Index
A
Academic performance, 105, 215, 252, 253
Action plan for prevention
clinical medicine approach, 107-108, 109
definitions and terminology, 79-83
developing recommendations, 16, 111-115, 323
evidence-based strategies, 3, 16, 107-115, 322-323
public health approach, 108-110, 115, 127, 129
Active Living by Design, 206
Added caloric sweeteners, 31, 145-146, 290
Adolescents. See Children and adolescent obesity;
Older Children and Youth
Adopted children, studies, 93
Adults
diabetes, 68
obesity, 5, 22, 43-44, 63-65, 68
overweight, 80
physical activity, 29, 35, 179
prevention goals, 88
treatment for obesity, 108
Advertising and marketing
alcoholic beverages, 175
bans and restrictions on, 174-175, 178, 268, 353, 362, 363
codes and monitoring mechanisms, 176-177
and eating behavior, 169-170, 172-173
energy density of advertised foods, 172
and energy imbalance, 172, 173, 174, 355
ethnic groups targeted by, 106
evidence of effects of, 353-354, 355
expenditures, 172
exposure time for children, 171, 174
First Amendment rights, 174-175, 353, 362
health and nutrient claims, 169-170, 176
litigation, 354
prevention through, 128, 268, 353, 367;
see also Public education
quantity and nature of commercials, 172
social and public health pressures, 366
standards development, 175-176
targeting children, 106, 145, 172, 174, 355
television commercials, 8, 44, 172-173, 174, 265, 301, 302, 355
vulnerability of children to, 8, 172-173, 267-268, 302, 353-354, 355
Advertising Council, 184
Advocacy
community mobilization, 210-211
by health professionals, 223-225
by parents, 300
Age
and child obesity trends, 1, 63
Agricultural policies, 6-7, 144-146, 148, 217
African Americans.
See also Ethnic groups;
Racial and ethnic disparities
body image dissatisfaction, 66, 104
defined, 58 n.4
diabetes, 68
targeted marketing of foods to, 106
Alabama, 61
Alaska, 61
Alcohol prevention analogies, 175, 352, 354, 366
America on the Move initiative, 141
American Academy of Family Physicians, 224
American Academy of Pediatrics, 174, 224, 253, 290, 358
American Cancer Society, 201
American Council on Food and Nutrition, 367 n.6
American Federation of School Teachers, 265
American Indians.
See also Ethnic groups;
Racial and ethnic disparities
body image dissatisfaction, 66, 104
defined, 58 n.4
diabetes, 68
school-based dietary interventions, 245, 246, 247-248
American Medical Association, 224
American Planning Association, 210, 218
American Psychological Association, 265, 371
PsychINFO database, 341
Task Force on Advertising and Children, 173-174, 355, 356
American Public Health Association, 132, 358, 359-360
American Stop Smoking Intervention Study (ASSIST), 199
Americans in Motion, 224
Americans’ Use of Time Study, 29, 159
Animal studies, 94
Appetite.
See also Hunger;
Satiety regulatory systems, 95, 157
Arkansas BMI initiative, 271
Asian/Pacific Islanders.
See also Ethnic groups;
Racial and ethnic disparities
body image dissatisfaction, 104
defined, 58 n.4
diabetes, 68
obesity trends, 105
Association of State and Territorial Health Officials, 132, 218
Atherosclerosis, 69
Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC), 140-141
Away-from-home foods.
See also Fast food;
Restaurant industry;
School food and beverages
consumption trends, 27-28, 30, 161, 357-358
costs and convenience, 26
defined, 331
frequency of dining out, 161-162
leisure/social aspects, 28
nutrition labeling, 163-164, 165, 168, 197, 356
portion sizes, 158
B
Back to Sleep campaigns, 179
Balanced diet
benefits associated with, 97
Basal metabolism, 331
Behavioral research, 17, 323-324
Behavioral Risk Factor Surveillance System (BRFSS), 29, 35, 36, 61, 160
Behavioral settings. See Community environment;
Home environment;
School environment
Better Business Bureau, 175
Beverages.
See also Food and beverage industry;
Milk and other dairy products;
School food and beverages;
Sodas and fruit drinks
consumption trends, 33
Blood pressure. See High blood pressure;
Hypertension
Blue Cross of California, 201
Body fat, 54, 80, 93, 137, 140, 334.
See also Body mass index
Body image, 66, 91-92, 100, 103-104, 199
Body mass index
age-specific trends, 56-57, 63-65, 80, 336
beverage consumption and, 293-294
calculation, 80
charts, 1 n.1, 55, 79-80, 88, 89-90
clinical screening and tracking, 221-222, 307-308
distribution trends, 61-62, 80, 336
obesity definition, 1 n.1, 22, 54-55, 63
optimum population goals, 86, 88-90
revised growth reference, 55
school screening, 270-271, 308
socioeconomic status and, 60-61
TV viewing and, 302
Body weight
CDC guidelines for children, 89
and energy intake, 159
healthy, 335
inappropriate gain, 90
physiological regulation of, 159
Boy Scouts, 202
Boys and Girls Clubs of America, 44, 202
Brain
regulation of energy balance, 69-70, 94, 95, 157
stress response, 70
Built environment.
See also Local
communities city planning, 210
community interventions, 203, 204-217
defined, 332
designing for physical activity, 11, 12, 125, 132, 196, 204-211, 273-274
evaluation of interventions, 208-209
land development codes, 210
race/ethnicity and, 205
rating, 218
recommendations, 11, 209-211, 213-214, 220
recreational facilities, 206, 211
safety considerations, 11, 205, 207-208, 211
smart growth principles, 209, 210
socioeconomic status and, 205, 207
street-scale interventions, 208
transportation issues, 38, 205
walking and biking opportunities, 207, 208, 209, 210, 211-215
C
California, 71, 103-104, 180, 200, 201, 213, 214, 242, 248, 358, 359
Caloric sweeteners. See Added caloric sweeteners
Calories, defined, 332.
