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Lester M. Crawford, D.V.M., Ph.D. - FTC/DHHS Conference

This text contains Dr. Crawford's prepared remarks. It should be used with the understanding that some material may have been added or deleted during actual delivery.

Speech before
FTC/DHHS Conference on
Marketing, Self-Regulation and Childhood Obesity

Remarks by
Lester M. Crawford, D.V.M., Ph.D.
Acting Commissioner of Food and Drugs


July 14, 2005

Good morning and thank you Lesley (Lesley Fair, Esq. Senior Attorney, Federal Trade Commission [FTC]) for your kind introduction.

I’m pleased to be here this morning and to once again share the podium with my friend and colleague, FTC Chair Deborah Majoras, to open what I am sure will be a very productive two days of dialogue about ways we can all work together to improve the health and well-being of our children. I would also like to thank FTC on behalf of Secretary Leavitt and the Department of Health and Human Services (DHHS) for convening this conference.

Chairman Majoras has outlined the presentations and discussions you will be participating in over the next two days, and I want to assure you that the prevention of childhood obesity is also one of the highest priorities for Secretary Leavitt and DHHS.

Within the Secretary’s Office and the various Operating Divisions of DHHS, we are working to engage all stakeholders in constructive partnerships to address this multi-faceted public health problem. As Chairman Majoras mentioned a moment ago, you will hear from Dr. Bill Dietz of the Centers for Disease Control (CDC) about the health risks of childhood obesity and the many factors related to childhood obesity. It is a complex problem that will not disappear quickly, but it behooves all of us here today to put our best efforts into halting and reversing the trends of obesity, particularly in our children.

In 1960, only 4% of children were obese. Today, that number has quadrupled. 16 percent of American children are overweight or obese - that's 9 million children who are developing risk factors for chronic illnesses that may reduce the length and quality of their lives. Childhood obesity significantly increases the chances of developing high cholesterol, hypertension, and Type 2 diabetes. In fact, Type 2 diabetes is rapidly becoming a disease of children and adolescents.

In case reports limited to the 1990s, Type 2 diabetes accounted for 8 to 45 percent of all new cases of pediatric diabetes – in contrast with fewer than 4 percent before the 1990s. Left unchecked, diabetes leads to serious illness and possible death.

Furthermore, overweight adolescents are 70% more likely to become overweight adults, and this tendency rises to 80% if their parents are also overweight. Obesity in adulthood greatly increases the risks of developing heart disease, diabetes, hypertension, arthritis, depression, and some types of cancer. The total medical cost of obesity in children and adults in the United States is well over $100 billion a year. Imagine the increase in the cost of obesity ten years from now if current trends continue

Both FTC and DHHS believe the food, beverage, and media advertising industry can work together to help children and their parents make healthier dietary choices. There are many factors that contribute to childhood obesity. But they can basically be narrowed down to eating too much and moving too little.

DHHS Initiatives
The good news is that this health crisis is almost entirely preventable through proper diet and exercise, and I want to highlight just a few of the major initiatives currently underway at DHHS to get this message out to our communities.

In January of this year, DHHS in conjunction with USDA released the sixth edition of the Dietary Guidelines for Americans. The newly updated Guidelines emphasize balancing caloric consumption with physical activity.

The Surgeon General has issued a ‘Call to Action’ to parents to help prevent and decrease overweight in children and adolescents by providing a variety of suggestions on specific ways parents can help their children to increase physical activity and choose healthy diets.

The Steps to a HealthierUS initiative provides grant funds to states, cities, and other local agencies to implement innovative, community-based programs to prevent chronic diseases such as obesity, diabetes, and asthma.

On June 1 st Secretary Leavitt announced the launch of “We Can!”, a national education program from the National Institutes of Health to help prevent overweight and obesity among youth ages 8-13. We Can! provides resources and community-based programs for parents, caregivers, and youth that focus on behaviors to encourage healthy eating, increase physical activity, and reduce sedentary time.

FDA Initiatives
I want to take just a few minutes this morning to also highlight some of the activities that my own Agency, the Food and Drug Administration (FDA), has initiated to engage the food and beverage industry to address this problem in areas that fall within the Agency’s purview.

FDA released a report from its Obesity Working Group in March of 2004, entitled “Calories Count”. This report made a number of recommendations, many of which we have already implemented.

Food Labels
The report recommended that FDA evaluate how the Nutrition Facts panel (NFP) can be revised to aid the food and beverage industry in highlighting the critical role calories play in consumers’ diets. The goal in modifying the food label is to arm consumers with more of the information they need to make sound food choices.

FDA published in the Federal Register two advance notices of proposed rulemaking (ANPRMs) in April 2005. One notice was to seek comment on how to give more prominence to calories on the food label. Some ideas include increasing the font size for calories on the label, adding a percent “Daily Value” column for calories on the Nutrition Facts panel and possibly eliminating the column listing calories from fat.

The other ANPRM asked for comment on issues regarding the labeling of serving size on food packages. Suggestions include requiring dual column nutrition labeling for multiple serving packages that could reasonably be consumed as a single serving or simply requiring such packages to be labeled as single servings. Since serving sizes are based on reference amounts commonly consumed (RACCs) that were established in the early 1990s, FDA also asked for comments on which, if any, RACCs for particular food categories have changed the most over the past decade and therefore may require updating.

FDA has strongly encouraged food manufacturers to take advantage of existing flexibility in the serving size regulations to label as single servings those packages where the entire contents can reasonably be consumed in one eating occasion. We also strongly encourage industry to use dietary guidance messages on your food labels, particularly on “reduced/low calorie” foods, and to use appropriate comparative labeling statements to provide consumers with information on healthy substitutions. Some manufacturers have already started to make voluntary label changes, and we hope this becomes more widespread throughout the food and beverage industry.

