Testimony

Statement by
Lynn C. Swann, Chairman
President's Council on Physical Fitness and Sports
Office of Public Health and Science
US Department of Health and Human Services

on
Combating the Obesity Epidemic
before the
The Committee on Government Reform
United States of Representatives

June 3, 2004

In a Presidential Proclamation for National Physical Fitness and Sports Month in May 2004, President George W. Bush stated,

"By exercising regularly and participating in sports, we can improve our health, set a positive example for our children, and help build a stronger future for our country."

In the last century, our nation made striking advances in public health. The chief enemy was infectious disease, such as tuberculosis, pneumonia, bacterial infections, and diseases caused by contaminated water and food.

By the end of the twentieth century, we could look back with pride at the enormous victories we achieved by creating drugs and adopting hygiene practices that have dramatically reduced the gravest threats to public health.

At the beginning of the twenty-first century, our nation faces a deadly health crisis with the potential to do great damage from a cause that until recently has not been a major threat. We are in the midst of an obesity epidemic caused by poor diet and our sedentary lifestyles. We are eating too much and moving too little.

The latest figures released recently by the Centers for Disease Control and Prevention show that 400,000 people a year – almost eleven hundred Americans a day-- die from conditions related to physical inactivity combined with poor diet. Only smoking kills more people--435,000 people a year. The gap is closing fast. However, if the numbers keep growing at the same rate as they did during the past decade, physical inactivity and poor diet will overtake smoking in less than ten years as the leading cause of preventable death in the United States.

Sixty-four percent --that's 123 million Americans -- are overweight or obese. Fifteen percent of our children are overweight—nine million young people. The percentage is even higher for African American, Hispanic, and Native American children—over twenty percent. Type 2 diabetes and cardiovascular risk factors such as high blood pressure are showing up in young children. This may be the first generation in modern history to be outlived by its parents.

Our children are suffering. Only about one-half of U.S. young people (ages 12-21 years) regularly participate in vigorous physical activity. According to a study done by the National Association of Sports and Physical Education (NASPE), children should engage in at least 60 minutes of physical activity daily and should not be sedentary for more than 60 minutes at a time except when sleeping. On average, children in the U.S. watch 18 hours of TV a week. As Secretary Thompson says, "We need to get our children away from the Play Station and out on the playground".

What if there were a drug that helped reduce the risk of developing or dying from heart disease, stroke, high blood pressure, type 2 diabetes, colon cancer, osteoporosis, arthritis, depression and anxiety? We'd probably demand that it be put in the public water supply. Everyone would clamor to have access to this magic pill. Let me tell you that such a remedy already exists, one that won't take years of research and development or clinical trials. It has no undesirable side effects. It has no costs except commitment and determination. That medical miracle is daily physical activity.

HHS studies and reports show that if adults would engage in only 30 minutes of moderate physical activity a day, such as brisk walking, on five or more days a week, it would decrease the risk of developing or dying from cardiovascular disease, type 2 diabetes, and some cancers—such as colon cancer—as well as helping to prevent osteoporosis, arthritis, anxiety and depression. As I mentioned earlier, children are not small adults and need at least 60 minutes of daily activity to be healthy.

Physical activity helps maintain a healthy weight. There's a concept called the "energy equation." We need to expend as many calories by physical activity as we take in.

As an athlete myself, I love to work out and play sports. But you don't have to sweat in a gym or run a marathon to gain the health benefits of regular physical activity. Brisk walking or raking leaves for 30 minutes; climbing stairs instead of taking the elevator; playing outdoors with children and grandchildren—all of these activities add up to better health. If you are age eighteen or older, it takes 30 to 60 minutes of physical activity a day to gain health benefits. And you don't have to do it all at once--you can accumulate 10 to 15 minutes of activity throughout the day. Children and teens up to age seventeen need at least 60 minutes of movement on most days of the week.

Right now we have a President in the White House, a Secretary of Health and Human Services, and a U.S. Surgeon General who advocate prevention and healthy lifestyles. They walk the talk and practice what they preach. President Bush is in the top 1% of health statistics for men his age and in the top 3% of men over age 30. Secretary Tommy Thompson lost 15 pounds. He walks around the HHS building and encourages employees to stop smoking. He wears a pedometer and exercises regularly. Surgeon General Dr. Richard Carmona speaks around the nation to school children and others stressing the health benefits of physical activity, nutrition, prevention, and other healthy behaviors.

