outcomes, including those not directly related to obesity prevention; potential reach, impact, and cost; and feasibility (see Appendix C).

In this report, healthy eating refers to consuming the types and amounts of foods, nutrients, and calories recommended by the Dietary Guidelines for Americans (HHS and USDA, 2005). In the area of physical activity, current recommendations are for children to engage in such activity at least 60 minutes per day (HHS and USDA, 2008).

The committee targeted its recommendations to the food and physical activity environments outside the school walls and the school day. What takes place inside schools from the morning bell to the end of the last class and its impact on childhood obesity has been widely discussed (IOM, 2005, 2007; Story et al., 2006). By contrast, many other aspects of children’s environments, from the accessibility and maintenance of neighborhood playgrounds to the food and beverage choices offered in after-school programs, have not been discussed and publicized to the same extent. Therefore, the report generally focuses on nonschool issues. This focus does not imply that schools are unimportant in the prevention of childhood obesity. In fact, the involvement of schools in obesity prevention is vital; obesity prevention initiatives undertaken outside of schools will be stronger and have a greater impact if they are coordinated with and complement those of schools.

In this report, the committee recommends nine healthy eating strategies and six physical activity strategies that local governments should consider. These strategies are organized under three healthy eating goals and three physical activity goals. For each strategy, the report recommends a set of actions that have the potential to make a difference. The report also highlights 12 actions that the committee believes have the greatest potential, based on an assessment of the available research evidence and a logical connection with the achievement of healthier eating and increased physical activity. These 12 actions are highlighted in the list of goals, strategies, and actions at the end of this summary.

Evidence points to multisectoral initiatives (involving government, schools, the private sector, nonprofit organizations, and families) as being most effective in promoting and sustaining a healthy environment for children and youth (Economos et al., 2007; Sacks et al., 2008; Samuels and Associates, 2009). In many communities, however, policy makers may want to begin their obesity prevention efforts with some individual actions that they believe would be a good starting point, in preparation for later work on broader efforts.

While overall strategies can be recommended in accordance with evidence-based research, this information must be balanced with the need for community



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