Influencing policy posed more of a challenge for the first lady, and not everyone welcomed her effort, criticizing it as a case of unwanted government intrusion.
Still, nutrition advocates and others give her credit for using her clout to help bring a range of interests to the table. They hope the increased awareness she has generated through speeches, her garden and her physical exploits will translate into further reductions in childhood obesity rates long after she leaves the White House.
About one-third of U.S. children are overweight or obese, which puts them at increased risk for any number of life-threatening illnesses, including diabetes, high blood pressure and heart disease.
While there is evidence of modest declines in childhood obesity rates in some parts of the country, the changes are due largely to steps taken before the first lady launched "Let's Move" in February 2010.
With the program entering its fourth year, Mrs. Obama heads out Wednesday on a two-day promotional tour with stops in Mississippi, Illinois and Missouri. She has been talking up the program on daytime and late-night TV shows, on the radio and in public service announcements with Big Bird. She also plans discussions next week on Google and Twitter.
"We're starting to see some shifts in the trend lines and the data where we're starting to show some improvement," the first lady told SiriusXM host B. Smith in an interview broadcast Tuesday. "We've been spending a lot of time educating and re-educating families and kids on how to eat, what to eat, how much exercise to get and how to do it in a way that doesn't completely disrupt someone's life."
Larry Soler, president and chief executive of the Partnership for a Healthier America, said Mrs. Obama has "been the leader in making the case for the time is now in childhood obesity and everyone has a role to play in overcoming the problem." The nonpartisan, nonprofit partnership was created as part of "Let's Move" to work with the private sector and to hold companies accountable for changes they promised to make.
Conservatives accused Mrs. Obama of going too far and dictating what people should — and shouldn't — eat after she played a major behind-the-scenes role in the passage in 2010 of a child nutrition law that required schools to make foods healthier. Former Alaska Gov. Sarah Palin, the Republican Party's vice presidential nominee in 2008, once brought cookies to a school and called the first lady's efforts a "nanny state run amok."
Other leaders in the effort, such as New York Mayor Michael Bloomberg, have felt the backlash, too. Last fall, Bloomberg helped enact the nation's first rule barring restaurants, cafeterias and concession stands from selling soda and other high-calorie drinks in containers larger than 16 ounces.
Despite the criticism, broad public support exists for some of the changes the first lady and the mayor are advocating, according to a recent Associated Press-NORC Center for Public Affairs Research poll.
More than eight in 10 of those surveyed, 84 percent, support requiring more physical activity in schools, and 83 percent favor government providing people with nutritional guidelines and information about diet and exercise. Seventy percent favor having restaurants put calorie counts on menus, and 75 percent consider overweightness and obesity a serious problem in this country, according to the Nov. 21-Dec. 14 survey by telephone of 1,011 adults.
Food industry representatives say Mrs. Obama has influenced their own efforts.
Mary Sophos of the Grocery Manufacturers Association, which represents the country's largest food companies, including General Mills and Kellogg's, said an industry effort to label the fronts of food packages with nutritional content gained momentum after Mrs. Obama, a mother of two, attended one of their meetings in 2010 and encouraged them to do more.
"She's not trying to point fingers," Sophos said. "She's trying to get people to focus on solutions."
A move by the companies signaling willingness to work with Mrs. Obama appears to have paid off as the Obama administration eased off some of the fights it appeared ready to pick four years ago.
The Food and Drug Administration has stalled its push to mandate labeling on the front of food packages, saying it is monitoring the industry's own effort. A rule that would require calorie counts on menus has been delayed as the FDA tries to figure out whom to apply it to. Supermarkets, movie theaters and other retailers have been lobbying to be exempted.
The industry also appears to have successfully warded off a move by the Federal Trade Commission to put in place voluntary guidelines for advertising junk food to kids. Directed by Congress, the guidelines would have discouraged the marketing of certain foods that didn't meet government-devised nutritional requirements. The administration released draft guidelines in 2011 but didn't follow up after the industry said they went too far and angry House Republicans summoned an agency official to Capitol Hill to defend them.
Besides labeling its store brands, Wal-Mart, the world's largest retailer, also pledged to cut sodium and added sugars by 25 percent and 10 percent, respectively, by 2015, and remove industrially produced trans fats.
Leslie Dach, an executive vice president, said sodium in packaged bread has been cut by 13 percent, and added sugar in refrigerated flavored milk, popular among kids, has been cut by more than 17 percent. He said Wal-Mart shoppers have told the company that eating healthier is important to them. Giving customers what they want is also good for business.
New York reported a 5.5 percent decline in obesity rates in kindergarteners through eighth-graders between the 2006-07 and 2010-11 school years, according a report last fall by the Robert Wood Johnson Foundation, which studies health policy. In Philadelphia, the decline was 4.7 percent among students in grades K-12 between the 2006-07 and 2009-10 school years, the foundation said.
