Sept. 30, 2004 -- Sweeping changes are needed in America to prevent the growing childhood obesityobesity epidemic from wreaking havoc on the nation's overall health and its medical system, concludes an Institute of Medicine panel.

Approximately 9 million U.S. children over age 6 qualify as clinically obese, while another 9 to 10 million are considered overweight, according to the Centers for Disease Control and Prevention. Obesity carries with it highly elevated risks of a host of chronic and expensive conditions, including diabetesdiabetes, heart diseaseheart disease, kidney failurekidney failure, and others.

An expert panel from the Institute of Medicine, part of the National Academies, says that a complex set of factors, including unhealthy eating habits, industry promotion of junk food, widespread elimination of school physical education classes, and a sedentary lifestyle marked by hours in front of television and video games, has helped 16% of the nation's children become overweight or obese.

Some suggested that the problem has become too large to counter with individual counseling or treatment of obese children.

"We're talking about something that's nothing less than a revolution in the way we address this problem," says Thomas N. Robinson, MD, an associate professor of pediatrics at Stanford University School of Medicine and a member of the committee issuing the 461-page report.

The committee urged parents to take a more active role in promoting healthful eating and exercise habits to their children, including limiting children's time in front of TV or video games to no more than two hours per day. At the same time, schools should provide kids time for no less than 30 minutes of vigorous physical activity per day, though the trend at many U.S. schools has been toward an elimination of gym classes and recess, they said.

The report also urges the U.S. Department of Agriculture to apply nutritionnutrition standards to all foods sold in public schools, including those dispensed from vending machines and snack bars. Many nutritionists have criticized the widespread presence of food and drink company advertisements and promotional programs in schools.

"Ideally schools would become commercial-free zones," says Shiriki K. Kumanyika, PhD, a University of Pennsylvania professor of epidemiology and panel member told reporters.

System 'Not Working'

The panel also calls for stricter regulation of advertisements aimed at young children, urging the Federal Trade Commission to take a harsher line on food and media companies who fail to abide by voluntary standards limiting junk food promotion.

Grocery manufacturers already use an industry-controlled panel known as the Children's Advertising Review Unit to monitor advertisements aimed at children less than 12 years of age. But the IOM committee says that the panel has been ineffective and that the U.S. government should step in to come up with comprehensive but voluntary guidelines on food advertising product placement aimed at kids.