[Congressional Record Volume 150, Number 64 (Monday, May 10, 2004)]
[Senate]
[Pages S5091-S5094]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FITZGERALD (for himself and Mr. Kennedy):
  S. 2399. A bill to provide for the improvement of physical activity 
and nutrition and the prevention of obesity for all Americans; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. FITZGERALD. Mr. President, I rise today to introduce the Healthy 
Lifestyles Act of 2004 with Senator Kennedy. This bill places the 
crafting of the Dietary Guidelines for Americans squarely on the 
shoulders of the independent Institute of Medicine of the National 
Academies of Sciences. This bill also establishes several grant 
programs to help curb the obesity epidemic that plagues more than one-
third of Americans.
  In the United States, approximately 300,000 of our citizens die each 
year as a result of being overweight or obese. This information becomes 
even more dire when you consider that 64 percent of adults and 13 
percent of children and adolescents are overweight, according to the 
Centers for Disease Control and Prevention. More staggering, twice as 
many children and three times as many adolescents are characterized as 
overweight today as in 1980--when the Federal Government, through the 
U.S. Department of Agriculture, first published the Dietary Guidelines. 
In 1990, Congress took a larger role in the establishment of these 
Guidelines and passed legislation requiring the USDA and HHS to review, 
and, if necessary, revise the Guidelines every 5 years.
  According to the CDC, in 1985, in no State in the union were more 
than 14 percent of the resident's obese, but in 2001, in every State 
but Colorado more than 15 percent of residents were obese. My own State 
of Illinois dramatically demonstrates this disturbing trend. According 
to CDC, in 1985, less than 10 percent of Illinois residents were obese. 
By 2001, between 20 and 24 percent of Illinois residents were obese.
  Furthermore, according to the CDC, the medical expenses of the 
overweight and obese accounted for 9.1 percent of total U.S. medical 
expenditures in 1998 and may have reached as high as $78.5 billion. 
Approximately half of these costs were paid by Medicaid and Medicare.
  It is time to fix this dysfunctional system. By placing the IOM in 
charge of drafting the Dietary Guidelines, we can help to ensure that 
the Guidelines

[[Page S5092]]

are based upon unbiased, sound, scientific evidence rather than which 
organization has the greatest influence. When dealing with the health 
and welfare of Americans, we can expect no less.
  Additionally, this measure directs the IOM to examine nutrition 
programs run by the Federal Government, an important step to discern 
whether USDA, HHS, and other Federal agencies are properly conducting 
nutrition research.
  While many factors contribute to this growing health crisis, the 
problem, in part, may be attributed to a lack of nutrition and fitness 
information available to the public, especially among low-income 
groups. This bill will help our communities to a better job of 
educating Americans about proper nutrition and the serious risks 
associated with obesity. The Federal Government can fund all the 
research that it wants, but that research will do no good unless it is 
properly communicated to the public.
  This legislation empowers schools, local and State governments, and 
employers, through grant programs, to establish obesity-prevention 
initiatives. We can only limit the prevalence of obesity in America by 
empowering the individual through grassroots and community programs to 
change their eating and exercise behaviors. Obesity is not only a 
preventable disease, it is a curable disease. By encouraging more 
physical activity and better eating habits, we can help reduce the size 
of waistbands in America and help curb heart disease, type II diabetes 
rates, and other obesity-related diseases.
  In communities at risk for poor nutrition, this legislation provides 
grant funding to help promote the consumption of foods that are 
consistent with the Dietary Guidelines and to promote water as the main 
daily drink choice for people. The measure provides grants to train 
health professionals and health science students in identifying, 
preventing, and treating obesity-related conditions.
  With 64 percent of the people in our country classified as overweight 
or obese, it is obvious that the Dietary Guidelines and Federal 
nutrition monitoring programs have failed. I thank Senator Kennedy for 
joining me today to introduce the Healthy Lifestyles Act of 2004. We 
owe it to the American people to disseminate unbiased, sound, 
scientific nutrition information. I urge my colleagues to support this 
important piece of legislation.
  I ask unanimous consent that the text of the bill be printed in the 
Record.

