[Congressional Record Volume 149, Number 176 (Tuesday, December 9, 2003)]
[Senate]
[Pages S16094-S16100]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              IMPROVED NUTRITION AND PHYSICAL ACTIVITY ACT

  Mr. FRIST. Mr. President, I ask unanimous consent that the Senate now 
proceed to the consideration of Calendar No. 417, S. 1172.
  The PRESIDING OFFICER. The clerk will report the bill by title.
  The legislative clerk read as follows:

       A bill (S. 1172) to establish grants to provide health 
     services for improved nutrition, increased physical activity, 
     obesity prevention, and for other purposes.

  There being no objection, the Senate proceeded to consider the bill 
which had been reported from the Committee on Health, Education, Labor, 
and Pensions with an amendment in the nature of a substitute, as 
follows:
  (Strike the part shown in black brackets and insert the part printed 
in italic.)

                                S. 1172

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     [SECTION 1. SHORT TITLE.

       [This Act may be cited as the ``Improved Nutrition and 
     Physical Activity Act'' or the ``IMPACT Act''.

     [SEC. 2. FINDINGS.

       [Congress makes the following findings:
       [(1) An estimated 61 percent of adults and 13 percent of 
     children and adolescents in the Nation are overweight or 
     obese.

[[Page S16095]]

       [(2) The prevalence of obesity and being overweight is 
     increasing among all age groups. There are twice the number 
     of overweight children and 3 times the number of overweight 
     adolescents as there were 29 years ago.
       [(3) An estimated 300,000 deaths a year are associated with 
     being overweight or obese.
       [(4) Obesity and being overweight are associated with an 
     increased risk for heart disease (the leading cause of 
     death), cancer (the second leading cause of death), diabetes 
     (the 6th leading cause of death), and musculoskeletal 
     disorders.
       [(5) Individuals who are obese have a 50 to 100 percent 
     increased risk of premature death.
       [(6) The Healthy People 2010 goals identify obesity and 
     being overweight as one of the Nation's leading health 
     problems and include objectives of increasing the proportion 
     of adults who are at a healthy weight, reducing the 
     proportion of adults who are obese, and reducing the 
     proportion of children and adolescents who are overweight or 
     obese.
       [(7) Another goal of Healthy People 2010 is to eliminate 
     health disparities among different segments of the 
     population. Obesity is a health problem that 
     disproportionally impacts medically underserved populations.
       [(8) The United States Surgeon General's report ``A Call To 
     Action'' lists the treatment and prevention of obesity as a 
     top national priority.
       [(9) The estimated direct and indirect annual cost of 
     obesity in the United States is $117,000,000,000 (exceeding 
     the cost of tobacco-related illnesses) and appears to be 
     rising dramatically. This cost can potentially escalate 
     markedly as obesity rates continue to rise and the medical 
     complications of obesity are emerging at even younger ages. 
     Therefore, the total disease burden will most likely 
     increase, as well as the attendant health-related costs.
       [(10) Weight control programs should promote a healthy 
     lifestyle including regular physical activity and healthy 
     eating, as consistently discussed and identified in a variety 
     of public and private consensus documents, including ``A Call 
     To Action'' and other documents prepared by the Department of 
     Health and Human Services and other agencies.
       [(11) Eating preferences and habits are established in 
     childhood.
       [(12) Poor eating habits are a risk factor for the 
     development of eating disorders and obesity.
       [(13) Simply urging overweight individuals to be thin has 
     not reduced the prevalence of obesity and may result in other 
     problems including body dissatisfaction, low self-esteem, and 
     eating disorders.
       [(14) Effective interventions for promoting healthy eating 
     behaviors should promote healthy lifestyle and not 
     inadvertently promote unhealthy weight management techniques.
       [(15) Binge Eating is associated with obesity, heart 
     disease, gall bladder disease, and diabetes.
       [(16) Anorexia Nervosa, an eating disorder from which 0.5 
     to 3.7 percent of American women will suffer in their 
     lifetime, is associated with serious health consequences 
     including heart failure, kidney failure, osteoporosis, and 
     death. In fact, Anorexia Nervosa has the highest mortality 
     rate of all psychiatric disorders, placing a young woman with 
     Anorexia at 18 times the risk of death of other women her 
     age.
       [(17) Anorexia Nervosa and Bulimia Nervosa usually appears 
     in adolescence.
       [(18) Bulimia Nervosa, an eating disorder from which an 
     estimated 1.1 to 4.2 percent of American women will suffer in 
     their lifetime, is associated with cardiac, gastrointestinal, 
     and dental problems, including irregular heartbeats, gastric 
     ruptures, peptic ulcers, and tooth decay.
       [(19) On the 1999 Youth Risk Behavior Survey, 7.5 percent 
     of high school girls reported recent use of laxatives or 
     vomiting to control their weight.
       [(20) Binge Eating Disorder is characterized by frequent 
     episodes of uncontrolled overeating, with an estimated 2 to 5 
     percent of Americans experiencing this disorder in a 6-month 
     period.
       [(21) Eating disorders are commonly associated with 
     substantial psychological problems, including depression, 
     substance abuse, and suicide.
       [(22) Eating disorders of all types are more common in 
     women than men.

                       [TITLE I--TRAINING GRANTS

     [SEC. 101. GRANTS TO PROVIDE TRAINING FOR HEALTH PROFESSION 
                   STUDENTS.

       [Section 747(c)(3) of title VII of the Public Health 
     Service Act (42 U.S.C. 293k(c)(3)) is amended by striking 
     ``and victims of domestic violence'' and inserting ``victims 
     of domestic violence, individuals (including children) who 
     are overweight or obese (as such terms are defined in section 
     399W(j)) and at risk for related serious and chronic medical 
     conditions, and individuals who suffer from eating 
     disorders''.

     [SEC. 102. GRANTS TO PROVIDE TRAINING FOR HEALTH 
                   PROFESSIONALS.

