the social environment, and physical activity need to be better understood to develop effective interventions (BMJ, 2004). Recent reports by the APA (2004) and the Kaiser Family Foundation (2004) advance the understanding of the role of the media in childhood obesity, but similar analyses are needed for other aspects of childhood obesity prevention, such as the role of fast foods and soft drinks, and how the social environment can be structured to contribute to the prevention of childhood obesity. For tobacco control, we may not know all the answers, but we know enough to make a difference. Research underlies tobacco control guidelines and recommendations, and similar research, recommendations, and guidelines are being developed for preventing childhood obesity. Once the relative effectiveness of various interventions is better known, there needs to be a concerted effort to disseminate and implement approaches that have been found to be effective. The lack of emphasis on the systematic diffusion of effective interventions has plagued multiple public health initiatives.

Need to Consider the Global Dimension

The epidemic of childhood obesity first appeared in the United States, but every indication is that it is beginning to appear in other developed countries, as well as in the developing world. The global implications of our domestic solutions should be considered, so we do not solve our problems by creating a larger one overseas (Yach et al., 2003; WHO, 2004).

REFERENCES

AAP (American Academy of Pediatrics). 2003. Prevention of pediatric overweight and obesity. Pediatrics 112(2):424-430.

AAP. 2004. Policy statement: Soft drinks in schools. Pediatrics 113(1):152-154.

AHRQ (Agency for Healthcare Research and Quality). 2002. Guide to Clinical Preventive Services. [Online]. Available: http://www.ahrq.gov/clinic/cps3dix.htm [accessed February 24, 2004].

APA (American Psychological Association). 2004. Report of the APA Task Force on Advertising and Children. [Online]. Available: http://www.apa.org/releases/childrenads.html [accessed February 24, 2004].

APHA (American Public Health Association). 2003. Food Marketing and Advertising Directed at Children and Adolescents: Implications for Overweight. Policy # 200317-1. Adopted November 2003. [Online]. Available: http://www.apha.org/legislative/policy/2003/2003-017.pdf [accessed February 24, 2004].

Ashe M, Jernigan D, Kline R, Galaz R. 2003. Land use planning and the control of alcohol, tobacco, firearms, and fast food restaurants. American Journal of Public Health 93(9):1404-1408.

Bero L. 2003. Implications of the tobacco industry documents for public health and policy. Annual Review of Public Health 24:267-288.

BMJ (British Medical Journal). 2004. Fighting obesity: Evidence of effectiveness will be needed to sustain policies. British Medical Journal 328:1327-1328.



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