The time is right for Congress to look at innovative ways to reduce staggering health care costs. Sometimes we need to shift our perspective to move in a new direction. Our entire health care system is organized around treating diseases after they occur, not preventing them before they occur. We need a paradigm shift that places prevention at the center of our health priorities. We need to focus not only on the people who are already sick with chronic disease but also on the generation that is growing up, the kids that are overweight at age two or three, and ill with type 2 diabetes and high blood pressure by the time they are eight years old. I encourage you to start with your own health and that of your staff.

On Wednesday, June 16, 2004, the President's Council on Physical Fitness and Sports will join with the Congressional Fitness Caucus to hold a Healthier US Fitness Festival on the National Mall, between the Capitol, and 3rd and 4th Street Southwest. I urge all members of Congress to come to this event to show support for active lifestyles.

On June 17 and 18, the Congressional Fitness Caucus will be asking members of Congress and their staffs to walk for health by signing up for the Congressional Challenge, "Walking Works" program, in partnership with the Blue Cross Blue Shield Association. This is your opportunity to change your life if you are inactive and to help inactive colleagues become active. During this 6-week challenge, you and your colleagues and staff members can earn a Presidential Active Lifestyle Award (PALA) by logging on to www.presidentschallenge.org

Secretary Tommy Thompson issued a similar challenge to HHS employees in downtown Washington, D.C. last fall, with the Secretary's Challenge for a Healthier HHS program. Secretary Thompson wants to extend the opportunity to all federal employees. Please follow the example of the President, Secretary Thompson, and Surgeon General Carmona by being a role model for active lifestyles.

I know that each and every member of Congress wants to help our nation become strong and healthy, ready to meet any challenge. You can be justly proud of the support given to research for new drugs and medical treatments for disease. But think of all the money we could save on health care if we begin to give equal emphasis to prevention now. As you consider what Congress and the Department of Health and Human Services can do to promote the health of the nation, remember that forty years ago, we were only beginning to hear the message about the dangers of tobacco use. It's taken that long to change the way people think about smoking.

We can't afford to wait forty years before people begin to take care of their health by stressing prevention. Today, we spend $117 billion annually on conditions related to obesity and $132 billion on type 2 diabetes. That's about $250 billion a year. What if we had that much money to build parks, playgrounds, and playing fields? We might begin to reverse the alarming health trends we are seeing in our children. What if we could put that money into preventive medicine, after school programs, senior recreation centers, and workplace wellness? If we want to see a bright and healthy future, we must change the way we think about health priorities and focus on prevention.

The federal government needs to stimulate all levels of government—federal, state, and local—to join with us to attack the obesity epidemic and its attendant health problems. Please consider how the Executive and Legislative branches of the federal government can work together to stimulate states, communities, families and individuals to make healthy choices.

We need our government to stand squarely behind initiatives and interventions to stress and encourage all Americans to be physically active every day, to eat a nutritious diet, to get preventive screenings, and to avoid risky behaviors. These are the four pillars of the President's Healthier US initiative. We need to ask ourselves, "What help and incentives are needed to make people take these steps toward better health to improve their lives? How can we provide them?"

It only takes small steps. It's important to spread that message. If we can encourage people to cut their calorie intake by 100 calories a day; to walk for 30 minutes five days a week, for example, we would begin to transform the health of the nation. It's the small steps that count – small steps in the individual lives of many would reap dramatic benefits for the nation as a whole, saving not millions but billions of dollars.

I urge you never to underestimate the power you have as legislators. Working together, we have the ability to promote the health of our fellow citizens and our nation. When you consider legislation on health, environment, transportation, and education—remember that you are dealing with the lives and well being of the American people for years to come. We are talking about our own children and grandchildren. May the mark that we, as public servants, leave on those we touch be one that nurtures and enhances the health and overall well being of this great nation we serve.

Thank you for inviting me to testify on this most important topic. At this time I would be happy to respond to any questions.

Last Revised: November 1, 2004