Will the organic veggie garden survive the transition?
This Friday we will see the transfer of power from the outgoing President to the incoming one. On that stage there will also be a more subtle change in power between two First Ladies—the power to engage the public and to persuade. Michelle Obama used her power to highlight several initiatives, including Let’s Move. Some consider her to be the one of the most influential persons in the area of healthcare of the last few years. Others, not so much. The basis of her plan was to get children to cut down on excessive eating, particularly junk foods, eat more fresh fruits and vegetables and exercise. She did this by working with parents, food companies, lawmakers and regulators. She has left an imprint on the American public thanks to her judicious use of the power of publicity and persuasion. An evaluation of the program is difficult, but I will tackle the question—“Was she successful?”
Yes, she was! Supporters of Let’s Move pointed out last year that a recent CDC study showed a decrease in obesity between 2004 and 2012 of 43% among children aged 2-5 and a general leveling off of rates of obesity since 2008. The news was widely circulated.
No, she was not! Then we hear that we should be wary of the data as childhood obesity has increased from 27.5% of all children aged 2-19 in 1999-2000 to 31.8% in 2011-2012 and 33.2% in 2013-2014. This news did not seem to be as prevalent in the mainstream media.
Who is right? From a scientific standpoint, it is not really clear (what else did you expect a scientist to say?). First, the same large datasets from NHANES were used by both the Yes and No camps to prove their points. The report for 2011-2012 on childhood obesity found a much lower level of childhood obesity than expected. The last year the government has numbers for childhood obesity is 2013-2014. It takes a long time to analyze these numbers, so we don’t see them for about 2 years after collection. Obesity numbers are particularly hard to get a handle on as they go up and down unpredictably every year rather than in a straight line. If we pick 2004 as the beginning year, which was unusually high, and limit it to 2-4 year old children we get the 43% reduction described in the optimistic report. If we go back to 1999 and look at the age groups 2-19, we get a 20.7% increase in obesity [(33.2-27.5)/27.5] we see a more pessimistic outlook. In short, both sides picked their starting and ending numbers and selected the age groups that supported the view they advocated.
How can we truly evaluate. If I were to take on such a task, I would make my starting point 2009-2010 as the program started in 2010. Next, I would graph each of the age groups (2-5, 6-11, 12-19 and 2-19) to see if there were any meaningful trends in any of the age groups over the next few years. Since we currently only have 3 data points (2009-2010, 2011-2012 and 2013-2014), it is very difficult to identify a trend. I would want at least one more data point (2015-2016) which won’t be available until at least 2018 to develop even a preliminary conclusion. I would be prepared for disappointment such as opposite trends for different age groups or generally inconclusive results. I would then want to revisit the data in 2020 and 2022 when the next two data points are released. I would also look at other changes in relative rates of obesity such as in the 2-11 year trends from 2009-2010 with that in 2015-2016 when those children who were 2 in 2009 would be would be 11 in 2016.
Did Michelle Obama really reduce obesity in America? We don’t have enough data yet to make a judgement and may never get a definitive answer. Among her major accomplishments were to
- call attention to childhood obesity,
- get certain restaurant chains to increase access to fruits and vegetables on kid’s menus,
- convince some grocery chains to move into food deserts to provide a wider range of food options,
- provide impetus to change food labels to make them more readable and understandable,
- motivate Congress to pass legislation to improve school-lunch nutrition, and
- advocate exercise and other forms of physical activity.
Mrs. Obama deserves to be saluted for her positive efforts to promote children’s health and combat obesity among the young. I would like to believe that Let’s Move has been effective and that we are beginning to find ways to halt childhood obesity which is now considered a world health issue. In studying the issue of obesity carefully over the last two years I have concluded that we are unlikely to do much to affect adult obesity in our lifetimes. The number of obese adults seems to be leveling off, but the number of obese adults who are becoming extremely obese continues to increase at a rather alarming rate. Most health-care professionals have given up on trying to help obese adults and are focusing on children and youth. If this effort is successful, it will be at least 20-30 years before the effort will make a serious dent in adult obesity.
A shout out to my friend, Kathy Monroe, who encouraged me to look at this issue.
Next week: Are all processed foods junk foods?