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Preventing Childhood Obesity: Health in the Balance
base is not yet available. Instead, we are in the midst of compiling that much needed evidence at the same time that there is an urgent need to respond to this epidemic of childhood obesity. Therefore, the committee used the best scientific evidence available—including studies with obesity as the outcome measure and studies on improving dietary behaviors, increasing physical activity levels, and reducing sedentary behaviors as well as years of experience and study on what has worked in addressing similar public health challenges—to develop the recommendations presented in this report. These recommendations constitute the committee’s priorities and the recommended steps to achieve them.
As evidence was limited, yet the health concerns are immediate and warrant preventive action, it is an explicit part of the committee’s recommendations that obesity prevention actions and initiatives should include evaluation efforts to help build the evidence base that continues to be needed to more effectively fight this epidemic.
From the report’s ten recommendations, the committee has identified a set of immediate steps based on the short-term feasibility of the actions and the need to begin a well-rounded set of changes that recognize the diverse roles of multiple stakeholders (Table 9-1). In discussions and interactions that have already begun and will follow with this report, each community and stakeholder group will determine their own set of priorities and next steps. Furthermore, action is urged for all areas of the 10 recommendations, as the list in Table 9-1 is only meant as a starting point.
The committee was also asked to set forth research priorities. There is still much to be learned about the causes, correlates, prevention, and treatment of obesity in children and youth. Because the focus of this study is on prevention, the committee concentrated its efforts throughout the report on identifying areas of research that are priorities for progress toward preventing childhood obesity. The three research priorities discussed throughout the report are:
Evaluation of obesity prevention interventions—The committee encourages the evaluation of interventions that focus on preventing obesity, improving dietary behaviors, increasing physical activity levels, and reducing sedentary behaviors. Specific policy, environmental, social, clinical, and behavioral intervention approaches should be examined for their feasibility, efficacy, effectiveness, and sustainability. Evaluations may be in the form of randomized controlled trials and quasi-experimental trials. Cost effectiveness research should be an important component of evaluation efforts.
Behavioral research—The committee encourages experimental research examining the fundamental factors involved in changing dietary behaviors, physical activity levels, and sedentary behaviors. This research