Testimony

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

on
Combating the Epidemic of Childhood Obesity
before the
The Committee on Health, Education, Labor & Pensions
United States Senate

October 5, 2004

In a Presidential Proclamation earlier this year (May 8, 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 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 might overtake smoking as the leading cause of preventable death in the United States.

Sixty-four percent --that's two thirds of American adults -- are overweight or obese.

As Chairman of the Council, I feel especially responsible for the health of millions of our children. Fifteen percent of our children and adolescents are overweight-nine million young people. The percentage is even higher for African American, Hispanic, and Native American children-over twenty percent. Ten percent of our little ones age two to five are overweight. Type 2 diabetes and cardiovascular risk factors such as high blood pressure are showing up in young children.

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.

But children are not small adults -they need more activity to be healthy, at least 60 minutes on most days of the week. There must be a concerted effort by parents, schools and communities to make sure that children have the time and opportunity to gain the health benefits of moving at least 60 minutes throughout the day.

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 children don't have to play sports to be active. Just walking the dog, helping with household chores, playing tag in the yard -any activities that cause children to move the large muscles of their bodies-afford the health benefits of regular physical activity. Parents can help by monitoring TV and computer time and making family time active time so the whole family becomes healthier. If you are age eighteen or older, it takes at least 30 minutes of physical activity a day to gain health benefits. And you don't have to do it all at once--you can accumulate 30 minutes of activity throughout the day in 5, 10 or 15-minute increments. But remember, children and teens up to age seventeen need at least 60 minutes of movement on most days of the week.

I applaud this committee for exploring the ways that public private partnerships can be effective in countering the growing obesity epidemic threatening the health of our children.

I'm proud to say that the President's Council on Physical Fitness and Sports is on the cutting edge in that area. We are already working closely with partners in corporations and business, with non-profit organizations, with health care providers and insurers, educators, fitness and sports professionals, and other public agencies to encourage Americans to be physically active every day for health.

Let me highlight some of our public-private partnerships:

Each year, the General Mills Champions Program awards 50 grants of $10,000 each to community-based groups that implement innovative programs to help youth improve their nutrition and fitness behaviors. To celebrate National Physical Fitness and Sports Month in May 2003 and May 2004, General Mills sponsored the President's Challenge awards for all Minneapolis schools. In a 2-year period, over 20,000 students competed in the 6-week active lifestyle program and received Presidential recognition. General Mills is now pledging to sponsor up to 50,000 youth.

The Coca Cola Company's "Step With It" program partnered with the President's Challenge program to encourage school children to be active. Coca Cola provided "stepometers" -- small pedometers that track the number of steps taken in a typical day to encourage participants to increase their daily walking and overall activity to maintain good health, while simultaneously fulfilling the requirements for the Presidential Active Lifestyle Awards (PALA) Program and awards. Coca Cola subsidizes the award and certificate for each child who completes the six-week program.

The Burger King Corporation sponsored President's Challenge awards during spring 2004. In this initiative, 206 schools nationwide received awards, and 66,000 students had an opportunity to receive presidential recognition for becoming and staying more fit and active. The sponsorship allowed parents, teachers and /or students to nominate their school for the awards as recognition of existing physical education programs.

Another partner, Wheaties, provided equipment such as soccer balls, footballs, jump ropes, etc. to each school selected by the Council as a State Champion award winner, part of the President's Challenge program. Each year, the PCPFS honors 3 schools with the State Champion award. Based on enrollment size, the 3 schools within each state that have the highest Presidential Physical Fitness Award winners receive this special recognition. Wheaties encouraged each winning school to create and submit a poster depicting fit and active lifestyles. Wheaties selects a winning poster for use as a backdrop for the next year's program. A poster is sent to each State Champion school. In addition, 3 schools based on enrollment size receive $5000 grants for their physical education department. One million Wheaties' boxes promoted and encouraged all Americans to adopt and maintain an active lifestyle while earning presidential recognition for their efforts.

The Kellogg Company is promoting physical activity for very young children (birth to age five) to parents and caregivers through a publication co-sponsored with the President's Council on Physical Fitness and Sports, "Kids in Action." The Kellogg Company is now partnering with the President's Council and the National Association of Sport and Physical Education (NASPE) to bring this important information to child care providers in day care centers as well as to parents and caregivers at home. The Kellogg Company produces, prints and distributes "Kids in Action" free of charge, and the Council assists in promoting physical activity for young children through cooperative media outreach and events and distribution of "Kids in Action" to the public.

The American Association of Clinical Endocrinologists co-sponsored a publication, "Rx: Take the President's Challenge: www.presidentschallenge.org", a prescription for physicians to give to youth during school visits, when the doctors give a presentation about physical activity and sound nutrition and promote www.presidentschallenge.org to students, teachers, and parents.

The Blue Cross Blue Shield Association's (BCBSA) "Walking Works" partnered with the President's Council on Physical Fitness and Sports to produce and print a walking guide designed to help Americans of all ages set their own benchmarks and achieve personal walking goals. Walking Works is a consumer education program developed to motivate BCBSA plan members and their families to integrate walking into every day, live healthier lives, and reduce the likelihood of costly health problems down the road.

Members of Congress and their staffs were asked to walk for health by signing up for the Congressional Challenge, "Walking Works" program, in partnership with Blue Cross Blue Shield. During this 6-week challenge, staff members worked toward a Presidential Active Lifestyle Award (PALA) by logging on to www.presidentschallenge.org.

Tomorrow (Wednesday, October 6, 2004) Secretary Tommy Thompson will join me and Kay Coles James, Director of the Office of Personnel Management, to issue a challenge to all federal employees, the HealthierFeds Physical Activity Challenge. We are challenging the Federal agencies to compete with each other to earn Presidential awards and to be national role models for active lifestyles.

Right now we have great leaders as role models--a President in the White House, a Secretary of Health and Human Services, and a U.S. Surgeon General who all advocate for 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.

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.

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.

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 some of that money into preventive medicine-for sidewalks, bike paths, playgrounds, sports facilities, after school programs, and youth recreation centers? 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 and with partners in the private sector 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 with corporations, organizations, educators, health care providers, 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. We must give our children the education and tools they need to make healthy nutritional choices. We must monitor their eating at home and at school. We must make time and opportunities for them to be active at 60 minutes on most days of the week. 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: October 5, 2004