Population-Based Prevention of
Obesity: The Need for Comprehensive Promotion of Healthful
Eating, Physical Activity, and Energy Balance
Date: June 30, 2008
Summary: Fighting the nationwide obesity epidemic
requires more than individual physicians and other
healthcare professionals counseling patients by. Policy
makers, legislators, city councils and even the U.S.
Congress need to find ways to change an environment that
promotes overeating of unhealthy foods and discourages
regular exercise.
Journal: Circulation
Journal citation: Circulation. 2008;118:000-000
Why it’s important: One in three U.S. adults is obese
and one in five children or teens are obese or overweight.
They face an increased risk of disability and possible early
death. In addition to being an individual health problem,
obesity has major public health implications. It is better
to avoid weight gain in the first place than to treat it, as
obesity is often hard to manage and many who lose weight
can’t maintain their weight loss. While individual
weight-loss efforts and clinician counseling are beneficial,
reducing the obesity epidemic may depend on population-based
strategies that encourage healthful eating and regular
physical activity.
What’s already known: The national increase in
obesity has reached alarming levels. An estimated 66 million
adults are obese and 74 million are overweight. Children are
also affected: among those ages 6 to 11, 4.2 million are
overweight, and another 5.7 million teens are overweight.
Obesity-related diseases such as diabetes increase the risk
of serious disability and early death. Based on current
trends, federal officials believe that a 2010 national goal
for reducing the prevalence of adult obesity to 15 percent
and childhood obesity to 5 percent may be unreachable for
several decades.
How this study was done: This is not a study in which
one group of people is compared to another. Instead, it is
an evaluation of public health data and a consensus
statement about where public policy should go next.
What was found: “A major emphasis on obesity
prevention is needed in the population at large to prevent
the development of obesity in normal-weight adults and in
successive generations of children and adolescents.
Treatment will continue to be of critical importance, but
treatment alone cannot curb the epidemic,” the authors
wrote.
“Almost all of our current eating or activity patterns are
those that promote weight gain — using the least possible
amount of energy or maximizing quantity rather than quality
in terms of food,” said Shiriki Kumanyika, Ph.D., R.D.,
M.P.H., chair of the working group that wrote the statement.
“People haven’t just made the decision to eat more and move
less; the social structure has played into people’s
tendencies to go for convenience foods and labor-saving
devices.”
“We’re not talking about creating a dieting society, but
looking at choices people make in day-to-day living that
affect their ability to manage their weight and then trying
to change the environment to facilitate healthier choices,”
said Dr Kumanyika, a professor of epidemiology at the
University of Pennsylvania School of Medicine in
Philadelphia.
The group recommends policies that affect factors that
influence people’s food and physical activity choices,
including:
• The locations of fast-food restaurants
• Restaurant portion sizes
• Availability of high-fat, low-fiber foods and sweetened drinks
• Community design and infrastructure that emphasizes sidewalks and other
areas where exercise can be done, that makes it possible for
people to get to work or school by walking or bicycling; and
that facilitates access to public transportation.
The bottom line: While medical treatment of obesity and
obesity related conditions is highly important, treatment
alone cannot curb the epidemic. Preventing weight gain will
depend on a population-wide approach that includes policy
and environmental changes.
Reprinted from: American Heart Association
Obesity
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