But changing the national attitude about obesity is not quite as simple as changing the way smoking is viewed, said primary care physician and health care system reform activist Dr. Joseph Jarvis.

"There is no legitimate, healthy use for tobacco smoke," he said, noting a person can quit tobacco, but can't quit food. "There is no doubt (at least now) that some kinds of food are better than others. Additionally, our society has become less active for a number of reasons."

According to the Wood Johnson report, the current economic crisis could exacerbate the obesity epidemic. Food prices, particularly for more nutritious foods, are expected to rise, making it more difficult for families to eat healthy foods. At the same time, safety-net programs and services are becoming increasingly overextended as the numbers of unemployed, uninsured and under-insured continue to grow. In addition, due to the strain of the recession, rates of depression, anxiety and stress, which are linked to obesity for many individuals, also are increasing.

Nineteen states, including Utah, now have nutritional standards for school lunches, breakfasts and snacks that are stricter than current USDA requirements. Five years ago, only four states had legislation requiring stricter standards.

Twenty-seven states have nutritional standards for competitive foods sold a la carte, in vending machines, in school stores or in school bake sales. Five years ago, only six states had nutritional standards for competitive foods.

Twenty states have passed requirements for body mass index (BMI) screenings of children and adolescents or have passed legislation requiring other forms of weight-related assessments in schools. Five years ago, only four states had such screening requirements.

e-mail: jthalman@desnews.com