Editors: The Institute of Medicine on Tuesday issued the report, "Local Government Actions to Prevent Childhood Obesity," which suggests environmental changes that could help remove obstacles -- such as a lack of healthy foods or safe areas for kids to play -- to healthier lifestyles. Indiana University public health and obesity experts Lloyd Kolbe and Susan Middlestadt comment on the significance of the report.

A NEW ERA OF COMBATING OBESITY

Newswise — The report suggests a much more comprehensive -- and much needed -- approach to reducing obesity than seen in the last 30 years, when efforts either cast obesity as a lack of discipline or a shortcoming of the individual, or were focused on educational programs geared toward healthier eating and more physical activity.

"Both of these approaches are important," said Lloyd Kolbe, associate dean for global and community health at Indiana University Bloomington's School of Health, Physical Education and Recreation. "But we're entering a third era, where we're recognizing that it's the social and environmental conditions in which people live that have the greatest influence on whether they can eat healthy foods and whether they can engage in physical activity, should they want to and be educated to do so."

This newer approach acknowledges the role that policies and community environments have in supporting, or in some cases, obstructing healthier lifestyles, and that local governments can potentially influence this. Regulations concerning public safety, menu labeling and advertising as well as business incentives for restaurants and stores that sell healthy foods are examples of potential governmental influence.

Kolbe describes this approach as a fundamental shift in how the Centers for Disease Control and Prevention and others address obesity, particularly involving children. He said this emphasis on social and environmental determinants has been part of public health efforts in Europe for several years.

"This is exactly what needs to be done if we're going to be effective in reducing the obesity pandemic worldwide."

Kolbe is a professor in the School of HPER's Department of Applied Health Science. He also was the founding director of the Division of Adolescent and School Health at the CDC.

FINDING CARROTS AS EASILY AS FRENCH FRIES

Susan Middlestadt, a health behavior expert in Indiana University Bloomington's School of Health, Physical Education and Recreation, said the report outlines specific steps that state and local leaders have taken and can take to make their communities more conducive to healthier eating and increased physical activity.

"We know the prevalence of childhood obesity is increasing at an alarming rate," she said. "What we need at this point are actions to address obesity for a full range of local actors including retailers, restaurants, schools, health agencies, work sites, the media and governments."

Middlestadt said public health professionals have long known that changing behavior requires education to improve beliefs and skills along with policies and practices to provide a supportive environment.

"All children, including those in poor neighborhoods, should be able to find apples and carrots as easily as potato chips and French fries," she said. "They should be able to find a safe place to walk and play. With its strategies to improve the environment, this report moves us forward and may help ensure the life expectancy of today's children is not reduced."

Middlestadt is an associate professor in the School of HPER's Department of Applied Health Science.

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