The goal of obesity prevention in children and youth is to create—through directed social change—an environmental-behavioral synergy that promotes:
• For the population of children and youth
♦ Reduction in the incidence of childhood and adolescent obesity
♦ Reduction in the prevalence of childhood and adolescent obesity
♦ Reduction of mean population BMI levels
♦ Improvement in the proportion of children meeting Dietary Guidelines for Americans
♦ Improvement in the proportion of children meeting physical activity guidelines
♦ Achieving physical, psychological, and cognitive growth and developmental goals
• For individual children and youth
♦ A healthy weight trajectory, as defined by the CDC BMI charts
♦ A healthful diet (quality and quantity)
♦ Appropriate amounts and types of physical activity
♦ Achieving physical, psychosocial, and cognitive growth and developmental goals
Because it may take a number of years to achieve and sustain these goals, intermediate goals are needed to assess progress toward reduction of obesity through policy and system changes. Examples include:
• Increased number of children who safely walk and bike to school
• Improved access to and affordability of fruits and vegetables for low-income populations
• Increased availability and use of community recreational facilities
• Increased play and physical activity opportunities
• Increased number of new industry products and advertising messages that promote energy balance at a healthy weight
• Increased availability and affordability of healthful foods and beverages at supermarkets, grocery stores, and farmers markets located within walking distance of the communities they serve
• Changes in institutional and environmental policies that promote energy balance
Thus, changes at many levels and in numerous environments will require the involvement of multiple stakeholders from diverse segments of society. In the home environment, for example, incremental changes such as improving the nutritional quality of family dinners or increasing the time and frequency that children spend outside playing can make a difference.
Changes that lead to healthy communities, such as organizational and policy changes in local schools, school districts, neighborhoods, and cities, are equally important. At the state and national levels, large-scale modifications are needed in the ways in which society promotes healthful eating habits and physically active lifestyles. Accomplishing these changes will be difficult, but there is precedent for success in other public health endeavors of comparable or greater complexity and scope. This must be a national effort, with special attention to communities that experience health disparities and that have social and physical environments unsupportive of healthful nutrition and physical activity.
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