National Academies Press: OpenBook

Early Childhood Obesity Prevention Policies (2011)

Chapter:Front Matter

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
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EARLY CHILDHOOD
OBESITY PREVENTION
POLICIES

Early Childhood Obesity Prevention Policies

Committee on Obesity Prevention Policies for Young Children

Leann L. Birch, Lynn Parker, and Annina Burns, Editors

INSTITUTE OF MEDICINE
           OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
×

THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This study was supported by Grant No. 61747, between the National Academy of Sciences and The Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-21024-9
International Standard Book Number-10: 0-309-21024-0

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Copyright 2011 by the National Academy of Sciences. All rights reserved.

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Suggested citation: Institute of Medicine (IOM). 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
×

Knowing is not enough; we must apply.
Willing is not enough; we must do.
”      

                                                —Goethe

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INSTITUTE OF MEDICINE
              OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
×

COMMITTEE ON OBESITY PREVENTION POLICIES FOR YOUNG CHILDREN

LEANN L. BIRCH (Chair), Professor and Director, Center for Childhood Obesity Research, Pennsylvania State University, University Park, Pennsylvania

ALICE AMMERMAN, Professor, Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill

BETTINA M. BEECH, Professor, Public Health Sciences, Wake Forest University School of Medicine, Winston Salem, North Carolina

SARA BENJAMIN NEELON, Assistant Professor, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina

LAUREL J. BRANEN, Professor, Family and Consumer Sciences, University of Idaho School of Family and Consumer Sciences, Moscow

DAVID V. B. BRITT, Retired President-Chief Executive Officer, Sesame Workshop, Amelia Island, Florida

DEBRA HAIRE-JOSHU, Professor and Associate Dean for Research, Washington University in St. Louis, Missouri

RONALD E. KLEINMAN, Physician in Chief, Department of Pediatrics, Massachusetts General Hospital, Boston

SUSAN LANDRY, Professor, Department of Pediatrics, University of Texas, Houston Medical Center

LYNNE OUDEKERK, Director, Child and Adult Care Food Program, New York State Department of Health, Albany

RUSSELL R. PATE, Professor, Department of Exercise Science, University of South Carolina, Columbia

DAVID A. SAVITZ, Professor, Department of Community Health, Brown University, Providence, Rhode Island

WENDELIN SLUSSER, Associate Clinical Professor, Department of Pediatrics, University of California at Los Angeles Schools of Medicine and Public Health

ELSIE M. TAVERAS, Co-Director, Obesity Prevention Program, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts

ROBERT C. WHITAKER, Professor, Center for Obesity Research and Education, Temple University, Philadelphia, Pennsylvania

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
×

Study Staff

LYNN PARKER, Study Director (from March 2011)

ANNINA CATHERINE BURNS, Study Director (until February 2011)

SHEILA MOATS, Associate Program Officer (from April 2011)

NICOLE FERRING HOLOVACH, Research Associate (until March 2011)

GUI LIU, Senior Program Assistant (from November 2010)

SAUNDRA LEE, Senior Program Assistant (until October 2010)

ANTON BANDY, Financial Officer

GERALDINE KENNEDO, Administrative Assistant

LINDA D. MEYERS, Director, Food and Nutrition Board

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
×

Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Sarah E. Barlow, Associate Professor of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Houston, Texas

Debbie Chang, Vice President, Policy and Prevention, The Nemours Foundation, Washington, DC

Myles Faith, Assistant Professor of Psychology, University of Pennsylvania School of Medicine, Philadelphia

Doris Fredericks, Executive Director, Choices for Children, San Jose, California

Bernard Guyer, Professor Emeritus, Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland

Dale Kunkel, Professor of Communication, University of Arizona, Tucson

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
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Trish MacEnroe, Executive Director, Baby-Friendly USA, East Sandwich, Massachusetts

Alan F. Meyers, Associate Professor, Department of Pediatrics, Boston University School of Medicine, Massachusetts

Lisa Pawloski, Associate Professor and Chair, Global and Community Health, George Mason University, Fairfax, Virginia

Virginia A. Stallings, Jean A. Cortner Endowed Chair in Gastroenterology and Nutrition, Children’s Hospital of Philadelphia, Pennsylvania

Dianne S. Ward, Professor, Department of Nutrition, University of North Carolina at Chapel Hill

Dawn Wilson, Professor, Department of Psychology, University of South Carolina, Sumter

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the report’s conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Neal A. Vanselow, Professor Emeritus, Tulane University, and Elena O. Nightingale, Scholar-in-Residence, Institute of Medicine. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
×

Preface

The obesity epidemic has not spared even the nation’s youngest children; about 20 percent of children are already overweight or obese before they enter school, and rates are even higher among low-income children and among African American and Latino children. These statistics are of particular concern because, contrary to popular belief, children do not “grow out of” their “baby fat.” Evidence indicates that excessive weight gain in the first years of life can alter developing neural, metabolic, and behavioral systems in ways that increase the risk for obesity and chronic disease later in life. Although few attempts have been made to prevent obesity during the first years of life, this period may represent the best opportunity for obesity prevention. During infancy and early childhood, lifestyle behaviors that promote obesity are just being learned, and it is easier to establish new behaviors than to change existing ones.

