I'm a member of the American Dietetic Association as well as an active participant on their Infectious Disease listserv/Infectious Disease Practice Group. The other day I started a firestorm when I suggested that childhood obesity was a parenting issue, not a food policy issue. The impetus for the conversation was when one member posted a link to an article in the NY Times about whether or not pizza could be counted as a vegetable (1). I stated that although the idea of counting pizza as a vegetable was emotionally charged (and ridiculous) it really had very little impact on obesity. Costs aside (and that's a big issue) if you add calories to a tray, even if it's in the form of nonstarchy vegetables, it does not induce weight loss. Replacing desserts with fruit would likely create a caloric drop but let's be honest; children are not becoming obese because of the standard school lunch tray.
A Parenting Issue
Cheap, calorically dense foods and sugar-laden drinks are the real issues but last I checked these were not free and who is it that buys these for the youth of today?
Excuse: Parents are pressured by kids because junk foods are marketed towards children.
Reality: You're the parent; act like one! When I was a child my mother had very little tolerance for me or my siblings "pressuring" her. When my daughter "pressures" me it's called whining and there are consequences if it doesn't stop.
Excuse: Children are not exposed to enough fruits and vegetables at school and thus don't develop tastes for them but instead learn to like sweet, salty, fatty foods.
Reality: Parents are responsible for exposing their child to healthy foods at home.
Excuse: Assigning blame to parents for being uneducated about nutrition is offensive
Reality: Does anyone really believe that the parent that has a 200# 9 y/o really doesn't know that giving him dollar menu, chips, and soda all the time is harmful?
Excuse: Many parents don't have time to prepare healthy meals
Reality: Would they tell their boss they dont' have time to do their job? It is their job to care for their child and that includes providing them with healthy meals. If preparing healthy meals for their children paid $100/meal, I would imagine many would miraculously figure out how to fit it into their schedule.
Excuse: I have to work 3 jobs and I can't control what my child eats when I'm not home
Reality: Unless the child has their own income the parent controls exactly what foods are in the home. If the child is receiving unhealthy foods at the sitter then the parent needs to step in and make the sitter aware of their wishes. If compliance is not met then the parent needs to find a new sitter. If the sitter is a family member/sits for free; then the parent should needs to relay to the family member that this is for the good of the child.
Excuse: I can't afford to buy healthy foods for my child.
Reality: Lentils, whole wheat pastas, canned vegetables, tuna, bagged apples, carrots, peanut butter, and oatmeal are just a few of the wholesome foods that can be attained cheaply and that's without even getting into the couponing conversation.
Excuse: I live in a food desert
Reality: While I admit it can be inconvenient, again, it is the parents' responsibility to attain healthy food for their child. Relative to my profession, I live in a job desert yet somehow I manage to make a living. We're not talking about crossing the Atlantic; come on people!
Type 2 DM is in double digit prevalence for Juveniles. This is ridiculous and the buck has to stop somewhere.