See also Energy expenditure;
Energy intake
Carbohydrates, 34
Cardiovascular disease
food label health claims, 169
prevention interventions, 107, 109, 196, 200, 223, 262
Center for Consumer Freedom, 367 n.6
Centers for Disease Control and Prevention, 346
BMI charts, 1 n.1, 55, 79-80, 88, 89-90
guidelines for healthy weight, 89
health curriculum recommendations, 261
Healthy Days Measures, 218
physical activity promotion, 141, 255
REACH 2010 initiative, 200
revised growth reference, 55
surveillance and monitoring, 29, 37, 61, 137
tobacco prevention policies, 358
VERB campaign, 141, 182-183, 184
Check-off programs, 145
Child and Adolescent Trial for Cardiovascular Health (CATCH), 245, 246, 256, 262-263, 270
Child and Adult Care Food Program (CACFP), 142, 143
Childhood and adolescent obesity.
See also Epidemic of childhood/adolescent obesity;
Prevalence of childhood/adolescent obesity
abuse and neglect and, 287
adult obesity trends and, 63-65
and co-morbid health risks, 62, 67-69, 319
definitions, 1 n.1, 22, 56, 63, 79-81, 115, 336
food insecurity and, 215
health care costs, 72
intergenerational transmission, 65
international dimensions, 2, 22
medical conditions and, 91
Children and youth.
See also Infants;
Older children and youth;
Toddlers and young children
balanced diet, 91
BMI distributions, 61-62, 80, 336
energy expenditure, 90
energy requirements, 97, 158, 167-168
physical activity trends, 35-36, 160
purchasing influence, 172, 292, 302
Children’s Advertising Review Unit, 175-176
Cholesterol, dietary, 180
Church-based interventions, 199-200
CINAHL (Cumulative Index to Nursing and Allied Heath Literature), 339, 340
Class of 1989 Study, 197
Clinical medicine.
See also Treatment of obesity
effectiveness of interventions, 365
evidence-based approach, 107-108, 109
preventive services, 221-224, 226
Clinical practice guidelines, 107
Coalition building, 7, 128, 198-199, 200, 202-203, 225-226
Common Sense for Consumption Act, 363
Community-based interventions.
See also Built environment;
Local communities
child/youth programs, 197-198, 201-204
coalition building, 7, 10, 11, 128, 198-199, 200, 202-203, 225-226
culturally appropriate and targeted strategies, 198, 199-201, 203
demonstration projects, 132, 200, 204, 208-209, 213
ecological framework, 196-199, 203
evaluation of, 11, 17, 203-204, 217-219, 325
evidence of effectiveness, 46, 196-198, 222-223, 348
large-scale, 196-197, 217-219, 345, 347
neighborhood associations, 210-211
physical activity, 12, 179-180, 196, 197, 201, 202, 211-215
public health preventive services, 125, 200, 346, 347, 348-349
recommendations, 10-12, 201-204, 219-221, 225
recreational programs, 202
“report cards,” 218
by youth organizations, 201
Community centers, schools as, 272-274
Community environment.
See also Built environment;
Local communities
access to food products, 144, 215-217, 357-358
health impact assessment, 217-219
Community health care
advocacy by professional organizations, 224-225
counseling by health-care professionals, 221-223
preventive services, 12, 221-225, 226, 348-349
quality-improvement programs, 226
recommendations, 12, 225, 226-227
Community Health Status Indicators Project, 218
Community Preventive Services Taskforce, 361
Co-morbidities of obesity.
See also Diabetes
defined, 332
disorders, 67
health risks of children, 62, 67-69
Congress for the New Urbanism, 210
Consumer attitudes.
See also Public interest in obesity
Consumer information, 128, 141-142, 163
Continuing Survey of Food Intakes by Individuals, 97, 137, 138, 159, 163, 293
Corn subsidies, 146
Coronary artery disease, 69
Cost-reduction interventions, 46, 347, 349
Costs of childhood obesity.
See also Economic costs of obesity
physical health, 65, 67-69, 71, 73
social and emotional health, 22-24, 65, 66-67, 69-70, 71, 73
Counseling
by health-care professionals, 221-223
Current Population Survey, 45
D
Dairy products. See Milk and other dairy products
Demonstration projects, 132, 200, 204, 208-209, 213
Denmark, 287
Depression and depressive symptoms, 66, 67, 69-70, 105
Diabetes, type 2
in adults, 68
in ethnic minority groups, 23, 68
high-fructose corn syrup and, 146
risk factors, 68
Diet.
See also Balanced diet
nutrient density, 96
Dietary Guidelines Advisory Committee, 131
Dietary Guidelines for Americans, 13, 96-97, 131, 164, 165, 239, 240, 292, 332
Dietary intake
economic environment and, 100, 101, 215-216, 358
and energy balance, 95-98, 101
health claims advertising and, 169-170
by macronutrient, 34
physiological regulation of, 159
psychosocial and behavioral considerations, 95-98, 105
Dietary interventions
effectiveness of, 241, 244-247, 364
school based, 240-241, 244-247, 252-253, 364
self-help, 365
tobacco control interventions compared, 350-351
Dietary Reference Intakes, 168, 333
Disability, defined, 333
Disease
defined, 333
emergency response to, 133
Discrimination, 66, 67, 100, 178
E
Eating behavior
in absence of hunger, 294-296, 305
brain’s regulation of, 69, 95, 157
breastfeeding and, 222, 288-290
“clean the plate” pressures and, 295
energy density of foods and, 156-157, 159, 291, 293
food as reward and, 295
health-claims advertising and, 169-170
home environment and, 14-15, 287-296
introducing new foods, 291
package size and, 159
parental influence, 287-289, 305-306
portion size and, 158, 291-292, 294-296, 305
selection and availability of foods, 292-294
TV viewing during meals and, 222, 293
Eating patterns, trends, 27-28, 30-35
Ecological systems theory model, 83-85, 115
Economic costs of obesity, 23, 70-71, 72, 225
Economic environment
and food intake, 100, 101, 215-216, 358-360
funding of school meals, 250, 252
and physical activity, 100, 102
in schools, 238, 250-252, 358, 359
taxation and pricing interventions, 44, 128, 146-147, 178, 358-360
Edible Schoolyard, 248
Education. See Public education
Electronic media.
