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Cutting-the-fat bills target overweight kids

The impact of childhood obesity on health has prompted efforts by Maine legislators to promote healthy eating and exercise.

By Susan J. Landers, amednews staff. March 10, 2003.

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Washington -- Obesity. Clearly it's an epidemic. And it is becoming an increasingly difficult public health problem to address.

Physicians' messages of personal health and responsibility as well as nutrition and exercise don't seem to find traction among patients at highest risk. The statistics are getting worse, not better. It's a frustrating challenge, and one that has led some doctors to look beyond the exam room for assistance.

In Maine, the state Legislature is taking on the problem of obesity with a comprehensive package of proposals to promote exercise, curtail the sale of soft drinks in schools and include information on the menu boards of large chain restaurants that spells out just how much fat there is in a Big Mac or a Coconut Crème Frappuccino.

The legislation has the support of the Maine Medical Assn., whose governing body decided last fall to work toward removal of foods with high sugar content from school vending machines and to encourage increased attention to physical education in the schools. The association was quick to support the package of bills introduced by Democratic State Rep. Sean Faircloth that could carry those aims forward, said Jacob Gerritsen, MD, chairman of the association's Public Health Committee.

The bills prohibit soda and candy bar sales in schools, allow the state to use gas tax revenue to pay for safer walking and biking routes to school, require fast food restaurants to list nutrition information on menus and call for studies of nutrition programs and the amount of physical education offered in schools.

The first bill to be considered is one to ban candy and soda from school vending machines. In Maine, foods without sufficient nutritional value are off-limits during school hours but are available before and after school.

That measure stands the best chance of passage, said Anna Bragdon, the Maine Medical Assn.'s assistant director of governmental affairs.

The legislation comes as Maine and most other states are struggling to pay rising health care costs with fewer resources. A 2001 report by the U.S. Surgeon General attributed $117 billion in direct and indirect health care costs in 2000 to the fact that so many Americans are overweight.

Dr. Gerritsen elaborated on those ills during a Feb. 20 hearing on the bill. "Overweight and obesity substantially raise the risk of illness from high blood pressure, high cholesterol, type 2 diabetes, heart disease and stroke, gallbladder disease, arthritis, sleep disturbances and problems, breathing [problems] and certain types of cancers," he said.

Dr. Gerritsen, an internist, told the Joint Committee on Education and Cultural Affairs that overweight children are more likely to become overweight adults.

He noted that type 2 diabetes was a rarity among children in the 1970s. However, today, the American Diabetes Assn. reports that between 8% and 45% of newly diagnosed cases of childhood diabetes are type 2, non-insulin-dependent, associated with obesity, he said. Poor eating habits are among the chief culprits in the obesity epidemic, said Dr. Gerritsen. Children ages 12 to 19 who drink soda consume nearly 16 teaspoons of sugar each day in their beverages, he said.

A state solution

"This type of comprehensive legislation is exactly what states should be doing to reverse the obesity epidemic," said Margo Wootan, director of nutrition policy for the Washington, D.C.-based Center for Science in the Public Interest.

The legislation would make it easier for people of all ages to eat well, be physically active and maintain a healthy weight, she said. "Maine has figured out that doing nothing about obesity is a prohibitively expensive option," said Wootan.

Several other states have banned the sale of candy and soft drinks in schools and a few have enacted transportation policies that encourage walking and other forms of physical activity, said Wootan.

Maine is believed to be the first state to consider legislation requiring chain restaurants with 20 or more outlets to list nutrition information on menus and menu boards.

"Nutrition information in chain restaurants is notoriously hard to find and hard to read. Without calorie labeling, consumers would have no clue that a large McDonald's shake has more than 1,000 calories -- about a half a day's worth just in a drink," Wootan said.

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