1

Introduction and Overview¹

Among the many troubling aspects of the rising prevalence of obesity in the United States and elsewhere in recent years, the growth of early childhood overweight and obesity stands out. As pointed out later in this workshop summary, the prevalence of obesity among U.S. children aged 2-5 years rose from approximately 5 percent in the early 1970s, the period used to establish a baseline for obesity, to 8.4 percent in 2012 (Ogden et al., 2014). As of 2012, approximately one in seven children in this age group was overweight (Fryar et al., 2012). The average 5-year-old girl in the United States weighed 43.2 pounds in 1976-1980 and 46.6 pounds in 2007-2010 (Fryar et al., 2012; Najjar and Rowland, 1987).

During the past decade, however, the prevalence of obesity among young children appears to have leveled off and may have begun to decline among some populations (Ogden et al., 2012). From 2003-2004 to 2011-2012, for example, the prevalence of obesity decreased from 13.9 percent to 8.4 percent among 2- to 5-year-olds (Ogden et al., 2014), although more data are needed to confirm this decline.

To explore what is known about effective and innovative interventions to counter obesity in young children, the National Academies of Sciences, Engineering, and Medicine’s (the Academies’) Roundtable on Obesity Solu-

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¹ The planning committee’s role was limited to planning the workshop, and this workshop summary has been prepared by the rapporteur with assistance from National Academies of Sciences, Engineering, and Medicine staff as a factual account of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the Academies, and they should not be construed as reflecting any group consensus.

tions held a workshop in Washington, DC, on October 6, 2015, titled “Obesity in the Early Childhood Years: Emerging Science and Implementation of Promising Solutions.” (Box 1-1 briefly describes the Roundtable and its objectives.) The workshop brought together many of the leading researchers on obesity in young children to describe the state of the science and potential solutions based on that research. The workshop also explored sustainable collaborations and new insights into the implementation of interventions and policies, particularly those related to nutrition and physical activity, for the treatment and prevention of obesity in young children (see Box 1-2 for the workshop’s complete statement of task). More

than 100 people attended in person, and 600 more registered to watch the webcast of the workshop.

After a brief welcome by Mary Story, professor of global health and community and family medicine at Duke University, vice-chair of the Roundtable on Obesity Solutions, and chair of the workshop planning committee, the workshop proceeded with four panels, each consisting of several presentations followed by a moderated discussion session.² (Appendix A contains the workshop agenda, and biographical sketches of the presenters appear in Appendix C.)

The first panel, which is summarized in Chapter 2, examined the prevalence of obesity in young children; trends over time; and the persistence of obesity into later childhood, adolescence, and adulthood. It also explored epigenetic factors related to the risk of early childhood obesity, as well as the development of taste and flavor preferences in the first few years of life.

The second panel, summarized in Chapter 3, addressed what is known about modifiable protective and risk factors associated with obesity through age 5. These factors include a mother’s prepregnancy weight and weight gain during pregnancy; gestational diabetes; smoking during pregnancy; breastfeeding; complementary feeding; responsive parenting; and sleep, activity, and sedentary behavior in young children.

The third panel, summarized in Chapter 4, turned to interventions, practices, and policies that have demonstrated promise in the prevention and treatment of early childhood obesity. Specific topics included the role of pediatricians in obesity prevention and treatment, programs that take place in early care and education settings, and family-focused interventions.

The fourth and final panel, summarized in Chapter 5, looked at innovative cross-sector solutions, including multifaceted government programs at the national and local levels and partnerships involving health care systems.

Finally, Chapter 6 summarizes the brief closing remarks of Bill Purcell, attorney, Farmer Purcell White & Lassiter, and chair of the Roundtable on Obesity Solutions.

Boxes at the beginning of each chapter highlight important points made by the presenters, with the presenters’ names shown in parentheses. It should be noted that these and other observations and conclusions described in this workshop summary represent the viewpoints of speakers and participants and should not be seen as conclusions or recommendations of the Academies or of the workshop as a whole.

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² Other members of the planning committee were Anne Dattilo, Allison Gertel-Rosenberg, Jennifer MacDougall, Brent McBride, Rafael Pérez-Escamilla, Sonya Shin, Elsie Taveras, and Dianne Ward.

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