was charged with developing a succinct report that would summarize the range of local government efforts, identify and describe the rationale for selected promising practices, discuss other relevant public health benefits of these practices, and present a set of recommendations for actions for local governments to consider in addressing childhood obesity. (See Appendix E for the official Statement of Task for the committee.)


Trends in Childhood Obesity

The city council member who approached the committee member with his urgent request for advice was right to be concerned. The health and well-being of children in the United States are threatened by the ever-increasing number and percentage who are overweight and obese—now at one in four children. Childhood and adolescent obesity has increased dramatically in just three decades. Among children aged 2–5, the prevalence of obesity has increased from 5 percent to 12.4 percent; among children aged 6–11, it has increased from 6.5 percent to 17 percent; and among adolescents (aged 12–19), it has more than tripled, from 5 percent to 17.6 percent (CDC, NHANES) (Figure 1-1). Overall, more than 16.3 percent of children and adolescents aged 2–19 are obese (Ogden et al., 2008). And while children in all race/ethnicity and socioeconomic groups are increasingly obese, those in some groups (the poor, African Americans, Latinos, American Indians, and Pacific Islanders) are disproportionately more overweight and obese.

Obesity is so prevalent that it may reduce the life expectancy of today’s generation of children and diminish the overall quality of their lives (Olshansky and Ludwig, 2005). This is because obese children and adolescents are more likely to have hypertension, high cholesterol, and type 2 diabetes when they are young (Daniels, 2009; Gunturu and Ten, 2007), and they also are more likely to be obese when they are adults (Freedman et al., 2009).

A Tool for Local Governments

Much has been written about the epidemic of childhood obesity and strategies for reversing current trends. Two previous IOM reports, Preventing Childhood Obesity: Health in the Balance and Progress in Preventing Childhood Obesity: How Do We Measure Up?, consider the issue of childhood obesity and present recommendations for consideration both generally and by specific groups or audiences (IOM, 2005,

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