WASHINGTON — Fighting obesity will require changes everywhere Americans live, work, play and learn, says a major new report that outlines dozens of options — from building more walkable neighborhoods to zoning limits on fast-food restaurants to selling healthier snacks in sports arenas.

However, schools should be a national focus because that’s where children spend most of their day, eat a lot of their daily calories, and should be taught better how to eat healthy and stay fit, the influential Institute of Medicine said Tuesday.

Among the most controversial of the recommendations: Communities could consider a tax on sugary sodas and offering price breaks for healthier beverage choices.

That prompted outrage from the American Beverage Association.

“Advocating discriminatory policies that uniquely focus on sugar-sweetened beverages is the wrong approach,” said an association statement that added those drinks account for just 7 percent of calories in the average person’s diet.

Most of us know we should eat less and move more, but the institute makes clear this isn’t just an individual but a societal problem. For a host of reasons, sedentary lives have become the norm and we’re surrounded by cheap, high-calorie foods.

The new report offers a road map of the most promising strategies to change that — and argues that the solutions can’t be implemented piecemeal.

“Each of us has this role. We can’t sit back and let the schools do it, or let a mayor do it or think somehow the federal government’s going to solve it,” said report co-author William Purcell III, former mayor of Nashville, Tenn. “These recommendations require concerted effort among all.”

A health advocacy group urged governments, industry and schools to adopt the recommendations.

“The country has begun to address obesity, but we are still doing far too little, given the tremendous burden it places on our health and health care costs,” said Margo Wootan of the Center for Science in the Public Interest.

Two-thirds of U.S. adults and almost a third of children are either overweight or obese, and progress to stop this epidemic has been too slow, the Institute of Medicine concluded.

For schools, it recommended that students get at least 60 minutes of physical activity every day — a combination of physical education, recess and other activities. Many schools have slashed P.E. and cut into recess in recent years in an effort to increase learning time amid tighter budgets. The report also says schools should serve healthier foods, backing national school nutrition standards, and teach nutrition.

Other recommendations include:

* Restaurants should ensure that at least half of children’s meals comply with federal dietary guidelines, without charging more for the healthier options.

* Healthier foods should be routinely available everywhere, from shopping malls to sports arenas.

* More food companies should improve how they market to children — and if they don’t, the government should step in and mandate changes.

* To make physical activity routine, communities should be designed with safe places to walk and exercise.

* Public and private insurers should ensure better access to obesity screening, preventive services and treatments.

* Employers should expand workplace wellness programs.

* The president should appoint a task force to evaluate the effect of U.S. agriculture policies on obesity.

The Institute of Medicine, an arm of the National Academy of Sciences, is an independent organization that advises the government.


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