Call for big-picture thinking to curb obesity

SOURCE: Circulation: Journal of the American Heart Association, online ahead of print (June 30, 2008)

"Overweight and obesity have become major public health challenges. Too much body fat is associated with multiple chronic conditions, including diabetes and heart disease, as well as being a risk factor on its own for disability and mortality. The World Health Organization estimates an increase of overweight and obese people to 1.5 billion by the year 2015 (Risk factor projections).

Citing the prevalence of overweight and obesity in the United States, European countries and other nations, a group of experts recommended attacking obesity by creating change through high-level public and social initiatives rather than expecting population-level change through individual’s efforts.

POPULATION APPROACHES. The American Heart Association scientific statement calls for a broad range of policy and environmental strategies (at the local, state and federal levels) that could increase opportunities for healthful eating and physical activity without requiring deliberate action by individuals, and could also help address inequalities.

RECOMMENDATIONS: Prevention strategies include influencing policy and legislation, mobilizing neighborhoods and communities, changing organizational practices, fostering coalitions and networks, educating providers, promoting community education, and strengthening individual knowledge and skills. Environmental assessments could target the locations of fast-food restaurants, restaurant portion sizes, availability of high-fat, low-fiber foods and sweetened drinks, and community design and infrastructure."

COMMENT: “Almost all of our current eating or activity patterns are those that promote weight gain—using the least possible amount of energy or maximizing quantity rather than quality in terms of food,” said Shiriki Kumanyika, PhD, RD, chair of the working group that wrote the statement. “People haven’t just made the decision to eat more and move less; the social structure has played into people’s tendencies to go for convenience foods and labor-saving devices.”