                                S. 2399

       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 ``Healthy Lifestyles Act of 
     2004''.

     SEC. 2. ACTIVITIES RELATING PHYSICAL ACTIVITY.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.) is amended by adding at the end the 
     following:

     ``SEC. 399O. INCREASING PHYSICAL ACTIVITY.

       ``(a) In General.--The Secretary, in collaboration with the 
     Director of the Centers for Disease Control and Prevention, 
     the Secretary of Education, the Secretary of Labor, and the 
     Director of the Federal Highway Administration, shall 
     establish and implement activities for the purpose of 
     increasing physical activity in schools, worksites, and 
     communities.
       ``(b) Schools.--The Director of the Centers for Disease 
     Control and Prevention, in collaboration with the Secretary 
     of Education shall award grants to public elementary and 
     secondary schools for programs that support--
       ``(1) the provision of daily physical education for 
     students in kindergarten through grade 12 through programs 
     that are consistent with the Guidelines for Physical Activity 
     as reported by Centers for Disease Control and Prevention and 
     the American College of Sports Medicine and National Physical 
     Education Standards;
       ``(2) the implementation of comprehensive school curricula 
     and school-based physical activity programs that provide 
     education about lifelong physical activity;
       ``(3) training for school personnel that provides the 
     knowledge and skills needed to effectively teach lifelong 
     physical activity; and
       ``(4) evaluations of school physical education programs and 
     facilities at annual intervals to determine the extent to 
     which national guidelines described in paragraph (1) are met.
       ``(c) Worksites.--The Director of the Centers for Disease 
     Control and Prevention and the Secretary of Labor, shall 
     award grants to eligible entities as determined by the 
     Director, which may include labor organizations, trade 
     associations, trade groups, and businesses for the 
     establishment of projects that include--
       ``(1) the development of activity friendly worksites (which 
     may include the provision of facilities for physical 
     activity, accessible and attractive stairwells, walking 
     trails, and supportive management practices) that encourage 
     employee participation in physical activity;
       ``(2) the development of worksite wellness programs that 
     improve physical activity by increasing the knowledge, 
     attitudes, skills, and behaviors of employees; and
       ``(3) the development of employee incentive programs (such 
     as cafeteria discounts, health club memberships, small cash 
     bonuses, and time off) to increase the participation of 
     employees in worksite health promotion programs that increase 
     physical activity.
       ``(d) Communities.--The Director of the Centers for Disease 
     Control and Prevention, the Secretary of Transportation, and 
     Secretary of the Interior shall award grants for the 
     implementation and evaluation of activities that may 
     include--
       ``(1) projects to design pedestrian zones and construct 
     safe walkways and cycling paths;
       ``(2) projects that create greenways and open-space areas 
     linking parks, nature preserves, and cultural or historic 
     sites with each other and with populated areas such as 
     residential communities and business locations;
       ``(3) initiatives to increase the use of walking and 
     bicycling as a transportation mode by creating or enhancing 
     informational outreach to parks or community recreation 
     centers; and
       ``(4) community-wide campaigns designed to increase 
     physical activity as part of multicomponent efforts that 
     include strategies such as support of self help groups, 
     physical activity counseling, risk factor screening and 
     education, and environmental or policy changes such as the 
     creation of walking trails.
       ``(g) Evaluation.--Not later than 2 years after the date on 
     which a grant is awarded under this section, the grantee 
     shall submit to the Director of the Centers for Disease 
     Control and Prevention a report that describes the activities 
     carried out with funds receive under the grant and the 
     effectiveness of such activities in increasing physical 
     activity.
       ``(g) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary for each of fiscal years 2005 through 
     2009.''.