       [Section 399Z of the Public Health Service Act (42 U.S.C. 
     280h-3) is amended--
       [(1) in subsection (b), by striking ``2005'' and inserting 
     ``2007'';
       [(2) by redesignating subsection (b) as subsection (c); and
       [(3) by inserting after subsection (a) the following:
       [``(b) Grants.--
       [``(1) In general.--The Secretary may award grants to 
     eligible entities to train primary care physicians and other 
     licensed or certified health professionals on how to 
     identify, treat, and prevent obesity or eating disorders and 
     aid individuals who are overweight, obese, or who suffer from 
     eating disorders.
       [``(2) Application.--An entity that desires a grant under 
     this subsection shall submit an application at such time, in 
     such manner, and containing such information as the Secretary 
     may require, including a plan for the use of funds that may 
     be awarded and an evaluation of the training that will be 
     provided.
       [``(3) Use of funds.--An entity that receives a grant under 
     this subsection shall use the funds made available through 
     such grant to--
       [``(A) use evidence-based findings or recommendations that 
     pertain to the prevention and treatment of obesity, being 
     overweight, and eating disorders to conduct educational 
     conferences, including Internet-based courses and 
     teleconferences, on--
       [``(i) how to treat or prevent obesity, being overweight, 
     and eating disorders;
       [``(ii) the link between obesity and being overweight and 
     related serious and chronic medical conditions;
       [``(iii) how to discuss varied strategies with patients 
     from at-risk and diverse populations to promote positive 
     behavior change and healthy lifestyles to avoid obesity, 
     being overweight, and eating disorders;
       [``(iv) how to identify overweight and obese patients and 
     those who are at risk for obesity and being overweight or 
     suffer from eating disorders and, therefore, at risk for 
     related serious and chronic medical conditions; and
       [``(v) how to conduct a comprehensive assessment of 
     individual and familial health risk factors; and
       [``(B) evaluate the effectiveness of the training provided 
     by such entity in increasing knowledge and changing attitudes 
     and behaviors of trainees.''.

[TITLE II--COMMUNITY-BASED SOLUTIONS TO INCREASE PHYSICAL ACTIVITY AND 
                           IMPROVE NUTRITION

     [SEC. 201. GRANTS TO INCREASE PHYSICAL ACTIVITY AND IMPROVE 
                   NUTRITION.

       [Part Q of title III of the Public Health Service Act (42 
     U.S.C. 280h et seq.) is amended by striking section 399W and 
     inserting the following:

     [``SEC. 399W. GRANTS TO INCREASE PHYSICAL ACTIVITY AND 
                   IMPROVE NUTRITION.

       [``(a) Establishment.--
       [``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention 
     and in coordination with the Administrator of the Health 
     Resources and Services Administration, the Director of the 
     Indian Health Service, the Secretary of Education, the 
     Secretary of Agriculture, the Secretary of the Interior, the 
     Director of the National Institutes of Health, the Director 
     of the Office of Women's Health, and the heads of other 
     appropriate agencies, shall award competitive grants to 
     eligible entities to plan and implement programs that promote 
     healthy eating behaviors and physical activity to prevent 
     eating disorders, obesity, being overweight, and related 
     serious and chronic medical conditions. Such grants may be 
     awarded to target at-risk populations including youth, 
     adolescent girls, racial and ethnic minorities, and the 
     underserved.
       [``(2) Term.--The Secretary shall award grants under this 
     subsection for a period not to exceed 4 years.
       [``(b) Award of Grants.--An eligible entity desiring a 
     grant under this section shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may require, including--
       [``(1) a plan describing a comprehensive program of 
     approaches to encourage healthy eating behaviors and healthy 
     levels of physical activity;
       [``(2) the manner in which the eligible entity will 
     coordinate with appropriate State and local authorities, 
     including--
       [``(A) State and local educational agencies;
       [``(B) departments of health;
       [``(C) chronic disease directors;
       [``(D) State directors of programs under section 17 of the 
     Child Nutrition Act of 1966 (42 U.S.C. 1786);
       [``(E) 5-a-day coordinators;
       [``(F) governors' councils for physical activity and good 
     nutrition; and
       [``(G) State and local parks and recreation departments; 
     and
       [``(3) the manner in which the applicant will evaluate the 
     effectiveness of the program carried out under this section.
       [``(c) Coordination.--In awarding grants under this 
     section, the Secretary shall ensure that the proposed 
     programs are coordinated in substance and format with 
     programs currently funded through other Federal agencies and 
     operating within the community including the Physical 
     Education Program (PEP) of the Department of Education.
       [``(d) Eligible Entity.--In this section, the term 
     `eligible entity' means--
       [``(1) a city, county, tribe, territory, or State;
       [``(2) a State educational agency;
       [``(3) a tribal educational agency;
       [``(4) a local educational agency;
       [``(5) a federally qualified health center (as defined in 
     section 1861(aa)(4) of the Social Security Act (42 U.S.C. 
     1395x(aa)(4));
       [``(6) a rural health clinic;

[[Page S16096]]

