It's been more than two years since Michelle Obama launched her Let's Move! campaign to fight childhood obesity, but don't go looking for statistics on how many kids have slimmed down. Contrary to popular belief, the scope of the first lady's efforts has never been about immediate results in pounds and inches lost, or how many pushups the average American middle schooler can execute.
Rather, the initiative is about generational change — designed with the goal that, a decade from now, our nation's children will live in a profoundly different food and physical-fitness culture.
"When we started Let's Move! we wanted to end our epidemic of childhood obesity in a generation," said Mrs. Obama at a Let's Move! event in March before staff at a New Hampshire community center. "So that kids growing up today would develop different habits and they would grow up healthier, and they would grow up with the tools and the information they would need to make good choices. And when we set this goal, we knew it was ambitious."
After pleading her case to the private food sector, elected public officials, school administrators and celebrities, the first lady has seen improvements on several fronts. But how effective are these changes in the long run? The Root asked experts to weigh in on the campaign's most prominent achievements.
Legislating School Lunches
When Michelle Obama launched Let's Move! in February 2010, her first priority was improving school nutrition. After persistent campaigning, six months later that goal gained steam with the passage of the Healthy, Hunger-Free Kids Act (pdf) — legislation that, for the first time in 30 years, increased funding for school breakfasts and lunches above the inflation rate. The act also gave the Agriculture Department the authority to regulate nutrition for all foods regularly sold in schools, from the fare served on lunch lines to that sold in vending machines (but not, as some paranoid naysayers feared, at bake sales).
Those new standards, which will be phased in starting in the 2012-13 school year, include requirements to double the amounts of fruits and vegetables on a weekly basis, switch all grains to whole grains and offer milk in only fat-free or low-fat varieties. And 115,000 more low-income children were enrolled in school meal programs through a provision that reduced paperwork to establish eligibility by using Medicaid data to directly certify participants.
"At the schools I've worked with, people are doing what needs to be done not only because they'll get federal funding in preparing healthier meals but also because it's the right thing to do," Fran Meyer, a consultant for policy and program development in school health programming, told The Root. Meyer also acknowledged that there are funding challenges when the federal government pays, on average, $2.68 per child for each school meal — an amount that increases by 6 cents under the Healthy, Hunger-Free Kids Act. "But our folks are doing the best they can for our kids."
Still, requirements to put more vegetables into school lunches are only as effective as what Congress (and influential food-industry lobbyists, which more than doubled their spending in Washington over the past three years) will allow. And with Congress passing a bill last year keeping french fries on school menus and allowing tomato paste on pizza to count as a vegetable, the degree to which school nutrition will truly improve remains in question.
Bringing Back Gym Class
The first lady rolled several existing federal health programs into the Let's Move! campaign, elevating their visibility and challenging more Americans to get involved. One example is the HealthierUS School Challenge, a voluntary USDA-certification program to recognize schools that meet the highest national standards for nutrition and physical activity.
With only 625 HUSSC schools at the time of Let's Move! launch, the campaign aims to double the number by July 20. Last year's goal was hit ahead of schedule in June, with the addition of 648 schools that stepped up their nutrition and fitness offerings (with some help from the USDA, which began offering monetary incentives for schools that meet the requirements).
Let's Move! also set a benchmark of adding 1,000 more HUSSC schools by this July, an objective that it has already exceeded. To meet the requirement of regular physical activity for children, schools found a range of solutions. Washington, D.C.'s River Terrace Elementary School, for instance, has its students walk on a track for 10 minutes each day and started a school walking club. Chicago Public Schools decided to bring back recess for elementary schools next fall and resume physical education for high school juniors and seniors for the 2013-14 school year.
Brian Smedley, vice president and director of the Health Policy Institute of the Joint Center for Political and Economic Studies, told The Root that the HUSSC award money (pdf), which is available until the funds are depleted, should prove especially helpful for cash-strapped schools forced to let physical activity fall to the wayside.
"There are budget pressures on schools, and the schools whose students could benefit the most are the very ones under the tightest budget pressures," said Smedley. "These kids often face multiple other barriers to the opportunity for good health, often living in neighborhoods with the poorest retail food environment and in communities that are less conducive to exercise and play."
Wal-Mart Taking on Food Deserts
A distinction that sets Let's Move! apart from the campaigns of first ladies past is the large-scale commitments that it has received from the private sector. Take Wal-Mart, the world's largest grocer, which pledged to build 275 to 300 stores in underserved "food deserts," which don't have easy access to fresh and healthy foods, by 2016. The company also agreed to reduce the prices of fresh produce for the 140 million customers who already shop at its stores each week and to reformulate thousands of its private-label processed foods for reduced sodium, sugar and trans fats by 2015.