See also Television viewing
time spent by children on, 171, 172
EMBASE (Excerpta Medica), 339, 340, 342
Employers and worksite interventions, 195, 202
Energy balance
action plan for prevention, 90-106
central nervous system regulation of, 69-70, 94, 95, 157, 159
dietary intake and, 95-98, 101
ecological systems theory model, 83-85, 115
environmental influences, 100-106
food marketing and advertising practices and, 172, 173, 174, 355
genetic variation and biological considerations, 91, 93-95, 159
physical activity and, 92, 98-99, 102
promotion, 115
psychosocial and behavioral
racial and ethnic disparities, 105-106
sociocultural environment and, 84-85, 91-92, 100-106
socioeconomic status, 104-105, 146-147
stigmatization considerations, 100, 103
surveys, 137
transportation patterns and, 37
Energy density of foods, 28
access and affordability issues, 216
of advertised foods, 172
of away-from-home foods, 92, 162, 163
defined, 333
infant response to, 290
taxes on energy-dense foods, 44, 146-147
Energy expenditure
adult patterns, 160
resting metabolism and, 92 n.6
Energy intake
away-from-home foods, 30, 158, 161
body weight and, 159
by gender, 35
measurement, 332
physiological regulation of, 289, 294
trends for children, 97
Energy requirements for children and adolescents, 97, 158, 167-168
Entertainment industry. See Leisure, entertainment, and recreation industries;
Television viewing
Environmental influences.
See also Community environment;
Home environment;
School environment
defined, 334
ecological layers, 15, 100, 101-102, 286, 320
monitoring needs, 140
Epidemic of childhood/adolescent obesity
adult obesity epidemic and, 63-65
costs for children and society, 22-24, 65-72
eating patterns and, 27-28, 30-35
in ethnic groups, 1, 26-27, 58-61
high-risk population subgroups, 58-61, 134
lifestyle trends, 25-26, 27-39
physical activity and, 29, 35-39
physical health implications, 22-23, 67-69
prevalence and time trends, 22, 54-65
public health implications, 22-24
public health precedents, 21, 44-47, 343-371
regional differences, 61
social and emotional consequences, 23, 66-67
socioeconomic difference, 60-61, 104-105
ERIC (Educational Resources Information Center) database, 339, 340-341
Ethnic groups.
See also Racial and ethnic disparities;
Sociocultural environment
body image perceptions, 199
definitions, 58 n.4
genetic susceptibility to obesity, 106
high-risk groups, 58-61, 68, 199-201
interventions targeted to, 199-201, 203, 257
media education campaigns, 182-183
obesity prevalence, 1, 10, 26-27, 58-61, 94, 105-106
physical activity, 29-30, 205, 257
and protective effects of breastfeeding in, 289
regional differences, 61
socioeconomic difference, 60-61, 106, 201
targeted marketing of foods to, 106
TV viewing time, 301
Evaluation of prevention interventions
BMI distribution as measure of change, 88
community-based participatory studies, 17, 203-204, 217-219, 325
design of studies, 304
health impact assessment, 217-219
intermediate goals and, 6, 17, 86-87, 323
natural experiments, 209
pilot programs, 242, 247-248, 251, 252, 274, 277
pretest/posttest design, 208
Exercise.
See also Physical activity
defined, 334
Expanded Food and Nutrition Education Program, 141, 142
F
Family Interaction, Social Capital and Trends in Time Use Data, 29, 160
Family life, trends, 25-26, 285-286
Farmers’ markets, 144, 216, 248
Fast food.
See also Restaurant industry
advertising and marketing, 302, 355
consumption trends, 162, 163, 358
defined, 334
nutrient density, 162
nutrition labeling, 356
sales, 162
Fat, dietary.
See also Body fat
consumption trends, 30-31, 34, 245
saturated, 169
Fat-brain axis, 95
Federal Trade Commission, 9, 153, 174, 175, 177, 355-356
Federal Transportation Enhancements Program, 209
Feeding Infants and Toddlers Study (FITS), 290, 291
Feet First, 206
Finland, 196
Fish and shellfish, 32
Fit ‘n Active Kids program, 141
Fitness.
See also Physical fitness
defined, 334
Five-a-Day media campaign, 141, 180, 244
Fluoridation campaigns, 199, 350
Food and beverage industry.
See also Advertising and marketing;
Restaurant industry;
School food and beverages
check-off programs, 145
liability protection, 360, 362
motivation for change, 154, 157, 170, 366
packaging, 154, 158-159, 167, 172, 356
positive changes, 7, 155, 156, 266-267
product development, 154, 155-157, 170
sales to young consumers, 153-154, 172
targeted marketing of foods, 106, 145, 172
Food and Drug Administration
nutrition labeling regulation, 9, 167-171, 362
Obesity Working Group, 163
tobacco regulation, 353
Food, Drug and Cosmetic Act, 361
Food environment
access and opportunity, 27, 100, 101, 105, 128, 144, 215-217, 292-294, 356-358
away-from-home foods, 26, 27-28, 331
community-based interventions, 144, 216-217, 218, 357-358
economic factors and, 100, 101, 215-216, 358-360
healthy foods, 105, 144, 215-217
policy and political considerations, 100, 101, 144-146, 369
rating, 218
recommendations, 217
restricting availability, 357
sociocultural considerations, 100, 101, 106
Food Marketing Institute, 167
Food service workers, 134
Food Stamp Program, 141, 142-143, 144, 216
Foods.
