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Acid Reflux causes and Treatment

Battling the Childhood Obesity Epidemic

Battling the Childhood Obesity Epidemic

Thank you so much. Thank you, Ms. Weymouth, for your hospitality, and thank you all for
coming. This is our cover subject. We tried to make the picture a little bigger. First Lady:
I know, right. (laughter) Newsweek:
But I will say Newsweek has been publishing for 77 years, and I believe this is the first
time within six weeks or so we’ve had both a husband and a wife write the cover story.
So — (laughter) — I know you’ll — First Lady:
So whose was better, though? (laughter) That’s ultimately how spouses operate, right? (laughter) Newsweek:
That’s a very good point, that’s a very good point. So with all this “first” stuff
and living in the White House, forget it. It’s the Newsweek — First Lady:
This is the one. Newsweek:
It’s the Newsweek cover. First Lady:
I agree. Newsweek:
Why this issue? Why childhood obesity, of all the things you could have picked? First Lady:
Well, first of all I think it’s absolutely relevant right now. The statistics are clear,
you know. We’re seeing rates of childhood obesity go up like never before. And I think
the country is also at a point where we’re ready. And I think that’s one of the reasons
why the “Let’s Move” initiative has been so well received by so many industries
and parents and teachers, is because I think we know there’s a problem, and we’re going
to have to come together to solve it. Now, personally, the issue for me is a personal
one. I’ve spoken about this often, how in my busy lifestyle, before coming into the
White House, I was living like most busy mothers — a husband traveled a lot, I had a full-time
job, I bought for convenience and cost. And I saw some changes — or my pediatrician saw
some changes in my children’s diet that caused him to say, “Hold on.” And I think
I was like most mothers — I thought I was doing absolutely everything that I was supposed
to be doing. And to me my kids looked fine. They were perfectly — hey, you know, they’re
my kids, they’re gorgeous. But I made some changes. And they were very simple changes
in our lifestyle, but it made significant differences — made a significant difference
in how the kids felt, how we felt as a family. And I started thinking, well, if I didn’t
know these things — and I’m educated, have resources, I have the support that I need
— what are other families doing? How are other mothers, people who live in communities
that don’t have grocery stores — how are they making these decisions? How are we teaching
kids how to eat? What’s happened to our habits? So even before coming to the White
House, this issue moved me in a way that made me think we need to explore this a little
bit more. And then we planted this beautiful garden, 1,100 square feet of pure joy. And
that gave us an opportunity in a very sort of non-confrontational way to begin exploring
the questions of how do kids respond to nutritious food and vegetables if they’re part of the
process of growing and getting involved. That’s one of the reasons why getting the kids in
the D.C. area involved in the work was critical. And their response really sent us the message
that we might be ready to begin this conversation in a more comprehensive way. So, you know,
the time is right. It’s also important in my husband’s administration, which is something
that I try to do with the issues that I take on. I mean, I say this a lot: I am here to
support the President of the United States, and health care is one of the most important
issues that this country is facing. We are spending $147 billion on obesity-related conditions
that are preventable. And if we can make ourselves healthier, that’s going to go a long way to
helping find some solutions to this problem. And these issues intersect in a
very important and compelling way. Newsweek:
How did we get here? What is the history of this? First Lady:
Well, you know, I don’t think there’s any one path to how we got there. I know I have
my theories. I think lifestyles have changed significantly. I reminisce with people about
what it was like for me growing up on the South Side of Chicago in a simple working-class
community. You went to the school around the corner from your house because all the schools
were solid enough that you just went to the school in your neighborhood. So you walked
to school, number one. And there was recess and gym. I was talking to one of my staff
members just about how lunchtime, it was an hour. And my mother was one of the mothers
that didn’t work, so me and all my friends, we’d come back to our house, we’d
watch soap operas, we’d eat lunch. (laughter) We’d complain about our teachers. Newsweek:
Which ones? First Lady:
“All My Children,” I have to say. (laughter) That was a big one. Newsweek:
We just made news, ma’am. (laughter) First Lady:
But that was a lunchtime treat, and it was a way — you know, I thought — so we ate,
we had time to eat our food, have a conversation with our parents, and then go back to school,
catch that last minute of play. So it was a lot of activity. We didn’t — we had seven
channels, not 107. Internet, video games were not a part of the culture. You had to go outside
to play. So I think kids were naturally more active than they are today. And now kids are
going to schools where they have to take a bus, a car ride. Some neighborhoods are not
safe. And no matter what you say, in some neighborhoods you can’t tell parents, “Just
let your kids go out and play,” because it isn’t safe. Some kids don’t even have
friends in their own neighborhood because they live in different communities. So things
have changed, and we are a busier culture. Parents — two parents working in the household,
so you’re coming home, you’re tired. We all do it, right? You know you shouldn’t
go to that drive-thru, but you’re just tired, and you know they’ll eat the food without
complaining. We’re also a culture and a society right now that snacks a lot more.
