WORKSHOP SUMMARY
Paula Tarnapol Whitacre and Annina Catherine Burns, Rapporteurs
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
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PERSPECTIVES FROM
U N ITED KI NGDOM AN D
U NITED STATES
POLICY MAKERS ON
OBESITY PREVENTION
WORKSHOP SUMMARY
Paula Tarnapol Whitacre and Annina Catherine Burns, Rapporteurs
Standing Committee on Childhood Obesity Prevention
Food and Nutrition Board
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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Govern-
ing Board of the National Research Council, whose members are drawn from the
councils of the National Academy of Sciences, the National Academy of Engineer-
ing, and the Institute of Medicine. The members of the committee responsible for
the report were chosen for their special competences and with regard for appropri-
ate balance.
This study was supported by Grant No. 61747 between the National Academy
of Sciences and The Robert Wood Johnson Foundation. Any opinions, findings,
conclusions, or recommendations expressed in this publication are those of the
author(s) and do not necessarily reflect the view of the organizations or agencies
that provided support for this project.
International Standard Book Number-13: 978-0-309-15078-1
International Standard Book Number-10: 0-309-15078-7
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Greece, now held by the Staatliche Museen in Berlin.
Suggested citation: IOM (Institute of Medicine). 2010. Perspectives from United
Kingdom and United States Policy Makers on Obesity Prevention: Workshop Sum-
mary. Washington, DC: The National Academies Press.
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“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
— Goethe
Advising the Nation. Improving Health.
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Upon the authority of the charter granted to it by the Congress in 1863, the Acad-
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The National Academy of Engineering was established in 1964, under the charter
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dent of the National Academy of Engineering.
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PLANNINg COMMITTEE FOR A WORKSHOP ON
PERSPECTIVES FROM THE UNITED KINgDOM AND UNITED
STATES POLICY MAKERS ON OBESITY PREVENTION*
WILLIAM H. DIETZ (Chair), Director, Division of Nutrition, Physical
Activity, and Obesity, Centers for Disease Control and Prevention
ADAM DREWNOWSKI, Professor of Epidemiology, School of Public
Health and Community Medicine, University of Washington
RUSSELL R. PATE, Professor of Exercise Science, Department of Exercise
Science, University of South Carolina
JOHN EDWARD PORTER, Partner, Hogan and Hartson, LLP,
Washington, DC
JOSEPH W. THOMPSON, Surgeon General, State of Arkansas
Study Staff
ANNINA CATHERINE BURNS, Study Director
LYNN PARKER, Scholar
NICOLE FERRINg HOLOVACH, Research Associate
SAUNDRA A. LEE, Senior Program Assistant
ANTON L. BANDY, Financial Associate
gERALDINE KENNEDO, Administrative Assistant
LINDA D. MEYERS, Director, Food and Nutrition Board
*Institute of Medicine planning committees are solely responsible for organizing the work-
shop, identifying topics, and choosing speakers. The responsibility for the published workshop
summary rests with the workshop rapporteurs and the institution.
v
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Reviewers
T
his report has been reviewed in draft form by individuals chosen for
their diverse perspectives and technical expertise, in accordance with
procedures approved by the National Research Council’s Report
Review Committee. The purpose of this independent review is to provide
candid and critical comments that will assist the institution in making its
published report as sound as possible and to ensure that the report meets
institutional standards for objectivity, evidence, and responsiveness to the
study charge. The review comments and draft manuscript remain confiden-
tial to protect the integrity of the process. We wish to thank the following
individuals for their review of this report:
William H. Dietz, Director, Division of Nutrition, Physical Activity,
and Obesity, Centers for Disease Control and Prevention,
Atlanta, GA
gail Woodward Lopez, Associate Director, Dr. Robert C. and
Veronica Atkins Center for Weight �� Health, University of
Center
California, Berkeley
Eduardo J. Sanchez, Vice President and Chief Medical Officer, Blue
Cross and Blue Shield of Texas, Richardson, TX
Although the reviewers listed above have provided many constructive
comments and suggestions, they were not asked to endorse the conclusions
or recommendations nor did they see the final draft of this report before its
release. The review of this report was overseen by Melvin Worth. Appointed
vii
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viii REVIEWERS
by the Institute of Medicine, he was responsible for making certain that an
independent examination of this report was carried out in accordance with
institutional procedures and that all review comments were carefully con-
sidered. Responsibility for the final content of this report rests entirely with
the authoring committee and the institution.
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Contents
Summary 1
1 Introduction 7
Setting the Stage, 7
Report Organization, 8
2 Scope of the Problem 9
Obesity as a Growing Epidemic in the United Kingdom, 10
Prevalence, Trends, and Contributing Factors in the
United States, 13
3 Government Structures to Address Obesity 17
Three Roles for the British Government, 18
Federal and Local Efforts in the United States, 20
4 School Meal Policies 23
Healthier Meals Through the UK School Food Trust, 23
Food and Nutrition Service Programs in US Schools, 26
Discussion, 27
5 Physical Activity and the Built Environment 31
Washington, DC: “Healthy by Design,” 32
Increasing Physical Activity Through the Built Environment in
England, 34
Discussion, 36
ix
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x CONTENTS
6 National Policies and Programs 39
US Department of Agriculture: Meeting Nutrition Needs, 39
US Department of Education: Promoting Physical Education in
US Schools, 41
UK Food Standards Agency: Encouraging Healthier Eating, 44
Implementing Change4Life, 46
Discussion, 48
7 Local Policies and Programs 51
Los Angeles County: The Health Department as a Focal Point, 52
New York City: Menu Labeling to Promote Health, 55
Hernando, Mississippi: Creative Leadership on a
Limited Budget, 58
Discussion, 59
8 Concluding Remarks 61
Final Thoughts: A UK Perspective, 61
Final Thoughts: A US Perspective, 62
References 65
Appendixes
A Workshop Agenda 67
B List of Participants 71
C Planning Committee Biosketches 75
D Speaker Biosketches 79