Several other grocers have made similar Let's Move! commitments to open or expand stores in food deserts, such as Save-a-Lot, SuperValu and Walgreens. But it's the partnership with Wal-Mart, with its nonunion status and reputation for shutting down local businesses, that has drawn the most controversy. Critics allege that the company is less concerned with combating obesity than with building ever more stores.
LaDonna Redmond, senior program associate for the Food and Justice Program at the Institute for Agriculture and Trade Policy, which favors solutions such as local farmers markets and community gardens, didn't mince words in an interview with the Nation: "Wal-Mart is using the term 'food desert' as a Trojan horse to get into our communities and bring about more corporate control of our food system."
Getting Healthier Fare at Red Lobster and Beyond
Another corner of the food sector to heed the first lady's call is the world of chain restaurants, which are changing how they approach their youngest customers. Mrs. Obama met with members of the National Restaurant Association in 2010, pleading with them to provide healthier options. Since last July, 68 restaurant companies — including Burger King, McDonald's, Chili's, Friendly's, Chevys, Outback Steakhouse and IHOP — have started offering healthier kids' options.
Last fall, Darden restaurants — parent company of the Olive Garden, Red Lobster, Bahama Breeze, LongHorn Steakhouse, the Capital Grille and Seasons 52 chains — also committed to doing better nutritionwise. Across its entire restaurant line, the company made a fruit or vegetable the default side dish, and 1 percent milk the default beverage (french fries, soda and other drinks by request only) for all children's meals. Darden also pledged to reduce the calories and sodium in its entire menu by 10 percent over five years, and by 20 percent over a 10-year period.
The promise to adjust its menus at an unspecified date in five and 10 years, however, seems like an awfully long lead time. Meyer suggests that restaurants are trying to balance pressure to change with holding on to the high-calorie fare that's most popular. "I think the food industry's been trying for a while to respond to the advocates who say that this needs to happen," said Meyer, "and yet still keep their profits high."
Putting Food Facts Up Front
Last year the Grocery Manufacturers Association and the Food Marketing Institute, which represent about 70 percent of food and beverage products — launched a new front-of-package nutrition-labeling system. The change, which lists the basics of calories, saturated fat, sodium and sugars per serving, hit the marketplace in late 2011 and will continue to grow through 2012.
Yet while the GMI and FMI insist that they acted in response to the Let's Move! campaign's call to help consumers make healthier choices, the White House distanced itself from the move. In a statement, the Obama administration vaguely echoed the concerns of critics who say that the label's context-free numbers are still confusing, and who suspect that the food industry is trying to bypass the Food and Drug Administration's ongoing work to develop consumer-friendly guidelines for food and beverage labels:
"We regard their commitment to dedicate space, for the first time, to an industry-wide front-of-pack label as a significant first step and look forward to future improvement," said the diplomatic but terse White House statement. "The FDA plans to monitor this initiative closely and will work with experts in the field to evaluate whether the new label is meeting the needs of American consumers and pursue improvements as needed."
Coming to a City Near You?
Environmental factors, such as a lack of parks or other safe recreational facilities where kids can be active, can contribute to childhood obesity. That's why Let's Move! is also working with mayors and local leaders. Nearly 500 communities across America have signed up for the Let's Move Cities and Towns program — a challenge to mayors and elected officials to adopt long-term, sustainable efforts to fight childhood obesity at the community level.
Kansas City, Mo., for example, has adopted new urban gardening programs and policies that encourage children to walk to school, and has undertaken planning efforts to make the city more bicycle-friendly. Meanwhile, Cambridge, Mass., launched a grant program to fund projects that promote healthy eating and physical activity among the city's youths.
"In addition to working with mayors and county officials, Let's Move! has been able to raise awareness of the issue of childhood obesity in Indian country," Dwayne Proctor, senior program officer at the health-oriented Robert Wood Johnson Foundation, told The Root of the campaign's reach. "It has taken a multifaceted approach, where different groups and sectors from all over the country are more aware of the complexities of this issue."
What Lies Ahead
While Mrs. Obama is optimistic about building on the initiative's progress (and waiting for the numerous food companies to fulfill their five- and 10-year commitments), health and nutrition advocates are quizzical about the campaign's apparent standstill when it comes to pursuing new battles around food. For example, Let's Move! has not used its platform to advocate for a plan developed by a federal interagency committee that recommends voluntary standards for food marketed to children — a plan that Congress has delayed for a year. The campaign has likewise kept silent on the FDA's forthcoming final version of rules requiring chain restaurants and other businesses to post calorie counts on menus and signs.
It's a caution that some observers attribute to pushback from food and beverage companies, which the campaign denies. In a recent Reuters special report, Sam Kass, White House associate chef and senior policy adviser on food initiatives, had a sunny outlook on the future of the program: "We are incredibly proud of the commitments that many food companies have made and are continuing to work with others to advocate for even more change to make sure our children are getting the healthy, nutritious food they need."
Cynthia Gordy is The Root's senior political correspondent.