and Prevention (2018). State Indicator Report on Fruits and Vegetables, 2018. Atlanta, GA: Centers for Disease Control and Prevention, U.S.Department of Health and Human Services.
Centers for Disease Control and Prevention (CDC, 2016). Division of Nutrition, Physical
Activity, and Obesity. Breastfeeding Report Cards. Retrieved from http://www.cdc.gov/breastfeeding/data/reportcard.htm
Kanekar, A., Karnik, S. (2012). Childhood Obesity: A Global Public Health Crisis.
International Journal of Preventive Medicine, 3(1), 1-7.
The National League of Cities (2018). Retrieved from http://www.healthycommunitieshealthyfuture.org/learn-the-facts/economic-costs-of-obesity/
Oddy, W. (2012). Infant Feeding and Obesity Risk in the Child. Breastfeeding Review,20 (2)
Perry, S. (2013). Breastfeeding Rates Improve, but Still Fall Short of Public Health Goals