       [``(7) a health department;
       [``(8) an Indian Health Service hospital or clinic;
       [``(9) an Indian tribal health facility;
       [``(10) an urban Indian facility;
       [``(11) any health care service provider;
       [``(12) an accredited university or college; or
       [``(13) any other entity determined appropriate by the 
     Secretary.
       [``(e) Use of Funds.--An eligible entity that receives a 
     grant under this section shall use the funds made available 
     through the grant to--
       [``(1) carry out community-based activities including--
       [``(A) planning and implementing environmental changes that 
     promote physical activity;
       [``(B) forming partnerships and activities with businesses 
     and other entities to increase physical activity levels and 
     promote healthy eating behaviors at the workplace and while 
     traveling to and from the workplace;
       [``(C) forming partnerships with entities, including 
     schools, faith-based entities, and other facilities providing 
     recreational services, to establish programs that use their 
     facilities for after school and weekend community activities;
       [``(D) establishing incentives for retail food stores, 
     farmer's markets, food coops, grocery stores, and other 
     retail food outlets that offer nutritious foods to encourage 
     such stores and outlets to locate in economically depressed 
     areas;
       [``(E) forming partnerships with senior centers and nursing 
     homes to establish programs for older people to foster 
     physical activity and healthy eating behaviors;
       [``(F) forming partnerships with day care facilities to 
     establish programs that promote healthy eating behaviors and 
     physical activity; and
       [``(G) providing community educational activities targeting 
     good nutrition;
       [``(2) carry out age-appropriate school-based activities 
     including--
       [``(A) developing and testing educational curricula and 
     intervention programs designed to promote healthy eating 
     behaviors and habits in youth, which may include--
       [``(i) after hours physical activity programs;
       [``(ii) increasing opportunities for students to make 
     informed choices regarding healthy eating behaviors; and
       [``(iii) science-based interventions with multiple 
     components to prevent eating disorders including nutritional 
     content, understanding and responding to hunger and satiety, 
     positive body image development, positive self-esteem 
     development, and learning life skills (such as stress 
     management, communication skills, problem-solving and 
     decisionmaking skills), as well as consideration of cultural 
     and developmental issues, and the role of family, school, and 
     community;
       [``(B) providing education and training to educational 
     professionals regarding a healthy lifestyle and a healthy 
     school environment;
       [``(C) planning and implementing a healthy lifestyle 
     curriculum or program with an emphasis on healthy eating 
     behaviors and physical activity; and
       [``(D) planning and implementing healthy lifestyle classes 
     or programs for parents or guardians, with an emphasis on 
     healthy eating behaviors and physical activity;
       [``(3) carry out activities through the local health care 
     delivery systems including--
       [``(A) promoting healthy eating behaviors and physical 
     activity services to treat or prevent eating disorders, being 
     overweight, and obesity;
       [``(B) providing patient education and counseling to 
     increase physical activity and promote healthy eating 
     behaviors; and
       [``(C) providing community education on good nutrition and 
     physical activity to develop a better understanding of the 
     relationship between diet, physical activity, and eating 
     disorders, obesity, or being overweight; or
       [``(4) other activities determined appropriate by the 
     Secretary.
       [``(f) Matching Funds.--In awarding grants under subsection 
     (a), the Secretary may give priority to eligible entities who 
     provide matching contributions. Such non-Federal 
     contributions may be cash or in kind, fairly evaluated, 
     including plant, equipment, or services.
       [``(g) Technical Assistance.--The Secretary may set aside 
     an amount not to exceed 10 percent of the total amount 
     appropriated for a fiscal year under subsection (k) to permit 
     the Director of the Centers for Disease Control and 
     Prevention to provide grantees with technical support in the 
     development, implementation, and evaluation of programs under 
     this section and to disseminate information about effective 
     strategies and interventions in preventing and treating 
     obesity and eating disorders through the promotion of healthy 
     eating behaviors and physical activity.
       [``(h) Limitation on Administrative Costs.--An eligible 
     entity awarded a grant under this section may not use more 
     than 10 percent of funds awarded under such grant for 
     administrative expenses.
       [``(i) Report.--Not later than 6 years after the date of 
     enactment of the Improved Nutrition and Physical Activity 
     Act, the Director of the Centers for Disease Control and 
     Prevention shall review the results of the grants awarded 
     under this section and other related research and identify 
     programs that have demonstrated effectiveness in healthy 
     eating behaviors and physical activity in youth.
       [``(j) Definitions.--In this section:
       [``(1) Anorexia nervosa.--The term `Anorexia Nervosa' means 
     an eating disorder characterized by self-starvation and 
     excessive weight loss.
       [``(2) Binge eating disorder.--The term `binge eating 
     disorder' means a disorder characterized by frequent episodes 
     of uncontrolled eating.
       [``(3) Bulimia nervosa.--The term `Bulimia Nervosa' means 
     an eating disorder characterized by excessive food 
     consumption, followed by inappropriate compensatory 
     behaviors, such as self-induced vomiting, misuse of 
     laxatives, fasting, or excessive exercise.
       [``(4) Eating disorders.--The term `eating disorders' means 
     disorders of eating, including Anorexia Nervosa, Bulimia 
     Nervosa, and binge eating disorder.
       [``(5) Healthy eating behaviors.--The term `healthy eating 
     behaviors' means--
       [``(A) eating in quantities adequate to meet, but not in 
     excess of, daily energy needs;
       [``(B) choosing foods to promote health and prevent 
     disease;
       [``(C) eating comfortably in social environments that 
     promote healthy relationships with family, peers, and 
     community; and
       [``(D) eating in a manner to acknowledge internal signals 
     of hunger and satiety.
       [``(6) Obese.--The term `obese' means an adult with a Body 
     Mass Index (BMI) of 30 kg/m\2\ or greater.
       [``(7) Overweight.--The term `overweight' means an adult 
     with a Body Mass Index (BMI) of 25 to 29.9 kg/m\2\ and a 
     child or adolescent with a BMI at or above the 95th 
     percentile on the revised Centers for Disease Control and 
     Prevention growth charts or another appropriate childhood 
     definition, as defined by the Secretary.
       [``(8) Youth.--The term `youth' means individuals not more 
     than 18 years old.
       [``(k) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this 
     section, $60,000,000 for fiscal year 2004 and such sums as 
     may be necessary for each of fiscal years 2005 through 
     2008. Of the funds appropriated pursuant to this 
     subsection, the following amounts shall be set aside for 
     activities related to eating disorders:
       [``(1) $5,000,000 for fiscal year 2004.
       [``(2) $5,500,000 for fiscal year 2005.
       [``(3) $6,000,000 for fiscal year 2006.
       [``(4) $6,500,000 for fiscal year 2007.
       [``(5) $1,000,000 for fiscal year 2008.''

     [SEC. 202. NATIONAL CENTER FOR HEALTH STATISTICS.

       [Section 306 of the Public Health Service Act (42 U.S.C. 
     242k) is amended by striking subsection (n) and inserting the 
     following:
       [``(n)(1) The Secretary, acting through the Center, may 
     provide for the--
       [``(A) collection of data for determining the fitness 
     levels and energy expenditure of children and youth; and
       [``(B) analysis of data collected as part of the National 
     Health and Nutrition Examination Survey and other data 
     sources.
       [``(2) In carrying out paragraph (1), the Secretary, acting 
     through the Center, may make grants to States, public 
     entities, and nonprofit entities.
       [``(3) The Secretary, acting through the Center, may 
     provide technical assistance, standards, and methodologies to 
     grantees supported by this subsection in order to maximize 
     the data quality and comparability with other studies.''.

     [SEC. 203. STUDY OF THE FOOD SUPPLEMENT AND NUTRITION 
                   PROGRAMS OF THE DEPARTMENT OF AGRICULTURE.

       [(a) In General.--The Secretary of Agriculture shall 
     request that the Institute of Medicine conduct, or contract 
     with another entity to conduct, a study on the food and 
     nutrition assistance programs run by the Department of 
     Agriculture.
       [(b) Content.--Such study shall--
       [(1) investigate whether the nutrition programs and 
     nutrition recommendations are based on the latest scientific 
     evidence;
       [(2) investigate whether the food assistance programs 
     contribute to either preventing or enhancing obesity and 
     being overweight in children, adolescents, and adults;
       [(3) investigate whether the food assistance programs can 
     be improved or altered to contribute to the prevention of 
     obesity and becoming overweight; and
       [(4) identify obstacles that prevent or hinder the programs 
     from achieving their objectives.
       [(c) Report.--Not later than 2 years after the date of 
     enactment of this Act, the Secretary of Agriculture shall 
     submit to the appropriate committees of Congress a report 
     containing the results of the Institute of Medicine study 
     authorized under this section.
       [(d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $750,000 for 
     fiscal years 2003 and 2004.