     SEC. 3. IMPROVING NUTRITIONAL INTAKE.

       Section 301 of the The National Nutrition Monitoring and 
     Related Research Act of 1990 (7 U.S.C. 5341) is amended to 
     read as follows:

     ``SEC. 301. DIETARY GUIDELINES.

       ``(a) In General.--Not later than 3 months after the date 
     of enactment of the Healthy Lifestyles Act of 2004, and at 
     least every 5 years thereafter, the Secretary of Health and 
     Human Services shall enter into a contract with the Institute 
     of Medicine for the development and publication of a report 
     containing the `Dietary Guidelines for Americans'.
       ``(b) Guidelines.--Each report under subsection (a) shall--
       ``(1) be complete within 1 year of the date on which the 
     contract was entered into under such subsection for such 
     report; and
       ``(2) contain--
       ``(A) an evaluation of scientific and medical knowledge 
     relating to healthy diets and nutrition;
       ``(B) dietary guidelines for Americans, with specifications 
     for different ages and other segments of the population as 
     determined appropriate by the Institute of Medicine.
       ``(c) Submission.--The Institute of Medicine shall submit a 
     final report under each contract under subsection (a) to the 
     Secretary of Health and Human Services, appropriate 
     committees of Congress, and the general public.
       ``(d) Use.--The Secretary of Health and Human Services 
     shall ensure that dietary guidelines established under this 
     section serve as the basis of any food, nutrition or health 
     program conducted or operated by each Federal health agency.
       ``(e) Food Guide Pyramid.--In accordance with the dietary 
     guidelines published in the report under subsection (b), the 
     Secretary shall publish revisions to the guide commonly known 
     as the `food guide pyramid' or any successor to such 
     guide.''.

     SEC. 4. IMPROVING THE USE OF DIETARY INFORMATION AND 
                   GUIDELINES.

       (a) In General.--The Secretary of Health and Human Services 
     shall enter into a contract with the Institute of Medicine 
     for the conduct of a study and the making of recommendations 
     concerning the implementation and dissemination of dietary 
     information and nutrition guidelines.
       (b) Content.--The recommendations made under subsection (a) 
     shall address the following:
       (1) The implementation of nutrition guidelines and dietary 
     information in Federal programs.
       (2) The dissemination of nutrition guidelines and dietary 
     information to the public.
       (3) The coordination, collaboration, and integration of 
     nutrition activities within and across the Federal agencies 
     and programs.
       (4) A means for ensuring scientific integrity in the 
     implementation and dissemination of dietary information and 
     nutrition guidelines.

[[Page S5093]]

       (5) A means for evaluating the impact of nutrition 
     guidelines and dietary information.
       (6) Other issues determined appropriate by the Institute of 
     Medicine.
       (c) Submission.--Not later than 1 year after the date of 
     enactment of this Act, the Institute of Medicine shall submit 
     to the Secretary of Health and Human Services, the 
     appropriate committees of Congress, and the public, a report 
     that contains the findings of the study and recommendations 
     under subsection (a).
       (d) Implementation.--
       (1) In general.--Not later than 1 year after the submission 
     of the report under subsection (c), the Secretary of Health 
     and Human Services, in collaboration with the Secretary of 
     Agriculture, shall prepare and publish a plan relating to the 
     strategy of the Secretary to implement the recommendations 
     made pursuant to subsection (a).
       (2) Public comment.--The Secretary of Health and Human 
     Services shall request public review and comment during the 
     development of the plan under paragraph (1). The final plan 
     shall describe the comments received and how comments were 
     incorporated into the plan.
       (3) Implementation reports.--Not later than 3 years after 
     the date of enactment of this Act, and biennially thereafter, 
     the Secretary of Health and Human Services shall evaluate and 
     report to Congress on the efforts of the Department of Health 
     and Human Services to implement the recommendations made 
     pursuant to subsection (a).

