On September 15, the House Government Reform Subcommittee on Human Rights and Wellness held a hearing entitled, “Conquering Obesity: The U.S. Approach to Combating this National Health Crisis.”
Chair Dan Burton (R-IN) stated, “It is imperative for the health and financial well-being of Americans that we find an effective way to reign in this healthcare epidemic. Our National health agencies and non-governmental organizations are doing their part to find means of comprehending the basis of this disease, and combat the current and future implications of obesity.” Rep. Burton pointed out that “the Federal Government has invested over $400 million in Fiscal Year 2004 on obesity research, and is projected to support further scientific research by increasing appropriations by over 10 percent in Fiscal Year 2005 to $440.3 million all in an effort to better understand this disease.”
Ranking Member Diane Watson (D-CA) noted that the Centers for Disease Control and Prevention (CDC) “has ranked obesity as the number one health threat facing America.” She raised the issue of changes to nutrition education funded through the Food Stamp Program, proposed by the U.S. Department of Agriculture (USDA) in its draft Food Stamp Nutrition Education (FSNE) Framework of May 2004. “The proposed changes would dramatically restrict what states can do with the money forcing them to abandon community wide efforts to do targeted counseling to women with children who are on Food Stamps,” Rep. Watson declared. “Rather than being a partner with states, this Framework would abandon them, abdicating USDA’s responsibility for good nutrition, nutrition education of low-income Americans, and helping to reverse the nation’s obesity epidemic.”
USDA Under Secretary of Food, Nutrition and Consumer Services Eric Bost reviewed the “staggering” statistics on obesity in America: more than “400,000 deaths a year are related to poor diet and physical inactivity…64 percent of adults aged 20-74 are either overweight or obese.” Stressing the link between obesity and diabetes, Mr. Bost noted, “Diabetes has increased 49 percent in the past 10 years, reflecting strong correlation with obesity; 18 million people have diabetes, and it is increasingly diagnosed in children and adolescents; 1 in 3 persons born in 2000 will develop diabetes if there is no change in current health habits.” He pointed out that the daily intake of calories increased by 22 percent for women and 7 percent for men between 1971 and 2000. “The costs to the nation due to obesity are enormous,” Mr. Bost declared. “Recent estimates have put direct medical costs at $92.6 billion or 9.1 percent of U.S. health expenditures,” he said, adding that “in 2003, the public paid about $39 billion or about $175 per taxpayer through Medicare and Medicaid programs for obesity-linked illness.”
“The immediate reasons for overweight and obesity are clear and uncomplicated,” Mr. Bost stated: “too many of us eat too much, eat too much of the wrong things, and get too little physical exercise.” About 30 percent of women and 25 percent of men get little or no exercise in their daily lives, he added.
In presenting a review of USDA measures to address this crisis, Mr. Bost highlighted programs authorized under the Child Nutrition and WIC Reauthorization Act (P.L.108-265, see The Source, 6/25/04). “Almost 29 million children are served by the National School Lunch Program each school day. More than half of those children get those meals either free or at a reduced price…We have also made runaway, homeless, and migrant children automatically eligible for meals.” Asserting that “our School Meals Programs make a difference,” Mr. Bost said, “Results from the second School Nutrition Dietary Assessment Study indicate that in school meals served during School Year 1998/1999, the percent of calories from total fat and saturated fat were significantly lower than the levels found in the first dietary assessment conducted in 1991/1992.”
Regarding the draft FSNE Framework proposals, Mr. Bost emphasized that the goal was “to better delineate the guiding principles and outcomes for nutrition education for the target audiences we serve, as well as to clarify the roles and responsibilities of federal, State, and local levels that are involved in FSNE.”
Testifying for the CDC, Ed Thompson, Chief of Public Health Practice, highlighted the role of community-based initiatives. “Although national initiatives can play an important role, they are not sufficient by themselves,” he said. “Community-based initiatives are critical for reaching Americans where they live, work, go to school, and play. State-level programs are critical for supporting and disseminating community-based activities.” Mr. Thompson reported the success of VERB, the CDC’s campaign to promote physical activity among “tweens,” children ages 9 13, citing “increased free-time physical activity among several important population subgroups, including the nation’s 10 million pre-teen girls, 8.6 million 9-10 year olds, and 6 million tweens from low-to-moderate income households.” Mr. Thompson added that the CDC is “the principal source of clinical data for the Nation” and supports “obesity prevention programs in 28 states.”
Director of Scientific and Regulatory Policy for the Grocery Manufacturers of America (GMA) Alison Krester assured the subcommittee of the GMA’s “long-term commitment to arrest and reverse obesity in America, and to provide consumers with the information and resources they need to establish healthy dietary habits for life.” Ms. Krester said that food companies are reformulating products to reduce calories, fat and sugars; decreasing and eliminating trans fats in products; and introducing smaller product serving sizes. She affirmed the GMA’s stance on advertising: “The industry is continuing to ensure that its advertising and marketing practices do not encourage overeating or inappropriate consumption of foods,” and said that the GMA “encourage[s] effective voluntary, national self-regulatory mechanisms promoting responsible advertising and marketing.”
Describing obesity as the “most prevalent, fatal, chronic disease of the 21st Century,” Morgan Downey of the American Obesity Association called on Congress to create a new National Institute of Obesity at the National Insitutes of Health for the purposes of research, training and education, and to establish an Office of Obesity Research, Prevention and Treatment in the office of the secretary of Health and Human Services (HHS). Furthermore, Mr. Downey stated, Congress should require HHS “to incorporate the NIH Guidelines for the Treatment of Obesity in its own programs such as Medicare, Medicaid and the Indian Health Service” and “encourage health maintenance organizations and traditional insurers to cover obesity treatments recommended by the NIH.”
Daniel Spratt, chairman of The Endocrine Society’s Government Relations Committee, supported the call for more research. “First, basic research should continue to better understand the body’s complex mechanisms of storing and utilizing energy. Second, transitional research should move these basic discoveries into trials of clinical treatments…Finally, as these approaches are implemented in the obese population, outcome or impact research should be designed and put in place to assess efficacy,” he stated.
During the question and answer period, Rep. Burton mentioned the comment by Mr. Wadden that children see 10,000 food-related commercials each year. He suggested that the food industry educate the public on healthly food through public service announcements. Ms. Kester responded that the industry has a great deal of information on websites and parents are primarily responsible for teaching their children healthy lifestyles. Rep. Burton stated that many children are “latchkey kids,” with both parents working. “The industry would be well served,” he said, “if they can help educate the kids.”
Rep. Watson asked Mr. Bost if he was open to criticism of the draft FSNE Framework proposals. “Absolutely,” he replied, adding that “no final decision has been made.” Mr. Bost pointed out that the goal is to use funds more efficiently and effectively.