Just some of the statistics I talked about in my speech yesterday was that the average
snack amount when I was growing up was one snack a day, if you were lucky. And now it’s
averaging two to three. They say the average school-age kid is getting six snacks a day.
So we’re taking 200 more calories than we were 40 years ago, 30 years ago just from
snacks alone. So I think some of that convenience, you know, makes it very easy. You pick up
a little bag of chips, you throw it in, the kids are hungry, they’re grabbing this,
they’re grabbing that, and before you know it, they’ve snacked their way through the
day. So I think those are just some of the things. But there are many, many, many —
physical education, the level of activity. All of that is I think a part of it. Newsweek:
What’s an analogous public health campaign that you think has been successful that
could be a kind of model for this? First Lady:
Oh, that’s a — Newsweek:
Is it smoking? Is it seat belts? First Lady:
Well, you know, I think seat belts is one of those. And I actually was talking to Mike
Huckabee about this, because he actually made the analogy that this is one of those issues
where culturally folks have to be ready to make the shift, you know. You cannot mandate,
legislate seat belt wearing. You could, but does it really work? The same thing is true
for how we eat and how we live. You can’t tell people what to do in their own homes,
and nor should you. But there comes a point when we start seeing enough statistics, we
sort of get aware of the problems in our own homes, and we start — we get emotionally
ready to make some of those changes. So we’re at a point now where I think the society is
ready for more information. Parents are looking for the answers. They know that something
is off, and they just now want to figure out, well, what do I need to know? What am I doing
wrong? Had a conversation with a girlfriend at dinner last night, and we were talking
about, “Well, is apple juice okay? And what about chocolate milk?” I mean, and this
is an educated woman who is confused about what beverage is actually going to be okay,
outside of water, which we know is fine. But parents, societies, schools, we’re now ready
to figure that out so that we can make good choices. We all care about our kids — that
goes without saying, and that’s why this is not a “blame game” kind of issue. People
are just trying to figure out how to survive, how to make sure their kids are happy and
healthy. And sometimes we just don’t get the information that we need. And seat belt
laws are a similar — one of those similar challenges, that once we were ready, we were
ready to take in the information and make the changes. Newsweek:
It has worked. How much — you’ve talked about the cultural shift — how much of this
is regulatory? What is government’s role in these issues, which I suspect is both a
federal and a state, even local question too? First Lady:
Right, right, right. Well, as I said, there is no expert that will tell you that having
government tell people what to do is going to make a difference in this issue. So the
role of government is not to mandate. And I think the roles are different. I think at
the federal level, at this level, we can highlight and inform. There are things that we can do
at this level, with the FDA, for example, working with food manufacturers to have better
front-of-package labeling, things like that. We can finance and leverage money to try to
get more groceries into underserved communities. We can make sure that we pass legislation
that gets us a strong Nutrition Authorization Act so that we get better food in our schools
and that there are guidelines that the private sector and schools can follow. But I think
the real work happens on the ground. It’s our governors, our mayors, our schools, our
communities. And that’s one of the reasons why I’ve been traveling so much, is that
a lot of the answers are already out there, even in states like Mississippi who struggle
more with this issue than most. I did some visits with the governor and his wife, terrific
folks. They care about this issue; they know it’s a problem. And they’re doing some
great work to really ramp up physical education in the schools. You’ve got teachers who
are redesigning play spaces and they’re getting kids hula-hooping and jumping rope
and they’re making teachers do more work and having them think about their diets. They’ve
created requirements where teachers have to eat lunch with the kids, and they’ve seen
vegetable and fruit consumption go up because — not just with the kids but
with the teachers as well. (laughter) So you can go into many states and see some
wonderful examples of things that work in those communities, because there isn’t a
one-size-fits-all answer. What works in Mississippi may not work in Arizona, may not work in Connecticut.
