The Childhood Obesity Epidemic

The speaker introduces the tenth Public Health Rounds, expressing amazement at its growth from a small talk series to a large event with significant CDC and global audience. The sessions are now broadcasted on the internet, allowing worldwide access, with previous sessions attracting over 14,000 live viewers outside CDC. The speaker also highlights the efforts to increase viewer participation and the move to YouTube for broader reach. Recognition is given to Shane Joiner for his work in media communications and policy, facilitating the event's online presence. The speaker also mentions the 'Science Clips' initiative and the continuing education credits available for participants.

The speaker discusses the obesity epidemic, emphasizing its cost and linkage to an unhealthy environment with overconsumption of sugar, salt, and fat. The speaker highlights the importance of changing the food environment to empower healthier living, mentioning the First Lady's 'Let's Move' campaign as a significant societal mobilization for healthier choices. The speaker also covers the critical role of CDC in understanding the epidemic and supporting state governments and communities in implementing and evaluating obesity-related programs.

Cynthia Ogden from the National Center for Health Statistics presents data on childhood obesity, defining it and discussing its consequences. She reveals that 12.5 million U.S. children and teens are obese, with the rate being twice as high among adults. Ogden explains the use of Body Mass Index (BMI) as a proxy for obesity and its complications in children, including high body fat percentage and significant differences across racial and ethnic groups. She also discusses the trends in obesity prevalence among children, noting a rapid increase in the 1980s and 1990s, a slowdown in the last decade, and a concerning rise in severe obesity among older boys.

The speaker delves into the long-term consequences of childhood obesity, noting its persistence into adulthood and the associated health risks such as diabetes, cardiovascular disease, and cancer. The speaker emphasizes that obesity affects all population groups and is not confined to the poor or middle class. The financial burden of obesity is also discussed, with costs increasing dramatically over the last decade. The speaker mentions the psychosocial problems and metabolic syndrome associated with childhood obesity and the risk factors it poses for type II diabetes, which is increasingly affecting children and adolescents.

Dr. Bill Dietz discusses appropriate behaviors, targets, and strategies for obesity prevention and control, citing examples from the field. He explains how modest imbalances in energy intake and expenditure contribute to the obesity problem and highlights changes in the food supply and decreased costs of high-fat and sugary foods. The speaker also addresses changes in physical activity for children, the impact of television viewing and marketing of high-calorie foods to children, and the importance of population strategies that alter food and physical environments. He introduces initiatives like 'Let's Move' and the establishment of an intergovernmental childhood obesity task force.

Judith Bell from Policy Link and the Healthy Eating Active Living National Convergence Partnership discusses the partnership's efforts on access to healthy food, building the field locally and regionally, and the built environment. She emphasizes the importance of policy changes in creating environmental shifts and mentions initiatives like the Fresh Food Financing Initiative in Pennsylvania, which has improved access to healthy food in underserved areas. The speaker also talks about the convergence partnership's funding and advocacy, focusing on areas with the greatest need, and the replication of successful policies at the national level.

Troy Rogers, a pediatrician from Maine, shares the story of community action against childhood obesity, highlighting the medical community's early involvement and collaboration with public health entities. He introduces the 5-2-1-0 message (5 servings of fruits and vegetables, 2 hours or less of TV time, and zero sugary drinks) and its impact on the state's landscape for children. Rogers discusses the success of the MYAC program in engaging physicians and effecting behavior change, and the expansion of this approach into the Let's Go program, which addresses childhood obesity across multiple sectors including child care, schools, workplaces, and health care.

Rogers continues to discuss the challenges and opportunities in expanding community health initiatives, such as the need for evidence-building and managing partner expectations for rapid change. He addresses difficulties in obtaining community data and the complexities of collaboration. Despite these challenges, Rogers remains optimistic, highlighting the small changes that keep progress going, such as rewarding children with physical activity, changing health options, and engaging all sectors. He shares the success of Let's Go in reaching thousands of students and children across Maine and the importance of local data in tracking progress and informing policy.

The panel engages in a discussion on the pros and cons of preempting local action for national change in public health, using menu labeling as an example. The importance of local innovation as a stepping stone to national impact is emphasized, and the need for national standards that are as strong as possible is discussed. Panelists also address the challenges of funding for local grassroots programs, suggesting partnerships with local institutions and community groups as potential starting points for funding. The conversation touches on the role of mental health in the obesity epidemic, acknowledging the need to address the disparities in obesity rates among different demographic groups.

The session concludes with an announcement about the rescheduling of future sessions to a more convenient time for viewers on the West Coast and other parts of the world. The next session in July will maintain the current time slot due to expected interest from Europe and Africa, but starting in August and September, the sessions are likely to begin around noon.