     [SEC. 204. HEALTH DISPARITIES REPORT.

       [Not later than 18 months after the date of enactment of 
     this Act, and annually thereafter, the Director of the Agency 
     for Healthcare Research and Quality shall review all research 
     that results from the activities outlined in this Act and 
     determine if particular information may be important to the 
     report on health disparities required by section 903(c)(3) of 
     the Public Health Service Act (42 U.S.C. 299a-1(c)(3)).

[[Page S16097]]

     [SEC. 205. PREVENTIVE HEALTH SERVICES BLOCK GRANT.

       [Section 1904(a)(1) of the Public Health Service Act (42 
     U.S.C. 300w-3(a)(1)) is amended by adding at the end the 
     following:
       [``(H) Activities and community education programs designed 
     to address and prevent overweight, obesity, and eating 
     disorders through effective programs to promote healthy 
     eating, and exercise habits and behaviors.''.

     [SEC. 206. REPORT ON OBESITY RESEARCH.

       [(a) In General.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit to the Committee on Health, Education, 
     Labor, and Pensions of the Senate and the Committee on Energy 
     and Commerce of the House of Representatives a report on 
     research conducted on causes and health implications of 
     obesity and being overweight.
       [(b) Content.--The report described in subsection (a) shall 
     contain--
       [(1) descriptions on the status of relevant, current, 
     ongoing research being conducted in the Department of Health 
     and Human Services including research at the National 
     Institutes of Health, the Centers for Disease Control and 
     Prevention, the Agency for Healthcare Research and Quality, 
     the Health Resources and Services Administration, and other 
     offices and agencies;
       [(2) information about what these studies have shown 
     regarding the causes of, prevention of, and treatment of, 
     overweight and obesity; and
       [(3) recommendations on further research that is needed, 
     including research among diverse populations, the 
     department's plan for conducting such research, and how 
     current knowledge can be disseminated.

     [SEC. 207. REPORT ON A NATIONAL CAMPAIGN TO CHANGE CHILDREN'S 
                   HEALTH BEHAVIORS AND REDUCE OBESITY.

       [Section 399Y of the Public Health Service Act (42 U.S.C. 
     280h-2) is amended--
       [(1) by redesignating subsection (b) as subsection (c); and
       [(2) by inserting after subsection (a) the following:
       [``(b) Report.--The Secretary shall evaluate the 
     effectiveness of the campaign described in subsection (a) in 
     changing children's behaviors and reducing obesity and shall 
     report such results to the Committee on Health, Education, 
     Labor, and Pensions of the Senate and the Committee on Energy 
     and Commerce of the House of Representatives.''.]

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Improved Nutrition and 
     Physical Activity Act'' or the ``IMPACT Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) An estimated 61 percent of adults and 13 percent of 
     children and adolescents in the Nation are overweight or 
     obese.
       (2) The prevalence of obesity and being overweight is 
     increasing among all age groups. There are twice the number 
     of overweight children and 3 times the number of overweight 
     adolescents as there were 29 years ago.
       (3) An estimated 300,000 deaths a year are associated with 
     being overweight or obese.
       (4) Obesity and being overweight are associated with an 
     increased risk for heart disease (the leading cause of 
     death), cancer (the second leading cause of death), diabetes 
     (the 6th leading cause of death), and musculoskeletal 
     disorders.
       (5) Individuals who are obese have a 50 to 100 percent 
     increased risk of premature death.
       (6) The Healthy People 2010 goals identify obesity and 
     being overweight as one of the Nation's leading health 
     problems and include objectives of increasing the proportion 
     of adults who are at a healthy weight, reducing the 
     proportion of adults who are obese, and reducing the 
     proportion of children and adolescents who are overweight or 
     obese.
       (7) Another goal of Healthy People 2010 is to eliminate 
     health disparities among different segments of the 
     population. Obesity is a health problem that 
     disproportionally impacts medically underserved populations.
       (8) The United States Surgeon General's report ``A Call To 
     Action'' lists the treatment and prevention of obesity as a 
     top national priority.
       (9) The estimated direct and indirect annual cost of 
     obesity in the United States is $117,000,000,000 (exceeding 
     the cost of tobacco-related illnesses) and appears to be 
     rising dramatically. This cost can potentially escalate 
     markedly as obesity rates continue to rise and the medical 
     complications of obesity are emerging at even younger ages. 
     Therefore, the total disease burden will most likely 
     increase, as well as the attendant health-related costs.
       (10) Weight control programs should promote a healthy 
     lifestyle including regular physical activity and healthy 
     eating, as consistently discussed and identified in a variety 
     of public and private consensus documents, including ``A Call 
     To Action'' and other documents prepared by the Department of 
     Health and Human Services and other agencies.
       (11) Eating preferences and habits are established in 
     childhood.
       (12) Poor eating habits are a risk factor for the 
     development of eating disorders and obesity.
       (13) Simply urging overweight individuals to be thin has 
     not reduced the prevalence of obesity and may result in other 
     problems including body dissatisfaction, low self-esteem, and 
     eating disorders.
       (14) Effective interventions for promoting healthy eating 
     behaviors should promote healthy lifestyle and not 
     inadvertently promote unhealthy weight management techniques.
       (15) Binge Eating is associated with obesity, heart 
     disease, gall bladder disease, and diabetes.
       (16) Anorexia Nervosa, an eating disorder from which 0.5 to 
     3.7 percent of American women will suffer in their lifetime, 
     is associated with serious health consequences including 
     heart failure, kidney failure, osteoporosis, and death. In 
     fact, Anorexia Nervosa has the highest mortality rate of all 
     psychiatric disorders, placing a young woman with Anorexia 
     Nervosa at 18 times the risk of death of other women her age.
       (17) Anorexia Nervosa and Bulimia Nervosa usually appears 
     in adolescence.
       (18) Bulimia Nervosa, an eating disorder from which an 
     estimated 1.1 to 4.2 percent of American women will suffer in 
     their lifetime, is associated with cardiac, gastrointestinal, 
     and dental problems, including irregular heartbeats, gastric 
     ruptures, peptic ulcers, and tooth decay.
       (19) On the 1999 Youth Risk Behavior Survey, 7.5 percent of 
     high school girls reported recent use of laxatives or 
     vomiting to control their weight.
       (20) Binge Eating Disorder is characterized by frequent 
     episodes of uncontrolled overeating, with an estimated 2 to 5 
     percent of Americans experiencing this disorder in a 6-month 
     period.
       (21) Eating disorders are commonly associated with 
     substantial psychological problems, including depression, 
     substance abuse, and suicide.
       (22) Eating disorders of all types are more common in women 
     than men.

