Remarks as prepared; not a transcript

Testimony
Before the Subcommittee on Competition,
  Infrastructure, and Foreign Commerce
Committee on Commerce, Science, and Transportation
United States Senate

Statement of
Richard H. Carmona, M.D., M.P.H., F.A.C.S.
Surgeon General
U.S. Public Health Service
U.S. Department of Health and Human Services

Good afternoon Mr. Chairman and distinguished members of the Subcommittee. My name is Dr. Richard Carmona, and I am the Surgeon General of the United States.

I want to take this opportunity to thank you for your service to our nation. I've had the honor of working with many of you, and I look forward to strengthening our partnerships to improve the health and well being of all Americans.

Mr. Chairman, thank you for your leadership in children's health and education. As the nation's doctor I thank you for taking steps to combat a growing epidemic in our country: childhood obesity. By calling this hearing you are telling Americans that there is a problem and that we need to work together to solve it.

I am joined by my colleague Dr. William Dietz, Director of the Division of Nutrition and Physical Activity at the Centers for Disease Control and Prevention. Dr. Dietz and I will be available to answer any questions you may have.

President Bush, Secretary Thompson, and I have worked to raise public awareness of the need for a comprehensive recommitment to public health through prevention. The science is conclusive: by taking a few simple steps in our personal lives we can greatly improve our health and our nation's health, both today and in the future.

For example, the findings of the Department of Health and Human Services' Diabetes Prevention Program clinical trial showed that people with pre-diabetes can delay and even prevent Type 2 diabetes by losing just 5 to 7 percent of their body weight through moderate changes in diet and exercise. These lifestyle changes worked for people of every ethnic or racial group who participated in the study. The changes—such as walking for 30 minutes a day five days a week—are simple, and prove that small steps can bring big rewards.

We must increase our efforts to educate and encourage Americans to take responsibility for their own health. Over the past 20 years, the rates of overweight doubled in children and tripled in adolescents. Today nearly two out of every three American adults and 15 percent of American kids are overweight or obese. That's more than 9 million children—one in every seven kids—who are at increased risk of weight-related chronic diseases. These facts are astounding, but they are just the beginning of a chain reaction of dangerous health problems—many of which were once associated only with adults.

Today pediatricians are diagnosing an increasing number of children with Type 2 diabetes—which used to be known as adult-onset diabetes. Research indicates that one-third of all children born in 2000 will develop Type 2 diabetes during their lifetime. Tragically, people with Type 2 diabetes are at increased risk of developing heart disease, stroke, kidney disease, and blindness. These complications are likely to appear much earlier in life for those who develop Type 2 diabetes in childhood or adolescence.

Because of the increasing rates of obesity, unhealthy eating habits, and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents.

And the economic costs of obesity are staggering—second only to the cost of tobacco use. The annual cost of obesity is now estimated at up to $117 billion in direct and indirect costs.

The good news is that there is still time to reverse this dangerous trend in our children's lives. Today I will discuss two key factors to reduce and eliminate obesity in America: increased physical activity and healthier eating habits.

I've traveled the nation talking to students as part of my "50 Schools in 50 States" initiative, and I've seen all kinds of kids. Kids of different races and ethnicities, backgrounds and upbringings. But one thing is constant: too many of them are living unhealthy lifestyles. You can tell just by looking at them. I love seeing their bright smiling faces, full of hope and happiness. But what they don't know about excess weight could end up killing them in a few decades.

We at HHS are taking aggressive measures to educate Americans about healthy living and provide incentives to encourage healthy choices.

• In June 2002 President Bush launched the HealthierUS initiative to help Americans take steps to improve their personal health and fitness by encouraging children and adults to be physically active every day, eat a nutritious diet, get preventive screenings, and make healthy choices.

• In support of the President's initiative, Secretary Thompson launched a bold initiative called Steps to a HealthierUS. This program focuses attention on the importance of prevention.

