Building a Healthier Future Summit 2014

March 13-14, 2014: Washington, DC Full Report - Draft

Executive Highlights

We are back in San Francisco, where we have been reflecting on the Partnership for a Healthier America’s 2014 Building a Healthier Future Summit. This year’s conference featured three plenaries and 18 breakout sessions across two days. The exhibition hall included booths from PHA sponsors, including veteran partners like Birds Eye and new partners like FirstBIKE, Del Monte, Dannon, and Sodexo. Below, is our commentary on our top ten highlights from the conference, as well as two honorable mentions and our exhibition hall commentary.

  1. First Lady Michelle Obama impressed crowd with her inspiring keynote address, the thrust of which was personal and decidedly non-corporate, on the value of home-cooked meals.
  2. Mrs. Obama also emphasized her commitment to fighting childhood obesity for the “long haul – even after I leave the White House.” Comparing her remarks to previous years, we heard less about eliminating childhood obesity in a generation and more about dramatically reducing childhood obesity.
  3. Dr. James Gavin (Chair, Partnership for a Healthier America, Washington, DC; Emory University, Atlanta, GA) argued that the 43% reduction in obesity in children between the ages of two and five (as reported in a recent JAMA article) should not distract the US from the steadily increasing obesity rates in the rest of the population. We also note that despite these reductions, morbid and severe obesity continues to increase in every population and age group.
  4. Philadelphia Mayor Michael Nutter and Lt. Gen. Mark Hertling (Senior VP, Global Partnering, Physicians Leadership Development; “Healthy 100,” Florida Hospital, Orlando, FL) shared the spotlight during the lunchtime plenary. Mayor Nutter commented on his role in making Philadelphia healthier and more active. Lt. Gen. Hertling characterized the obesity epidemic as a “national security issue,” because new armed forces recruits are in far worse shape than their previous counterparts.  
  5. Nestlé, Campbell Soup Company, and PepsiCo highlighted their progress in improving the nutritional quality of products, while smaller companies (e.g., Earthbound Farm and Victors & Spoils) discussed their efforts to market healthy foods effectively. We remain on the fence about how notable the changes are, but we do see more attention in the right area.
  6. Several of PHA’s co-founders highlighted the organization’s outlook on areas for future collaboration outside its current focus on private-public partnerships. They include forming partnerships with non-vested sectors, initiating regional efforts, and engaging with larger companies who may not feel a direct relationship to the fight against childhood obesity.
  7. PHA announced 11 partnerships at the meeting. The new partners included (i) FirstBIKE; (ii) Knowledge Universe; (iii) Nutri Ventures; (iv) Sodexo; (v) Eskenazi Health; (vi) Meridian; (vii) St. Luke’s Hospital; (viii) UnityPoint Health – Trinity; (ix) Del Monte: (x) Kwik Trip;  and (xi) Dannon.
  8. Senator Cory Booker (D-NJ) once again delivered an engaging keynote (this time via webcam) urging the audience to get more groups (religious organizations, industry, activists) involved in the fight against childhood obesity.
  9. Apps and web-based platform development garnered increased attention. For example, the meeting featured  a panel on app development as well as the Innovation Challenge (this year’s winner: the school garden app StartAGarden) and an update from last year’s Innovation Challenge winner, Mr. Dennis Ai (Founder, JiveHealth, Chicago, IL), on the progress of his new app to help get kids to eat vegetables (the fact that this hasn’t been a game-changer does reinforce how hard changing healthcare delivery is).
  10. Mr. Mark Schiller (Executive VP, Pinnacle Food Group, Mountain Lake, NJ) of Birds Eye demonstrated how ultra-savvy marketing (@birdseye, #ilikeveggies) got the attention of conference attendees. Our thirty-minute talk with him was incredibly interesting – please let us know if you’d like an in-depth primer on this!

Our report also includes two honorable mentions: 1) we attended the black-tie REAL Food Innovators Award dinner where eight awards were presented to health leaders from different food sectors (ranging from best beverage to food access), and 2) PHA “walked the talk” by offering nutritious breakfasts, morning workout suggestions, and audience-wide, participation-encouraged exercise breaks during each plenary session. Finally, we’re also bringing you our favorites from this year's exhibition hall.


