A major report on the growing problem of childhood obesity calls for "fundamental changes in our society" that would affect how children spend their time and how food is advertised, packaged and sold to them.
The report by the Institute of Medicine calls for schools to restrict vending machine sales and require at least 30 minutes of physical activity each day. Planners should design communities that encourage walking and other exercise, parents should restrict television and computer time to a total of two hours a day, and federal officials should monitor food advertising geared toward children, it says.
There are 9 million obese children in the United States, and the number is rising so fast that the problem is a major threat to the nation's health, the report says. The two-year study is the most comprehensive one to focus on the problem.
In the past 30 years, obesity rates have tripled for children ages 6 to 11 and more than doubled for teenagers and preschoolers, according to the institute, an arm of the National Academy of Sciences.
Obesity is defined as a body mass index - a calculation of weight and height - 20 percent above recommended levels.
Doctors say they are seeing increasing numbers of children with obesity-related ailments once confined to adults, including diabetes, high blood pressure, high cholesterol levels and sleeping disorders.
"It's not just that people are fat. The extra weight is causing real health threats to them," said Dr. Debra R. Counts, an endocrinologist at the University of Maryland Medical Center.
Experts blame the barrage of food advertisements aimed at children, often during the school day, larger food portions and many children's preference for television and computer games over physical activity.
The average child is exposed to 110 TV commercials a day, most of them for candy, cereal, soft drinks and fast food, studies have found. The food and beverage industry spends $10 billion to $12 billion a year marketing to children.
"We lead such stressed lives, food has become a way of coping," said Dr. Lawrence Cheskin, who treats obese families at the Johns Hopkins Weight Management Center.
The report says that combating the problem will require a shift in public attitudes similar to shifts in past decades that discouraged smoking and encouraged seat belt use.