                        TITLE I--TRAINING GRANTS

     SEC. 101. GRANTS TO PROVIDE TRAINING FOR HEALTH PROFESSION 
                   STUDENTS.

       Section 747(c)(3) of title VII of the Public Health Service 
     Act (42 U.S.C. 293k(c)(3)) is amended by striking ``and 
     victims of domestic violence'' and inserting ``victims of 
     domestic violence, individuals (including children) who are 
     overweight or obese (as such terms are defined in section 
     399W(j)) and at risk for related serious and chronic medical 
     conditions, and individuals who suffer from eating 
     disorders''.

     SEC. 102. GRANTS TO PROVIDE TRAINING FOR HEALTH 
                   PROFESSIONALS.

       Section 399Z of the Public Health Service Act (42 U.S.C. 
     280h-3) is amended--
       (1) in subsection (b), by striking ``2005'' and inserting 
     ``2007'';
       (2) by redesignating subsection (b) as subsection (c); and
       (3) by inserting after subsection (a) the following:
       ``(b) Grants.--
       ``(1) In general.--The Secretary may award grants to 
     eligible entities to train primary care physicians and other 
     licensed or certified health professionals on how to 
     identify, treat, and prevent obesity or eating disorders and 
     aid individuals who are overweight, obese, or who suffer from 
     eating disorders.
       ``(2) Application.--An entity that desires a grant under 
     this subsection shall submit an application at such time, in 
     such manner, and containing such information as the Secretary 
     may require, including a plan for the use of funds that may 
     be awarded and an evaluation of the training that will be 
     provided.
       ``(3) Use of funds.--An entity that receives a grant under 
     this subsection shall use the funds made available through 
     such grant to--
       ``(A) use evidence-based findings or recommendations that 
     pertain to the prevention and treatment of obesity, being 
     overweight, and eating disorders to conduct educational 
     conferences, including Internet-based courses and 
     teleconferences, on--
       ``(i) how to treat or prevent obesity, being overweight, 
     and eating disorders;
       ``(ii) the link between obesity and being overweight and 
     related serious and chronic medical conditions;
       ``(iii) how to discuss varied strategies with patients from 
     at-risk and diverse populations to promote positive behavior 
     change and healthy lifestyles to avoid obesity, being 
     overweight, and eating disorders;
       ``(iv) how to identify overweight and obese patients and 
     those who are at risk for obesity and being overweight or 
     suffer from eating disorders and, therefore, at risk for 
     related serious and chronic medical conditions;
       ``(v) how to conduct a comprehensive assessment of 
     individual and familial health risk factors; and
       ``(B) evaluate the effectiveness of the training provided 
     by such entity in increasing knowledge and changing attitudes 
     and behaviors of trainees.''.

 TITLE II--COMMUNITY-BASED SOLUTIONS TO INCREASE PHYSICAL ACTIVITY AND 
                           IMPROVE NUTRITION

     SEC. 201. GRANTS TO INCREASE PHYSICAL ACTIVITY AND IMPROVE 
                   NUTRITION.

       Part Q of title III of the Public Health Service Act (42 
     U.S.C. 280h et seq.) is amended by striking section 399W and 
     inserting the following:

     ``SEC. 399W. GRANTS TO INCREASE PHYSICAL ACTIVITY AND IMPROVE 
                   NUTRITION.

       ``(a) Establishment.--
       ``(1) In general.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention 
     and in coordination with the Administrator of the Health 
     Resources and Services Administration, the Director of the 
     Indian Health Service, the Secretary of Education, the 
     Secretary of Agriculture, the Secretary of the Interior, the 
     Director of the National Institutes of Health, the Director 
     of the Office of Women's Health, and the heads of other 
     appropriate agencies, shall award competitive grants to 
     eligible entities to plan and implement programs that promote 
     healthy eating behaviors and physical activity to prevent 
     eating disorders, obesity, being overweight, and related 
     serious and chronic medical conditions. Such grants may be 
     awarded to target at-risk populations including youth, 
     adolescent girls,

[[Page S16098]]