Top Ten Highlights

  1. In a characteristically captivating keynote, First Lady Michelle Obama highlighted the importance of home-cooked meals. Closing out the Summit, Mrs. Obama spoke to the power of a home-cooked meal, calling it the “single most impactful way” for a family to improve their health. James Beard Award-winning chefs Hugh Acheson and Barbara Lynch, who prepared the Summit’s Thursday lunch menus, also shared this sentimetn. Typically, meals cooked at home have fewer calories, less fat, and less cholesterol than food eaten out since families can control what goes in the food. Additionally, children who eat home-cooked meals typically perform better in school, have improved emotional health, and have better relationships with their peers. Mrs. Obama said that, although most people cite lack of time or money as barriers to cooking at home, the real issue is that people don’t have the basic kitchen skills that could save both time and money. For example, a whole roast turkey costs less than four Big Macs; with the right skills and meal planning, that turkey could feed a family of four for several meals (roast turkey, sandwiches, soup, etc.). New PHA initiatives will attempt to increase the number of home-cooked meals by increasing recipe distribution, the number of cooking classes, and the number of cooking demonstrations. Meals eaten out are a clear target in the fight against the obesity epidemic, but we are glad to see PHA focusing on the other side of the coin, namely the healthier meals families can prepare at home.
    • We noted that Mrs. Obama’s focus diverged from some of the other Summit speakers, who instead emphasized improving the nutritional content and convenience factor of pre-prepared or to-go meals found in retail. No matter how easy or affordable the process of preparing meals at home is, there will always be a market for pre-prepared food. We foresee both components, at-home cooking and convenient, to-go reatil, interacting. We could imagine PHA partners providing recipes for full meals on food labels.
  2. “When it comes to our children’s future, we cannot walk away until obesity rates drop for every age and every background… until every child has a shot at a healthy life… I’m in it for the long haul even after I leave the White House.” Mrs. Obama said that the recent JAMA article demonstrating a sizable (43%) drop in obesity rates among 2- to 5-year-olds indicates that the youngest Americans are growing up healthier, and PHA is on track to meet its goal of ending childhood obesity. However, she also emphasized that at this point, “our biggest risk to success is our impatience.” Only through continued and increased efforts will the US truly end childhood obesity. She highlighted that the obesity epidemic took decades to escalate to current levels, and will likely take decades to resolve. Rather than take these early results as an indication that we have met our goal, Mrs. Obama urged the audience to take them as an indication that our methods are working and that we must redouble our efforts. We appreciate that she acknowledged the time commitment required for this vast undertaking, although her goal of eliminating childhood obesity within a generation is also ambitious. Regardless of the exact timeline, we were thrilled to hear that the First Lady is committing herself long-term to this public health crisis, as since she has been an inspirational and grounding leader, through both her call to companies to step up and her “Let’s Move!” program.
  3. Dr. James Gavin (Chair, Partnership for a Healthier America, Washington, DC; Emory University School of Medicine, Atlanta, GA) kicked off PHA’s Building a Healthier Future Summit with a grounded and hopeful perspective on the fight against obesity. Dr. Gavin began by highlighting the results from the recently published study in JAMA mentioned above, but he tempered his enthusiasm by emphasizing that other age groups saw a plateau in obesity rates, noting  “one blossom does not make a spring but provides hope that a season will come.” Although Dr. Gavin remained optimistic that the obesity epidemic could be conquered, he emphasized that the public and private sector relationships will be crucial in finding the solution. We agree that cautious optimism is a wise perspective, particularly given that rates of severe obesity in adults are still on the rise. Dr. Gavin also highlighted the transparency of PHA’s partnerships, noting that third parties independently verify results from partners’ commitments (please see PHA's 2013 annual progress report), demonstrating that partnerships with PHA emphasize action instead of “publicity handshakes.” We also appreciated Dr. Gavin’s shout-out to PHA’s Building a Healthier Future Summit national sponsor, Novo Nordisk, for its dedication to fighting the diabetes epidemic.
