FIGURE 1-5 Comprehensive approach for preventing and addressing childhood obesity.

NOTE: SES = socioeconomic status.

SOURCE: IOM, 2007.

agreements that affect the food supply, food advertising, retail and restaurant food locations and marketing practices (including labeling and portion sizes), food prices, agricultural policies and food production systems, community design aspects that influence outdoor activity, building design aspects that influence indoor activity, public transportation, insurance coverage for wellness services, poverty levels, funding levels for and regulations guiding federal nutrition assistance programs, and school and worksite environments related to food and physical activity (IOM, 2009; James et al., 2006; WHO, 2004; World Cancer Research Fund and American Institute for Cancer Research, 2009).

Obesity prevention initiatives related to the settings and pathways shown on Figure 1-5 are ongoing, and more are undertaken or proposed every day. Many are quite far-reaching in their potential implications for such variables as food prices; food availability; community infrastructure; entertainment; and the nature and flow of information about food, activity, and weight. When the needed evidence exists to inform these decisions, the challenge is how to ensure that it appears in the right place at the right moment in the decision-making process and is taken to heart. If the evidence that exists is faulty or biased, the challenge is how to prevent this evidence from being used to support decisions that will ultimately prove to be poor ones. If the evidence is inadequate, one challenge is to prevent the lack of evidence from preclud-