Wal-Mart is putting special labels on some store-brand products to help shoppers quickly spot healthier items. Millions of schoolchildren are helping themselves to vegetables from salad bars in their lunchrooms, while kids' meals at Olive Garden and Red Lobster restaurants automatically come with a side of fruit or vegetables and a glass of low-fat milk.
The changes put in place by the food industry are in response to the campaign against childhood obesity that Michelle Obama began waging three years ago. More changes are in store.
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.
RECOMMENDED: Are you a Helicopter Parent? Take our quiz.
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.