local governments; and assisting states when they lack resources or expertise to adequately respond to a public health crisis (TFAH, 2006).

The U.S. Congress and several federal executive branch departments have become actively engaged in obesity prevention. The U.S. Department of Health and Human Services (DHHS) and the U.S. Department of Agriculture (USDA) are demonstrating leadership in these efforts, with growing involvement of the U.S. Department of Education and the U.S. Department of Transportation. However, a great deal more must be accomplished. Examples of the federal agency programs, initiatives, and surveillance systems that support and monitor the prevention of obesity in U.S. children and youth are discussed throughout this chapter, with additional information provided in Appendix D, including information on the extent and the nature of federal evaluation efforts based on the available data. It should be noted that this report is not a complete and systematic inventory of government programs and initiatives, as this was not the charge to the committee. Rather, the committee highlights some of the efforts that illustrate the key roles of government and that point to further work that can be done to increase the opportunities for children and youth to become more physically active and improve their eating patterns and diets.


Leadership is an essential function of the federal government as it determines the priorities for funding and brings its considerable resources to bear on the problem. Government leadership influences the actions of those working within the federal government and across other sectors. Evidence of leadership includes the acknowledgement of and commitment to address a problem, followed by the development of a plan of action, the establishment of policies, and the commitment of financial and human resources to carry out a comprehensive and coordinated plan. The Health in the Balance report recommended federal leadership through the following actions (IOM, 2005a):

  1. The president should appoint a high-level task force to coordinate federal agency responses.

  2. DHHS and the Federal Trade Commission (FTC) should develop guidelines with broad stakeholder input for the advertising and marketing of foods, beverages, and sedentary entertainment directed at children and youth, with attention to product placement, promotion, and content.

  3. The U.S. Food and Drug Administration (FDA) should revise the Nutrition Facts panel on packaged food and beverage products.

  4. FDA should allow industry to have greater flexibility to use evidence-based nutrient and health claims regarding the link between

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