Cradle-to-grave customers

I wasn’t going to even comment on this news item because Junkfood Science readers have become quite familiar with the goings-on of the Robert Wood Johnson Foundation** but because of the evidence, I just have to....

This week, the news has been saturated with reports of the announcement made by RWJF President Risa Lavizzo-Mourey, M.D., M.B.A., that the Foundation was committing another $500 million over the next five years “to reverse the epidemic of childhood obesity in the United States by 2015.” She said that the “prevalence of childhood obesity is excessive and rapidly escalating, with severe clinical consequences... Past efforts have been too small and fragmented.”

“Missing is a sense of national urgency to act and the resources to help communities, states and the nation coordinate efforts, advocate for change and evaluate impact,” she said.

Has new evidence to support any of their initiatives suddenly surfaced? The Foundation’s 2006 Annual Report reveals they essentially have no evidence but will know it when they see it:

Our approach is direct, practical and strong:

* First, make the case...for the problem, what works to roll it back and what doesn't....

* Second, test and retest the best approaches, then widely install the most promising models as a firewall against the epidemic's further spread...

* Third, educate and motivate our leaders and invest in advocacy to foster change.

And build a resource base big enough to match the enormity of the problem. How will we know it is working? We'll know when the evidence tells us so.

Next to adequate and sustained funding for programs that work, it is evidence we need more than anything else, evidence that establishes:

* How to get kids to eat well and physically move more;

* What school and family actions work best;

* That industry's interest in healthier lifestyles and eating habits is sincere and produces innovations that work; and

* That government “gets it,” with realistic and responsive policies and budgets.

Like all childhood obesity initiatives, they work from the assumption that children are fat because they eat too much, especially bad foods, and don’t get enough exercise. In interviews this week, Dr. Lavizzo-Mourey talked repeatedly of an “energy gap,” saying that for at least 30 years American’s have been taking in “enormously more energy than we burn.”

Which brings us to the evidence for this claim. A December, 4, 2006 press release, available on their website, explains. The source is found in their Research Highlights paper: “‘Energy Gap’ contributes to adolescent obesity.”

It states that the key findings of a study, which they funded, were:

U.S. children and adolescents overall experienced an energy gap of roughly 110-165 calories per day over 10 years, on average. This gap led to an excess 10 pounds of body weight for all adolescents, or one pound per year, on average.

The study specifically notes that it is referring to kilocalories and that 3,500 kcal = 1 pound and that this energy gap is beyond that needed for normal growth and development.

Do they actually believe consumers and healthcare professionals are too stupid to do the math and that people have no common sense at all? If children and teens were eating an excess of 110-165 calories a day for 10 years beyond what is needed for growth, that would mean the average kid would weigh 114.7 to 172 pounds too much!

[110kcal x 365 days = 40,150kcal. Divided by 3,500kcal = 11.47 pounds/year. Times 10 years = 114.7 pounds.]

Their next finding:

U.S. overweight adolescents have consumed an average of 700 to 1,000 more calories a day than required for normal growth, physical activity and body function. Over a 10-year period, this energy gap produced an average of 58 extra pounds beyond the weight gain that would be associated with normal growth, or, on average, an extra 6 pounds per year.

Now here is where things get just plain silly. An excess of 700-1000 calories a day for 10 years would mean, according to their own math [3,500 kcal=1 pound], the average teenager would have packed on an additional 730 pounds to 1,042.85 pounds!

And these are the folks leading the nation’s war on childhood obesity.

** For new readers: For those new to this blog who haven’t had a chance to catch up with the archives, Robert Wood Johnson Foundation is the country’s largest foundation exclusively funding healthcare initiatives, with assets of $8.99 billion (2004). It was established in 1972 by the President and Chairman of the Board of Johnson & Johnson, one of the world’s largest healthcare products companies, offering drugs for obesity, blood pressure, cholesterol, cancer, etc. and medical and diagnostic supplies. More than 60% of RWJF assets are in J&J stock which, according to its 2006 annual report, had worldwide sales of $53.324 billion. It named obesity its priority of the decade and has been granting massive amounts of money towards efforts to get obesity declared a disease, mandate government coverage for obesity treatments, and legislate government and employer obesity initiatives. It has a much bigger agenda but for today’s discussion, we’ll focus on this one, with a few examples.

· It gave the American Medical Association more than $50 million in 2003 to create clinical practice guidelines, “Assessment and Management of Adult Obesity: A Primer for Physicians,” written in collaboration with the Dept. of Health and Human Services to support the government’s Healthy People 2010, Steps to a Healthier US and other anti-obesity initiatives.

· It funds NCQA, which establishes the screening and treatment standards and performance measures used by health insurers.

· And it funded the National Business Group on Healths’ “Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage,” with guidelines for employer “wellness” programs.

· Childhood obesity has been its particular focus and its alliances are extensive. RWJF commissioned and funded the 2004 Institute of Medicine report, “Preventing Childhood Obesity: Health in the Balance” and has funded countless childhood obesity initiatives over the past few years to the tune of $80 million.

· For instance, former Arkansas Gov. Mike Huckabee’s statewide program was a recipient, reviewed here.

· And RWJF granted $8 million last year to fund former President Bill Clinton’s Alliance’s Healthy Schools Program, reviewed here.