See also specific food groups
ethnic, 156
of minimal nutritional value, 241, 335
product groups with health claims, 169
reduced-calorie products, 156
as reward and, 295
4H Clubs, 202
Framework Convention on Tobacco Control (FCTC), 350-351, 356, 360
France, 44
Fruits and vegetables
access to fresh foods, 144, 216, 242, 251
children’s acceptance of, 291
health benefits, 107, 169, 223
promotion, 107, 141, 180, 198, 200, 223
school offerings, 240, 242, 247-248, 251, 291
subsidies, 360
Funding
community-based interventions, 132-133, 209
for evaluation studies, 204, 215
G
Gender
and body image dissatisfaction, 104
and energy intake, 35
and physical activity, 257-258
Genetics
and energy balance, 91, 93-95, 159
environmental interactions, 93-94
and body fatness, 93
and prevalence of obesity, 94
single-gene disorders, 94
susceptibility to obesity, 65, 106
Germany, 44
Girls Health Enrichment Multi-site Study (GEMS), 200, 203
Girls on the Run, 197
Global Strategy for Diet, Physical Activity and Health, 367
Glucose intolerance/insulin resistance, 67, 68, 69, 70
Go for Health, 256
Growth charts, 89 n.4.
See also Body mass index, charts
Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People, 255
Gun control analogies, 350, 361, 362
H
Health
costs of obesity, 22-23, 65, 67-69, 71, 73
defined, 335
food security and, 215
promotion, 100, 106, 128, 335, 359-360
Health-care professionals
obesity screening and counseling by, 10, 221-223, 272
school referrals to, 272
Health-care system, 128
Health education, 106
classroom requirements and practices, 261-262
Health insurance coverage, 60-61, 225-226, 307
Health services.
See also Community health care
Healthful diet. See Balanced diet
Healthy Days Measures, 218
Healthy Eating Index (HEI), 96-97
Healthy People 2000, 156
Healthy People 2010, 129, 194, 321
Hepatic steatosis, 67
See also Hypertension
High-density lipoprotein (HDL) cholesterol, 69
High fructose corn syrup, 145-146
High-risk population subgroups, 6, 58-61, 68, 134, 199-201, 322
Highway safety analogies, 44-45, 126, 128, 132, 350, 361, 366
Hispanics.
See also Ethnic groups;
Racial and ethnic disparities
body image dissatisfaction, 66, 104
energy gaps, 93
defined, 58 n.4
diabetes, 68
HIV prevention, 107
Home environment.
See also Parents;
Television viewing
and eating behavior, 14-15, 287-296
family characteristics and, 25-26, 285-287
food and beverage selection and availability, 292-294
obesogenic families, 306
and physical activity, 14-15, 296-301
recommendations, 14-15, 290, 308-309
Hunger.
See also Appetite;
Satiety eating in absence of, 294-296, 305
in U.S., 88
Hypertriglyceridemia, 69
Hypothalamic-pituitary-adrenal axis, 70
I
Illinois, 213
Inactivity
deaths related to, 67
defined, 336
safety reasons, 207
technology and, 160
Indiana, 247
Industry.
See also Advertising and marketing;
Food and beverage industry;
Leisure, entertainment, and recreation industries;
Restaurant industry
health promotion by, 128, 161, 182
recommendations, 8, 165-166, 177
Infants
food insecurity, 105
low birthweight, 288
mortality rates, 21
Information environment. See Advertising and marketing;
Public education
Injury prevention campaigns, 345, 361
Institute of Medicine, 144, 168, 344, 360
Institute of Traffic Engineers, 210
Insulin levels, 62.
See also Diabetes;
Glucose intolerance/insulin resistance
International dimensions of obesity, 2, 22, 367, 371
International Food Information Council, 40-41
Intervention programs.
See also Community-based interventions
behavioral theory and, 345
comprehensive approaches, 46-47, 128, 131, 196-199, 203, 262-263, 345, 349-352
ethnic groups targeted, 199-201, 203, 257
evaluation of, 133, 134, 136-137, 142, 214-215
evidence of effectiveness, 45-46, 196-198, 222-223, 262-263, 348, 349-352, 370-371
funding, 6, 44, 128, 131, 132-133, 142, 148, 359-360
industry-sponsored, 161
international efforts, 44
large-scale, 196-197, 217-219, 345, 347
parental involvement, 287
registry of, 44
successful elements of, 46-47, 350-351
taxes on soft drinks and snack foods, 44, 128, 146-147
translation and diffusion of, 134-135
Intrauterine environment, 65, 95, 288
Iowa, 247
J
Joint Committee of National Health Education Standards, 261
Jump Up and Go Program, 225
K
Kaiser Family Foundation, 184, 355, 371
Kidney failure, 69
Kids Off the Couch, 201
Know Your Body study, 244
L
Labeling. See Nutrition labeling
Laws and regulations, 357
evidence of effectiveness, 46, 347, 349
Lead paint control analogies, 350, 362
Leisure, entertainment, and recreation industries, 7-8, 159-161, 166, 172, 175-176
Leisure time
physical activity trends, 29, 35, 36, 37
Leptin, 95
Life expectancy, 23
Lifestyle Education for Activity Program, 257
Lifestyle trends, 25-26, 27-39
Litigation, 128, 154, 354, 362-364
Local communities.