  4. During the lunchtime “Childhood Obesity Solutions Showcase,” Philadelphia Mayor Michael Nutter provided an overview of Philadelphia’s efforts to improve its nutritional and exercise environment, and Lt. Gen. Mark Hertling (Senior VP, Global Partnering, Physicians Leadership Development and “Healthy 100,” Florida Hospital, Orlando, FL) explained why obesity is a national security issue. Mayor Nutter’s current mission is to eliminate sugar-sweetened beverages in all schools and homes; in a disheartening moment, he commented that there are 3 oz. (73 g) of sugar in a 24 oz. bottle of Mountain Dew (we note that one serving – 12 oz. – has 1.5 times as much sugar as a milk chocolate Hershey’s bar!). Although Mayor Nutter assured the audience that he wasn’t against soda, he did remark, “It’s a struggle to find something more worthless.” Lt. Gen. Hertling said the army couldn’t recruit 75% of the current population of 17- to 24-year-olds due to health issues, with 20% of these people either overweight or obese. He has noticed that new recruits are coming in with weak bones, excess weight, and behavioral issues associated with poor nutrition. To combat the increased frailty of recruits – and the increased cost of associated medical expenses – Lt. Gen. Hertling began the Fueling the Soldier Initiative, which provides a dietician and menu planner to those in the Army.
    • Mayor Nutter has begun initiatives to help reduce the number of vending machines in schools and instead introduce low-fat milk. Speaking to the success of his health campaigns in Philadelphia schools, Mayor Nutter commented that teacher support has helped immensely, and now students are getting involved themselves; ~170 schools have wellness councils (out of the over 200 schools in Philadelphia). Thousands of students are wellness council advisors who share their knowledge of nutrition with other students and assist cafeterias in choosing healthy menu items.
    • Turning to the root of the problem, Lt. Gen. Hertling highlighted that there are only six states in the US that require physical education for all students in K-12. The US needs to reverse this trend and reinvest in PE and home economics to encourage exercise and teach students about nutrition.
  5. We gained some insight into what big food companies – namely Campbell Soup, PepsiCo, and Nestlé – are doing to help fight the obesity epidemic. In Campbell’s presentation, we were impressed with its recent 10-year commitment to reduce childhood obesity rates by 50% in the company’s hometown of Camden, NJ. The year 2024 seems far away, but we’re eager to see the results of this longitudinal commitment, as Camden has one of the highest childhood obesity rates in the US (~40%). Mr. Richard Black (VP, Global R&D Nutrition, PepsiCo, Valhalla, NY) highlighted that PepsiCo has removed a combined 3,386 tons of sodium and 22,000 tons of saturated fat from its global product profile, as well as 270,000 tons of sugar from its North American product profile (all comparisons 2012 vs. 2006). Additionally, PepsiCo has initiated a public-private partnership with the USDA/ARS, International Life Science Institute, and Agricultural Technology Innovation Partnership in order to augment the USDA’s national nutrient database with more detailed information on the nutrient composition of branded foods. Mr. Paul Bakus (President of Corporate Affairs, Nestlé USA, Washington, DC) presented initiatives taken with some of the company’s less healthy foods, particularly highlighting the reduction of sodium in its pizzas as well as the marketing of smaller versions of Nestlé’s Drumsticks ice cream brand. Notably, Nestlé hopes by 2020 to eliminate all added sugar in the product (although we do wonder what qualifies as “added” vs. “natural”).
    • Although the progress we heard from these companies is a step in the right direction, some panelists remarked that, at the end of the day, companies are out to make the “biggest buck.” Overall, we view this as a reductive way of looking at the issue, as the barriers to marketing and developing healthier foods remain high. According to an Industrial Research Institute [IRI] study, 90% of new products fail, and 80% achieve less than $7.5 million in first-year sales, making it unsurprising that these large, risk-averse companies would not want to invest in a new product line. Mr. Hank Cardello (Senior Fellow and Director, Obesity Solutions Initiative, Hudson Institute, Washington, DC) noted that ~25% of the US population is unwilling to give up taste for nutrition and that ~50% of people want to be healthy but feel they don’t have the time, resources, or incentive to buy healthy products. These statistics seem to have forced companies to adopt the “stealth health” mentality, wherein healthy changes are made carefully and incrementally so as to hedge risks and ease consumers into the product shift (even if said shift is glacially slow). Mr. Black provided some hope when he borrowed a line from Malcolm Gladwell, remarking, “If you’re going to fail…fail fast, fail often, and fail cheap.” If failures are cheap, companies may be more willing to take a chance, especially if a product shift means better publicity in the long run (a noteworthy point from Friday’s “foundational viewpoint” breakout session).
    • In a Friday breakout session, small grocers and organic food distributers also focused on marketing and consumer pressure; however, the conversation focused on how to make purchasing healthier products an easy, attractive option. Ms. Samantha Cabaluna (VP, Marketing and Communications, Earthbound Farm, San Juan Bautista, CA) shared Earthbound's market research, which found that 80% of consumers who tried the company’s nutritious “power meal bowls” said its main appeal was convenience. Mr. Andy Nathan (CMO, Victors & Spoils, Boulder, CO) also stressed innovative marketing and suggested breaking classical food conventions. A memorable example: Why not market carrots as convenient, cool, and delicious snacks in the same way that Cheetos are? Lastly, Mr. Ric Jurgens (Chairman Emeritus, Hy-Vee, West Des Moines, IA) highlighted the company’s successful placement of chefs and dieticians in their grocery stores. He said that if you can leverage the trust factor that these specialists have with consumers, then you could widely dispense nutrition knowledge and basic cooking skills (a point that the First Lady emphasized in her keynote). As a whole, this panel focused on transforming consumer perspective so that people will want to buy the healthy products that these companies already offer. This proved a refreshing contrast to the larger, risk-averse companies’ emphasis on designing healthier products only if the market demands it.