     SEC. 5. INCREASING THE INTAKE OF NUTRITIONAL FOODS.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.), as amended by section 2, is further 
     amended by adding at the end the following:

     ``SEC. 399P. INCREASING THE INTAKE OF NUTRITIONAL FOODS.

       ``(a) In General.--The Secretary, in collaboration with the 
     Director of the Centers for Disease Control and Prevention, 
     the Secretary of Education, and the Secretary of Agriculture, 
     shall establish and implement activities to improve the 
     consumption of nutritional foods (such as fruits and 
     vegetables, and foods that are low in fat, sugar, and salt) 
     in communities.
       ``(b) Communities.--The Secretary, acting through the 
     Director of the Centers of Disease Control and Prevention, 
     shall award grants for projects that--
       ``(1) implement campaigns, in communities at risk for poor 
     nutrition, that are designed to promote the intake of foods 
     consistent with established dietary guidelines through the 
     use of different types of media including television, radio, 
     newspapers, movie theaters, billboards, and mailings;
       ``(2) implement campaigns, in communities at risk for poor 
     nutrition, that promote water as the main daily drink choice 
     through the use of different types of media including 
     television, radio, newspapers, movie theaters, billboards, 
     and mailings;
       ``(3) conduct outreach to commercial food establishments, 
     grocery stores, and other food suppliers, to increase the 
     availability and accessibility of healthy foods and 
     beverages;
       ``(4) partner with national programs that provide parents 
     and mentors with the skills to help guide and influence 
     healthy meals and snack selections for children and 
     adolescents; and
       ``(5) partner with national afterschool and summer programs 
     that provide children with the education and skills needed to 
     make healthy meal and snack selections.
       ``(c) Health Professionals.--The Secretary, acting through 
     the Administrator of the Health Resources and Services 
     Administration, shall award grants to--
       ``(1) support the development, implementation, and 
     evaluation of curricula to educate and train health 
     professionals about effective nutrition education and 
     counseling strategies for obese individuals and parents of 
     overweight children, with emphasis on the Dietary Guidelines 
     for Americans or other nationally accepted standards; and
       ``(2) use information technology to develop, implement, and 
     evaluate the effectiveness of dietary counseling in health 
     care settings.
       ``(d) Evaluation.--Not later than 12 months after the date 
     on which a grant is awarded under this section, the grantee 
     shall submit to the Director of the Centers for Disease 
     Control and Prevention a report that describes the activities 
     carried out with funds received under the grant and the 
     effectiveness of such activities in improving the intake of 
     nutritional foods.
       ``(e) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, such sums as 
     may be necessary for each of fiscal years 2005 through 2009.

     SEC. 6. FEDERAL OBESITY PREVENTION AND CONTROL ACTIVITIES.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.), as amended by section 5, is further 
     amended by adding at the end the following:

     ``SEC. 399Q. FEDERAL OBESITY PREVENTION AND CONTROL 
                   ACTIVITIES.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Centers for Disease Control and Prevention, 
     shall directly or through a grant to an eligible entity, 
     conduct, support, and promote the coordination of research, 
     investigations, demonstrations, training, and studies 
     relating to the prevention, control, and surveillance of 
     obesity.
       ``(b) Duties of the Secretary.--The activities of the 
     Secretary under subsection (a) shall include--
       ``(1) the collection, publication, and analysis of data on 
     the prevalence and incidence of obesity;
       ``(2) the development of uniform data sets for public 
     health surveillance and clinical quality improvement 
     activities;
       ``(3) the identification of evidence-based and cost-
     effective best practices for the prevention, diagnosis, 
     management, and treatment of obesity;
       ``(4) research, including research on behavioral 
     interventions to prevent obesity and on other evidence-based 
     best practices relating to obesity prevention, diagnosis, 
     management, and care; and
       ``(5) demonstration projects, including community-based 
     programs of obesity prevention and control, and similar 
     collaborations with academic institutions, hospitals, health 
     insurers, researchers, health professionals, and nonprofit 
     organizations.
       ``(c) Training and Technical Assistance.--With respect to 
     the planning, development, and operation of any activity 
     carried out under subsection (a), the Secretary may provide 
     training, technical assistance, supplies, equipment, or 
     services, and may assign any officer or employee of the 
     Department of Health and Human Services to a State or local 
     health agency, or to any public or nonprofit entity 
     designated by a State health agency, in lieu of providing 
     grant funds under this section.
       ``(d) Obesity Prevention and Control Research at the 
     Centers for Disease Control and Prevention Centers.--The 
     Secretary shall provide additional grant support under this 
     section for research projects at the Centers for Prevention 
     Research of the Centers for Disease Control and Prevention to 
     encourage the expansion of research portfolios at the Centers 
     for Prevention Research to include obesity specific research 
     activities related to the prevention and control of obesity.
       ``(e) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, such 
     sums as may be necessary for each of fiscal years 2005 
     through 2009.''.