In fact, Kraft Foods announced last year that beginning in October 2004 they would provide both single serving and entire package nutrition labeling for their snack items containing up to four servings per package. The Coca Cola Company also plans to provide dual column labeling for their 20 oz. sodas to display information for both the 8 oz. serving and the full 20 oz. container.

FDA recognizes that education is an essential component of efforts to address obesity, and we are focusing our education strategies to impart knowledge and influence behavior, in the context of healthy eating choices for consumers. We are focusing our education efforts to youth-oriented organizations – through collaborations with various private and public sector groups.

In October of 2004, the Department signed a Memorandum of Understanding with the Girl Scouts of America, and the Secretary has asked FDA to take the lead on this partnership. Our Center for Food Safety and Applied Nutrition (CFSAN) is currently working with the GSA on a “Healthy Living” Initiative.

Our Florida District Office is involved in a Seminole County (FL) Healthy Kids Partnership to promote positive opportunities for school-aged children in Seminole County to learn healthy nutrition and the value of increased physical activity via Boys and Girls Clubs.

In addition to these educational initiatives, CFSAN has recently revised its web site to provide more information to consumers on using the food label, including the Nutrition Facts Panel (NFP), to make more healthful food choices. FDA has posted a “Power of Choice” link on the CFSAN website. This is a joint USDA-FDA educational program designed to guide young adolescents to a healthier lifestyle.

Foods Eaten Away from Home
American consumers now spend approximately 46 percent of their total food budget on food consumed outside of the home, and these foods account for a significant portion of total calories consumed.

FDA has urged the restaurant industry to launch a nation-wide, voluntary, point-of-sale nutrition information campaign for customers, to include information on calories. As a companion to this effort, FDA continues to encourage consumers to routinely request nutrition information when eating out.

FDA is working with the Keystone Center on a national policy dialogue to seek consensus-based solutions to specific aspects of the obesity problem involving foods consumed away from home. One of the goals of this dialogue is to develop a series of options for providing voluntary, simple, and understandable nutrition information at the point-of-sale to consumers in restaurants.

Keystone held the first of several Forums on April 26-27 in Washington. The focus of this Forum was on Away-from-Home Foods and the opportunities that exist in that venue for preventing weight gain and obesity.

We had excellent attendance at this forum, with representatives from the food industry, academia, consumer groups and other federal agencies. Some of the issues that were explored included:


  • Market trends, consumer demands, and changes in eating out over time
  • Nutritional similarities and differences of at-home versus away-from-home foods
  • Effects of food composition on energy intake
  • Effects of food composition on cost and consumer choice
  • Industry experiences on changing the energy and nutrient density of a menu or products
  • Lessons that could be applied to future product formulation, pricing approaches, and portion size decisions
  • Policies, incentives and other actions that could have a positive effect on future product formulations

Obesity Working Group 2
Following release of the “Calories Count” report, and FDA’s endorsement of its recommendations, it became important to keep obesity prevention efforts in the forefront of FDA’s many critical initiatives. FDA convened a follow-on Obesity Working Group (OWG2) in August of 2004 to continue the Agency’s focus on obesity efforts and ensure that activities related to the implementation of the “Calories Count” recommendations are being addressed in a timely and coordinated fashion.

Although responsibility for many of the recommendations rests with CFSAN, several recommendations and activities involve multiple FDA Centers (e.g., therapeutics recommendations, stakeholder involvement, partnership activities, and activities surrounding the National policy dialogue efforts underway with the Keystone Center). The committee has met formally twice and receives regular updates on the status of the implementation of the report recommendations.

In closing, let me remind you that personal choices affect overall health, and our health is under our control. For children, their choices are influenced by examples they see every day—from parents to peers to celebrity icons. Parents have a duty to make judicious and wise decisions about their children’s education, entertainment, eating, and exercise. In making these decisions, parents should consider the types of food and exercise messages their children receive.

However, parents are not the only ones who must take responsibility for ensuring that children receive positive messages about their health. Everyone who is involved in communication to children—from schools to entertainment companies to food companies and government agencies—should send healthy messages to children about the importance of nutrition and physical activity.

We at DHHS and FDA are striving to encourage all Americans, not just children, to get up and move. We have created public education and advertising campaigns that run on TV, radio, the Internet, and billboards, in English and in Spanish. We have also met with different food and beverage companies to encourage self-regulation towards marketing to children, and they have already taken steps to ensure that the messages that they direct towards children are healthy.

For example, Kraft Foods has eliminated in-school marketing, improved single-serve labeling and enhanced the nutritional profile of its products. The Coca-Cola Company has also made strides in providing consumers with more beverage choices, reducing calories, and adding nutritional benefits. Pepsi is producing its Frito Lay salty snack foods with non-hydrogenated oils – to eliminate the health risks of trans fat.

Decisions like these don’t force people to lead healthy lives, but they make it easier. When we grow old and look back over our lives, we will find a few key decisions that made a big difference. Where we lived, who we married, how much we saved for retirement, who our friends were. But we’ll also find that many of our routine daily choices made a big difference, too, because they have a cumulative effect. Our daily habits affect our energy, our health, and our longevity.

That’s why we want every organization of every size to encourage healthy habits. We have a responsibility to American consumers to send positive messages, ones that will better their lives, not promote risky behavior. Today’s event is a great way to exchange ideas, and I hope you will use this time to brainstorm practical solutions for childhood obesity.

Thank you.