In the two years since the release of the Health in the Balance report, childhood obesity prevention efforts have become the topic of discussion and the focus of action in homes, schools, communities, corporations, state legislatures, and federal agencies across the nation. Unfortunately, few of these new or ongoing efforts are being systematically documented or evaluated, thereby limiting the potential to learn from these efforts and to use the results in further developing and refining population-based approaches to prevent childhood obesity.

This subsequent IOM report, Progress in Preventing Childhood Obesity: How Do We Measure Up?, assesses progress made on the first report’s recommendations by focusing on the evaluation of actions taken by all sectors of society. Given the numerous changes being implemented throughout the nation to improve the dietary quality and extent of physical activity for children and youth, an overarching assessment of progress in preventing childhood obesity necessitates both the tracking of trends across the nation and a more detailed examination of lessons learned through the evaluations of relevant interventions, policies, and programs. Evaluation is the basis for identifying effective interventions that can then be scaled up to statewide or nationwide efforts as well as ineffective interventions that can be refined or replaced with efforts that are shown to be more promising as a result of evidence-based analyses. A complementary set of efforts is needed—population-based public health interventions coupled with individual-level and institutional interventions—and these efforts should be collectively monitored and evaluated. The childhood obesity epidemic is at the point where it is time to move beyond a reactive small-scale approach and toward a proactive, coordinated, and sustained response.

As the previous report acknowledged, there is an urgent need for action on this public health concern—action requiring the use of the best available evidence. Now that numerous changes are underway to increase physical activity and improve dietary intake it is time to bolster the evidence base. Key questions to consider include the following: Are interventions to promote a healthful diet and to increase physical activity reaching enough people to make a difference? Is the breadth of interventions sufficiently adequate to address the scope of the problem? Much remains to be learned about how to effectively increase physical activity, improve dietary quality, and decrease sedentary lifestyles in America’s children and youth.


The Health in the Balance report acknowledged the many transformations in U.S. society over the past 30 years—including changes in the physical and built environments, social and cultural environments, and commercial and media environments—that have contributed to the energy

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