Growing up on a Texas farm, Otelio Randall quickly became familiar with the basic principles involved in preparing livestock for butchering: Put an animal in a small pen to keep it from moving around too much and stuff it with food to fatten it up. Randall, who now runs an anti-obesity clinic at Howard University Hospital in Washington, D.C., worries that too many humans are following the ready-for- slaughter model. "What these people are doing is sitting themselves in a pen, watching TV and eating," he says. "It's no mystery why people are getting fatter."
Obesity is on the rise in the United States, particularly among young people. The number of obese and overweight children has doubled over the past 20 years; the percentage of overweight adolescents has tripled. This has led to an enormous spike in diabetes and other illnesses, which makes weight gain an obvious public health concern. But what can public policy makers do to influence individual decisions about eating high-calorie foods and failing to exercise?
A lot of attention is being expended in state legislatures on a couple of ideas. One is to tax snacks and sodas with little nutritional value. At least 18 states considered so-called "fat taxes" last year, and a similar number are taking a look again in 2003. But most of the debate centers around schools and the twin issues of declining physical activity and rising amounts of junk food sales on campus. "We're actually setting our people up to lead short, fat lives," worries Tom Burch, who chairs the Kentucky House Health and Welfare Committee.
Congress has been experimenting with grants to promote P.E. courses in local districts, an idea that some of the major food lobbies are pushing as well. Illinois is the only state that still requires daily physical education courses from kindergarten until high school graduation. "When schools faced a budget crunch and new education requirements, they had to make cuts somewhere," notes Stephanie Childs of the Grocery Manufacturers of America, "and unfortunately phys ed and nutrition classes were often the first to go."
Fewer than one-third of high school students take daily P.E. courses now, and schools have been cutting back on recess as well. Atlanta has had a no-recess policy in place long enough that it now builds new schools without playgrounds. There may be good reasons for the drop- off in exercise--schools are concentrating more on academics, especially with the rise of standardized testing--but some are complaining that long days chained to a desk more closely resemble house arrest than a healthy childhood.
If schools aren't giving kids many opportunities to run around, they are certainly supplying them with ample chances to snack. School lunches served in cafeterias have to meet federal nutrition guidelines, but there are no such regulations on snacks and sodas sold in vending machines and at food carts. Sodas are now on sale at 60 percent of middle and high schools nationwide, according to the National Soft Drink Association, and about 20 percent of the schools have also opened their doors to name-brand purveyors of high-fat foods, such as Taco Bell and Domino's pizza. "Teaching kids in a health class about making healthy choices and then turning them into a corridor lined with soft drinks and poor-nutrition snacks is sending a very mixed signal," complains Barry Sackin of the American School Food Service Association.
Some state legislators such as Burch have looked at requiring schools to step up their physical activity programs while cutting back on sugary and fatty food offerings. But local school districts covet their rights to set their own policies. And the schools are quick to note that the soft drink vendors have been generous with funds in a way that state legislators can't always be. "One of the reasons you have soft drinks in schools," says Gerald N. Tirozzi, executive director of the National Association of Secondary School Principals, "is that if we didn't have that as a resource, we wouldn't have bands and field trips and even athletic teams."
Nevertheless, several large districts have banned sodas from schools, including Philadelphia, Oakland and Madison, Wisconsin. The Los Angeles Unified School District will ban soda sales on its campuses next year, but at a cost of $40 million in lost revenue over the next decade. "This is absolutely the right thing to do," declared board president Caprice Young after last August's vote, "but I wish we could have chosen an implementation plan that would have made it less painful for the schools."