Workshop Summary

Lynn Parker, Emily Ann Miller, Elena Ovaitt, and
Stephen Olson, Rapporteurs

Standing Committee on Childhood Obesity Prevention

Food and Nutrition Board


Washington, D.C.

The National Academies of Sciences, Engineering, and Medicine
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ALLIANCES FOR OBESITY PREVENTION FINDING COMMON GROUND Workshop Summary Lynn Parker, Emily Ann Miller, Elena Ovaitt, and Stephen Olson, Rapporteurs Standing Committee on Childhood Obesity Prevention Food and Nutrition Board

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THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Govern- ing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineer- ing, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropri- ate balance. This study was supported by Grant No. 61747 between the National Academy of Sciences and the Robert Wood Johnson Foundation. Any opinions, findings, conclu- sions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number-13: 978-0-309-22472-7 International Standard Book Number-10: 0-309-22472-1 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; For more information about the Institute of Medicine, visit the IOM home page at: Copyright 2012 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. Suggested citation: IOM (Institute of Medicine). 2012. Alliances for Obesity Pre- vention: Finding Common Ground: Workshop Summary. Washington, DC: The National Academies Press.

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“Knowing is not enough; we must apply. Willing is not enough; we must do.” — Goethe Advising the Nation. Improving Health.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Acad- emy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineer- ing programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is presi- dent of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Insti- tute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sci- ences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.

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PLANNING COMMITTEE FOR A WORKSHOP ON ALLIANCES FOR OBESITY PREVENTION* THOMAS N. ROBINSON (Chair), Professor of Pediatrics and Medicine, Stanford Prevention Research Center, Stanford University School of Medicine ADAM DREWNOWSKI, Professor of Epidemiology, School of Public Health and Community Medicine, University of Washington SHIRIKI K. KUMANYIKA, Associate Dean, Health Promotion and Disease Prevention, Professor of Epidemiology, University of Pennsylvania Perelman School of Medicine JOSEPH THOMPSON, Director, Robert Wood Johnson Foundation Center to Prevent Childhood Obesity, and Surgeon General, State of Arkansas ANTRONETTE YANCEY, Professor of Health Services, Co-Director, Center to Eliminate Health Disparities, Department of Health Services, University of California, Los Angeles, School of Public Health Study Staff LYNN PARKER, Scholar EMILY ANN MILLER, Associate Program Officer ELENA OVAITT, Senior Program Assistant ANTON L. BANDY, Financial Officer GERALDINE KENNEDO, Administrative Assistant LINDA D. MEYERS, Director, Food and Nutrition Board *Institute of Medicine planning committees are solely responsible for organizing the work- shop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution. v

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Reviewers T his report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confiden- tial to protect the integrity of the process. We wish to thank the following individuals for their review of this report: SHEILA FLEISCHHACKER, Institute of Food Technologists DOUGLAS IMIG, University of Memphis JAMES KRIEGER, Public Health–Seattle & King County MICHAEL METALLO, National Gardening Association Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the report before its release. The review of this report was overseen by MELVIN WORTH. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review com- ments were carefully considered. Responsibility for the final content of this report rests entirely with the workshop rapporteurs and the institution. vii

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Contents 1 BACKGROUND AND RATIONALE 1 Social Movements and Obesity Prevention, 2 Organization of This Summary, 5 2 MISSION: READINESS 7 Too Fat to Fight, 8 Changing Food Intake, 8 Improving Fitness, 10 Investing for the Future, 10 3 FOOD AND AGRICULTURE 11 Obesity and the Environment, 11 The Animal Connection, 13 Community Food Security, 14 A Commercial-Free Childhood, 16 Food and Gardening, 18 Food Retailers and Obesity Prevention, 20 Discussion, 22 4 PHYSICAL ACTIVITY AND THE BUILT ENVIRONMENT 25 Community Development, 25 Transportation Policy, 27 Bringing Back Recess, 28 Working with the Police, 30 Healthy Parks, Healthy People, 30 ix

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x CONTENTS Places to Play, 31 Discussion, 33 5 FORMING SUCCESSFUL ALLIANCES 35 Characteristics of Successful Social and Ideological Movements and Alliances, 35 The Importance of Building Authentic Trust, 38 Discussion, 41 6 BUILDING ALLIANCES 43 Creating Cross-Sector Alliances, 43 Working with Unexpected Allies, 46 7 FINAL OBSERVATIONS 49 REFERENCES 51 APPENDIXES A Workshop Agenda 57 B Speaker Biographical Sketches 61 C Statement of Task 71 D Acronyms 73