So we really need to look to the governors and mayors who know their communities, who
understand their issues, their challenges, and that we work from there, and that we highlight
those things that work — like in Pennsylvania. They’ve done an amazing job to deal with
the issue of food deserts that I’ve talked about; you know, the 23.5 million Americans
that live in communities without access to a supermarket. And there were neighborhoods
like that when I was growing up. There’s one community in Philadelphia — we went to
visit a grocery store — that community hadn’t had a grocery store in a decade. So you think
about — you know, that’s a child’s life, right? Ten years of a child’s life where
their mother couldn’t walk down the street and buy some fruit and a head of broccoli.
So they’ve structured a financing initiative that leverages government dollars with private
sector dollars, and they’ve been able to incentivize getting grocery stores into underserved
communities, not just in urban areas but in some of the more rural areas in the state. So
we need to — we can highlight those successes and hopefully give other states an example
of what they might try, what might work. Newsweek:
On Tuesday, you spoke to the Grocery Manufacturers Association. They sell not only in those supermarkets,
those grocery stores, they sell vegetables and fruit; I hear that there’s
also some sugary stuff around — (laughter) First Lady:
A few things, a few things. Newsweek:
My five-year-old has briefed me on this. First Lady:
Yes, yes. (laughter) Newsweek:
And my question is, one logical extension, if the epidemic is as significant and widespread
as it seems to be, what would you think about a warning label on Twinkies
or Froot Loops that says — First Lady:
“Warning.” Newsweek:
— “This is known to cause obesity in the absence of other kinds of eating and exercise”? First Lady:
You know, that strikes me as extreme, because a Twinkie is not a cigarette, you know. And
what — what parents need is just information about what’s in the Twinkie and how much
of this can we eat. It’s not that we can’t have a Twinkie. And our kids would be pretty
upset. And I am not supporting that. (laughter) So all the kids out there — right? Newsweek:
It’s called triangulation, ma’am. (laughter) First Lady:
I’m all in favor of good snacks. We grew up with snacks and chips. We did. But we have
to exercise more, parents have to understand what’s in the Twinkie; again, how does it
fit into the overall diet. So we don’t need a warning, we need information. And we need
information that’s easy to understand. That’s something that I said yesterday in the speech.
You read labels now and it’s like the small print and it’s all “oleosutomay” —
or I don’t — the chemicals, you can’t even pronounce them, and the portion sizes
compared to one and you’ve got a small one and a big one. And then, before you know it,
you don’t know what to buy and how much to give to your kids and in what amounts.
That’s the kind of information that families need. And I think that the Grocery Store Manufacturers
who are — they have been magnificent. And I know that there are those who say, well,
are they going to really make changes? Look, the people who run those companies are parents
and grandparents, too. They care about their kids. They’re trying to figure out how to
meet the demand and how to give information. And we know that they’re going to sit down
— you know, we know they’re going to sit down and help us figure this stuff out. You
know, what are the facts that parents need to know; how do we structure it in a way that
they can understand; and how do they meet the demands that we are now going to make
— because it’s really up to us, as the parents and the consumers, to change the demand.