  6. Friday morning’s “Foundation Viewpoints” session with PHA’s co-founders highlighted areas for future collaboration outside of the organization’s current focus on private-public partnerships. Dr. Gavin prefaced this session as “an assessment of PHA’s report card,” starting off by reviewing the organization’s successes. The panel was unanimously proud of PHA’s three-year track record — not surprising given that they metaphorically “gave birth” to the organization, as Ms. Marion Standish (Senior Advisor, Office of the President, Washington, DC) joked. However, the speakers stressed that while PHA has been laser-focused on private-public partnerships, many other avenues for change have yet to be fleshed out. Future interest areas include: 1) forming partnerships with non-vested sectors (e.g. government municipalities, public service organizations); 2) initiating smaller, regional efforts; and 3) engaging with large companies that feel “they may not have a dog in the fight” against childhood obesity. The Q&A session also raised new focus areas for PHA to consider, such as government and environmental policy, prevention programs, private insurers, and populations outside of PHA’s current focus (one specific example was children with disabilities). Some new PHA partnerships that we would love to see the organization pursue include: 1) the Special Olympics; 2) Nike; 3) Facebook/ Instagram; 4) Local government officials, i.e., public figures like Mayor Michael Nutter and Senator Cory Booker; 5) Starbucks; and, of course, a range of healthcare companies (please email if you’d like to hear our other ideas or share your own!)
  7. PHA announced 11 new partners at this year’s PHA: FirstBIKE, Knowledge Universe, Nutri Ventures, Sodexo, four new hospital systems (Eskenazi Health, Meridian, St. Luke’s Hospital, and UnityPoint Health – Trinity), Dannon, Del Monte, and Kwik Trip. These additions bringing PHA’s total number of partners to over 50. PHA’s continued commitment to expanding its growing net of partnerships is certainly impressive; an area we would like to follow more closely in the future, particularly in how partners are following through on their commitments. Thus, we’re excited to read PHA’s recently 2013 progress report, which provides year-end updates on partnership commitments. We have heard that Wal-Mart, which had arguably the most ambitious challenges, is actually turning in the best results.
    • FirstBIKE is committing to donating bikes to the YCMA and similar organizations.
    • Knowledge Universe is committing to limiting screen time (i.e. watching TV, playing with video games, etc.) for children; their other goals include encouraging physical activities and healthy food choices, accommodating mothers who wish to breastfeed, and offering nutrition education to parents.
    • Sodexo will commit to implementing healthy dining programs in 95% of its food service accounts, expanding healthier food choices in hospitals, and offering healthier vending and lunch options in schools as well as more free breakfasts.
    • Nutri Ventures has committed to using entertainment to promote healthy lifestyle and nutritious foods. For background, the company produces the first multi-platform children’s show, Nutri Ventures: The Quest for the 7 Kingdoms, which emphasizes healthy eating through adventures.
    • The four hospitals have committed to offering healthier options throughout their facilities in the upcoming years.
    • Dannon has committed to improving nutrient density by 10% and reducing sugar (to less than 23 g per 6 oz. serving) and fat in its yogurt products, all by June 2016. The nation’s leading yogurt producer has also committed to investing $3 million for education and research focused on healthy eating habits (although we note that this is just a small drop in the bucket compared to its ~$2.1 billion annual revenue).
    • Del Monte, a leading canned fruit and vegetable company, committed even larger sums ($5 million in 2014, $6 million in 2015, and $7 million in 2016) to execute marketing campaigns that encourage families and children to eat healthier. The company will also improve product nutrient density and donate more produce to anti-hunger efforts.
    • Kwik Trip committed to improving healthier food access and implementing new EATSmart and Healthy Concessions programs to promote healthy choices among consumers and local organizations.
