Obesity rates have reached epidemic proportions in the United States and in my home state of California. The ACC’s Governor of Northern California William Bommer, MD, FACC, co-authored a study that was recently published in the American Heart Journal. The study evaluated serial changes in obesity and fitness in California school children following implementation of prevention measures in all California public schools and found that following these measures has stabilized or improved obesity and fitness levels in 5th through 9th grade students. This is an important study as we all look for ways to improve the heart health of children and adults.

Dr. Bommer describes his study for ACC in Touch blog readers below:

It’s easy to give advice on losing excess weight, “Just eat less and exercise more.” It works on TV, where contestants often lose 100 pounds. However it’s very hard in the real world to follow that advice and lose weight and keep it off for ourselves, our patients and our community. Thus, the prevalence of obesity in many countries has been increasing for the last four decades. Since childhood obesity leads to adult obesity and both carry a significant risk for cardiovascular and other major diseases, it behooves us to develop effective programs to prevent these increases in obesity.

How do we do this? Multiple programs and trials have attempted to prevent obesity. A 2009 Cochrane review identified and screened 14,000 publications and selected 29 papers on interventions for preventing obesity in children. Although the evidence showed that prior diet and exercise programs had been effective in promoting healthy diets and increased physical activity levels, they were not effective in preventing weight gain and obesity.

This obesity problem was recently addressed in California with a more comprehensive diet, exercise, and education program mandated for all school children. At the request of the California Department of Education, ACC member Barry Coughlin, MD, FACC, chaired a Task Force to study and develop an obesity prevention program for all California school children. A comprehensive set of recommendations were made and incorporated into school policy and procedures.

The program was unique in that it made major changes at every school facility and followed the progress with extensive testing in all 6.3 million students.

Our recent analysis of the test results revealed that obesity rates no longer increased in students once they entered into testing at 5th, 7th, and 9th grades. In fact, physical fitness metrics actually improved while body composition remained stable. For once, obesity within the school classes was no longer increasing. This is a big step but there is still more work that needs to be done.

Despite controlling obesity within the school classes, we found that new students entering school testing each year continued to show increasing obesity. Therefore we need to also focus our efforts on preventing obesity in preschool and early primary years. Since preschool years, are outside of the Public School jurisdiction, we will have to focus on community programs for families, day care centers, and preschools to reduce obesity in these younger children.

Early, comprehensive, prevention programs can be effective. Once children or adults are obese, it is still very hard to get long-term weight reduction. Further research on afterschool programs, diet modified gut flora, and novel pharmaceuticals may offer promise. But until then, early and effective prevention is our best medicine.

The ACC at the national level is working to combat obesity, and has partnered with the Obesity Action Coalition (OAC) and 45+ other organizations in a nationwide effort to encourage individuals to contact their legislators and raise awareness of obesity as a serious medical condition.

This topic is also timely as the CDC is currently holding a “Weight of the Nation” Conference and next week a HBO Documentary series, The Weight of the Nation, on May 14 and 15 will feature the Institute of Medicine's extensive work on obesity. The four documentary films examine pressing issues of obesity as they relate to children, communities, policies and systemic challenges.  Click here to find a viewing party near you and learn about what’s driving the nationwide obesity epidemic.

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