They will make what we tell them we want to buy. And if we want healthier foods for our
kids, and that’s what we’re purchasing, our power will shift their market. We don’t
need much more than our own demands to change, and we need to work with our kids to also
get them to change their eating habits as well. So it’s going to require all of us
to do their parts, and then we don’t need the warning labels. We just need
common sense and good information. Newsweek:
Twinkies are safe in the Obama administration. (laughter) First Lady:
Yes, we are — (laughter) — yes, I think I’m — I
feel good going on record. (laughter) Newsweek:
Okay. We don’t have to pass a special rule. (laughter) First Lady:
No. Newsweek:
Where do you stand on a beverage
tax for sugary beverages? First Lady:
You know, the “Let’s Move” initiative doesn’t — we’re not — doesn’t involve
a tax. But there are communities that believe that taxing sodas and other things works for
them. And again, because, you know, we believe that those ideas and those approaches need
to come from the bottom up, there are going to be cities and states and towns who believe
that that’s what they need in their communities. And, again, there is no one-size-fits-all
answer. And I think that’s where mayors, governors, citizens, schools, you know, working in your
own states and communities — to figure out really what’s going to work and what’s
going to move the bar on this issue. Newsweek:
What’s your sense of posting calorie counts? It happens in New York — actually, where
I live, and it’s very depressing, actually. (laughter) The mayor of New York has made it
very hard to go to Dunkin’ Donuts. (laughter) But it works. Is that something else that
should be a weapon in the arsenal? First Lady:
I think the more information we can give to consumers, families, parents, the better.
There are examples outside of New York — in Somerville, Massachusetts, the mayor there
has been working with some of the local restaurant owners to get them to change their menus so
that there are healthier options and customers have more information about what’s in stuff.
I think that’s a good thing. But also in Somerville they’re going beyond just what we eat and
they’re also thinking more creatively about how in every aspect of what they do to run
that city, they’re thinking about the health and well-being of kids. So that comes down
to how many parks they have; and what their roads look like; and if they’re building
a new street, making sure there’s a sidewalk and a place for kids to ride their bikes.
I mean, again, this isn’t just about what we eat, this is about how we live. In some
of the towns in Mississippi they have to think creatively about where they don’t have places
to play — you know, maybe you take an old field and turn it into a soccer field and
let the city pay a dollar for it. And you find ways, creative ways, to make sure there
are spaces for families to live in a healthy way. Those are the kind of ideas that we want
to promote. Those are the kind of things that are working. We just need to do more
of it and we need to do it faster. Newsweek:
There’s also, both in rural areas and in urban areas, there’s an economic issue,
which is — you mentioned convenience, but often the fast food can be even less expensive
sometimes than getting healthy food. First Lady:
Absolutely. Newsweek:
Can you talk about that disparity and what we can do about it? First Lady:
That disparity is very real. I mean — no, I talked about it with the grocery manufacturers
as well. It’s not just making healthy food, but it’s making healthy food that’s affordable.
And that’s a challenge, as well, but we have to recognize that we need to move in that
direction. There are — you know, we can’t look families in the face and say, “You
fix this problem,” but then you can’t afford the food that they need to fix the problem;
they don’t have access to it. We have to figure this out. The school lunch program is a major
— is going to be a major player in the whole resource issue because many kids are getting
the majority of their meals at school. So that’s one of those areas where we have some
control over as a society because, you know, we’re going to feed these kids for two out
of three or four of their meals, depending upon how many they have. So we need to make
sure that we pass legislation that makes sense, that sets clear basic nutritional guidelines,
not just in the school lunch lines, but in the vending machines and a la carte lines;
that we have the resources to help schools bring their standards up. Things like —
in Mississippi, what Governor Barbour did with some of his stimulus money was to remove
fryers and put in ovens. I mean, it’s just something as simple — the school nutritionist
will tell you, we want to do better, but all we have is a fryer, which means when you
have a fryer then you have to fry stuff. (laughter) So we need to make sure that the schools have
the resources they need to make the changes to get healthier food into the schools. But
we also have to make sure that every single child that is eligible for free and reduced
lunch actually gets it, that we reduce the paperwork to make sure that — if you look
at some of the paperwork that families get to sign up, and then they have to re-sign
up and then they have to fill it out. You know, you look at that, you’re busy and, you
know, you just brush it under the rug, you don’t complete it. We have to make those processes
and procedures easier. And I think we can go a long way to helping underserved
families with the school lunch program. Newsweek:
How does obesity affect classroom learning? First Lady:
I think, you know, this week it opened this up, right, to the audience. I mean, we know
— in our own kids, in our own lives — how kids respond when they have a good meal,
they’ve eaten the right things. We know what happens to kids when they are hyped up
on sugar and they’re operating on too much sugar and not enough substance. We see it
in our own lives. So you just imagine if you send a kid to school with a sugary breakfast
and a sugary drink, and they have to learn for a few hours and they stop maybe for 10
minutes for lunch — maybe — and they haven’t had a chance to run and run off that energy.