     health disparity populations (as defined in section 485E(d)), 
     and the underserved.
       ``(2) Term.--The Secretary shall award grants under this 
     subsection for a period not to exceed 4 years.
       ``(b) Award of Grants.--An eligible entity desiring a grant 
     under this section shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may require, including--
       ``(1) a plan describing a comprehensive program of 
     approaches to encourage healthy eating behaviors and healthy 
     levels of physical activity;
       ``(2) the manner in which the eligible entity will 
     coordinate with appropriate State and local authorities, 
     including--
       ``(A) State and local educational agencies;
       ``(B) departments of health;
       ``(C) chronic disease directors;
       ``(D) State directors of programs under section 17 of the 
     Child Nutrition Act of 1966 (42 U.S.C. 1786);
       ``(E) 5-a-day coordinators;
       ``(F) Governors' councils for physical activity and good 
     nutrition;
       ``(G) State and local parks and recreation departments; and
       ``(H) State and local departments of transportation and 
     city planning; and
       ``(3) the manner in which the applicant will evaluate the 
     effectiveness of the program carried out under this section.
       ``(c) Coordination.--In awarding grants under this section, 
     the Secretary shall ensure that the proposed programs are 
     coordinated in substance and format with programs currently 
     funded through other Federal agencies and operating within 
     the community including the Physical Education Program (PEP) 
     of the Department of Education.
       ``(d) Eligible Entity.--In this section, the term `eligible 
     entity' means--
       ``(1) a city, county, tribe, territory, or State;
       ``(2) a State educational agency;
       ``(3) a tribal educational agency;
       ``(4) a local educational agency;
       ``(5) a federally qualified health center (as defined in 
     section 1861(aa)(4) of the Social Security Act (42 U.S.C. 
     1395x(aa)(4));
       ``(6) a rural health clinic;
       ``(7) a health department;
       ``(8) an Indian Health Service hospital or clinic;
       ``(9) an Indian tribal health facility;
       ``(10) an urban Indian facility;
       ``(11) any health provider;
       ``(12) an accredited university or college;
       ``(13) a community-based organization;
       ``(14) a local city planning agency; or
       ``(15) any other entity determined appropriate by the 
     Secretary.
       ``(e) Use of Funds.--An eligible entity that receives a 
     grant under this section shall use the funds made available 
     through the grant to--
       ``(1) carry out community-based activities including--
       ``(A) city planning, transportation initiatives, and 
     environmental changes that help promote physical activity, 
     such as increasing the use of walking or bicycling as a mode 
     of transportation;
       ``(B) forming partnerships and activities with businesses 
     and other entities to increase physical activity levels and 
     promote healthy eating behaviors at the workplace and while 
     traveling to and from the workplace;
       ``(C) forming partnerships with entities, including 
     schools, faith-based entities, and other facilities providing 
     recreational services, to establish programs that use their 
     facilities for after school and weekend community activities;
       ``(D) establishing incentives for retail food stores, 
     farmer's markets, food co-ops, grocery stores, and other 
     retail food outlets that offer nutritious foods to encourage 
     such stores and outlets to locate in economically depressed 
     areas;
       ``(E) forming partnerships with senior centers and nursing 
     homes to establish programs for older people to foster 
     physical activity and healthy eating behaviors;
       ``(F) forming partnerships with daycare facilities to 
     establish programs that promote healthy eating behaviors and 
     physical activity; and
       ``(G) providing community educational activities targeting 
     good nutrition;
       ``(2) carry out age-appropriate school-based activities 
     including--
       ``(A) developing and testing educational curricula and 
     intervention programs designed to promote healthy eating 
     behaviors and habits in youth, which may include--
       ``(i) after hours physical activity programs;
       ``(ii) increasing opportunities for students to make 
     informed choices regarding healthy eating behaviors; and
       ``(iii) science-based interventions with multiple 
     components to prevent eating disorders including nutritional 
     content, understanding and responding to hunger and satiety, 
     positive body image development, positive self-esteem 
     development, and learning life skills (such as stress 
     management, communication skills, problem-solving and 
     decisionmaking skills), as well as consideration of cultural 
     and developmental issues, and the role of family, school, and 
     community;
       ``(B) providing education and training to educational 
     professionals regarding a healthy lifestyle and a healthy 
     school environment;
       ``(C) planning and implementing a healthy lifestyle 
     curriculum or program with an emphasis on healthy eating 
     behaviors and physical activity; and
       ``(D) planning and implementing healthy lifestyle classes 
     or programs for parents or guardians, with an emphasis on 
     healthy eating behaviors and physical activity;
       ``(3) carry out activities through the local health care 
     delivery systems including--
       ``(A) promoting healthy eating behaviors and physical 
     activity services to treat or prevent eating disorders, being 
     overweight, and obesity;
       ``(B) providing patient education and counseling to 
     increase physical activity and promote healthy eating 
     behaviors; and
       ``(C) providing community education on good nutrition and 
     physical activity to develop a better understanding of the 
     relationship between diet, physical activity, and eating 
     disorders, obesity, or being overweight; or
       ``(4) other activities determined appropriate by the 
     Secretary.
       ``(f) Matching Funds.--In awarding grants under subsection 
     (a), the Secretary may give priority to eligible entities who 
     provide matching contributions. Such non-Federal 
     contributions may be cash or in kind, fairly evaluated, 
     including plant, equipment, or services.
       ``(g) Technical Assistance.--The Secretary may set aside an 
     amount not to exceed 10 percent of the total amount 
     appropriated for a fiscal year under subsection (k) to permit 
     the Director of the Centers for Disease Control and 
     Prevention to provide grantees with technical support in the 
     development, implementation, and evaluation of programs under 
     this section and to disseminate information about effective 
     strategies and interventions in preventing and treating 
     obesity and eating disorders through the promotion of healthy 
     eating behaviors and physical activity.
       ``(h) Limitation on Administrative Costs.--An eligible 
     entity awarded a grant under this section may not use more 
     than 10 percent of funds awarded under such grant for 
     administrative expenses.
       ``(i) Report.--Not later than 6 years after the date of 
     enactment of the Improved Nutrition and Physical Activity 
     Act, the Director of the Centers for Disease Control and 
     Prevention shall review the results of the grants awarded 
     under this section and other related research and identify 
     programs that have demonstrated effectiveness in healthy 
     eating behaviors and physical activity in youth.
       ``(j) Definitions.--In this section:
       ``(1) Anorexia nervosa.--The term `Anorexia Nervosa' means 
     an eating disorder characterized by self-starvation and 
     excessive weight loss.
       ``(2) Binge eating disorder.--The term `binge eating 
     disorder' means a disorder characterized by frequent episodes 
     of uncontrolled eating.
       ``(3) Bulimia nervosa.--The term `Bulimia Nervosa' means an 
     eating disorder characterized by excessive food consumption, 
     followed by inappropriate compensatory behaviors, such as 
     self-induced vomiting, misuse of laxatives, fasting, or 
     excessive exercise.
       ``(4) Eating disorders.--The term `eating disorders' means 
     disorders of eating, including Anorexia Nervosa, Bulimia 
     Nervosa, and binge eating disorder.
       ``(5) Healthy eating behaviors.--The term `healthy eating 
     behaviors' means--
       ``(A) eating in quantities adequate to meet, but not in 
     excess of, daily energy needs;
       ``(B) choosing foods to promote health and prevent disease;
       ``(C) eating comfortably in social environments that 
     promote healthy relationships with family, peers, and 
     community; and
       ``(D) eating in a manner to acknowledge internal signals of 
     hunger and satiety.
       ``(6) Obese.--The term `obese' means an adult with a Body 
     Mass Index (BMI) of 30 kg/m2 or greater.
       ``(7) Overweight.--The term `overweight' means an adult 
     with a Body Mass Index (BMI) of 25 to 29.9 kg/m2 and a child 
     or adolescent with a BMI at or above the 95th percentile on 
     the revised Centers for Disease Control and Prevention growth 
     charts or another appropriate childhood definition, as 
     defined by the Secretary.
       ``(8) Youth.--The term `youth' means individuals not more 
     than 18 years old.
       ``(k) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, 
     $60,000,000 for fiscal year 2004 and such sums as may be 
     necessary for each of fiscal years 2005 through 2008. Of the 
     funds appropriated pursuant to this subsection, the following 
     amounts shall be set aside for activities related to eating 
     disorders:
       ``(1) $5,000,000 for fiscal year 2004.
       ``(2) $5,500,000 for fiscal year 2005.
       ``(3) $6,000,000 for fiscal year 2006.
       ``(4) $6,500,000 for fiscal year 2007.
       ``(5) $1,000,000 for fiscal year 2008.''.

     SEC. 202. NATIONAL CENTER FOR HEALTH STATISTICS.