  8. We were surprised – and pleased – when Senator Cory Booker (D-NJ) Skyped into the closing plenary to encourage attendees to “continue the progress and roll up our sleeves.” In looking at what PHA and the country in general have accomplished, Senator Booker applauded the “measurable strides” that many PHA partners and supporters have made; however, he also called for increased participation. He noted that the fight to end childhood obesity is not a spectator sport, and everyone – including religious organizations, nonprofits, and industry – must get involved. He remarked that it is necessary for the US to continue the “cultivation of our most precious resource…children.” Senator Booker also acknowledged that the process is hard. We take his word since childhood obesity is one of the most difficult challenges facing New Jersey, yet Senator Booker made significant strides to address the epidemic in his community during his tenure as mayor of Newark.
  9. “There’s no better time to be an innovator in health than right now,” Mr. Aneesh Chopra (Senior Advisor, The Advisory Board Company, Washington, DC) remarked during the breakout session on health and wellness apps. As data grows exponentially and datasets start to intersect, there is much opportunity for the contextualization of real-time data, e.g., connecting a meal-planning app with open health data from the CDC to help families living in food deserts find affordable, nutritious groceries. Additionally, there is the “blue button” phenomenon, i.e., apps opting to share data with HCPs. While the sticky issue of personal data privacy remains a challenge for app development, we think this concept of shared data has the potential to create smarter physicians and more holistic care. Indeed, we have seen similar partnerships recently in diabetes care; on February 24, Diasend announced a partnership to sync data with Practice Fusion’s EHR. Additionally, Mr. Travis Bogard (VP, Product Management and Strategy, Jawbone, San Francisco, CA) noted that real-time data on sleep, calorie intake, and step counts collected with current fitness technology could open up opportunities for policy change and future innovations. However, this field is not without challenges, and one issue that innovators must seriously consider is that of “gamification,” a problematic phenomenon in the mind of video-game developer Mr. Ben Sawyer (Co-Founder, Games for Health, Portland, ME). Instead of arbitrarily adding points and badges to an app in order to make it more like a game, he advocated for app developers to partner with experienced video game developers to create something fresh and interesting. By building honest narratives based on the principles of social learning theory, future health apps have the potential to change behavior, including improving eating habits and increasing physical activity.
    • PHA has taken this idea seriously, hosting its second annual Innovation Challenge – the Audience Choice Award went to the StartAGarden platform. Competing in the “hackathon” sponsored by The Feast were 30 tech-savvy developers aiming to address one of two questions: 1) How can we inform lower-income families about physical activity and healthy food in their community? or 2) How can we empower students to make healthier choices in schools? The two finalists presented their designs on Thursday afternoon: SuperFuel helps lower-income families eat healthier and exercise more by involving the entire family and gamifying the process; families achieve “superhero status” by completing a weekly meal or physical activity “mission.” Successful completion earns points towards family-based incentives that increase over time e.g., larger discounts on nutritious foods. StartAGarden tackles the dual problem that kids are only consuming half of the recommended number of fruit and vegetable servings and that teachers only have limited time and resources to address this deficit. This innovative platform provides teachers, students, and even parents with user-friendly information to grow and maintain a school garden.
    • Mr. Dennis Ai (Co-founder, JiveHealth, Chicago, IL), winner of last year’s Innovation Challenge, provided an update on his company’s app Easy Eater, aimed to encourage kids to eat more fruits and vegetables. Additionally, Mr. Ai remarked that the second generation of the app, available on the iPhone, has launched, and the company is looking to further improve the app and launch a third iteration.
  10. We talked at length with Mr. Mark Schiller, President of Birds Eye (a large producer of frozen vegetables). Mr. Schiller struck us as a very savvy CEO who has an excellent job: selling more frozen vegetables. We learned a number of surprising things from him: 1) Approximately 30% of fresh vegetables spoil and are thrown away; 2) The entire fresh vegetable global market is at least 10 times bigger than the frozen market; and 3) The barriers to persuading people to eat frozen vegetables (which he emphasized are healthy) are quite significant. Although frozen vegetables are arguably easier to prepare, are certainly cheaper, have year-round accessibility, do not spoil, and provide consumers with a greater variety of vegetables than they can often purchase fresh, there are still large barriers to address. Examples include negative public perception and criticism – indeed, annual growth for frozen vegetables (~5%) falls short the growth seen in the fresh vegetable market (5-10%). Still, Birds Eye took a savvy approach at PHA, making a great impression as the Summit's premiere sponsor in addition to offering the coolest conference giveaway – its carrot-shaped pens were increasingly scarce and sought-after – and excellent food doled out by engaging chefs.


