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Stepping up on nutrition: Can Let's Move! end childhood obesity in a generation?

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Michelle Obama cuts an impressive figure as First Lady – not only because she’s a highly qualified lawyer and  mother of two (with impressive biceps), but also because she’s used her position at the White House to advocate for childhood obesity prevention, an important issue given the epidemic of weight gain in the United States.

The First Lady’s key project is Let’s Move!  – a sweeping campaign that aims to improve nutrition and make young people more active, with the goal of ending childhood obesity within a generation. But the Mom-in-Chief isn’t nagging children into eating healthier food and stepping away from the computer. Let’s Move! targets the broader factors that shape children’s eating and play patterns: the provision of healthy food in schools, food marketing targeted to young people, and children’s access to playgrounds and safe routes for walking to school. Mrs Obama has enlisted a wide range of partners in her effort to improve America’s “obesogenic” environment, including advocates in science, business and the arts, and in the health and education sectors.

Michelle Obama really is talking the talk. The White House recently convened a diverse group of health activists, food industry representatives and NGOs to discuss food marketing to children. At this meeting Mrs Obama challenged food manufacturers and fast-food restaurants to market their products to children in a more constructive fashion. In the words of the First Lady, “…we need you [the food industry] to lead the way in creating demand for healthy foods so that kids actually start ‘pestering’ us for those foods in the grocery store.”  Not only is the First Lady talking the talk, she’s walking it too:  Mrs Obama has danced with Jimmy Fallon on Late Night, jumped rope on Live with Kelly and beaten Ellen DeGeneres at a push-up competition.  She’s also involved with the release of rap album in support of childhood obesity prevention, probably to the embarrassment of her two daughters.

Let’s Move! – combined with a range of other influences – seems to be producing the desired effect. Americans increasingly acknowledge that obesity in young people is a serious issue and support government action to tackle the problem. Many large multinational food manufacturers and retailers (collectively referred to as “Big Food”) have agreed to improve the nutritional quality of their products, and to market only healthier foods and beverages to children.  In response to Let’s Move! a coalition of food manufacturers created the Healthy Weight Commitment Foundation, which aims to eliminate 1.5 trillion calories from the food supply by 2015.  The good news story doesn’t just end there: many U.S. states and territories are showing a decline in childhood obesity – a trend that’s mirrored in other developed countries like Australia and Switzerland.

There’s a lot to admire about Let’s Move!, but the campaign is not without its critics. Health advocates Marion Nestle and Michele Simon are skeptical about Let’s Move!, as well as other partnership initiatives with Big Food. As they point out, it’s difficult to engage with the food industry without getting tangled up in a web of corporate interests that potentially damage public health.  Mega-star Beyoncé is a case in point: although a key supporter of Let’s Move!, she recently signed a multi-million dollar promotional deal with Pepsi  – one of the leading producers of sugar-sweetened sodas, which is a key contributor to diabetes.

Sure, companies like PepsiCo may be marketing “Good-for-You” products like water and diet soda, but they’re still spruiking their full-strength sodas, particularly to consumers in developing countries who can ill-afford the health consequences of drinking heavily sweetened beverages.  Big Food also lobbies aggressively against any kind of government interference in its activities, including restrictions on advertising to children. In 2009 the Federal government established an Interagency Working Group on Marketing to Children, with the aim of developing uniform nutrition standards for foods promoted to young people. Although the standards were entirely voluntary, they were attacked by the food industry as being “quasi-regulatory” and anti-constitutional.  As a result of aggressive lobbying, the standards are unlikely to ever see the light of day.

Given the food industry’s political strength, it’s not a bad idea to use “soft power” to improve the food environment. We can’t regulate the food industry out of existence (like we might be able to with Big Tobacco), and it’s hard to confront head on with strong legislative measures. In these circumstances, self-regulation, voluntary commitments and partnerships are a good way of making incremental progress. But we need to keep in mind that Big Food’s first job to make a buck, not to promote public health, and food companies will only create healthier foods and beverages when it turns a profit for their shareholders. Even if some companies genuinely want to be “part of the solution” to childhood obesity, they risk losing profits to unscrupulous competitors with less healthy – but more tasty – products. For this reason, Big Food can never be an equal partner in obesity prevention efforts.

Engaging with Big Food is a complex problem, and there’s no easy way forward. But some simple steps will help keep up the momentum of Let’s Move! and further reduce the burden of childhood obesity. First, we shouldn’t leave public health in the hands of the private sector. We need close government supervision and coordination of public health programs, especially those involving industry participation. Second, good population health means giving our public institutions enough funding, so that they don’t have to rely on corporate dollars to provide basic services. Parents shouldn’t have to accept promotions for Coke, Pepsi and McDonald’s in their children’s schools and at young people’s sports events. Finally, public health needs to enlist more charismatic leaders who can place childhood obesity squarely in the public eye – just as First Lady Michelle Obama has done with Let’s Move!

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The views reflected in this expert column are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.

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