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    The IOM Obesity Plan

    On the face of it, the IOM plan is simple. There are five main goals:

    1. Make physical activity an integral and routine part of life.
    2. Create food and beverage environments that ensure that healthy food and beverage options are the routine, easy choice.
    3. Transform messages about physical activity and nutrition.
    4. Expand the roles of health care providers, insurers, and employers.
    5. Make schools a national focal point.

    As usual, the devil is in the details. For each of these broad goals there are distinct proposals. And as committee members made clear, it's an integrated plan. It won't work if policy makers act only on one part and not on others.

    Making Americans more physically active includes:

    • Improving communities to create access to places and programs where people can be active in safe, fun ways.
    • Ongoing, high-visibility programs to promote physical activity.
    • Requiring child-care providers to offer 30 minutes of physical activity for each half day of care.

    Creating healthy food and beverage environments includes:

    • Ensuring that chain restaurants decrease offerings of calorie-dense foods to children and increase healthy options at competitive prices.
    • Setting nutritional standards for all foods and beverages sold or provided by the government, and ensuring "that these healthy options are available in all places frequented by the public."
    • In low-income communities, limiting the concentration of fast-food restaurants and convenience stores, and encouraging or attracting supermarkets and other healthy-food outlets.
    • The president should create a task force to review agricultural policies, including farm subsidies.

    Transforming messages about physical activity and nutrition includes:

    • Federal funding of a sustained program of "culturally appropriate messages aimed at specific audiences." The messages would urge things like taking a daily walk, drinking fewer sugar-sweetened beverages, and learning how to read the new front-of-package nutrition labels.
    • An "or else" threat to the food, beverage, restaurant, and media industries: They must "take broad, common, and urgent voluntary action to make substantial improvements in their marketing aimed directly at children" and teens. If a "substantial majority" of these "marketing standards" have not been met within two years, government should set "mandatory nutritional standards for marketing" to this age group.
    • A single standard nutritional labeling system for all packages and store shelves. Chain restaurants must provide calorie labeling on menus.

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