Honorable Mentions

  • On Thursday evening, we had the honor of attending the REAL Food Innovator Awards at the Whittemore House. Sponsored by the US Healthful Food Council (USHFC), the REAL Food Innovator Awards "celebrates leaders in healthful sustainable foods." The USHFC is a nonprofit, nongovernmental organizaiton, which aims to improve the nutritional profile of food from industry in order to improve health outcomes. Entering the historic stone building and proceeding to the ballroom, attendees at this sold-out event were met with dimmed lights and elegantly set tables. The event was co-chaired by Mr. Ashley Koff (Ashley Koff, RD, Washington, DC) and Chef Michel Nischan (President and CEO, Wholesome Wave, Bridgeport, CT), who has children with type 1 diabetes. The dinner party featured food from Chef Sam Talbot (Montauk, NY), who has type 1 diabetes. During the meal, eight awards were announced in eight categories that influence food and nutrition. Most notable for us were: 1) Ms. Kristin Richmond (Co-founder, Revolution Foods, Oakland, CA) and Ms. Kirsten Tobey (Co-founder, Revolution Foods, Oakland, CA), who received their award for child nutrition in recognition of their work delivering meals for kids and producing Meal Kits, available at retailers around the world; 2) Dr. Marion Nestle (NYU, New York City, NY), who was named innovator of the year for her food policy education work and her research on food choice, obesity, and food safety; and 3) Mr. Michael Bloomberg, the former mayor of New York City, who was honored for his work on a variety of public health policies (which we know well!), including his work advocating for taxes on trans fats. Served family-style, dinner was mouth-watering and packed with veggies: kale chips, chicken thigh braised with adobo, dogfish, mushrooms with broccoli, parsnips, roasted turnips with braised sweet potato leaves, and roasted kohlrabi with pea greens. Dessert consisted of poppy seed cake and lemon, vegan “buttercream” chocolates, and macaroons; the murmurs of delight were audible around the ballroom.
    • Other awardees include: 1) Mr. Seth Goldman (President and CEO, Honest Tea, Bethesda, MD) for the best beverage (Honest Tea which has less sugar than most bottled drinks); 2) Mr. Robert Egger (President, LA Kitchen, Los Angeles, CA) for food access, as his L.A. Kitchen will recover fruits and vegetables and use the kitchen as a way to train men and women coming out of foster care or those coming out of jail; 3) Mr. Ken Cook (President, Environmental Working Group, Washington, DC) for his nonprofit advocacy, which critically evaluates US farm and food policy as well as federal chemicals and pesticides law; 4) Mr. Steve Ells and Mr. Monty Moran (Co-CEOs, Chipotle Mexican Grill, Denver, CO) for food marketing of their sustainability efforts; and 5) Mr. Stephen McDonnell (CEO, Applegate Farms, Bridgewater, NJ) for food production, since Applegate Farms is a proponent of sustainable agricultural practices and humane livestock treatment.
    • Sponsored by the United States Healthful Food Council (USHFC), the REAL Food Innovator Awards “celebrate leaders in healthful and sustainable foods.” The USHFC is a nonprofit, nongovernmental organization, which aims to improve the nutritional profile of food from industry in order to improve health outcomes.
  • We were very pleased with PHA’s attention to healthy details throughout the conference, including exercise breaks and nutritious breakfasts featuring fresh fruit, yogurt, and oatmeal. We also noted that the conference featured only zero-calorie drinks (which stands in stark contrast, unfortunately, to many conferences we attend!). The morning plenary on Day 1 ended with a video of students, bus drivers, office staff, and many others guiding the audience through a series of dance and aerobics moves, including toe taps and squats. While the light exercise break was certainly welcome, the lunch-time sessions kicked it up several notches with appearances by renowned rapper Doug E. Fresh (VP, Hip Hop Public Health, New York City, NY) – whose organization creates songs to inspire healthy living in children – and professional fitness instructors from the City Gym Boys, a New York City group that mentors youth on fitness and exercise. Audience volunteers performed a series of strength exercises that we bet made them wish they had worn their sneakers! Lt. Gen. Hertling even competed in a push-up contest with the instructors. Once everyone’s heart rates were up, Doug E. Fresh led the audience in an unexpected dance party. Trust us when we say that watching the entire conference audience doing “The Dougie” dance move was a sight to remember.
    • During the final plenary, the charismatic Ms. Kathleen Tullie (Founder, Executive Director, BOKS, Canton, MA) led an energizing exercise break including aerobics and jogging musical chairs. BOKS (Building Our Kids’ Success) is an initiative of Reebok and the Reebok Foundation created by a group of moms who were concerned about the lack of physical activity in schools – surprisingly, less than 47% of elementary schools have daily PE and only 57% have regular recess. This free, before-school physical activity program is already active in almost 900 schools worldwide.  In our opinion, it seems like a simple, cost-effective solution that we hope will be implemented in many more schools nationwide.


