Preventing Childhood Obesity Health in the Balance (2005) / Chapter Skim
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4 A National Public Health Priority
4 A National Public Health Priority
Pages 125-152
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From page 125... ...
For example, local communities are passing ordinances that ban or limit cigarette vending machines, schools and community youth organizations are discouraging or banning smoking, states are passing excise taxes to raise tobacco prices, the federal government is providing national leadership and the resources for research and programs, and the private sector is restricting smoking in workplaces (Box 4-1) (Econorlos et al., 2001; IOM, 2003)
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From page 126... ...
Grassroots efforts made by citizens and organizations will likely drive many of the obesity prevention efforts at the local level and can be instrumental in driving policies and legislation at the state and national levels (Economos et al., 2001)
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From page 127... ...
However, as institutions, organizations, and individuals across the nation begin to make changes, societal norms are likely to change as well; in the long term, we may become a nation where proper nutrition and physical activity that support energy balance at a healthy weight will become the standard. Within the United States and globally, attention is being focused on obesity prevention efforts.
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From page 128... ...
Healthcare system—As with numerous other health promotion issues, the health~care system provides opportunities for parent and child education as well as for prevention interventions such as administering vaccines. Changes in the physical envinonment~odifications of highways, roads, and intersections to enhance pedestrian and traveler safety provide parallel examples for the funding, regulatory, and pnontization efforts required to enhance opportunities for physical activity.
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From page 129... ...
No simple solutions are anticipated; therefore, multiple stakeholders need to make a long-term commitment to improve opportunities for healthful nutrition and physical activity Although this chapter focuses on actions that need to be taken by the federal, state, and local governments, it is essential to mobilize and involve the numerous private organizations that fund obesity prevention programs and initiatives. It is in the best interest of the nation's children for all relevant stakeholders to make obesity prevention efforts a priority.
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From page 130... ...
It is expected that high-level focused attention on this issue will result in fostering interdisciplinary and interdepartmental research collaborations that span agriculture, health, behavioral sciences, economics, urban planning, and other relevant disciplines. Given the public health nature of the childhood obesity epidemic, it is the committee's judgment that the Secretary of Health and Human Services should chair this coordinating task force.
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From page 131... ...
These departments along with other relevant federal entities (e.g., the Departments of Tlanspoltation, Housing and Urban Development, interior, and Defense) should together pursue an integrated approach that promotes healthful eating and regular physical activity to achieve energy balance.
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One avenue for expanding state-based obesity prevention efforts is through CDC's grants program that focuses on local capacity building and implementation of programs to prevent obesity and other chronic diseases (CDC, 2004a)
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From page 133... ...
State and local governments should make childhood obesity prevention a priority by devoting resources to this issue and providing leadership in launching and evaluating prevention efforts. State and Local Public Health Agencies Government public health agencies are critical components of the nation's response to childhood obesity at national, state, and local levels, not only because the public health workforce has the needed expertise, but also because it has access to a large number of children, youth, and families; the ability to galvanize community efforts; and the resources to implement prevention programs.
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From page 134... ...
RESEARCH AND EVALUATION Much remains to be learned about the causes and correlates of childhood obesity, as well as the optimum measures for preventing it. Experimental behavioral research and community-based research are key to learning more about changes in dietary and physical activity behaviors in individuals and populations (see Chapter 9)
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From page 135... ...
. As discussed throughout the report, there are many studies on correlates of obesity, physical activity, sedentary behavior, and various dietary intake patterns, many of which conclude that their findings will be useful in designing effective prevention programs.
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Until a sufficient evidence base is built, therefore, attention must be given to ensuring that careful evaluation research is conducted as part of all new policy and program initiatives. Through these evaluation efforts, interventions can be refined; those that are unsuccessful can be discontinued or refocused, and those that are successful can be identified, replicated, and disseminated.
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From page 137... ...
. The current NHANES measures many factors that relate to energy balance: dietary intake, physical activity, body mass index, body composition, cardiovascular fitness, and biochemical indicators such as blood pressure and serum glucose.
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From page 140... ...