     SEC. 7. STATE OBESITY PREVENTION AND CONTROL ACTIVITIES.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.), as amended by section 6, is further 
     amended by adding at the end the following:

     ``SEC. 399R. STATE OBESITY PREVENTION AND CONTROL PROGRAMS.

       ``(a) In General.--The Secretary shall award grants to 
     eligible entities to provide support for comprehensive 
     obesity prevention and control programs and to enable such 
     entities to provide public health surveillance, prevention, 
     and control activities related to obesity.
       ``(b) Eligibility.--To be eligible to receive a grant under 
     this section, an entity shall--
       ``(1) be a State or an Indian tribe; and
       ``(2) submit to the Secretary an application at such time, 
     in such manner, and containing such agreements, assurances, 
     and information as the Secretary may require, including a 
     comprehensive obesity control and prevention plan that--
       ``(A) is developed with the advice of stakeholders from the 
     public, private, and nonprofit sectors that have expertise 
     relating to obesity prevention, control, and treatment;
       ``(B) is intended to reduce the morbidity of obesity, with 
     priority on preventing and controlling obesity in at-risk 
     populations and reducing disparities in obesity prevention, 
     diagnosis, management, and quality of care in underserved 
     populations; and
       ``(C) describes the obesity-related services and activities 
     to be undertaken or supported by the entity.
       ``(c) Use of Funds.--An eligible entity shall use amounts 
     received under a grant awarded under subsection (a) to 
     conduct, in a manner consistent with the comprehensive 
     obesity prevention and control plan submitted by the entity 
     in the application under subsection (b)(2)--
       ``(1) public health surveillance and epidemiological 
     activities relating to the prevalence of obesity and 
     assessment of disparities in obesity prevention, diagnosis, 
     management, and care; and
       ``(2) public information and education programs.
       ``(d) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, such 
     sums as may be necessary for each of fiscal years 2005 
     through 2009.''.

     SEC. 8. STATE OBESITY PREVENTION AND CONTROL ACTIVITIES.

       Part P of title III of the Public Health Service Act (42 
     U.S.C. 280g et seq.), as amended by section 7, is further 
     amended by adding at the end the following:

     ``SEC. 399S. COMPREHENSIVE OBESITY PREVENTION ACTION GRANTS.

       ``(a) In General.--The Secretary shall award grants on a 
     competitive basis to eligible entities to enable such 
     eligible entities to assist in the implementation of a 
     national strategy for obesity prevention and control.
       ``(b) Eligibility.--To be eligible to receive a grant under 
     this section, an entity shall--
       ``(1) be a national public or private nonprofit entity; and
       ``(2) submit to the Secretary an application at such time, 
     in such manner, and containing such agreements, assurances, 
     and information as the Secretary may require, including a 
     description of how funds received

