tic as possible. The committee acknowledges, as have many other similar efforts, that obesity prevention is a complex issue, that a thorough understanding of the causes and determinants of the obesity epidemic is lacking, and that progress will require changes not only in individual and family behaviors but also in the marketplace and the social and built environments. 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.

The committee recognizes the importance of combined social deliberation, problem analysis, and social mobilization around the issue of childhood obesity prevention at different levels and in various settings. This report and others that follow can set forth recommendations and broadly outline suggested actions; however, many of the next steps for progress on this issue will involve discussions and interactions of the implementers and innovators—the people, agencies, and organizations concerned about this issue and ready to work together to develop, implement, and evaluate approaches to prevent childhood obesity that fit the needs of their state, county, community, school, or neighborhood.

LEADERSHIP, COORDINATION, AND PRIORITY SETTING

A National Priority

The federal government has a long-standing commitment to programs that address nutritional deficiencies (beginning in the 1930s) and encourage physical fitness, but only recently has obesity been targeted. Physical activity and overweight/obesity are now designated as priority areas and leading health indicators in the nation’s health objectives, Healthy People 2010, developed by the Department of Health and Human Services (DHHS) in collaboration with state and territorial health officials and numerous national membership organizations. The goal set by Healthy People 2010 is to reduce the proportion of children and adolescents who are obese to 5 percent by 2010 (DHHS, 2000).

Obesity prevention is a cross-cutting issue that does not naturally fall under the purview of any one federal department. It encompasses health concerns central to the mission of DHHS; nutrition, nutrition education, and food-related issues for which the U.S. Department of Agriculture (USDA) has responsibilities; and school curriculum and school environ-



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