Declines also were reported in California and in Mississippi, where Mrs. Obama stops Wednesday.
In Philadelphia, an organization called the Food Trust has worked since 1992 to help corner stores offer fresh foods, connect schools with local farms, bring supermarkets to underserved areas and ensure that farmers' markets accept food stamps, according to Robert Wood Johnson.
New York City requires chain restaurants to post calorie information on menus. Licensed day care centers also must offer daily physical activity, limit the amount of time children spend in front of TV and computer screens, and set nutrition standards.
Both cities also made changes to improve the quality of foods and beverages available to students in public schools.
Some results of first lady's anti-obesity effortSteps that retailers, restaurants and others are taking as part of Michelle Obama's campaign to reduce childhood obesity.
Pledged in January 2011 to reformulate its store-brand, packaged foods by cutting sodium 25 percent and added sugars by 10 percent, and removing all remaining industrially produced trans fats by 2015. Leslie Dach, the company's executive vice president, said sodium in packaged bread has been cut by 13 percent; added sugar in refrigerated flavored milk, popular with children, has been cut by more than 17 percent; and sugar and sodium in bottled spaghetti sauce has been reduced by 15 percent and 4-5 percent, respectively. As promised, Wal-Mart also has begun labeling the fronts of hundreds of its store-brand products with a special "Great for You" seal designed to help shoppers easily identify healthier foods.
Michelle Obama actively campaigned behind the scenes in 2010 for a child nutrition law, which passed in the final days of a Democratic-controlled House. The law helped schools pay for healthier lunches and also set new nutrition requirements for all foods in schools. Congressional Republicans fought the bill and later rolled back some of the Agriculture Department's efforts to get rid of junk food in the school lunch line. As directed by the new law, USDA last month proposed new requirements to make school vending machines and "a la carte lines" healthier as well.
AMERICAN BEVERAGE ASSOCIATION
The association, which represents Coca-Cola and PepsiCo, now also puts calorie labels on the front of cans, bottles and packs, fulfilling its pledge to do so.
HEALTHY WEIGHT COMMITMENT FOUNDATION
This coalition of retailers, and food and beverage manufacturers, said in 2010 that it would remove 1.5 trillion calories from their products by 2015 — about 12.5 calories per person per day. The group said it couldn't comment on its progress, but the nonprofit Robert Wood Johnson Foundation is monitoring the overall effort and has a report due out this summer.
The chain pledged in September 2011 to cut calories and sodium in all meals by 10 percent by 2016, and by 20 percent by 2021, and to serve all kids' meals with a side of fruit or vegetables and glass of 1 percent milk, unless an adult asks for a substitution. Spokesman Rich Jeffers said the changes to kids' meals are complete at Darden's four restaurant brands that serve children: Olive Garden, Red Lobster, LongHorn Steakhouse and Bahama Breeze. Jeffers said the company, which also has four other restaurant brands, is "on track" to meet its calorie- and sodium-cutting goals.
Other restaurants have pledged to improve their children's menus, too.
LET'S MOVE SALAD BARS TO SCHOOLS
Partners in the initiative — the National Fruit and Vegetable Alliance, the United Fresh Produce Association Foundation, the Food Family Farming Foundation and the Whole Kids Foundation — set a goal in November 2010 of putting 6,000 salad bars in school lunchrooms by the end of 2013. More than 2,100 salad bars have been funded, and more than 2,500 are expected to be in schools by May, said Lorelei DiSogra, vice president for nutrition and health at United Fresh Produce Association.
FRONT-OF-PACK CALORIE LABELS
Food and Drug Administration officials said at the beginning of Obama's first term that they were working on standards for front-of-package calorie labels, and Michelle Obama encouraged the industry to be more upfront with nutritional information to make it easier for shoppers to know what they are buying. A food industry coalition later developed its own voluntary front-of-package labels, saying Mrs. Obama's encouragement inspired the effort. FDA officials have since backed off its attempt to mandate the nutrition labels for the fronts of packages.
UNITED STATES TENNIS ASSOCIATION
Last year the association created 4,647 tennis courts sized for children ages 10 and under after committing to creating just 3,200, said spokesman Barry Ford. It also donated $285,000 worth of tennis equipment to schools and youth facilities nationwide; the association had pledged to donate $150,000 worth of equipment, Ford said.
Wal-Mart, Walgreens, Supervalu and several smaller grocers committed to build or expand 1,500 stores in areas with limited or no access to healthy food, areas the Agriculture Department calls "food deserts." Wal-Mart, which announced it would open 275-300 such stores by the end of 2016, had opened 86 by the end of last year, said Dach, the executive vice president. Supervalu has opened 69 of the 250 Save-A-Lot stores it pledged to build by 2016, said spokesman Mike Siemienas. Walgreens declined to say how many of the 1,000 stores it promised by 2016 have been built.