Obesity deaths may eclipse tobacco fatalities

WASHINGTON -- Some 300,000 Americans a year die from illnesses caused or worsened by obesity, a toll that may soon overtake tobacco as the chief cause of preventable deaths, the surgeon general said Thursday.

Surgeon General David Satcher called for major steps by schools, communities and industry to fight fat.

The first steps: daily physical education for every student, more healthful school foods, "reasonable portions" at fast-food restaurants, and safe places for all Americans to exercise.

"We're not talking about quick-fix diets," Satcher said. "We're talking about lifestyles."

Some 60 percent of adults are overweight or obese, as are nearly 13 percent of children. The toll has been rising for a decade, and threatens to wipe out progress fighting cancer, heart disease and other ailments, Satcher warned.

The reason isn't a mystery: People eat more calories -- too often by shunning fruits and vegetables in favor of super-sized junk foods -- than they work off.

Among Satcher's recommendations:

Schools must provide daily physical education for every grade. P.E. has gradually been disappearing, particularly for older students. Just 6 percent of schools require it for high-school seniors.

Schools must provide more healthful food options, and better enforce federal rules restricting students' access to junk food in the vending machines present in most middle and high schools. Agriculture Department rules say school lunches should contain no more than 30 percent fat, but the national average is 34 percent, and a recent survey found just 20 percent of high-school lunches provide proper vitamin levels.

Communities must create safe playgrounds, sidewalks or walking trails, particularly in inner cities. Employers should provide time for workers to get physical activity on the job. After all, healthier workers mean employers' insurance and absenteeism costs will drop.

Industry should promote more healthful food choices, including "reasonable portion sizes."

The poor have a tendency to be fattest, and Satcher noted that fast food crowds out access to more healthful foods in inner cities.

He urged communities to study fast-food marketing practices, comparing the situation to tobacco companies' targeting of inner-city minority communities in the 1990s. And he encouraged government-funded projects to increase access to affordable fruits and vegetables.

"Sometimes the most fattening foods are the cheapest," Satcher lamented.

The National Restaurant Association rejected as "simplistic" the idea that fast-food restaurants cause obesity, and the National Soft Drink Association urged more focus on Satcher's exercise recommendations, calling vending machines in schools adequately regulated.