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August 23, 2016 01:00 AM

Gauging the public health value of Michelle Obama's 'Let's Move' campaign

Steven Ross Johnson
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    AP
    First lady Michelle Obama visits a school as part of the White House's Let's Move! campaign, an effort by the administration to make Americans healthier.

    For all of the polarizing views and debate surrounding President Barack Obama's signature healthcare law, what is often overlooked is the role first lady Michelle Obama has played in helping to change food nutrition policy.

    The 2010 launch of the first lady's “Let's Move” campaign was touted as an initiative to raise public awareness about the problems associated with childhood obesity by urging kids to be more physically active.

    Health experts noted the effort as being the first time the issue was taken on as such a high priority by a presidential administration.

    “Her efforts have really resulted in the nation as a whole I think recognizing what an important issue it is for us...to have all children grow up to have a healthy weight,” said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation.

    But the initiative has its share of critics. Some felt a campaign that promoted exercise and healthy eating habits was proof of a “nanny state” mentality from the government that sought to infringe on individual rights to make their own dietary choices. Others raised concerns the project would amount to nothing more than a high-profile public relations campaign that lacked any real substance.

    Some questions remain six years after the start of the campaign as to how effective its efforts have been toward curbing the childhood obesity rate, and whether its efforts will be able to be sustained after the Obamas leave the White House.

    “There are lots of different components to the campaign—there are those that are really visible to the public like the first lady being a key spokesperson on the issue of childhood obesity,” said Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest. “What most people don't see are the lasting policy changes that she and the administration have also contributed to.”

    Months after the launch of “Let's Move,” the White House Task Force on Childhood Obesity (PDF) released a report that included a list of 70 recommendations of actions that could be taken to address the problem with the ambitious goal of lowering the childhood obesity rate down to just 5% by 2030.

    One of the most significant and controversial actions the report identified was improving the quality of food served in schools, which included a lobbying effort to update nutritional standards for meals in the National School Lunch and Breakfast programs.

    The effort culminated in 2010 with the passage of the Healthy, Hunger-Free Kids Act, which allowed the U.S. Agriculture Department to set new nutritional standards for all food sold in schools for the first time in more than 30 years. The new requirements called for increased servings of fruits, vegetables and whole grains in meals, as well as decreases in the amount of sodium and sugar and a ban on transfats.

    Other efforts included lobbying for menu labeling requirements that list the amount of calories. Michelle Obama also collaborated with the food and beverage industry to get them to reduce sodium content and to include calorie amounts on the labels of soft drinks.

    “I think it has stimulated a lot of collaborations, initiatives and opportunities that I don't think would have been there if it weren't for the first lady really making the goals of 'Let's Move' a priority,” said Lindsey Mitchell, executive director for the Momentum Center at the University of Michigan's School of Public Health.

    The move to change school lunch nutritional standards sparked a fight between the first lady and school food producers and school cafeteria directors who complained that the new requirements would be too expensive to comply with and that kids would not like the menu changes.

    Others have felt the campaign has not gone far enough to hold food producers more accountable for their role in contributing to an obesity epidemic that has doubled among children and quadrupled among adolescents over the past three decades.

    “I would have to say that it's been an unqualified failure,” Dr. Neal Barnard, founder and president of nutrition advocacy organization Physicians Committee for Responsible Medicine, said of the “Let's Move” campaign. “I would certainly give (Obama) credit for raising the profile of the issue. Where I think they went wrong is that they ended up doing more harm than good by convincing Americans that the causes of it were things that were completely fictional.”

    Barnard felt the campaign has focused too much of its attention toward reducing sugar intake and not enough to limiting consumption of cheese, meat and grains. Others also have pointed out the childhood obesity rate has not gone down since the start of “Let's Move.”

    Nearly 17% of children between the ages of 2 and 19 were obese in 2012, according to a 2014 study by the Centers for Disease Control and Prevention published in JAMA, a rate that has remained relatively unchanged over the past decade.

    Supporters of the first lady's initiative contend it will likely be years before the effects of the campaign will be known. A possible benefit that already may have taken root has been its ability to help ideas—such as calorie counts on menu labels and limiting junk food within schools—gain greater acceptance within the public's consciousness.

    “Ultimately, we need that cultural shift where the expectation of places where kids live, learn, eat and play are healthy environments, so that the expectation is when kids go to school of course what's available is healthy food,” said Jessica Donze Black, director of the Kids' Safe and Healthful Food Project at the Pew Charitable Trusts.

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