       Section 306 of the Public Health Service Act (42 U.S.C. 
     242k) is amended--
       (1) in subsection (m)(4)(B), by striking ``subsection (n)'' 
     each place it appears and inserting ``subsection (o)'';
       (2) by redesignating subsection (n) as subsection (o); and
       (3) by inserting after subsection (m) the following:
       ``(n)(1) The Secretary, acting through the Center, may 
     provide for the--
       ``(A) collection of data for determining the fitness levels 
     and energy expenditure of children and youth; and
       ``(B) analysis of data collected as part of the National 
     Health and Nutrition Examination Survey and other data 
     sources.
       ``(2) In carrying out paragraph (1), the Secretary, acting 
     through the Center, may make grants to States, public 
     entities, and nonprofit entities.
       ``(3) The Secretary, acting through the Center, may provide 
     technical assistance, standards, and methodologies to 
     grantees supported by this subsection in order to maximize 
     the data quality and comparability with other studies.''.

     SEC. 203. HEALTH DISPARITIES REPORT.

       Not later than 18 months after the date of enactment of 
     this Act, and annually thereafter, the Director of the Agency 
     for Healthcare Research and Quality shall review all research

[[Page S16099]]

     that results from the activities outlined in this Act and 
     determine if particular information may be important to the 
     report on health disparities required by section 903(c)(3) of 
     the Public Health Service Act (42 U.S.C. 299a-1(c)(3)).

     SEC. 204. PREVENTIVE HEALTH SERVICES BLOCK GRANT.

       Section 1904(a)(1) of the Public Health Service Act (42 
     U.S.C. 300w-3(a)(1)) is amended by adding at the end the 
     following:
       ``(H) Activities and community education programs designed 
     to address and prevent overweight, obesity, and eating 
     disorders through effective programs to promote healthy 
     eating, and exercise habits and behaviors.''.

     SEC. 205. REPORT ON OBESITY RESEARCH.

       (a) In General.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit to the Committee on Health, Education, 
     Labor, and Pensions of the Senate and the Committee on Energy 
     and Commerce of the House of Representatives a report on 
     research conducted on causes and health implications of 
     obesity and being overweight.
       (b) Content.--The report described in subsection (a) shall 
     contain--
       (1) descriptions on the status of relevant, current, 
     ongoing research being conducted in the Department of Health 
     and Human Services including research at the National 
     Institutes of Health, the Centers for Disease Control and 
     Prevention, the Agency for Healthcare Research and Quality, 
     the Health Resources and Services Administration, and other 
     offices and agencies;
       (2) information about what these studies have shown 
     regarding the causes of, prevention of, and treatment of, 
     overweight and obesity; and
       (3) recommendations on further research that is needed, 
     including research among diverse populations, the 
     department's plan for conducting such research, and how 
     current knowledge can be disseminated.

     SEC. 206. REPORT ON A NATIONAL CAMPAIGN TO CHANGE CHILDREN'S 
                   HEALTH BEHAVIORS AND REDUCE OBESITY.

       Section 399Y of the Public Health Service Act (42 U.S.C. 
     280h-2) is amended--
       (1) by redesignating subsection (b) as subsection (c); and
       (2) by inserting after subsection (a) the following:
       ``(b) Report.--The Secretary shall evaluate the 
     effectiveness of the campaign described in subsection (a) in 
     changing children's behaviors and reducing obesity and shall 
     report such results to the Committee on Health, Education, 
     Labor, and Pensions of the Senate and the Committee on Energy 
     and Commerce of the House of Representatives.''.

  Mr. HARKIN. Mr. President, I wish to engage in a colloquy with the 
distinguished majority leader, the Senator from Tennessee, Mr. Frist. 
From time to time, Congress is confronted with a public health crisis 
of such magnitude that we have no choice but to act. For a number of 
reasons, including the changing physical environment, eating and 
physical activity habits, obesity has now emerged as a serious new 
public health threat. More than 65 percent of American adults and 15 
percent of children are obese or overweight. These figures double the 
levels during the 1980s for adults and triple the levels for children. 
Obesity now contributes to an estimated 300,000 deaths annually. We 
also know that obesity contributes to diabetes, high blood pressure, 
high cholesterol, cancers and heart disease. The economic impact also 
is alarming. The Surgeon General reports that obesity costs the Nation 
over $117 billion directly and indirectly. These tends will continue if 
we do not develop a comprehensive strategy to prevent and treat this 
condition.
  I commend Senator Frist and others for introducing the Improved 
Nutrition and Physical Activity Act to begin to tackle this challenge. 
Senator Frist as a physician certainly understands the impact of rising 
obesity rates. I commend his leadership on this issue. I believe that 
he and I agree that this IMPACT bill is an important step forward, but 
that more may need to be done to prevent and treat obesity. In view of 
the continuing and growing public health threat, I wonder if my friend 
and colleague would agree with me now that the Health, Education, Labor 
and Pensions Committee, as the committee of jurisdiction in this policy 
area, should devote further attention to this problem next year. I 
wonder whether he, as a fellow member of that HELP Committee, would 
agree with me now to urge chairman and ranking member of that committee 
to hold a hearing early in the next session of this Congress for that 
purpose.
  Mr. FRIST. I thank my colleague for his kind remarks. As he knows, I 
believe this issue of obesity is one of the largest unaddressed public 
health issues we face today, and I am pleased by the action we are 
taking today. I agree that it is critical that we continue to direct 
our attention to this issue, and it is my hope that the HELP Committee 
will continue to examine the issue, including by holding a hearing next 
year.
  Mr. HARKIN. I appreciate the attention of the majority leader to this 
subject. I commend his work and congratulate him on passage of this 
bill. I look forward to sending a joint letter to the HELP Committee, 
requesting a hearing, and I look forward to working with the Senator 
from Tennessee and others to build on this important start in combating 
harmful obesity.
  Mr. FRIST. Mr. President, I ask unanimous consent that the committee 
substitute amendment be agreed to, the bill, as amended, be read a 
third time and passed, the motion to reconsider be laid upon the table, 
and that any statements relating to the bill be printed in the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The committee amendment in the nature of a substitute was agreed to.
  The bill (S. 1172), as amended, was read the third time and passed.
  Mr. FRIST. Mr. President, this bill we just passed does exactly as 
stated. It establishes grants to address health services for nutrition, 
for increased physical activity, and for obesity prevention.
  It is late in the day, and a little bit later we will bring this 
session to a close. I am delighted personally, as a physician and as a 
Senator, that this body came forward to pass this important piece of 
legislation. I draw the attention of my colleagues to last week's 
edition of Newsweek magazine. It features a special section on the top 
10 health stories of 2003. Weighing in as No. 1 in the Newsweek story 
in the judgment of its editor is the obesity epidemic in America. That 
comes before depression, it comes before cancer, and it comes before 
even the SARS virus.

