Adolescents in states with strict laws regulating the sale of snacks and sugary
drinks in public schools gained less weight over a three-year period than those
living in states with no such laws, a new study has found.
The study, published Monday in Pediatrics, found a strong association between
healthier weight and tough state laws regulating food in vending machines, snack
bars and other venues that were not part of the regular school meal programs.
Such snacks and drinks are known as competitive foods, because they compete with
school breakfasts and lunches.
The conclusions are likely to further stoke the debate over what will help
reduce obesity rates, which have been rising drastically in the United States
since the 1980s. So far, very little has proved effective and rates have
remained stubbornly high. About a fifth of American children are obese,
according to the Centers for Disease Control and Prevention.
Public health experts have urged local and state governments to remove
competitive foods from schools, and in recent years states have started to pass
laws that restrict their sale, either banning them outright or setting limits on
the amount of sugar, fat or calories they contain.
The study tracked weight changes for 6,300 students in 40 states between 2004
and 2007, following them from fifth to eighth grade. They used the results to
compare weight change over time in states with no laws regulating such food
against those in states with strong laws and those with weak laws.
Researchers used a legal database to analyze state laws. Strong laws were
defined as those that set out detailed nutrition standards. Laws were weak if
they merely offered recommendations about foods for sale, for example, saying
they should be healthy but not providing specific guidelines.
The study stopped short of saying the stronger laws were directly responsible
for the better outcomes. It concluded only that such outcomes tended to happen
in states with stronger laws, but that the outcomes were not necessarily the
result of those laws. However, researchers added that they controlled for a
number of factors that would have influenced outcomes.
Still, the correlation was substantial, researchers said, suggesting that the
laws might be a factor. Students who lived in states with strong laws throughout
the entire three-year period gained an average of 0.44 fewer body mass index
units, or roughly 2.25 fewer pounds for a 5-foot-tall child, than adolescents in
states with no policies.
The study also found that obese fifth graders who lived in states with stronger
laws were more likely to reach a healthy weight by the eighth grade than those
living in states with no laws. Students exposed to weaker laws, however, had
weight gains that were not different from those of students in states with no
laws at all.
The authors argued that the study offered evidence that local policies could be
effective tools.
“Competitive-food laws can have an effect on obesity rates if the laws are
specific, required and consistent,” said Daniel Taber, a fellow at the Institute
for Health Research and Policy at the University of Chicago, who was one of the
authors of the study.
Still, many states have no laws at all regulating the sale of such foods, and
the group that helped finance the study, the Robert Wood Johnson Foundation,
argued that the results made the case for a strong national standard for snacks
and beverages in schools. The United States Department of Agriculture has been
developing new standards for some time, but they have yet to emerge.
Some experts argue that a real reduction in the obesity rate will come only when
many more local governments adopt tough policies to change the food environment.
Still others say that school is such a small part of a child’s day that
healthier options will make little difference when coupled with a home
environment with a lot of unhealthy choices.
WASHINGTON
(AP) -- Loosen the belt buckle another notch: Obesity rates continued to climb
in 31 states last year, and no state showed a decline.
Mississippi became the first state to crack the 30 percent barrier for adults
considered to be obese. West Virginia and Alabama were just behind, according to
the Trust for America's Health, a research group that focuses on disease
prevention.
Colorado continued its reign as the leanest state in the nation with an obesity
rate projected at 17.6 percent.
This year's report, for the first time, looked at rates of overweight children
ages 10 to 17. The District of Columbia had the highest percentage -- 22.8
percent. Utah had the lowest -- 8.5 percent.
Health officials say the latest state rankings provide evidence that the nation
has a public health crisis on its hands.
Unfortunately, we're treating it like a mere inconvenience instead of the
emergency that it is,'' said Dr. James Marks, senior vice president at the
Robert Wood Johnson Foundation, a philanthropy devoted to improving health care.
Officials at the Trust for America's Health want the government to play a larger
role in preventing obesity. People who are overweight are at an increased risk
for diabetes, heart problems and other chronic diseases that contribute to
greater health care costs.
''It's one of those issues where everyone believes this is an epidemic, but it's
not getting the level of political and policymaker attention that it ought to,''
said Jeffrey Levi, the organization's executive director. ''As every candidate
for president talks about health care reform and controlling health care cost
costs, if we don't home in on this issue, none of their proposals are going to
be affordable.''
At the same time, many believe weight is a personal choice and responsibility.
Levi doesn't dispute that notion, but he said society can help people make good
choices.
''If we want kids to eat healthier food, we have to invest the money for school
nutrition programs so that school lunches are healthier,'' he said. ''If we want
people to be more physically active, then there have to be safe places to be
active. That's not just a class issue. We've designed suburban communities where
there are no sidewalks for anybody to go out and take a walk.''
To measure obesity rates, Trust for America's Health compares data from
2003-2005 with 2004-2006. It combines information from three years to improve
the accuracy of projections. The data come from a survey of height and weight
taken over the telephone. Because the information comes from a personal
estimate, some believe it is conservative.
Indeed, the Centers for Disease Control and Prevention released a study last
year noting a national obesity rate of about 32 percent -- a higher rate than
was cited for any of the states in the Trust for America's Health report. The
CDC's estimate came from weighing people rather than relying on telephone
interviews, officials explained.
Generally, anyone with a body mass index greater than 30 is considered obese.
The index is a ratio that takes into account height and weight. The overweight
range is 25 to 29.9. Normal is 18.5 to 24.9. People with a large amount of lean
muscle mass, such as athletes, can show a large body mass index without having
an unhealthy level of fat.
A lack of exercise is a huge factor in obesity rates. The Centers for Disease
Control and Prevention found last year that more than 22 percent of Americans
did not engage in any physical activity in the past month. The percentage is
greater than 30 percent in four states: Mississippi, Louisiana, Kentucky and
Tennessee.
Meanwhile, Minnesotans led the way when it came to exercise. An estimated 15.4
percent of the state's residents did not engage an any physical exercise -- the
best rate in the nation. Still, the state ranked 28th overall when it came to
the percentage of obese adults.
Another factor in obesity rates is poverty. The five poorest states were all in
the top 10 when it came to obesity rates. An exception to that rule was the
District of Columbia and New Mexico. Both had high poverty rates, but also one
of the lower obesity rates among adults.
Poverty can lead to less safe neighborhoods, which deter children from playing.
It can lead to fewer grocery stores offering fruits and vegetables, and it can
lead to greater reliance on fast food, officials said.
''It seems the cheapest foods are the worst ones for you,'' Marks said.
Officials said the report is not designed to stigmatize states with high obesity
rates but to stir them into action.
''These are the states where the urgency is the greatest. They need not to wait
for others to lead. They need to become the leaders,'' Marks said. ''It's the
only way that they can restore the health of their children and their families.
It's the only way that they can improve their economic competitiveness.''
