AMA House of Delegates

AMA meeting: Fight obesity by adopting nutritional rating system

■ Delegates also agree that healthy foods should be more affordable and that food labels need greater accuracy.

By Christine S. Moyer — Posted June 28, 2010

Chicago -- The American Medical Association is boosting its efforts to reduce obesity by tackling the price disparity between nutritious and unhealthy foods, and addressing inaccuracies on nutritional labels.

The AMA House of Delegates approved several nutrition-related policies, including one that urges the Food and Drug Administration to use more precise processes to measure fat content in foods. Delegates at the Annual Meeting in June also called on the FDA to include the most accurate nutritional information on food labels.

FDA nutrition labeling requirements allow trans fat or saturated fat content to be reported as zero if the food product contains less than 0.5 grams per serving. That means someone eating a product labeled "trans fat-free" could be consuming as much as 20% to 25% of his or her recommended daily allowance of trans fat, said Ryan Ribeira, regional medical student alternate delegate. The American Heart Assn. recommends limiting trans fat intake to less than 1% of total daily calories.

Citing a price gap between nutritious foods and calorie-dense, nutrition-poor products, delegates also adopted policy that supports efforts to lessen the cost disparity. The policy calls on the AMA to encourage the expansion of existing programs that aim to improve nutrition and reduce obesity.

But even when individuals can afford healthy food, delegates noted, it is not always clear what products are the most nutritious. To help consumers make better food choices, delegates asked the AMA to support implementation of a uniform nutritional rating system in the U.S. The system should be evidence-based, developed without food industry influence, applicable to nearly all foods and easily understood by consumers. It should also permit relative comparisons of different foods.

"We know we have a significant obesity epidemic. ... If people eat healthier food that will reduce [the problem] ... but they can't understand existing labels on food," said Robert Gilchick, MD, MPH, of Los Angeles, a delegate of the American College of Preventive Medicine.

The house action came as the Dept. of Agriculture and the Dept. of Health and Human Services issued preliminary recommendations June 15 in the 2010 Dietary Guidelines Advisory Committee Report. The report said a disconnect exists between dietary recommendations and what Americans consume. Americans eat too much added sugars, solid fats, refined grains and sodium, it said.

The guidelines recommend that people reduce calorie consumption, increase physical activity and shift food intake patterns to a more plant-based diet, while eating only moderate amounts of lean meats, poultry and eggs.

The guidelines, updated every five years, will be released at the end of the year.

ADDITIONAL INFORMATION

Meeting notes: Public health

Issue: Despite efforts to educate parents about the safety of vaccines, a 2010 Pediatrics study found that 25% of American parents still believe that some immunizations cause autism in healthy children.

Proposed action: Ask the Office of the Surgeon General to offer a definitive repudiation of the link between either thimerosol-containing vaccines or the measles, mumps and rubella vaccine and developmental disorders, such as autism. [Adopted]

Issue: People of color are significantly affected by skin cancer, but awareness of prevention and screening is low.

Proposed action: Encourage and support efforts that increase awareness of skin cancer risks and sun-protective behavior in communities of color. [Adopted]

Issue: Prescription monitoring programs help physicians track the narcotics their patients are on, but confidentiality rules mean that those medications given as part of opioid treatment programs are not included.

Proposed action: Seek changes to allow states more flexibility in requiring reporting to prescription monitoring programs. [Adopted]

Issue: An increasing number of children and adolescents are being treated with atypical antipsychotic medications, but there is limited evidence on their safety and efficacy in this age group.

Proposed action: Ask the AMA Council on Science and Public Health to prepare a report on the safety and appropriate use of drugs in the pediatric population. [Adopted]

Issue: Unused over-the-counter and prescription drugs are getting into the hands of those who shouldn't have them, such as children. They also are polluting the environment.

Proposed action: Support initiatives designed to promote safe and proper disposal of unused medications. [Adopted]

Issue: Adolescents are not getting enough sleep, and this is leading to a host of health problems.

Proposed action: Identify insufficient sleep and sleepiness in adolescents as a public health issue. [Adopted]

Issue: The adult film industry is an $11 billion industry in the U.S., and performers in this occupation are subject to public health concerns, including multiple sex partners during short periods. More than 2,850 cases of sexually transmitted diseases, including HIV, were diagnosed among 2,000 such performers from 2004 to 2008.

Proposed action: Support legislation that requires mandatory condom use in the production of adult films. That would make it easier for local health departments and the Occupational Safety and Health Administration to investigate and control occupational exposures to infectious diseases and enforce workplace regulations in a timely manner. Urge that occupational standards be enforced to reduce exposure to infectious diseases within the adult film industry. [Adopted]