Doing our best to save children

Why has Save the Children departed from its mission — to prevent hunger and malnutrition, supply emergency relief, and provide prenatal care and immunizations to save millions of infants and children in poverty-ridden areas — and now lobbying for childhood obesity legislation?

Save the Children has historically advocated for the most vulnerable around the world, namely young children and mothers.

It offers food aid and emergency relief, and supports efforts to improve agricultural production, to prevent hunger and malnutrition. Its school health and nutrition programs have recognized that children in developing countries are intensely suffering from worm infestation and nutritional deficiencies, such as iron, iodine and vitamin A, that stunt their growth throughout their school years, reduce their ability to learn and handicap their futures.

Malaria in some developing countries, alone, accounts for up to 20% of child mortality. With a child dying every 3 seconds in the developing world, mostly from preventable and treatable illnesses such as pneumonia, diarrhea, malaria, measles and complications of childbirth, its Survive to 5 program is committed to saving the lives of babies and children by providing basic healthcare.

Each year, nearly 4 million newborn babies needlessly die around the world. As Save the Children has reported, infections, asphyxia and preterm births lead to 85% of newborn deaths, three out of four babies die the first week of life, and most of these newborn deaths occur in poor, remote communities around the globe. Its Saving Newborn Lives health programs were established to try and avert this alarmingly high rate of deaths.

As Save the Children has said, less than $1 per capita each year could provide essential care to 90% of the babies and mothers in high-mortality countries, such as prenatal care (immunizations, management of complications and infections, and nourishing food), childbirth care (to ensure clean deliveries and skilled birth attendees and newborn resuscitation), and postnatal care (nutrition, treatment and prevention of infections, warmth and shelter, and special care for small babies). Essential...life saving.

For more than 75 years, Save the Children has responded quickly to emergencies and disasters around the world that put the survival, protection and well-being of significant numbers of children at risk, including providing urgently needed safe drinking water, shelter and life-saving resources. They are currently appealing for donations to help children affected by the deadly earthquake in China, cyclone Nargis Myanmar, tropical storm Alma, children vulnerable in war-torn Iraq and the violence in West Darfur and those caught in the global food crisis.

So, it was disturbing to hear that this week it is sponsoring a panel to brief legislators on the “growing U.S. childhood obesity epidemic” and to lobby for H.R. 2677, the Improved Nutrition and Physical Activity (IMPACT) Act. This legislation would establish a “reliable funding stream for U.S. childhood obesity prevention that encourages community partnerships.” Specifically, this legislation provides $10 million for 2008, and to be renewed with as much sums as needed for every year through 2012, to add obesity to the list of priority conditions for Title VII training of health professionals and provide training grants to identify, treat and prevent obesity. It mandates another $60 million for 2008, plus as many sums as needed through 2012, for grants to promote environmental initiatives for physical activity and healthy eating behaviors coordinated with existing federal programs; and to enact school-based initiatives such as ‘healthy lifestyle’ educational curricula and intervention programs. The IMPACT Act also gives the CDC authority to collect data on fitness levels and energy expenditure on the nation’s children and for a “National Campaign to Change Children’s Health Behavior and Reduce Obesity.”

That’s about $350 million over the next five years that could go a long way towards providing essential care to poor mothers and babies, dying from preventable infections, lack of medical care and starvation.

Instead, those potential resources will be diverted to address a nonexistent growing epidemic of childhood obesity in the U.S. and support programs that have no evidence of effectiveness (in fact, have proven failures) in helping children, reducing obesity or bettering their lives and futures.

More unsettling, why are our donations to Save the Children going towards helping to support childhood obesity initiatives of Robert Wood Johnson Foundation?

Behind the scenes and disclosures

This week’s Save the Children’s panel will be moderated by Susan Blumenthal, the former Assistant Surgeon General and chair person of Save the Children’s CHANGE National Advisory Council. The other panelists include Eduardo J. Sanchez, chief medical officer and Vice President of Blue Cross Blue Shield of Texas; and Christina Economos, the New Balance Chair in child nutrition at Tufts University's Friedman School of Nutrition Science and Policy.

