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In 2001, the U.S. Surgeon General issued the Call to Action to Prevent and Decrease Overweight and Obesity to stimulate the development of specific agendas and actions targeting this public health problem. In recognition of the need for greater attention directed to prevent childhood obesity, Congress, through the fiscal year 2002 Labor, Health and Human Services, Education Appropriations Act Conference Report, directed the Centers for Disease Control and Prevention (CDC) to request that the Institute of Medicine (IOM) develop an action plan targeted to the prevention of obesity in children and youth in the United States. In addition to CDC, this study was supported by the Department of Health and Human Services' Office of Disease Prevention and Health Promotion (ODPHP); National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); the National Heart, Lung, and Blood Institute (NHLBI); the National Institute of Child Health and Human Development (NICHD); the Division of Nutrition Research Coordination of the National Institutes of Health; and The Robert Wood Johnson Foundation (RWJF).

The charge to the IOM committee was to develop a prevention-focused action plan to decrease the prevalence of obesity in children and youth in the United States. The primary emphasis of the study's task was on examining the behavioral and cultural factors, social constructs, and other broad environmental factors involved in childhood obesity and identifying promising approaches for prevention efforts. To address this charge, the IOM appointed a 19-member multidisciplinary committee with expertise in child health and development, obesity, nutrition, physical activity, economics, xm education, public policy, and public health. Six meetings were held during the 24-month study and a variety of sources informed the committee's work. The committee obtained information through a literature review (Appendix C) and a commissioned paper discussing insights, strategies, and lessons learned from other public health issues and social change campaigns that might be relevant to the prevention of obesity in children and youth (Appendix D). The meetings included two workshops that were key elements of the committee's information-gathering process (Appendix E). Held in June 2003, the first workshop focused on strategies for developing school-based policies to promote nutrition and physical activity in children and youth. The second workshop was organized in December 2003 and addressed marketing and media influences on preventing childhood obesity and issues related to family dynamics. Each workshop included public forum sessions, and the committee benefited from the breadth of issues raised by nonprofit organizations, professional associations, and individuals.

Since the inception of this study, the committee recognized that it faced a broad task and a complex problem that has become an epidemic not only in the United States but also internationally. The committee appreciated the opportunity to develop an action plan on the prevention of obesity in children and youth and developed its recommendations to encompass the roles and responsibilities of numerous stakeholders and many sectors of society.

Children are highly cherished in our society. The value we attach to our children is fundamentally connected to society's responsibility to provide for their growth, development, and well-being. Extensive discussions will need to continue beyond this report so that shared understandings are reached and support is garnered for sustained societal and lifestyle changes that will reverse the obesity trends among our children and youth.

Jeffrey P. Koplan, Chair

Committee on Prevention of Obesity in

Children and Youth

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