[[Page S5094]]

     under a grant awarded under this section will--
       ``(A) supplement or fulfill unmet needs identified in the 
     comprehensive obesity prevention and control plan of a State 
     or Indian tribe; and
       ``(B) otherwise help achieve the goals of an obesity 
     prevention strategic plan designated by the Secretary.
       ``(c) Priority.--In awarding grants under this section, the 
     Secretary shall give priority to eligible entities submitting 
     applications proposing to carry out programs for preventing 
     and controlling obesity in at-risk populations or reducing 
     disparities in underserved populations.
       ``(d) Use of Funds.--An eligible entity shall use amounts 
     received under a grant awarded under subsection (a) for 1 or 
     more of the following purposes:
       ``(1) To expand the availability of physical activity 
     programs designed specifically for people with obesity.
       ``(2) To provide awareness education to patients, family 
     members, and health care providers, to help such individuals 
     recognize risk factors for obesity, and to address the 
     control and prevention of obesity.
       ``(3) To decrease the long-term consequences of obesity by 
     making information available to individuals with regard to 
     obesity prevention.
       ``(4) To provide information on nutrition education 
     programs with regard to preventing or mitigating the impact 
     of obesity.
       ``(e) Evaluation.--An eligible entity that receives a grant 
     under this section shall submit to the Secretary an 
     evaluation of the operations and activities carried out under 
     such grant that includes an analysis of increased utilization 
     and benefit of public health programs relevant to the 
     activities described in subsection (d).
       ``(f) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section, such 
     sums as may be necessary for each of fiscal years 2005 
     through 2009.''.

  Mr. KENNEDY. Mr. President, it is a privilege to join Senator 
Fitzgerald in introducing the Healthy Lifestyles Act. This important 
bill will give families greater access to practical information on 
nutrition and physical activity and enable Americans of all ages, 
especially the young, to live healthier, fitter, and longer lives.
  Two-thirds of our citizens are overweight. The cost of diseases 
associated with obesity has been estimated at $117 billion each year. 
Physical inactivity and unhealthy eating, the two primary causes, are 
responsible for at least 300,000 preventable deaths each year in the 
United States, and they increase the risk of many chronic diseases, 
including cancer, diabetes and cardiovascular diseases.
  Environments that promote poor nutrition and sedentary lifestyles are 
major causes of this public health epidemic. The numerous messages and 
advertisements from various sources about what and how much to eat have 
produced serious public confusion about good nutrition. Many citizens 
would like to be more active but live in ways that discourage exercise 
and vigorous lifestyles that involve walking, bicycling, or other 
similar activities.
  The Healthy Lifestyles Act is a major step in addressing these 
challenges. It establishes a partnership between the Department of 
Health and Human Services and the Institute of Medicine to conduct a 
comprehensive assessment of what is being done by whom on nutrition 
guidelines and education. The Institute of Medicine is eminently 
respected for its scientifically sound opinions on health issues. Its 
study will provide indispensable oversight for the development and 
dissemination of national nutrition guidelines, and an independent 
impartial source of nutrition information for the public.
  The legislation also supports community outreach programs to support 
healthy nutrition and physical activity. Communities will be able to 
conduct campaigns encouraging consumption of healthy foods, and after-
school programs will be available to encourage exercise and good 
nutrition for children. Support will be available for each state for 
obesity prevention and control programs, to encourage coordinated 
ongoing efforts to enhance awareness of guidelines for healthy eating 
and activity.
  Finally, the legislation assures that the information will be widely 
available to the public and to health professionals. State-of-the-art 
curricula will be developed to educate and train professionals about 
nutrition education and counseling.
  The Healthy Lifestyles Act is only a first step in preventing 
unhealthy nutrition environments by ensuring consistency and high 
quality in dietary information, and improving physical activity in our 
communities. Working together we can halt this worsening public health 
epidemic. I commend Senator Fitzgerald for his leadership, and I urge 
our colleagues in Congress to support the Healthy Lifestyles Act.

                          ____________________