Exhibition Hall

In addition to our top ten highlights, we also attended a packed exhibition hall this year. The Summit Expo this year featured 35 exhibits (almost doubling last year’s 19) where attendees could try healthy snack examples, see the latest health technology in action, and learn more about the companies and organizations working to end childhood obesity. Some notable presenters that we enjoyed included: Let’s Move! Active Schools; Wat-aah, which gave out eye-catching bottles of their signature product (vibrantly-branded H2O); Walmart, which featured an interactive, real-scale grocery aisle set-up; Dannon, which passed out its yogurt products including a new Greek yogurt marketed to kids; BRITA, which gave out its bright green “Drink Up” Nalgene bottle, which could be filled up at water stations around the hall; Del Monte Foods, which passed out samples of their portable fruit purees; Birds Eye Foods, which featured its fun stationary bike set-up that allowed participants to race each other; Kurbo Health, which showcased its new app that helps kids and teens plan their meals and track physical activity (very intuitive and easy to use, we think).


Appendix: Detailed Discussion and Commentary

Closing Main Plenary

Keynote Address: Michelle Obama

Michelle Obama, JD (First Lady of the United States, Washington, DC)

In the highly anticipated keynote event, First Lady Michelle Obama delivered her address to a packed ballroom. Cool, calm, collected, and uber-composed, as we’ve come to expect of the First Lady, Mrs. Obama focused her presentation on the importance of home-cooked meals. She called this the “single most impactful way” that a family can improve its health. When families control what goes in their food, meals often contain fewer calories, less fat, and less cholesterol. Additionally, she highlighted that children who eat home-cooked meals have better emotional health, perform better in school, and get along better with their peers. While people often believe that cooking at home is too time-consuming and expensive, Mrs. Obama explained that typically the root of the problem is that people don’t have the necessarily skills to cook efficiently. While this is a step in a different direction for PHA, the First Lady remarked that the organization would begin initiatives in order to increase the number of meals cooked at home. Mrs. Obama closed her keynote by urging the audience to continue its efforts to reduce childhood obesity. Although she acknowledged the successes we have seen in reducing obesity in 2- to 5-year-olds, she highlighted that a third of children are still overweight or obese, a fact that further highlights the need to redouble our efforts rather than pat ourselves on the back. Excitingly, she announced her commitment to the cause even post-White House, explaining that none of us can afford to walk away until obesity rates drop for every age and background.

