levels—federal, state, and local—in childhood obesity prevention. Local government leadership is critical to both reducing and preventing further increases in childhood obesity. The places in which people live, work, study, and play have a strong influence on their ability to consume healthy foods and beverages and engage in regular physical activity. Local governments make decisions every day that affect these environments. Thus, this report focuses on specific actions for local governments and is meant to be a tool for use by local government officials—mayors, managers, commissioners, council members, or administrators; elected, appointed, or hired; at the city, town, township, or county level—in planning, implementing, and refining childhood obesity efforts in their jurisdictions.

In 2008, the IOM Standing Committee on Childhood Obesity identified local government actions as key to front-line efforts addressing obesity prevention and requested a study to examine the evidence on such local government efforts, with a focus on identifying promising practices and developing a set of recommended actions. That committee was inspired by the recommendations in the previous IOM reports on childhood obesity and by the clear need for more detail at the local government level on which specific actions have the potential to make a difference. The IOM Committee on Childhood Obesity Prevention Actions for Local Governments was formed to address this task. The committee entered this project knowing that evidence on the best childhood obesity prevention practices is still accumulating and is limited in many important areas. However, the committee also knew that many local government officials want to act now on the best available information.

The committee reviewed the published literature, examined reports from organizations that work with local government, invited presentations from experts on the role of local government in obesity prevention, and explored a variety of toolkits that have been developed for communities. The committee worked to develop actionable recommendations for promoting healthy eating and physical activity and guided its decisions toward actions that are within the jurisdiction of local governments; are likely to affect children directly; are based on the experience of local governments or knowledgeable sources that work with local governments; and have the potential to make positive contributions to the achievement of healthy eating and/or optimum physical activity based on research evidence or, where such evidence is lacking or limited, a logical connection with the achievement of healthier eating and increased physical activity. The committee developed a set of criteria to consider in assessing the actions to recommend. Using the best evidence available, the committee took into account effectiveness and effect size;



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