As the public health threat of childhood obesity has become clear, the issue has become the focus of local, state, and national initiatives. Many of these efforts are centered on the community environment in recognition of the role of environmental factors in individual behaviors related to food and physical activity. In many communities, for example, fresh produce is not available or affordable, streets and parks are not amenable to exercise, and policies and economic choices make fast food cheaper and more convenient than healthier alternatives. Community efforts to combat obesity vary in scope and scale; overall, however, they remain fragmented, and little is known about their effectiveness. At the local level, communities are struggling to determine which obesity prevention programs to initiate and how to evaluate their impact. In this context, the Institute of Medicine held two workshops to inform current work on obesity prevention in children through input from individuals who are actively engaged in community- and policy-based obesity prevention programs. Community perspectives were elicited on the challenges involved in undertaking policy and programmatic interventions aimed at preventing childhood obesity, and on approaches to program implementation and evaluation that have shown promise. Highlights of the workshop presentations and discussions are presented in this volume. Table of Contents Front Matter SUMMARY OF WORKSHOP--June 2008 1 Introduction 2 Perspectives of Evaluators 3 Perspectives of Site Leaders References SUMMARY OF WORKSHOP 2--May 2009 Summary 4 Introduction 5 Community-Based Programs: How Does Information Help Them Achieve Their Goals? 6 Research and Advocacy Groups: How Does Evidence Inform Policy? 7 Decision Makers: How Do Community Perspectives Influence Policy? 8 Closing Remarks References Appendix A: Workshop Agendas Appendix B: Biographical Sketches Appendix C: Workshop Attendees

Childhood Obesity Prevention in Texas summarizes the information gathered at a workshop held February 5-6, 2009, in Austin, Texas. At this workshop, committee members met with Texas lawmakers, public officials, and community leaders to exchange ideas and to view first-hand strategies that are being implemented effectively at the state and local levels to prevent and reverse childhood obesity. Texas leaders at the workshop expressed the strong belief that the state's economic vitality and security depend on the health of its population. Accordingly, the state is no longer simply describing the personal, community, and financial costs of its obesity crisis; it is taking proactive steps to address the problem through strategic initiatives. An overarching strategy is to address obesity by targeting the state's youth, in whom it may be possible to instill healthy behaviors and lifestyles to last a lifetime. A guiding principle of these efforts is that they should be evidence based, community specific, sustainable, cost-effective, and supported by effective partnerships. Moreover, the goal is for the responsibility to be broadly shared by individuals, families, communities, and the public and private sectors. Table of Contents Front Matter Summary 1 Introduction 2 Opening Session 3 Childhood Obesity in Texas: An Overview 4 Texas State Government: Successes to Date 5 Texas State Government: What the Future Holds 6 A Look at the Texas Landscape 7 A Look at the Austin Landscape 8 Live Smart Texas Panel Presentation 9 Major Themes Appendix A: Workshop Agenda Appendix B: Biographical Sketches Appendix C: Workshop Participants

Both the United Kingdom and the United States are grappling with nationwide epidemics of obesity. Obesity contributes to diabetes, cardiovascular disease, and some cancers, among other diseases. Although many people are aware of obesity's causes and consequences, few see it as a problem for their own families-despite clinical evidence to the contrary. Given this disconnect between perception and reality, policy makers in both countries struggle to find a way to reach people to encourage change. The IOM brought together policy makers from the U.K. and U.S. for a workshop on October 22, 2009, to discuss the challenges of and promising approaches to the struggle against obesity. Presenters spoke about current policies, programs, and partnerships that are addressing the obesity epidemic and evidence for effective strategies to change perception and behaviors. The workshop, summarized in this document, provided an opportunity for both countries to learn from each other's efforts and to consider how to apply new strategies at home. Table of Contents Front Matter Summary 1 Introduction 2 Scope of the Problem 3 Government Structures to Address Obesity 4 School Meal Policies 5 Physical Activity and the Built Environment 6 National Policies and Programs 7 Local Policies and Programs 8 Concluding Remarks References Appendix A: Workshop Agenda Appendix B: List of Participants Appendix C: Planning Committee Biosketches Appendix D: Speaker Biosketches

Childhood obesity is a serious health problem that has adverse and long-lasting consequences for individuals, families, and communities. The magnitude of the problem has increased dramatically during the last three decades and, despite some indications of a plateau in this growth, the numbers remain stubbornly high. Efforts to prevent childhood obesity to date have focused largely on school-aged children, with relatively little attention to children under age 5. However, there is a growing awareness that efforts to prevent childhood obesity must begin before children ever enter the school system.
Early Childhood Obesity Prevention Policies reviews factors related to overweight and obese children from birth to age 5, with a focus on nutrition, physical activity, and sedentary behavior, and recommends policies that can alter children's environments to promote the maintenance of healthy weight. Because the first years of life are important to health and well-being throughout the life span, preventing obesity in infants and young children can contribute to reversing the epidemic of obesity in children and adults. The book recommends that health care providers make parents aware of their child's excess weight early. It also suggests that parents and child care providers keep children active throughout the day, provide them with healthy diets, limit screen time, and ensure children get adequate sleep.
In addition to providing comprehensive solutions to tackle the problem of obesity in infants and young children, Early Childhood Obesity Prevention Policies identifies potential actions that could be taken to implement those recommendations. The recommendations can inform the decisions of state and local child care regulators, child care providers, health care providers, directors of federal and local child care and nutrition programs, and government officials at all levels.