  • “Right now the biggest risk to success [in defeating childhood obesity] is our impatience.” In highlighting the need to redouble efforts to fight obesity, Mrs. Obama pleaded for the audience to not feel like small wins – such as the decrease in obesity in children between the ages of two and five reported recently in JAMA – are evidence that the country has reversed the obesity epidemic. She emphasized that resolving the obesity epidemic is not a five- or ten-year goal, but rather a generational goal; she remarked that it took decades for the obesity epidemic to get to where it is and it will take decades to fix it.
  • Mrs. Obama emphasized her commitment to ending childhood obesity, remarking, “I’m in it for the long haul, even after I leave the White House.” Mrs. Obama highlighted that the country cannot walk away until obesity rates drop for every age and every background and until every child has the opportunity to have a healthy life. She commented that, if PHA and the nation as a whole don’t keep pushing the initiatives, there is no guarantee that obesity levels won’t return to where they started. We commend Mrs. Obama for expressing her dedication to the cause, and we are so thrilled to see her continue on this front – her resolve and charisma will be invaluable for future efforts.
  • Cooking at home has fallen by the wayside – many people either feel like they don’t have time to cook, think it is more expensive to cook, or don’t know how to cook. Mrs. Obama commented that her mother would go to the store to buy groceries for the entire week, and her family would always eat at home since they could not afford to eat out; however, the First Lady remarked that times are changing and more and more people are not learning basic cooking skills, and people are increasingly overwhelmed with the simplest recipes. Mrs. Obama assured the audience that, with the proper skills, there are numerous 30-minute meals that families can make. Indeed, with some education, people can learn to buy food economically. For instance, while most people believe that fast food is cheap, a family of four could eat one meal at McDonalds for ~$16 or buy a frozen turkey for $20, which would provide several meals.
    • Mrs. Obama commented that she had always prioritized her education and career over learning to cook, a decision that eventually resulted in “less than optimal health outcomes” for her children. While Mrs. Obama’s mother and grandmother planned meals a week in advance and cooked planned meals through the week (“Wednesday was liver night – it was a sad night”), she remarked that she thought she never had time to cook: “My grandmother would always ask me what I was cooking. I would say ‘Grandma, I’m a lawyer. I don’t cook.’” However, she lamented that, when she had children, cooking was exhausting and, often, the family reverted to ordering pizza or take-out food.
  • Mrs. Obama remarked that PHA initiatives will begin to focus on increasing the amount of meals that are cooked at home through increased recipe distribution, an increase in the number cooking classes, and an increase in the number of cooking demonstrations. All of these initiatives could help people gain the skills necessary to make cooking time and cost efficient. However, we wonder what the accessibility to these initiatives will be (e.g., Will cooking classes only take place in urban areas?).
  • The message of increased pressure on home-cooked meals is unique from the message we heard at the rest of the meeting: namely, that it is important for companies to improve their nutrition profile and convenience factor of their pre-made products. We applaud Mrs. Obama for changing the conversation at PHA; however, we wonder how the larger companies will respond to this message.
  • “Kids born today will grow up healthy…we are on track to achieve our goal; however, if we don’t keep innovating and pushing forward, there is no guarantee we won’t go right back to where we started.” Mrs. Obama commented that healthy habits are becoming the new norm. She pointed to the statistics that obesity rates have fallen by 43% among children two to five years old (Ogden et al., JAMA, 2014). While these small victories are hints of progress and reminders that our strategies are beginning to work, Mrs. Obama cautioned that it is important to remember that obesity rates are still high, particularly among older children. It is important to keep pushing forward, building healthier schools, bringing fresh foods into communities, urging businesses to market healthier foods, and attacking the problem from every possible angle.
  • Mrs. Obama highlighted the successes of PHA and its partners. There are 32 million kids getting healthier school meals, tens of thousands of schools are removing junk food ads, 15,000 childcare centers are providing healthier snacks, 6.4 trillion calories have been cut from products, and 700,000 food items have better labels.


--by Hannah Martin, Jenny Tan, Manu Venkat, and Kelly Close