No More Happy Meals in San Francisco

San Francisco's board of supervisors has voted, by a veto-proof margin, to ban most of McDonald's Happy Meals as they are now served in the restaurants.

The measure will make San Francisco the first major city in the country to forbid restaurants from offering a free toy with meals that contain more than set levels of calories, sugar and fat.

The ordinance would also require restaurants to provide fruits and vegetables with all meals for children that come with toys.

"We're part of a movement that is moving forward an agenda of food justice," said Supervisor Eric Mar, who sponsored the measure. "From San Francisco to New York City, the epidemic of childhood obesity in this country is making our kids sick, particularly kids from low income neighborhoods, at an alarming rate. It's a survival issue and a day-to-day issue."

Just after the vote, McDonald's spokeswoman Danya Proud said, "We are extremely disappointed with today's decision. It's not what our customers want, nor is it something they asked for."

The ban, already enacted in a similar measure by Santa Clara County, was opposed by San Francisco Mayor Gavin Newsom, who was vying to be lieutenant governor in Tuesday's election. But because the measure was passed by eight votes — one more than needed to override a veto — his opposition doesn't matter unless one of the supervisors changes his or her mind after the promised veto.

Under the ordinance, scheduled to take effect in December 2011, restaurants may include a toy with a meal if the food and drink combined contain fewer than 600 calories, and if less than 35% of the calories come from fat.
Over the last few weeks, the proposed ban caused a stir online and on cable television, with supporters arguing that it would help protect children from obesity, and opponents seeing it as the latest example of the nanny state gone wild.

Supervisor Bevan Dufty, whose swing vote provided the veto-proof majority, said critics should not dismiss the legislation as a nutty effort by San Franciscans. "I do believe the industry is going to take note of this. I don't care how much they say, 'It's San Francisco, they're wacked out there.' "

Proud, the McDonald's spokeswoman, said the city was out of step with the mainstream on the issue.

"Public opinion continues to be overwhelmingly against this misguided legislation," she said. "Parents tell us it's their right and responsibility — not the government's — to make their own decisions and to choose what's right for their children."

McDonald's is not the only fast-food chain to offer toys with children's meals, but because it is so prominent the company has become a key face of opposition to the ban.

Daniel Conway, spokesman for the California Restaurant Assn., bemoaned the ordinance's passage and contrasted it with San Franciscans' exuberant feelings after the Giants won the world series on Monday night.

"One day you're world champions, and the next day, no toys for you," Conway said.

He said the industry could respond in a number of ways to the ordinance. Some might continue to include toys but charge separately for them. Others might reformulate their meals so that they comply with the law. Restaurants might also simply stop offering children's meals altogether, he said.

Proud said the company does offer more healthful menu options, including apple slices that can be ordered with kids' meals instead of French fries.

The vote was held the same day that McDonald's reintroduced nationwide its McRib sandwich, a pressed pork patty that gets half its calories from fat and has a cult-like legion of fans.

Mar said it would lead the fast-food giant and other restaurants to provide more healthful food for kids. The ban, he said, was crucial to the fight against childhood obesity and the illnesses that go along with it, including diabetes and the risk of heart problems and stroke. The cost of fighting those diseases, he said, will be in the billions.

"It's astronomical how much it's going to cost if we don't address it," Mar said. "It's incredible the crisis that's going to hit us."

Source:sharon.bernstein@latimes.com

Copyright © 2010, Los Angeles Times

What comes first - inactivity or obesity?

New research from the UK suggests that physical inactivity in children is the result of obesity and not the other way around, challenging the popular view that getting overweight children to exercise more is the key to preventing the childhood obesity; the researchers maintain the path to childhood obesity is set very early in life, long before children go to school and is linked to early feeding habits.

While we all know that overweight children tend to do less exercise, this does not necessarily mean, as many of us might assume, that it is inactivity that leads to obesity, it could be the other way around, and Wilkin and colleagues set out to find some evidence for this and ask the "chicken and egg" question: What came first? Does lack of physical activity precede the changes that lead to fatness in children, or does increasing fatness in children precede changes in physical activity?

By examining the data they had collected over 11 years on over 200 children recruited from 40 Plymouth primary schools, they concluded unequivocally that physical activity had no effect on weight change, but weight change led to less physical activity.

For the study, they examined data on 202 children (25 per cent were overweight or obese, and 53 per cent were boys). The main outcome measures were physical activity and percentage body fat, measured every year.

When the researchers analysed the results, they found that:
Percentage body fat was predictive of changes in physical activity over the following three years.

Physical activity was not predictive of subsequent changes in percentage body fat over the same follow-up period.

A 10 per cent higher body fat percentage at age 7 predicted a relative decrease in daily moderate and vigorous intensities of physical activity (4 min from 7 to 10 years of age).

But more physical activity at age 7 did not predict a relative decrease in percentage body fat between 7 and 10 years of age.
The researchers suggested that children who become overweight may lack confidence and feel embarassed about how they look and this stops them taking part in sporting activity and exercise.They also suggested that overweight children might find exercise discomforting, making them feel pain earlier than normal weight children.

Wilkin and colleagues concluded that:

"Physical inactivity [PA] appears to be the result of fatness rather than its cause."

"This reverse causality may explain why attempts to tackle childhood obesity by promoting PA have been largely unsuccessful," they added.

The implications of this study are very important for public health policy, because it implies that the physical activity of children, which is vital for their fitness and general wellbeing, may never improve unless childhood obesity is tackled first.

A press statement from Peninsula Medical School suggests that EarlyBird has already shown that the paths leading to obesity in childhood are set very early in life, long before children go to school, and that in many cases, obese children are often offspring of an obese same sex parent.

The study suggests that calorie reduction, rather than physical activity, appears to the key to weight reduction in overweight and obese children, pointing to early feeding errors, and the contribution of "portion size, calorie-dense snacks and sugary drinks".

Other findings from EarlyBird include:
Many parents of obese children seem unaware and unconcerned.

Children's inactivity is not due to lack of green spaces and sport centres.

Social inequalities are no longer a major factor: all children are at risk.

Healthy weight for life starts at birth (eg do not overfeed low birth weight babies, they are most at risk of later weight gain).

Obese mothers breed obese girls and obese fathers breed obese boys: it may be more effective to target the obese parent than the obese child.

Girls are naturally more insulin resistant than boys, and therefore at greater risk of type 2 diabetes.

Type 1 and Type 2 diabetes are essentially the same disorder of insulin resistance, differing only in rate of progress: keeping weight down should help prevent, or at least delay, the onset of both type 1 and type 2 diabetes.
Perhaps one of the most controversial findings from the overall study is that the average child is no heavier than 25 years ago, suggesting the majority of children have not changed in a generation, that the rise in obesity is confined to a small group, and there may be no widespread childhood obesity epidemic.

Source: Fatness leads to inactivity, but inactivity does not lead to fatness: a longitudinal study in children
B S Metcalf, J Hosking, A N Jeffery, L D Voss, W Henley, T J Wilkin.
Arch Dis Child, Published Online First: 23 June 2010
DOI:10.1136/adc.2009.175927