The Sad State of American Kids’ Food Environments

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Nearly half of all American children and teens are overweight or obese, according to government statistics, and a large part of the problem may be lack of access to healthy foods in kids’ environments.

At home, children are bombarded with junk-food advertising on TV. At school, they’re surrounded by cheap, unhealthy choices like sugar-sweetened soda in lunchrooms and vending machines. Together, these factors contribute to what has been referred to as the “toxic food environment,” which many child obesity researchers say is a key hurdle to getting kids to eat right and exercise.

In the Centers for Disease Control and Prevention’s (CDC) current Children’s Food Environment State Indicator Report [PDF], the agency takes a state-by-state look at three major food environments for American kids: child care, school and the community. Based on certain measures of the health of these settings — for instance, whether state regulations require restriction of sugary drinks and access to drinking water in day-care centers — the report gives a general sense of the state of American kids’ larger food environment.

(More on TIME.com: “Health-Washing: Is ‘Healthy’ Fast Food for Real?”)

It’s not good. Overall, only two states (Georgia and Nevada) have regulations to restrict sugary drinks in child-care centers; about half require access to drinking water throughout the day; and 18 specifically limit TV-watching time.

It doesn’t get much better by the time kids get to school age: the report finds that 64% of U.S. middle and high schools allow sodas and other sugar-laden drinks to be sold on campus; 51% stock vending machines with chips, cookies, cakes and other unhealthy snacks; and 49% allow junk-food advertising at school.

It’s no wonder, then, that a recent study in the Journal of the American Dietetic Association found that 40% of the calories that children and teens consume in a day come from fat and sugar, with a large portion coming directly from sugar-sweetened beverages like soda and fruit drinks.

(More on TIME.com: “5 Ways Parents May Be Sabotaging Their Kids’ Health”)

Indeed, the CDC report found that 29% of high-schools students drank at least one soda a day. Teen boys got an average 300 calories a day from sugary drinks alone.

The CDC report also scored states on something called the modified Retail Food Environment Index (mRFEI), which measures the number of stores in a community that sell healthy, whole foods (supermarkets) and those that offer junky, processed foods (fast-food restaurants, convenience stores). The score goes from 0 to 100 — 100 means there are only food retailers that sell healthy foods, and 0 means there are none. The overall U.S. score is 10. The country’s highest-ranking states were Montana and Maine, scoring 16 and 15, respectively. The lowest-ranking states were Rhode Island (5) and D.C. (4).

“Lack of access to retail venues in communities to purchase healthy foods, such as supermarkets, has been associated with a lower quality diet and increased risk of obesity,” the report notes, but “areas without these types of healthy food retailers may still provide adequate access if smaller stores and fast food restaurants provide quality and affordable healthy foods and beverages.”

Arguably the most important food environment is the one within the four walls of children’s homes. But home is no haven from food advertising and unhealthy habits. The report found that 33% of high-school students watch at least three hours of TV a day, and 50% of kids aged 6 to 17 have a TV in their rooms. The ways that TV influences obesity risk are many and varied: by exposing kids to junk-food advertising, occupying time that could be better spent doing something active, encouraging snacking on fatty foods while watching.

(More on TIME.com: “5 Highlights From the ‘Toxic Sugar’ Video”)

So what can parents do to help their kids get healthy? For starters, take the TV out of kids’ bedrooms. And then start eating dinner as a family. “Eating meals together as a family is associated with positive effects on children across many domains of life, including the development of healthy eating behaviors and the maintenance of a healthy weight status,” the report says. Indeed, the American Association of Pediatrics says family meals are linked with a host of benefits to health and well-being, including better grades and less drug use.

For more tips on creating a healthy home for your kids, see our special on common parenting pitfalls.