This report is one of a series of publications dedicated to providing succinct information on childhood obesity prevention specifically for policy makers. Funded by The Robert Wood Johnson Foundation, the report addresses some of the same themes as previous Institute of Medicine (IOM) reports on obesity (including Local Government Actions to Prevent Childhood Obesity and Bridging the Evidence Gap in Obesity Prevention), but focuses on young children from birth to age 5. A number of key factors influence the risk for obesity in an infant or young child, including prenatal influences, eating patterns, physical activity and sedentary behavior, sleep patterns, and marketing and screen time. Young children are dependent on parents, caregivers, and others to provide environments that can

Suggested Citation:"Front Matter." Institute of Medicine. 2011. Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press. doi: 10.17226/13124.
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help shape these factors in positive ways by, for example, supporting the development of lifestyle behaviors that promote growth and development, making healthy foods available in appropriate amounts, and providing safe places for active play. Moreover, all of these factors come into play in the policy environment that surrounds and influences parents and children and must be addressed in a coordinated manner if progress is to be made against the early onset of childhood obesity.

This report addresses all of these factors and offers policy recommendations that together form an action plan for addressing obesity in young children. It focuses on the environments in which young children spend their time and is directed at the adults who shape those environments. Parents play the primary role in shaping children’s development and influencing their obesity risk through genetics and home environments. However, the focus of this report is on policies that are developed and implemented by policy makers and by caregivers who interact with parents and young children. Thus the report’s recommendations are not made directly to parents but to these “intermediaries,” to ensure that early childhood obesity prevention policies are implemented in a way that complements and supports parents’ efforts to maintain healthy weight in their young children. In particular, it is the committee’s hope that the report will find its way to federal, state, and local government policy makers who work in areas that impact young children in infancy and early childhood. The committee attempted to make the report user-friendly so that what we have learned about obesity prevention for young children can be put to good use in efforts to improve the present and future health of the nation’s children.

I want to express my sincere appreciation to the other committee members for their commitment to our task and the countless volunteer hours they contributed to this study and the development of the report. I also want to thank our workshop speakers for their insight and perspectives on preventing obesity in the first years of life. In addition, many thanks to Rona Briere for her editing of the report. Finally, I want to express my gratitude to the dedicated IOM staff who worked with the committee on this project: Annina Catherine Burns, study director; Nicole Ferring Holovach, research associate; Gui Liu, senior program assistant; Sheila Moats, associate program officer; Lynn Parker, scholar; and Linda Meyers, director, Food and Nutrition Board.

Leann L. Birch, Chair
Committee on Obesity Prevention Policies for Young Children

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Childhood obesity is a serious health problem that has adverse and long-lasting consequences for individuals, families, and communities. The magnitude of the problem has increased dramatically during the last three decades and, despite some indications of a plateau in this growth, the numbers remain stubbornly high. Efforts to prevent childhood obesity to date have focused largely on school-aged children, with relatively little attention to children under age 5. However, there is a growing awareness that efforts to prevent childhood obesity must begin before children ever enter the school system.

Early Childhood Obesity Prevention Policies reviews factors related to overweight and obese children from birth to age 5, with a focus on nutrition, physical activity, and sedentary behavior, and recommends policies that can alter children's environments to promote the maintenance of healthy weight. Because the first years of life are important to health and well-being throughout the life span, preventing obesity in infants and young children can contribute to reversing the epidemic of obesity in children and adults. The book recommends that health care providers make parents aware of their child's excess weight early. It also suggests that parents and child care providers keep children active throughout the day, provide them with healthy diets, limit screen time, and ensure children get adequate sleep.

In addition to providing comprehensive solutions to tackle the problem of obesity in infants and young children, Early Childhood Obesity Prevention Policies identifies potential actions that could be taken to implement those recommendations. The recommendations can inform the decisions of state and local child care regulators, child care providers, health care providers, directors of federal and local child care and nutrition programs, and government officials at all levels.

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