ents as well as growth outcomes. Any national longitudinal cohort study of children that is established should examine antecedents and outcomes, including physical activity levels, dietary patterns, eating behaviors, and weight status, related to the development of obesity during childhood.

NUTRITION AND PHYSICAL ACTIVITY PROGRAMS

A number of public- and private-sector programs educate consumers of all ages about proper nutrition and regular physical activity. For example, the USDA’s Expanded Food and Nutrition Education Program (EFNEP) uses the resources of county Cooperative Extension System services and other local agencies to reach low-income families and youth, and both the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Food Stamp Program (FSP) have nutrition education components. Team Nutrition has been developed by USDA to improve school nutrition and nutrition education, and it has components for students, parents, teachers, and food service personnel. The Five-A-Day media campaigns, the result of an extensive public-private partnership, promote the consumption of fruits and vegetables. These programs still face challenges, however. A recent assessment of several USDA nutrition education efforts revealed limited resources, competing program requirements, and a lack of systematic data collection on the types of nutrition education offered (GAO, 2004). Actions are therefore needed that clearly identify program goals, tailor nutrition education to meet the needs of participants, and collect data on program results (GAO, 2004).

Increasingly, more public- and private-sector programs are focusing on physical activity, or they are working to promote both good nutrition and physical activity. The President’s Council on Physical Fitness and Sports is developing a Fit ‘n Active Kids program. The Partnership for a Walkable America is an extensive public-private collaboration to promote walking and improve conditions for walking. The America on the Move initiative sponsored by the Partnership to Promote Healthy Eating and Active Living (an organization of nonprofit and private-sector partners) targets prevention of adult weight gain as a first step toward combating obesity; the initiative specifically advocates increasing physical activity by 100 calories per day and decreasing caloric intake by 100 calories per day (America on the Move, 2004). CDC’s VERB campaign (see Chapter 5) 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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