Save the Children’s CHANGE (Creating Healthy, Active, and Nurturing Growing-up Environments) program was created in 2005 to support initiatives to increase physical activity and “healthy” snacks among rural children to address childhood obesity. The food standards it advocates are those “developed by the Institute of Medicine and the Alliance for a Healthier Generation,” which say that healthy snacks (including both a food and a beverage) should be limited to 150-200 calories and be high in fiber and low in total fat, saturated and transfat, added sugars, salt and caffeine. Partners are to encourage fruits, vegetables, wholegrains and nonfat-lowfat dairy, with bottled water as the preferred beverage.

The Institute of Medicine’s committee on childhood obesity was established and funded by Robert Wood Johnson Foundation with a $5.7 million grant in 2007 alone. And the Alliance for a Healthier Generation’s Healthy Schools Program, under the American Heart Association, was established and funded by RWJF with an $8 million grant in 2006 and another $19.98 million in 2007 to expand it.

You’ll also note among just the 2007 RWJF grants to promote its childhood obesity initiatives, $1.55 million for communications “to produce high-quality, consistent, timely products and messages that increase impact,” with an additional $21,750 (ID 61839) just for town hall meeting signage and $34,200 (ID 63031) for building online community support. To advance public policies to support its healthy eating and active living initiatives to prevent childhood obesity, the 2007 RWJF grants, alone, included $5.2 million towards efforts directed at elected and appointed officials, with an additional $711,144 (ID 62546) to governors’, and $3.32 million (ID 61206) for “empowering advocates, decision-makers and communities.” Similar numbers appear among the 2006 childhood obesity grants.

In 2007-2009, Save the Children partnered with Tufts University’s Friedman School of Nutrition Science and Policy to “design, implement, and evaluate the first large-scale childhood obesity prevention intervention in rural America.” The CHANGE program adopts Tuft’s Shape Up Somerville program and expands it across the country. JFS readers will remember that this 3-year intervention in Somerville applied every conceivable popular program to change an “obesogenic” environment and reduce childhood obesity through increased physical activity and healthy eating behaviors. Shape Up Somerville, described in depth here, included intense school-based programs to increase fruits and vegetable consumption, restrict sweets and unhealthy foods; implemented mandatory health curriculums focused on healthy eating , exercise and decreasing screen time; began an intense after-school curriculum to promote exercise, organic farming, and healthy cooking; and worked through community coalitions to focus community events and community designs on increasing activity and healthy eating; approved restaurants and menus that met its criteria for low-fat, small portions, fruits and vegetables, signs to label “healthier options,” and measured BMIs in school and trained local school personnel to identify fat children and counsel families of fat kids. Whether any objective medical professional would call the program’s results effect or beneficial, however, is extremely doubtful.

Tuft's Shape Up Somerville was developed in partnership with RWJF and its Active Living initiative, receiving grants of $205,474 (ID 59453) and $61,616 (ID 59458) in 2006 alone. This year, Tuft’s Children in Balance is expanding its Shape Up program and replicating it in more cities, with additional funding from RWJ. New Balance Shoes, Inc. has also provided a ten-year $5 million grant to Tufts University Friedman School of Nutrition Science and Policy to enable it to continue and expand its Children in Balance childhood obesity programs, which includes Shape Up Somerville. RWJF and New Balance also sponsored the Time [Magazine]/ABC News Summit on Obesity in Williamsburg, Virginia, in 2005 to bring national attention to obesity as a public health crisis.

So, this week, Save the Children panelists say they will “define the magnitude and extent of the U.S. childhood obesity problem.” Their program will discuss H.R. 2677, the IMPACT Act. Will legislators and the public hear that CDC’s National Center for Health Statistics has reported no increase in childhood obesity rates for nearly a decade, since the definition change, or that children are no less physically active and fit today than in past generations? Will they hear that all of the childhood obesity interventions have no supportive evidence and aren’t recommended by expert reviews, even the U.S. Preventive Services Task Force after it examined 40 years of evidence and 6,900 studies and abstracts? Will they learn that the Dept. of Health and Human Services report, Health United States 2007, found no medical evidence of a crisis of childhood obesity and that today’s young people are actually healthier and expected to live longer than at any other time in our history?

Will legislators consider how the $350 million of taxpayer moneys that the IMPACT Act will spend could, instead, provide essential care to millions of poor mothers and babies dying from preventable infections, lack of medical care and starvation? Or is this really about saving the lives of children?

© 2008 Sandy Szwarc