See also Community health care;
Community interventions
built environment, 132, 204-217
mobilization, 43-44, 128, 194-221
recommendations, 213, 217, 219-221
stakeholders and coalitions, 128, 133, 194, 195, 196-204
Low-income populations
community-based interventions, 199, 206, 217, 274
food access issues, 215-216, 217
overweight in, 206
Lung cancer prevention, 107
M
Macronutrients. See Carbohydrates;
Fat, dietary;
Protein, dietary
Marketing. See Advertising and marketing
Maryland, 207
Mass media
advertising and marketing, 8, 171-177, 178
anti-tobacco campaigns, 178, 181-182, 347
dietary interventions, 180
effectiveness of campaigns, 46, 179, 347, 349, 364-365
obesity coverage, 40-41, 154, 181, 202
physical fitness promotion, 179-180
public education campaigns, 8, 9-10, 177-185, 349, 364, 371
public service announcements, 184
Meals.
See also Balanced diet;
Eating behavior
breakfast, 28
“clean the plate” pressures, 295
eating out, 26
home preparation, 26
snacks, 28
Meat and poultry
consumption trends, 32
Media.
See also Electronic media;
Mass media;
Television viewing
Early and Periodic Screening, Diagnostic, and Treatment program, 226
Medical Expenditure Panel Survey Household Component, 61
Menstrual abnormalities, 67
Metabolism. See Basal metabolism;
Energy balance
Metropolitan Planning Organizations, 210
Micronutrient deficiencies, 88 n.3
Middle-School Physical Activity and Nutrition study, 257
Midwestern Prevention Project, 197
Military recruits, weight-for-height standards, 24
Milk and other dairy products, 31-32, 240, 293
Heart Health Program, 179, 180, 196, 197
Monitoring the Future Survey, 40
Montana, 207
N
National Association for Sport and Physical Education, 98, 253
National Association of County and City Health Officials, 132, 218
National Cancer Institute, 180, 199
National Center for Health Statistics, 54
National Committee for Quality Assurance, 226
National Governors Association, 132
National Health and Nutrition Examination Survey (NHANES), 6, 29, 36, 54, 55-56, 60, 61, 63, 68, 89, 137, 138, 139, 140, 148, 157, 160
National Health Education Standards, 261
National Health Examination Survey (NHES), 36, 60
National Health Interview Survey, 29, 159-160, 221
National Heart, Lung, and Blood Institute, 179, 225
National Highway Traffic Safety Administration, 361
National Household Travel Survey (NHTS), 38, 39, 138
National Human Activity Pattern Survey, 160
National Institutes of Health, 358
Task Force on Obesity Prevention, 131, 135
National Library of Medicine, 341
National Longitudinal Study of Adolescent Health, 60, 138
National Longitudinal Survey of Youth (NLSY), 60, 61, 62, 139
National Personal Transportation Surveys, 39
National School Lunch Program, 142, 143, 145, 237 n.1, 239-241, 250
National Walk Our Children to School Day, 213
National Youth Anti-Drug Media Campaign, 182
Native Americans. See American Indians
Neighborhood associations, 210-211
Neonatal critical period, 95
New Mexico, 247
North Carolina, 266
North Carolina Black Churches United for Better Health project, 199-200
North Karelia Project, 179, 196-197
Nutrient density of foods, 96, 115, 162, 171, 172, 243, 335
Nutrition Academic Award Program, 225
Nutrition and Physical Activity Program to Prevent Obesity and Other Chronic Diseases, 204
Nutrition assistance programs, 6-7, 142-144, 148
Nutrition education
availability, 100
community-based interventions, 198, 201, 273
food service personnel, 134
health education curriculum, 261-262
media campaigns, 141
by restaurant industry, 164-166
Nutrition labeling
calorie content, 168
health claims, 9, 167, 169-170, 171, 362
ingredient disclosure, 356
nutrient claims, 9, 167, 168-169, 171
Nutrition Facts Panel, 9, 158, 166-168, 169, 171, 335
percent Daily Value, 166-167, 171
restaurant foods, 163-164, 165, 168, 197, 356
Nutrition Labeling and Education Act, 166, 170 n.8
Nutrition standards, 44, 125, 129-130, 131, 134
O
Obesity.
See also Childhood and adolescent obesity;
Epidemic of childhood/adolescent obesity;
Prevalence of childhood/adolescent obesity
Older children and youth
family decision-making responsibilities, 304-305
fast food consumption, 163
healthful eating behaviors, 290-292
1% or Less campaign, 180
Orthopedic problems, 67
Overweight
P
Parents
as advocates, 300
defined, 14
involvement in interventions, 287
labor force participation, 25, 26
media campaigns targeting, 179, 183
nutrition education, 142, 287, 299
obese or overweight, 64-65, 93, 104, 199, 289
perception of weight as health issue, 42-43, 65-66, 269, 306-308
physical activity patterns of, 297-298, 302
physician counseling for, 222
promoting healthy food choices, 14-15, 287-296
promoting physical activity, 14-15, 299, 300-301
as role models, 183, 195, 197, 273, 286, 292, 298, 305-306
Partnership for a Walkable America, 141, 213 n.2
Partnership for the Public’s Health, 200
Partnership to Promote Healthy Eating and Active Living, 84, 141
Pawtucket Heart Health Program, 179, 196
Pediatric Nutrition Surveillance System (PedNSS), 139
Pennsylvania, 207
Physical activity.