And then they start dropping because they’re coming down from all that sugar. And they
don’t even know it. They don’t even know why they feel lethargic, why they get sleepy at
about eleven o’clock during the day — just like we all do when we don’t eat right.
I mean, we all experience it. So it definitely affects how kids feel throughout the day,
which is something that we have to remember. This issue is not about looks and appearance.
This is about how our kids feel and how they feel about themselves, because how you feel
inside affects the way you approach the day; even the way you tackle the challenge. If
you feel like, you know, you’re full and you’ve eaten some fruit and you’ve gotten some grains,
that affects the way you think. So this isn’t an image issue. This is truly an overall health
issue. And kids, in addition to needing to eat well, have to run. They have to run around
during the day. They have to get the energy out, you know? I mean, you’ve got kids. You
imagine trying to teach your child sitting still for hours — Newsweek:
Oh, in our house (inaudible) the time. (laughter) First Lady:
Right. All right, okay, Jon. (laughter) Newsweek:
We read “Newsweek” aloud. (laughter) They love the Obama collection. First Lady:
Oh, good. It’s very good. (laughter) Newsweek:
No, you’re right, absolutely. But why isn’t — I mean, we’re lucky in that our kids
— where our kids go to school, they run around. That’s not true in a lot of places.
Physical education is often the first thing to go. Recess has been cut back. From a policy
perspective, is that simply a financial issue? Is it because the standards, classroom standards
have been set at a point where they can’t afford a single moment of classroom time?
What’s your analysis of the end of recess? First Lady:
I think that educators, administrators, parents would say it’s all of it. Some of it feels
like a resource issue. And some of it is when you’re testing so much and you’re meeting
requirements, you feel like the first thing that goes — if your money is tied to a test
score and not to recess, you know, and whether your kids can run around, then the choice
is already made for you, some administrators feel. But there are also examples where schools
are figuring out how even in this current climate of testing and lack of resources,
how to put that stuff back into the curriculum. The Department of Agriculture has the U.S.
Healthier School Challenge, which is an initiative that we’re promoting as part of the “Let’s
Move” initiative. We’re going to — we want to double the number of schools in this
country that qualify as U.S. Healthier Schools. There are currently about 600 of them around
the country. Our goal under “Let’s Move” is to double that, because these are schools
that are the models for what we’d like to see happening with nutrition and physical
education, because without any additional resources, they figured out how to restructure
their curriculum, how to use nutrition education as part of math and science; they found ways
to mandate and reincorporate recess and gym back into their classrooms. I mean, there
are schools — wonderful, public schools — all over the country that are figuring
how to restructure the day. But what I’ve found when I’ve talked to principals, administrators
who’ve made that choice, they have decided as a school community that exercise and nutrition
isn’t an extra; that it is an essential part of what a good curriculum has to look
like. So in one school that I visited in Virginia, they don’t allow teachers to take recess
or gym away as a punishment because their feeling is that’s counter-productive. So
now you’ve got a problem, so you’ve taken away the one thing that may help the kid wind
out of the problem. So they’ve — you know, they’ve said you can’t take that away,
because that’s part of the curriculum. That’s like telling the kid, well, you didn’t do
well in spelling, so you’re not going to be able to do math today. Newsweek:
In addition to the Twinkie thing, that might be a very good political move —
(laughter) — pull them out of math. First Lady:
Right, right. (laughter) But I am not — now, I did not say that. (laughter) Newsweek:
No, ma’am, just me. (laughter) It was me. First Lady:
That’s your idea. Newsweek:
Yes, ma’am. First Lady:
But there are schools that are figuring out how to make this happen. Our job is to give
them the resources they need, hold them up, celebrate those successes and help other school
districts figure out how do they do the same thing. How have they managed in the current