More detailed information is needed on weight status; physical activity; nutrition; social, environmental, and behavioral risk factors for obesity; and economic and medical consequences of obesity (such as type 2 diabetes in children and youth)
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From page 141... ...
focuses on media messages on physical activity for 9- to 13-year-olds and involves collaborations with schools, youth organizations, and other organizations. The existing infrastructure and capabilities of these and other relevant federal programs and public-private collaborations can provide an avenue to raise awareness of the health consequences of childhood obesity and to convey, through well-evaluated interventions, information on energy bal
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From page 142... ...
Federal support is needed for programs that emphasize improved nutrition and physical activity in children, youth, and their families, with particular attention paid to populations at high risk of obesity. These programs should be required to have strong evaluation components, and the evaluation results should consequently be reflected in program refinements that strengthen their evidence-based approaches.
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From page 143... ...
. As noted in Chapter 3, food insecurity in children has not been associated with obesity, except in white girls aged 8 to 16 years (Alaimo et al., 2001; Casey et al., 2001; Frongillo, 2003)
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From page 144... ...
for the populations served. USDA should also continue to explore pilot programs within the nutrition assistance programs that encourage diet and physical activity behaviors that promote energy balance at a healthy weight in children and youth.
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A NATIONAL PUBLIC HEALTH PRIORITY 145 committee acknowledges that the nation's food supply is part of a global food system, and that many food-related issues lie outside of any one nation's purview. However, the committee also realizes that the global implications of domestic solutions to the childhood obesity epidemic should be thoughtfully considered so that new problems are not created that may produce adverse consequences (Appendix D)
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From page 146... ...
food system that supports energy balance at a healthy weight. OTHER POLICY CONSIDERATIONS The Imposition of taxes on certarn foods or beverages, particularly high-calorie food items or those with low nutrient density, has been discussed with regard to the obesity epidemic.
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From page 147... ...
The committee suggests that research into the effects of taxation and pricing strategies be considered a priority to help shed light on the potential outcomes of more broadly applying taxation as a public health strategy for promoting improved dietary behaviors, more physical activity, and reduced sedentary behaviors. RECOMMENDATION Childhood obesity is a serious nationwide health problem requiring urgent attention and a population-based prevention approach.
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From page 148... ...
148 PREVENTING CHILDHOOD OBESITY · Strengthen research amd program efforts addressing obesity prevention, with a focus on experimental behavioral research amd coououoitybased intervention research amd on the rigorous evaluation of the effectiveness, cost-effectiveness, sustainability, amd scaling up of effective prevention mterventions · Support extensive program amd research efforts to prevent childhood obesity in high-nsk populations with health disparities, with a focus both on behavioral amd envirommental approaches · Support nutrition amd physical activity gl;mt programs, particularly in states with the highest prevalence of childhood obesity · Strengthen support for relevamt surveillance amd monitoring efforts, particularly NHANES · Undertake am independent assessment of federal nutrition assistamce programs amd agricultural polices to ensure that they promote healthful dietary intake amd physical activity levels for all children amd youth · Develop amd evaluate pilot projects withm the nutrition assistamce programs that would promote healthful dietary intake amd physical activity amd scale up those found to be successful To implement this recommendation, state amd local governments should: · Provide coordinated leadership amd support for childhood obesity prevention efforts, particularly those focused on bigh-risk populations, by increasing resources amd strengthening policies that promote opportunities for physical activity and healthful eating in communities, neighborhoods, amd schools · Support public health agencies amd community coalitions in their collaborative efforts to promote amd evaluate obesity preventlon interventions REFERENCES Alaimo K, Olson CM, Ftongillo EA Jr, 2001, Low family income and food insufficiency in telation to ovetweight in US child en: is thete a paradox? Arch Pediatric Adolesc Med 155(10)
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CDC.2004a. CD C s State-Based Nutrition end Physical Activity Program to Prevent Obesity end Other Chronic Diseases.
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From page 150... ...
Baor L, Uany R IASO Inremational Obesity Task Fotce.
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From page 151... ...
2003. Diet Nutntion and the Prevention of Chronic Diseases.
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