See also Inactivity;
Sedentary behavior
and academic performance, 253
after-school programs, 260, 272-274
biological correlates, 69, 296-297
built environment and, 38, 125, 132, 196, 204-211
classroom curricula, 255, 262-263
community mobilization, 44, 179-180, 196, 197, 201, 202, 211-215
competitive sports, 202, 258-259, 299
counseling, 223
dance classes, 257
developmental correlates, 296-297
economic environment and, 100, 102
education programs, 141-142, 299
effectiveness of interventions, 256-258, 262-263
and energy balance, 92, 98-99, 102
environmental influences, 102, 105, 257
evaluation of programs and policies, 213, 260, 274-275, 364
extracurricular programs, 258-259
family-based interventions, 299-300
funding for programs, 44
gender differences, 257-258, 296-297
home environment and, 14-15, 296-301
industry-sponsored efforts, 182
interactive effects of diet and, 92-93
interventions, 136-137, 141-142, 179-180, 182, 211-215, 223, 245
leisure time, 36, 105, 159-160
measurement of, 98-99, 205, 209
outdoor play, 205, 222, 299, 300
parental role, 299
PE classes and recess, 35, 37, 125, 253-258, 259, 336
physical environment and, 125, 132, 196, 204-211, 299
promoting, 44, 141-142, 148, 161, 179-180, 200-201, 222, 299
psychosocial and behavioral correlates, 98-99, 297
race/ethnicity and, 29-30, 205, 257
recommendations, 6, 259-261, 273
recommended levels, 29 n.3, 98, 253
reducing sedentary behaviors, 263-264, 301-305
safety issues, 205, 211, 299, 300
school-based interventions, 43, 245, 256-258, 299
social environment and, 297-299
socioeconomic status and, 105, 201, 205, 206, 298-299
transportation patterns and, 37-39, 71
types, 29
walking and biking, 37, 38-39, 92, 125, 141, 160, 211-215, 259, 300
Physical environment.
See also Built environment;
Food environment;
School food and beverages
and physical activity, 100, 102
Physical fitness, 129, 137, 140, 141, 269-270, 334, 336
Planet Health, 137, 245, 246-247, 263, 264
Policy/political environment
agricultural policies, 144-146
food environment and, 100, 101, 144-146, 369
and implementation of interventions, 348
and physical activity, 100, 102, 214
age and, 165
of away-from-home foods 158
defined, 158 n.3
and eating behavior, 158, 291-292, 294-296
marketing strategy, 158-159, 366
quantifying dietary intakes, 98
regulation of, 362
Potatoes, 28
Pregnancy
intrauterine environment, 65, 95, 288, 289
President’s Council on Physical Fitness and Sports, 141
Prevalence of childhood/adolescent obesity
away-from-home foods and, 26, 331
in ethnic groups, 1, 26-27, 58-61, 94, 105-106
high-risk population subgroups, 58-61, 72-73
population genetics and, 94
regional differences, 61
socioeconomic status and, 60-61, 104-105
Prevention of childhood/adolescent obesity.
See also Action plan for prevention;
Intervention programs
behaviors targeted, 222
clinical screening and tracking, 221-224, 226
community health services, 221-225, 226, 348-349
congressional support, 131, 177
coordinating task force, 5-6, 130-131, 147
cost considerations, 100
economic benefits of, 72
federal commitment to, 5, 129-131
food industry as target of, 370
global dimension, 371
government support and funding, 5-6, 128
guide to preventive services, 209, 348-349
individual-level approach, 86, 87, 107-108, 109, 110, 221-223
individual responsibility vs. collective action, 369
insurance coverage, 100, 224, 225-226
legislation and regulations, 360-361
lessons learned from other initiatives, 103, 109, 125, 128, 179-183, 344-352, 369-370
longitudinal studies, 140-141, 209
multifactorial approaches, 16, 46-47, 81-82, 83, 109, 125, 126, 128, 178, 179, 245-246, 249, 299, 322, 344, 349-352, 370
national priorities, 5-7, 127, 129-131, 147-148
population-level approach, 82, 86, 87, 88-90, 107-109, 125, 199-201
primary prevention approach, 82, 107, 115, 337
psychosocial considerations, 222
public health precedents for, 24, 44-47, 83, 107, 179-183, 321, 350-351
public-private partnerships, 141
social environment and, 320, 365-367
sociocultural considerations, 100, 103, 106, 109-110, 369
stakeholders, 16, 19, 127, 320, 321, 324
state and local priorities, 6, 131-134, 148
targeted to high-risk populations, 81, 142
treatment distinguished from, 81-82
Prevention research.
See also Evaluation of prevention interventions
best practices and effectiveness evaluations, 97-115, 344-345, 346, 370-371
clinical practice approach, 107-108, 109, 110
cost-effectiveness analyses, 136-137
developing recommendations, 111-115
experimental behavioral, 134, 135-136
falsifiability, 108
federal investment in, 135, 177
framework, 136
generalizability, 107-108, 111, 260, 345, 346, 350, 364
incorporation into program planning and implementation, 136
interdisciplinary and interdepartmental collaborations, 130, 134, 135
phases, 108
predictability, 107
public health approach, 108-110
randomized controlled trials, 110, 111, 114
recommendations, 148
scientific uncertainty and, 109
standard of evidence, 111, 114
Project MOVE (Measurement of the Value of Exercise), 136-137
Protein, dietary
consumption trends, 34
food supply trends, 34
Provider reminder systems, 46, 347, 348, 349
Psychosocial and behavioral considerations
depression and depressive symptoms, 66, 67, 69-70, 105
and dietary intake, 95-98, 105
in energy balance, 69-70, 95-99
health costs of obesity, 23, 65, 66-67, 69-70, 71, 73
stigmatization of obesity, 2, 23, 103
Puberty, 297
Public education
complementary components, 178
dietary interventions, 180, 345
evaluation and monitoring component, 178
funding for, 184
media campaigns, 9-10, 43, 128, 177-185, 353
nutrition and physical activity programs, 141-142
recommendations, 9-10, 183-185
sensitivity in design of, 178
Public health.