climate? What’s the difference? Why does one school manage to do it and another can’t? Is
it at the regional level? Is it the superintendent support? I mean, we could probably talk to
educators in this room right now who are — just they know the answer to this, and
they’re ready to jump on it. But there are schools that are doing it. And we need to
make sure that more are doing it. This should be the standard of how our kids
get an education in this country. Newsweek:
Last question, ma’am. How will you measure success, as you look at the lifetime of the
administration, of your own ongoing work, presumably? First Lady:
Well, the goal for “Let’s Move,” the whole goal of this initiative, is to end the
problem of childhood obesity in a generation. So this is a generational issue. And our view
is that we want kids born today to grow up at a healthy weight. And it will take a generation
to see how that’s going. But one of the things that the administration is doing now
— the President signed an executive order creating the first ever Council on Childhood
Obesity. They are now reviewing every single program and policy, not just in the government
but in the country, that focuses on education and nutrition. And we need to figure out how
to use the resources we have more smartly. But we’re going to get that report in May.
We’re looking forward to that. And part of that — the interesting thing about that
approach is that we’re saying we need real, measurable outcomes. And the foundation that
was set up as part of this initiative — and we’ve got some wonderful foundations
who have been researching and investing in this issue for decades — RJW, Kellogg —
I don’t want to begin to name all of them, because I’ll miss some — but they are going
to be sort of the future arm of this, so that when I’m gone, when the President is gone
and the next administration comes in, you’ve got an independent group that’s going to
continue to look at these goals and help us figure out whether we’re reaching the goals,
and keep our feet to the fire, because, again, this isn’t something that’s going to happen
in this administration. This is — we are looking at this as a forever proposition,
because fundamentally, as I said in my speech to the food manufacturers, we have to change
the way we view food and health forever. And we can start with kids, because they haven’t
— their habits haven’t been ingrained. We can shift the way they think, even the
way they taste food. We can do that. Us, you know, grownups — (laughter) — not so much.
We’re a little stuck in our ways. But we can still guide our children. I still think
of my mother, who said — you know, she had no problem doing things that
she told me I couldn’t do. (laughter) So even though we, as parents, haven’t conquered
it and maybe we don’t — we’re not doing it, we can still help our kids get to a different
place. And it’s going to take time. And it’s going to take patience. And we’re
going to need everyone involved. But I think about where we started a year ago with the
planting of this little garden. And now, we have this wonderful initiative that has the
food industry coming together; and bipartisan support all over the country; parents feeling
excited and support it; kids — (laughter) — you know, they’re coming. (laughter) We’ve got the professional sports community
standing by. This is an issue that can unite the country. And it can unite us with the
rest of the world, because the truth is there isn’t a single head of state or spouse of
a head of state who I have met who has not been fascinated by our garden and our conversations
around nutrition, because so many other countries are beginning to see some of the effects as
they develop. They’re seeing their rates go up. So this is an issue for the world.
And we can truly be a leader, but we have to be patient. And we also have to be clear
that we need to work really hard and stretch. So when we talk to the food industry, we say,
you have to do more. When we talk to ourselves as parents, we have to push ourselves. We
have to talk to Congress. And we have to say, you have to push to ensure that we’re getting
the kind of regulations and support so that our school meals are healthy. We all have
to stretch on this one. And if we do, I think we can — we will see a change in
our kids that we can be proud of. Newsweek:
Well, thank you so much for your work, for your piece this week — First Lady:
Thank you. Thank you for
investing in this conversation. Newsweek:
— and for this remarkable presentation. Thank you very much. (applause)

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