ATLANTA – According to The 2011 Children's Food Environment State Indicator Report – a recent study from the Centers for Disease Control and Prevention – states in the US can do more to improve food access, regulations and policies to promote healthy eating and fight childhood obesity. Communities, child care facilities and schools all have roles to play, it further notes.

"Childhood obesity has tripled over the past 30 years," said Thomas Frieden, CDC director, M.D., M.P.H. "This report underscores the need to make healthier choices easier for kids and more accessible and affordable for parents."

CDC reports that 32 states and the District of Columbia scored at or below the national average for the Modified Retail Food Environment Index (mRFEI), a measure of the proportion of food retailers typically selling healthy foods within a state. Scores can range from 0 (no food retailers that typically sell healthy food) to 100 (only food retailers that typically sell healthy food).

Those states with lower mRFEI scores have more food retailers, such as fast-food restaurants and convenience stores, that are less likely to sell less healthy foods and fewer food retailers, such as supermarkets, that tend to sell healthy foods, such as fresh fruits and vegetables.

The national average mRFEI score was 10. State-by-state scores ranged from highs of 16 in Montana and 15 in Maine to lows of five in Rhode Island and four in the District of Columbia.

As of December 2008, only Georgia had enacted all of the following state licensure regulations for child care facilities: to restrict sugar drinks, to require access to drinking water throughout the day and to limit TV and computer screen time, the study shows. CDC and other experts see the childcare setting as an important opportunity to address nutrition and physical activity issues.

Twenty-nine states had enacted one of these regulations, while 13 states and the District of Columbia had enacted none.

Forty-nine percent of middle and high schools allowed less-healthy foods such as candy, soft drinks and fast-food restaurants to be advertised to students on school grounds. Approximately 70 percent of middle and high schools in Ohio a allowed such advertising, while in New York only 24 percent of schools allowed it.

"To feed their children healthy food at home, parents must have ready access to stores that sell affordable, healthy food," said William Dietz, M.D., Ph.D., director of CDC's Division of Nutrition, Physical Activity and Obesity. "Parents also want their children to continue eating well in school or child care facilities. This report highlights actions that states, communities, and individuals can take to improve children's food choices and influences."