See also Prevention of childhood/adolescent obesity
access and opportunity issues, 356-358
achievements of 20th century, 21, 44-46, 346-348
action plan for preventions, 108-110, 115, 127, 129
agricultural policies and, 144-146, 148
community preventive services, 7, 125, 200, 346, 347, 348-349
criteria for comparison of prior approaches, 368
economic factors, 347, 358-360
evidence-based approach, 108-110, 126
framework for interventions, 352-367
implications of obesity epidemic, 22-24
individual and clinical efforts, 348, 365
information environment, 353-356
leadership, coordination, and priority setting, 7, 129-134
legal environment, 349, 360-361
lessons learned, 125, 128, 179-183, 344-352, 369-370
media campaigns, 179-183, 346, 347, 349, 364-365
multi-problem approaches, 126, 349-352
nutrition assistance programs, 142-144, 148
nutrition education programs, 141-142
oversight and enforcement role, 133-134
physical activity programs, 141-142
precedents for prevention, 21, 24, 44-47, 83, 125-126, 128, 179-183, 343-371
prevention and treatment programs, 107-109, 364-365
product labeling, 356
recommendations, 131, 134, 135, 137, 140, 141, 142, 144, 147-148
regulatory environment, 361-362
research and evaluation, 107-109, 134-137, 148
school-based interventions, 347, 348, 349, 364
social environment and, 126-127, 365-367
state and local agencies, 133-134, 148
surveillance and monitoring, 137-141, 148
taxes on food and beverages, 146-147
Public Health Foundation, 218
Public interest in obesity
and policy changes, 178-179, 365-367
R
Racial and ethnic disparities.
See also Ethnic groups;
Sociocultural environment
in body size dissatisfaction, 103-104
in built environment, 205
community health interventions, 203
in physical activity opportunities, 205
in prevalence of obesity, 105-106
REACH 2010 initiative, 200
Recommendations
evidence-based approach to developing, 16, 111-115, 323
Recreation industry. See Leisure, entertainment, and recreation industries
Recreational facilities and programs, 202, 206, 211
Regional differences in prevalence of obesity, 61
Research priorities, 16-17, 88, 177, 322-325.
See also Prevention research
Restaurant industry.
See also Away-from-home foods;
Fast food
healthier food options, 162, 163-164
nutrition labeling, 163-164, 165, 168, 197, 356
sales, 162
Reyes Syndrome campaigns, 179
Risk, defined, 337
Risk analysis, defined, 337
Robert Wood Johnson Foundation, 206, 218
Role models
health professionals as, 223
parents as, 183, 195, 197, 273, 292, 298, 305-306
Roper Youth Report, 173
S
Safe Routes to School programs, 213, 214
Safety
in built environment, 205, 207-208, 211
defined, 337
Satiety, 157, 159, 289, 294, 295
School Breakfast Program, 142, 143, 237 n.1, 239-241, 258-259
School environment
after-school and extracurricular programs, 200, 258-259, 260, 272-274
behavioral nutrition curricula, 262-263
changes needed in, 248-250, 252-263, 264-265
classroom curricula, 253, 261-265
evaluation of programs and policies, 260, 274-275, 277-278
fitness screening and counseling, 269-272
health services, 14, 269-272, 308, 349
interventions, 46, 114-115, 128, 137, 141, 197, 211-215, 244-247, 256-258, 349
location in community, 213-215
nutrition education programs, 141, 249-250, 273
PE classes, 125, 336, 253-258, 259, 260, 358
physical activity, 13, 14, 43, 211-215, 253-261, 262-263, 276-277, 358
prevention opportunities, 12-13, 237-238
rating, 218
recommendations, 12-14, 114-115, 259-261, 264-265, 273, 276-278
reducing sedentary behaviors, 263-264
research needs, 261
tobacco prevention policies, 358
School food and beverages
advertising, 14, 176, 251, 265-269
bonus commodities, 145, 248, 250
cafeteria offerings, 238-239, 240
changes needed in, 248-250, 252-263
competitive foods, 13, 241-244, 250, 251-252, 332
dietary intervention studies, 240-241, 244-247, 252-253, 364
energy intakes, 237
environmental interventions, 245-246
federal meal programs, 142, 143, 145, 237, 239-241, 250, 337, 358, 364
fresh fruits and vegetables, 217, 242, 243, 247-248, 251, 291
funding of meals, 250, 252, 277
nutrition guidelines, 239
nutritional quality and standards, 13, 240, 241, 243, 245, 249, 251, 277
pilot programs, 242, 247-248, 251, 252, 274, 277
recommendations, 13-14, 114-115, 248-250, 252-253, 276-277
restricting sales of, 241-242, 249, 250, 358, 359
revenue issues, 250-252, 358, 359
standards setting, 44, 125, 129-130, 131, 134
training of food service personnel, 249-250
vending machines, 44, 114-115, 239, 241, 242, 243, 250, 251-252, 266, 358, 359, 364
School Health Policies and Programs Study (SHPPS), 137, 139, 242, 253, 254, 266, 269
School Meals Initiative for Healthy Children, 240
School Nutrition Dietary Assessment Study, 240, 250
Section 402 State and Community Highway Safety Grant program, 132
Sedentary behavior
defined, 337
electronic media and, 40
energy expenditure patterns, 160
health care costs, 70
Self-efficacy, 262
Self-esteem issues, 43
race/ethnicity and, 66
Self-help interventions, 126, 365
Serving size.
See also Portion size
defined, 158 n.3
infant feeding and, 290
package size and, 167, 168, 356
recommended, 165
Shaping America’s Youth, 44, 161
Small Steps campaign, 181
Smart Growth America, 210
Smart Growth Network, 210
Smart growth principles, 209, 210
Snacks and snacking
activities needed to burn calories in, 92
Social cognitive theory, 262, 264
Social marketing campaign, 182-183, 184
Social movement theory, 350-351, 360
Social norms and values, 8, 15-16, 84-85, 91-92, 100, 103, 106, 126, 286, 320, 321, 369
Sociocultural environment
body image, 66, 91-92, 100, 103-104
and energy balance, 84-85, 91-92, 100-106
and food intake, 100, 101, 106
and physical activity, 100, 102
and prevention, 100, 103, 369, 371
prior reform movements, 45
stigmatization, 23, 43, 66, 100, 103
targeting interventions to, 198, 199-201, 203, 275
Socioeconomic status.
