AMELIA ISLAND, FLA. — With efforts to address rising childhood obesity rates gaining momentum, bakers should work to become part of the solution, said Ira C. Magaziner, a longtime adviser to former president Bill Clinton.

Speaking April 6 at the annual meeting of the American Bakers Association, Mr. Magaziner discussed the Clinton Foundation’s Alliance for a Healthier Generation. His presentation was part of the general session of the A.B.A. convention, held April 5-8 at the Ritz-Carlton hotel, Amelia Island.

Mr. Magaziner currently is chairman of the Clinton Climate Initiative and the Clinton Foundation HIV/AIDS Initiative.

The Alliance for a Healthier Generation emerged after Mr. Clinton experienced heart problems in 2004 and was subsequently approached by the American Heart Association about looking for ways to reduce childhood obesity.

Setting the stage for the program, Mr. Magaziner showed a series of color-coded U.S. maps depicting the percentage of the population that is obese from the mid-1980s until the present. The steady and steep increases were dramatic to see, even for a baking industry very familiar with the data (see map selections at bottom right).

"That’s a problem, and the medical expenses are going to be very costly," he said of the trends, which he said looked like an infectious epidemic.

In addition to citing data about rising rates of type 2 diabetes, he said further evidence of the problems has been found in autopsies of soldiers slain in Iraq and Afghanistan, Mr. Magaziner said.

"The autopsies showed the arteries of 60 to 70 year olds, not 18 to 20 year olds, because of what they ate and a lack of exercise," he said.

The alliance is focusing on children for its program in part because of epidemiologist predictions that the current generation of children will not live as long as their parents, a first in history, Mr. Magaziner said. Children also are a focus because of the potential to influence their behavior and because of their greater awareness of their environment.

"When children grow up used to something, they take it into adulthood," Mr. Magaziner said.

The alliance’s program, which focuses on altering what is served at school cafeterias and vending machines, has been expanding rapidly with about 8,000 schools currently participating and a total of 30,000 targeted for 2010.

Much of the work of the alliance seeks to achieve its goals by leveraging the self interest of the private sector, Mr. Magaziner said.

In addition to working with the food and beverage industries, the alliance has worked with the health care sector, which Mr. Magaziner said has extended benefits available to children such as regular checkups and consultations to help prevent obesity. The program allows four extra visits with a primary care physician and four extra visits with dieticians.

"If you want to bring about massive change rapidly, you need to get it in the market economy," Mr. Magaziner said. "You have to create an incentive. While government can set a framework, it is the market that can respond."

Mr. Magaziner said beverage companies have diversified their product bases with new drinks tilted toward health and wellness, but the issue has been market demand.

"When there has been a low-calorie alternative, sometimes the consumer didn’t want it," he said.

The premise of the alliance project with the beverage sector, beginning in 2006, has been that in shifting options in vending machines from high sugar products to better-for-you choices, companies are able to achieve the same level of profitability.

"The only risk is if overall demand goes down," Mr. Magaziner said.

Beverage guidelines were issued for elementary school, middle school and high school. For middle school, for example, bottled water may be sold in any size bottles; of fat-free and low-fat regular and flavored milk, up to 10-oz bottles; and 100% juice with no added sweeteners, up to 10 oz. Diet soft drinks are incorporated into the selections for high school.

An added incentive for participation in the alliance has been a patchwork of laws being passed in states and cities, which made the national standard proposed by Mr. Clinton less aversive to the business community.

Since the program was implemented with beverage makers, the alliance has seen a 65% decrease in full-calorie soda shipments to schools, a 58% decrease in beverage calories shipped to schools and 79% of school district contracts in compliance with alliance standards.

Describing the beverage initiative as "very successful," Mr. Magaziner said sales have continued to grow at historical levels. The partnership has helped move the beverage industry from one that had been vilified to one that is part of the solution, he said.

The next industry to partner with the alliance was the snack industry, also in 2006, an effort described by Mr. Magaziner as "much more complicated."

A dairy agreement was signed in May 2007 pushing toward skim milk rather than full-fat products. He said less calories are being consumed, and the industry is flourishing.

Only modest behavior changes are required to have the desired long-term impact on weight, Mr. Magaziner said.

"I should say, to calibrate youth, if a five-year-old child consumes 40 fewer calories per day, he or she will weigh 30 lbs less when they are 18 years old," he said. "This program is not about telling children they have to eat carrots and broccoli. If you can control calories and vary ingredients somewhat, you can make a huge difference."

For the snack industry, the alliance set standards for qualifying products that no more than 35% of calories come from fat, 10% from saturated fat and 35% from total sugar.

Exceptions were made for nuts, nut butter seeds, reduced-fat cheese and eggs.

Mr. Magaziner said, "We are not looking for perfect because perfect can be the enemy of good."

For the baking industry, Mr. Magaziner said he wanted to find "common ground," and he counseled the bakers to take a proactive approach.

"I’m not saying you should do this out of charity," he said. "It isn’t sustainable that way.

"One way or another, this epidemic will be met. I think you will be a target, and the best course is to get out in front of it."

He said the science behind the guidelines includes objectives of cutting back on intake of total fat, saturated fat, trans fat, total calories, sodium and added sugar. Objectives include increasing intake of vitamins (A, C, E and folate), minerals and fiber.

Harkening back to a long career as a business consultant, Mr. Magaziner said "one of the hardest things in the world to do is figuring out the timing on any kind of market transformation, even when you are introducing a product."

He acknowledged the risk of "getting out too far ahead of the market." Similar risks exist for those who wait too long.

"I’m not trying to suggest this is an easy set of decisions from a business point of view," he said. "But I think that the world is going to head in this direction. That will happen either through mandatory regulations or voluntary agreements. As one who has experienced Washington at its fullest in the White House, once the government apparatus takes a hold of something, the results can often be unpredictable and rationality does not necessarily win out over emotion or perception."

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