Americans should know how much they should eat. "If you ask any American how many calories they need on a given day, most of them are clueless," says Linda Van Horn, chair of the advisory committee and professor of preventive medicine at Northwestern University. The panel believes that if people had a better sense of that, and of how many calories they take in, the obesity epidemic might be slowed. So the 2010 guidelines, says Van Horn, must offer effective, consumer-friendly tools to help individuals come up with reasonable estimates, personalized according to age, sex, and level of physical activity. The report does not propose a form for those tools.
Treat kids and pregnant women as special groups. Previous guidelines lumped all children ages 2 and up with adults and didn't address pregnant women separately. The advisors want the dietary needs of infants, children ages 2 to 18, and pregnant women treated separately. While all groups need to eat less overall, pregnant women need to seek out foods rich in folate and iron, while kids should give up soda for milk to bolster levels of vitamin D and calcium, nutrients essential for healthy bones.
Tackle childhood obesity before birth. "The only effective way to combat obesity is to never develop it in the first place," says Van Horn. Promoting nutrition and exercise when kids are young isn't enough. The report cites evidence from the Institute of Medicine that mothers who are obese when they are pregnant put their child at a greater risk of following suit when they get older. Prevention, the advisors said, must start in utero, with nutritional and exercise programs during and after pregnancy.
Put more emphasis on kids. According to the report, the incidence of overweight and obese kids since the early 1970s has approximately doubled among children ages 2 to 11 years and tripled among adolescents ages 12 to 19 years. Advice like "spend more time outside and less time in front of the TV" won't cut it in 2010. The environment at home, at school, and in the community needs a complete overhaul, the panel concludes: Get TVs out of children's bedrooms. Create safe routes for walking or biking to school. Organize recreational sports leagues that encourage kids who may not be athletically gifted to join up. Get soda and junk food out of school.
Change the environment. The report is the first to identify community barriers that get in the way of a healthy lifestyle and to offer suggestions for how to get around them. Healthy food should be cheaper and easier to find, say the advisors, especially in low-income neighborhoods. Among their solutions: open more grocery stores and promote farmers' markets. And to meet minimum weekly standards for physical activity of an hour of vigorous exercise or 2½ hours of moderate exercise, the report calls for more workplace help, perhaps by offering employees gym membership discounts and encouraging them to get up and move around during frequent breaks built into the work day.
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