See also Low-income populations
and community interventions, 10, 203, 205
and energy balance, 104-105, 146-147
and healthy food access, 105, 106, 201
and intergenerational obesity, 65
and obesity prevalence, 10, 60-61, 104-105
and physical activity opportunities, 105, 201, 205, 207
racial/ethnic disparities, 60-61, 106, 201
Sociological Abstracts, 339, 341
Sodas and fruit drinks
bans on school sales, 242
diet beverages, 156
energy density and nutrient density, 170 n.7, 293
limiting consumption, 222, 242
marketing contracts with schools, 251, 266
taxes on, 44, 128, 146-147, 359
South Australian Daily Physical Activity Program, 256-257
South Carolina, 61
Special Supplemental Nutrition Program for Women, Infants and Children (WIC), 55, 65, 141, 142, 143-144, 216
Sports, Play and Active Recreation for Kids (SPARK), 247, 256
Stanford Adolescent Heart Health Program, 245, 247, 263
Stanford Dance for Health, 257
Stanford Five-City Project, 179-180, 196
Stanford SMART (Student Media Awareness to Reduce Television), 247, 263-264
Stanford Three Community Study, 179, 196
Steps to a Healthier U.S. Initiative, 132-133, 181, 204
Stereotyping, negative, 66
Stigmatization, 2, 23, 43, 66, 100, 103, 178, 222, 270
Stress response, 70
Stroke, 69
Sudden Infant Death Syndrome, 179
Summer Food Service Program, 142
Surveillance and monitoring.
See also individual surveys
energy balance, 137
funding, 140
needs, 140
nutrition and health, 29, 36, 54, 55-56, 60, 61, 63, 68, 89, 137, 138, 139
physical activity, 29, 137, 140
school health policies and programs, 137, 139
time use, 60, 61, 62, 139, 159-160
transportation patterns, 38, 39, 138
Sweden, 44
Sweeteners. See Added caloric sweeteners
T
Task Force on Community Preventive Services, 299
Taxation and pricing interventions, 44, 128, 146-147, 178, 358-360
Team Nutrition, 141
Television viewing
advertising, 8, 44, 172, 174, 265, 301, 302, 355
household sets, 39
interventions to reduce, 200, 222, 247, 263-264, 303-304
mealtime viewing, 222, 293, 302
and obesity prevalence, 177-178, 301-302, 303
position statements of medical professionals, 224, 304
recommended limits, 15, 304, 308
time management monitor, 264
time spent, 39-40, 41, 114, 160-161, 301-302
Texas, 61
Tobacco control analogies, 45, 103, 107, 126, 128, 133, 146, 154, 178, 197, 199, 223, 350-351, 352-356, 357, 360, 361, 362, 363, 364, 366, 368, 369-371
Toddlers and young children
food insecurity, 105
healthful eating behaviors, 290-292
predictors of energy intake, 158-159
Transportation
and access to healthy foods, 216
Transportation Alternatives, 214
Transportation Research Board, 205, 341
Treatment of obesity
prevention distinguished from, 81-82
research approach, 108
TRIS (Transportation Research Information Services) database, 339, 341
21st Century Community Learning Centers program, 273
2 Fruit ‘n’ 5 Veg Every Day, 180
U
United Kingdom, 44, 213, 214, 248
University of California Cooperative Extension, 201
U.S. Census Bureau, 105
U.S. Conference of Mayors, 132
U.S. Department of Agriculture, 268, 332
Agricultural Marketing Service, 145
Cooperative Extension Service, 141
dietary guidelines, 96-97, 131, 164-165, 332
dietary intake surveys, 137-138
Farm Service Agency, 145
and industry, 153
nutrition programs, 129, 141-142, 144, 145, 238, 239, 240, 250, 252
obesity prevention role, 13, 129, 130, 131
research on nutrition, 135
U.S. Department of Defense, 130, 131
Fresh Produce Program, 145, 248
U.S. Department of Education, 130, 131, 268, 273, 341
U.S. Department of Health and Human Services, 253, 332
collaboration with CDC, 200
dietary guidelines, 96-97, 131, 164, 332
funding of community-based health efforts, 132-133, 208
guideline development for advertising and marketing, 9, 175-176, 177
health and nutrition survey, 29, 36, 54, 55-56, 60, 61, 63, 68, 89, 137-138, 139, 140, 148
obesity prevention role, 129, 130, 131, 147, 204, 220-221
registry of research and intervention programs, 44
Small Steps campaign, 181, 184
U.S. Department of Housing and Urban Development, 130, 131
U.S. Department of Justice, 354
U.S. Department of the Interior, 130, 131
U.S. Department of Transportation, 130, 131, 208, 220-221
U.S. Preventive Services Task Force (USPSTF), 221
V
Vegetables. See Fruits and vegetables
VERB campaign, 141, 182-183, 184
Virginia, 207
W
Walking and biking opportunities
built environment and, 207, 208, 209, 210, 211-215
Walking School Bus program, 213
Washington, 206
Weight. See Body weight
White House Office of National Drug Control Policy, 182
Whites.
See also Racial and ethnic disparities
body image dissatisfaction, 66, 104
defined, 58 n.4
obesity prevalence, 143
World Health Organization, 290, 350, 367
Y
YMCA, 202
Youth Media Campaign Longitudinal Survey, 37
Youth Risk Behavior Surveillance System (YRBSS), 35, 137, 139, 209, 256, 258, 301
Z
Zuni Indian Tribal Organization, 247