1. Kennedy, Maureen Shawn MA, RN


Addressing obesity requires more than self-control.


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Our cover this month, showing a vibrant display of fresh produce at a farm stand, heralds summer. But it's not just summer we're showcasing-it's the relationship between food and health. The saying "you are what you eat" seems more apt than ever, as researchers are finding more and more links between diets high in sugar and other "empty" calories and preventable chronic diseases, including type 2 diabetes, cancer, heart disease, and stroke. While the increasing size of Americans' collective girth has become obvious, the multifactorial nature of the underlying causes hasn't been as clear. Recent reports from the Institute of Medicine (IOM) and a public health campaign against overweight and obesity are revealing "the unvarnished truths" about this public health crisis.

Figure. Maureen Shaw... - Click to enlarge in new windowFigure. Maureen Shawn Kennedy

In February, the IOM released a workshop report, Measuring Progress in Obesity Prevention, and noted these sobering statistics on its Web page: "Nearly 69 percent of U.S. adults and 32 percent of children are either overweight or obese, creating an annual medical cost burden that may reach $147 billion." In May, the IOM followed up with a committee report, Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. These reports emerged in part as a result of a multipronged national campaign against obesity, spearheaded by the Centers for Disease Control and Prevention, called The Weight of the Nation. Last month it launched a four-part television series examining the issue. (The films can be viewed free at


In its committee report, the IOM calls for action in five areas: incorporating physical activity into one's daily routine; creating environments that facilitate healthier food choices; changing marketing messages about food, especially those that target children; increasing opportunities for physical activity and teaching food literacy in schools; and enlisting employers and health care professionals in supporting workplace wellness programs.


The IOM reports and the campaign haven't come a moment too soon. As the committee report points out, multiple changes in American society and culture-in individual lifestyles, the environments in which we live, and the food industry's products and marketing practices-have insidiously altered the daily lives of most families. We've become increasingly sedentary, and in many communities there may be few easy opportunities to engage in physical activity. Children of working parents may go from school to an indoor after-school program or an empty apartment, where they'll spend their time watching television-an activity associated with "a cluster of unhealthy eating behaviors," according to study findings in the May issue of the Archives of Pediatrics and Adolescent Medicine. Given that the prevalence of childhood obesity is rising steadily, the IOM's recommendation that we "make schools a national focal point for obesity prevention" is critical to starting each new generation off on the right track.


These efforts won't be enough to reverse the trends. It will also take revamped policies on various fronts. We'll need Congress to get tough with the food industry, set higher standards regarding the nutritional content of foods, and mandate transparency in labeling. We'll need local communities to insist that schools remove unhealthy foods and beverages from cafeterias and vending machines. Another study published in the same issue of the Archives of Pediatrics and Adolescent Medicine provided new evidence to support such measures: after California passed laws regulating the nutritional content of foods sold in high schools, students consumed less sugar, fat, and total calories at school than did students in states lacking such regulation.


Lastly, if we're serious about reversing the epidemic of overweight and obesity, we need to enlist in a campaign of our own. For too many of us, after a long workday, takeout and a night on the couch sound more inviting than salad and a run around the block. That doesn't make us the best role models, and we know it's not good for us, either. So I invite you to pick one new action and make it a habit. Maybe you'll vow to add more vegetables to your dinner plate, grab a colleague for a lunchtime walk, or watch the evening news while on a treadmill. Start anywhere. But start.