  The magazine reports that more than 65 percent of Americans are 
overweight or obese and rates of obesity-related illnesses are 
skyrocketing. Fifteen percent of America's children are seriously 
overweight, triple the number in 1970. It is an epidemic that is 
getting worse day by day, week by week, month by month, and year by 
year.
  As a physician and as a Senator, this particular issue is one about 
which I care passionately. I have spoken to this issue frequently in 
the Senate and I return tonight to do so for a few moments. I applaud 
the media outlets because they have done a very good job in 
highlighting and spotlighting this new epidemic. They are taking this 
obesity threat seriously and helping to communicate that around the 
United States of America.
  The message is simple, that obesity, which is growing day by day, is 
debilitating. It is effectively debilitating millions of Americans. 
Indeed, it has reached epidemic proportions in all ages but in 
particular in children.
  Historically, obesity was considered just another lifestyle choice. 
It was a tolerable consequence of eating food, eating good food, and 
eating lots of food. It was a consequence of driving instead of 
walking. But now we know obesity literally causes heart disease. Heart 
disease is the No. 1 killer in Americans. Now we know that obesity 
causes diabetes, causes cancer, contributes to stroke. Indeed, a 
whopping 300,000 deaths a year can be linked directly to fat. And it is 
spreading. It is spreading in children. The percentage of kids age 6 to 
19 who are overweight has not just doubled, not just tripled but almost 
quadrupled since the 1960s.
  Nationwide, type 2 diabetes, which is the kind associated with being 
overweight, being obese, has skyrocketed. The Centers for Disease 
Control and Prevention estimates that one in three Americans born 
today--they studied the year 2000--will develop diabetes in their 
lifetime. It is the type of diabetes that can be prevented and it can 
be treated.
  With African-American children and you look at Hispanic children, 
that number jumps to nearly half; one out of two African American and 
Hispanic babies born this year or last year will develop diabetes. As 
adults, we know it is hard to battle being overweight. But imagine, for 
a 10-year-old child, the challenge to both prevent and to treat this 
epidemic.
  Diabetes leads to a whole host of chronic illnesses. It is the 
leading cause of amputations in our society today. It is the leading 
cause of blindness in our society today. It is the

[[Page S16100]]

leading cause of heart disease and kidney disease in our society today.
  With regard to children, teachers can tell the story. Teachers have 
the opportunity to see children in classrooms on a regular basis. They 
say they see kids out of breath simply walking up the stairs in school. 
They tell us about kids who, when they get outside of the school and go 
to the schoolyard, are out of breath or, they come back exhausted from 
a simple field trip.

  Activities that we associate with exercise such as kick ball, jumping 
rope, climbing trees, for many kids today these are grueling exercises, 
grueling activities that are to be avoided at all cost because of their 
feeling of overexertion and being out of breath. Twenty-five percent of 
our Nation's children say they do not participate in any vigorous 
activity. That is one in four. Obesity is robbing them not only of 
enjoying the normal traditional childhood pastimes but it also is 
literally robbing them of their childhood years. By that I mean that 
obesity is associated with the early onset of puberty among girls. 
According to a study from the University of North Carolina, 48 percent 
of African-American girls begin puberty by age 8, over a quarter by age 
7.
  Indeed, this is a national health crisis. It is harming our children 
in ways we can readily observe. It is also harming our children in ways 
we do not so readily observe that will not become apparent until later 
in life. Yes, you observe the obesity but you do not see the side 
effects of the obesity until much later. Those side effects, as I 
mentioned before, are heart disease, amputation, blindness, a 
debilitating disease that condemns them to more illness, condemns them 
to a shorter life.
  Again, this is a new phenomena. If we look at the history of medicine 
in this country, back a few hundred years, we are going along like this 
and in the 1960s or 1970s we have hit epidemic proportions. The reason 
I talk about it in the Senate and the reason why the bill just passed, 
the IMPACT Act, is so important is because this trend can be reversed. 
If we reverse it, we also reverse heart disease, lung disease, stroke, 
various types of cancer. That is what this body should be about. That 
is what this body is about and we demonstrated it by passing this so-
called IMPACT Act that looks at nutrition, looks at physical activity, 
that focuses on young people. We are taking action; we are offering 
solutions. We cannot solve it all with this particular bill, but we 
show we are addressing identified problems; we are reversing problems 
that are apparent in our society.
  In this session, the Committee on Health, Education, Labor, and 
Pensions unanimously approved the IMPACT Act, which we just passed in 
the Senate, the Improved Nutrition and Physical Activity Act. It was 
introduced earlier this year by myself with Senators Bingaman, Dodd, 
and others. This IMPACT Act uses a multifaceted approach that 
emphasizes youth education to jump-start healthy habits early. It funds 
demonstration projects to find innovative ways, creative ways, to 
improve eating and exercise. In addition--and this is critically 
important--it includes rigorous evaluation so we can learn what is 
best.
  We see many different proposals. We cannot turn on television without 
seeing the latest fad, the latest diet or the latest cure. It is a huge 
industry. What we in the Government can do and should be doing is 
evaluating what works best in terms of what we implement through this 
program. This bill does not attempt to control what Americans eat or 
what Americans do not eat. This bill does not outlaw bad foods. It does 
not attempt to replicate in any way that $1 billion diet and fitness 
industry. It does have a modest pricetag and that reflects the 
appropriate role of the Federal Government.
  Working with the chairman of the HELP Committee, Senator Judd Gregg, 
and Senator Dodd, Senator Bingaman, and others, I am delighted--I am 
delighted--that we have, as authors, as sponsors, just seen this bill 
pass by unanimous consent.
  I do hope the House of Representatives will join us early next year 
in sending this legislation to the President of the United States for 
his signature.
  Again, this is not ``the'' solution. There is no single solution to 
this growing epidemic of obesity, but there are solutions. This 
epidemic can be reversed, and the start is awareness and then action. 
That is why, indeed, I am speaking at this fairly late hour on this 
particular issue, because we have just demonstrated, through action, 
that this body will work toward solutions, and to also state the 
importance of the awareness, especially awareness among children. And 
that is where this IMPACT bill will have a direct impact.
  We know the consequences of obesity. We can and we should keep our 
kids safe by helping to keep them fit. Tonight, in this body, we 
demonstrated the start.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DASCHLE. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Fitzgerald). Without objection, it is so 
ordered.

                          ____________________