America's progress in arresting its obesity epidemic has been too slow, and the condition continues to erode productivity and cause millions to suffer from potentially debilitating and deadly chronic illnesses, says a new report from the Institute of Medicine. Solving this complex, stubborn problem requires a comprehensive set of solutions that work together to spur across-the-board societal change, said the committee that wrote the report. It identifies strategies with the greatest potential to accelerate success by making healthy foods and beverages and opportunities for physical activity easy, routine, and appealing aspects of daily life.
 
The report, which was released at the Centers for Disease Control and Prevention's "Weight of the Nation" conference, focuses on five critical goals for preventing obesity: integrating physical activity into people's daily lives, making healthy food and beverage options available everywhere, transforming marketing and messages about nutrition and activity, making schools a gateway to healthy weights, and galvanizing employers and health care professionals to support healthy lifestyles. The committee assessed more than 800 obesity prevention recommendations to identify those that could work together most effectively, reinforce one another's impact, and accelerate obesity prevention.
 
Specific strategies that the committee noted include requiring at least 60 minutes per day of physical education and activity in schools, industry-wide guidelines on which foods and beverages can be marketed to children and how, expansion of workplace wellness programs, taking full advantage of physicians' roles to advocate for obesity prevention with patients and in the community, and increasing the availability of lower-calorie, healthier children's meals in restaurants.

"As the trends show, people have a very tough time achieving healthy weights when inactive lifestyles are the norm and inexpensive, high-calorie foods and drinks are readily available 24 hours a day," said committee chair Dan Glickman, executive director of congressional programs, Aspen Institute, Washington, D.C., and former secretary, U.S. Department of Agriculture. "Individuals and groups can't solve this complex problem alone, and that's why we recommend changes that can work together at the societal level and reinforce one another's impact to speed our progress."

The report's proposed strategies and action steps aim to support individuals' and families' abilities to make healthy choices where they work, learn, eat, and play. For example, healthy food and beverage options should be available at competitive prices everywhere that food is offered and an effort should be made to reduce unhealthy products. Fast-food and chain restaurants could revise their recipes and menus to ensure that at least half of their children's meals comply with federal dietary guidelines for moderately active children and charge little or no more for these options, the report says. Shopping centers, convention centers, sports arenas, and other public venues that make meals and snacks available should offer a full variety of foods, including those recommended by the dietary guidelines.
 
Americans are surrounded by messaging that promotes sedentary activities and high-calorie foods and drinks, the report notes. The food, beverage, restaurant, and media industries should step up their voluntary efforts to develop and implement common nutritional standards for marketing aimed at children and adolescents up to age 17. Government agencies should consider setting mandatory rules if a majority of these industries have not adopted suitable standards within two years. To increase positive messaging about physical activity and nutrition, government agencies, private organizations, and the media could work together to develop a robust and sustained social marketing campaign that encourages people to pursue healthy activities and habits.
 
Fiscal policies could help increase access to healthy foods and activity, the committee noted. For example, flexible financing or tax credits could be used to encourage developers to build sidewalks near new housing and locate supermarkets in communities without them.
 
Given that children spend up to half of their waking hours in school and consume a third to half of their daily calories there, schools can be a gateway to healthy habits, the report says. Schools should be given the resources and support to implement federal nutrition standards for meals and for products served in vending machines, concession stands, and other venues. Students in every grade should have opportunities to engage in at least 60 minutes of physical activity daily through quality physical education and active classroom activities. Schools should make food literacy part of their curricula; USDA could support this by developing age-appropriate nutrition information for lesson guides.
 
"Obesity is both an individual and societal concern, and it will take action from all of us — individuals, communities, and the nation as a whole — to achieve a healthier society," said IOM President Harvey V. Fineberg. The report's blueprint for action is being released in conjunction with the new "Weight of the Nation" initiative, which includes an HBO documentary series presented in collaboration with IOM, in association with CDC and the National Institutes of Health, and in partnership with Kaiser Permanente and the Michael and Susan Dell Foundation. The initiative seeks to spur individuals and groups to get involved in local efforts to promote healthy eating and activity. More information is available at theweightofthenation.hbo.com.
 
The IOM report was sponsored by the Robert Wood Johnson Foundation. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The Institute of Medicine, National Academy of Sciences, National Academy of Engineering, and National Research Council together make up the independent, nonprofit National Academies. For more information, visit national-academies.org or iom.edu.