• In 2003 the HHS Steps to a HealthierUS Community Program awarded $13.7 million to 23 communities to implement action plans. These community initiatives include walking programs, smoking cessation programs, and increasing healthy foods in schools. The number of applications for the 2003 funding far exceeded what we were able to award. Secretary Thompson and I thank you for increasing the Steps to a HealthierUS funding to $44 million in 2004, and ask you to support the President and Secretary's request that Congress increase the funding for this program to $125 million in 2005.

• Last year Secretary Thompson initiated a challenge to HHS employees to be physically active for 30 minutes a day, five times a week. Many Governors are issuing similar challenges in their states. Many Americans are using the President's Council on Physical Fitness and Sports web site to track their physical activity. These challenges raise health awareness and teach individuals to be responsible for their own health.

• HHS and USDA are revising the Dietary Guidelines for Americans. The Guidelines give advice on food choices, based on recommendations of a panel of health and nutrition experts, and serve as the basis for the U.S. Government's nutrition policy. The revised Dietary Guidelines will be released in 2005, and a new Food Guide Pyramid will be released shortly thereafter.

• HHS is also partnering with private-sector groups such as the Girl Scouts and Boys and Girls Clubs to make the best use of resources for targeted prevention-related initiatives.

• In addition, HHS is developing a national action plan on diabetes. The plan will promote better coordination of HHS efforts in diabetes research, detection, prevention, and treatment, and explore ways to promote similar activities in the private sector.

• In April 2003, NIH Director Elias Zerhouni established the NIH Obesity Research Task Force to develop a strategic plan for obesity research. The plan will be released soon, and will put forth a research agenda for addressing obesity.

• Also in 2003, FDA Commissioner Mark McClellan formed the HHS FDA Obesity Working Group. He charged the group with preparing an action plan to address the obesity problem. That plan will also be released this spring.

• Finally, the CDC remains at the forefront of collecting data on prevalence and trends for obesity and overweight individuals in the United States and in developing tools to improve nutrition and physical activity and prevent chronic disease, including in children.

In addition to these HHS initiatives and activities, it is very important for parents to take responsibility. We must teach our children to enjoy healthy foods in healthy portions and encourage them to be physically active for at least 60 minutes a day. The average American child spends more than four hours a day looking at some kind of screen. Parents, make the healthy choices: turn off the TV and the video games, go outside with your kids, play ball, go for a walk. Talk with your kids, spend quality time with them, and when you're together as a family, do something active.

Kids don't automatically know how important it is to be physically active for an hour a day. They don't all know that they need five to nine servings of fruits and vegetables a day. That concept is part of what I'm talking about with Americans of all ages: increasing our health literacy.

Health literacy is the ability to access, understand, and use health-related information and services to make appropriate health decisions. We must close the gap between what health professionals know and what parents and children understand about physical activity and healthy eating.

Every morning people wake up and, while they're sitting at the kitchen table, they read the newspaper and the cereal box. Throughout the day they read the nutritional information on their meals and on their snacks. But do they really understand the information they're reading? Can parents explain it to their children, who see tantalizing "kid food" products that they don't know are loaded with sugar and fat?

To make healthy choices, parents and children need easy-to-understand information that fits into their busy lifestyles. Many people, even educated Americans, don't know what a calorie is, or how to burn it. It's our job to make that kind of health information meaningful and helpful. For example, Secretary Thompson recently announced that food labels will list trans fat content. This will give American families information to make smart choices to lower their intake of these unhealthy fats.

I ask you to work with the President, the Secretary, and me, as well as every mom and dad in America, to promote healthy living, improve health literacy, and encourage healthier lifestyles so that we can end our nation's obesity problem before it has a chance to reach into another generation of Americans. Working together, industry, government, and individuals can achieve these goals.

Industry can help by providing healthier choices for customers and including better information about its products. Secretary Thompson is working with industry to assure that healthy choices are developed and made available to all Americans.

Scientific leaders in government and the private sector need to make sure that people have accurate, science-based information about the factors that contribute to overweight and obesity. This testimony has outlined for you HHS' efforts to combat the obesity epidemic.

Most importantly, parents need to be good role models by being physically active and by encouraging their children to exercise and make healthy choices about what they eat and how much they eat.

Thank you. I'll be happy to respond any questions you may have.

Last revised: January 8, 2007