This is a presentation from Soraya Ghebleh that looks at the problem of childhood obesity in America and offers potential policy and strategy solutions.

1. Soraya
Ghebleh
CHILDHOOD OBESITY IN
AMERICA:
STRATEGIES AND POLICY OPTIONS
FOR PREVENTION AND REDUCTION

2. ¡ 1 out of 3 children in the United States are overweight
¡ Rates of childhood obesity have tripled since the 1960s
¡ 17% of children have a BMI over the 95th percentile
¡ Hospital costs associated with childhood obesity are upwards
of $150 million a year
¡ Total costs of obesity, both child and adult, are estimated to
be over $100 billion annually
¡ Children who are obese are more prone to develop high-risk
diseases such as type II diabetes, elevated blood pressure,
and other diseases that can be life threatening and lead to
poor quality of life
SCOPE OF THE PROBLEM

3. Conclusions and Priorities determined by the IOM
INSTITUTE OF MEDICINE:
PROGRESS REPORT
While the country has responded to the
obesity epidemic, the current level of
investment does not match the scale of
the problem
Various entities are implementing
programs, policies, and interventions, but
researchers need to produce evidence-
based approaches that will guide national
action.
Evaluation needs to occur at multiple
levels and settings. This layered
information will help guide improvements
to childhood obesity efforts. Surveillance,
monitoring, and research are all
components of evaluation.
Current evidence is not sufficient to
complete a comprehensive assessment of
the progress that the nation has made.
Researchers should use best practices in
the short term with the goal of developing
a larger evidence base with which to
develop initiatives that can be used in
various settings.
We need short term, intermediate, and long term evaluation in order to have a
sustained improvement of the childhood obesity epidemic.

4. ¡ Lack of physical activity
¡ Improper diet
¡ Socioeconomic factors
¡ Education on healthy behaviors and diet is often minimal
¡ Marketing of unhealthy foods to children
¡ Sedentary lifestyles
¡ Built environment
¡ Cultural determinants
¡ Modeling of unhealthy habits
¡ Poor physical education education in schools
CONTRIBUTING FACTORS TO
CHILDHOOD OBESITY

5. STRATEGIES
Regulate
Food
Sales
Encourage
Healthy
Behavior
Education
and
Prevention

6. ¡ Studies and surveys have demonstrated
that consumers support menu labeling,
available nutrition information provided
in restaurants is inadequate and
insufficient, and menu labeling is
consistent with requiring producers to
disclose product information and any
other potentially harmful facts about
products.
¡ Eating outside of the house increases
calorie intake and can lead to poorer
nutrition and that fast-food
consumption is associated with risk for
poor nutrition and obesity.
Citation: Roberto, C. A., M. B. Schwartz, et al. (2009). "Rationale and evidence for
menu-labeling legislation." American journal of preventive medicine 37(6): 546-551.
REGULATE FOOD SALES: MENU LABELING

7. ¡ Food stamps have the potential to result in excessive caloric
intake and it has been suggested that food stamp recipients
consume more sugar and fat than eligible non-recipients,
indicating the need for a potential re-evaluation of the food
stamp distribution method.
Citation: Baum, C. L. (2011). "The effects of food stamps on obesity." Southern Economic Journal
77(3): 623-651.
REGULATE FOOD SALES:
RESTRICT FOOD STAMPS

8. ¡ Decreased access to foods leading to obesity and increased
access to healthy foods may combat obesity.
¡ Sugar-sweetened beverages are directly linked to excessive
weight gain and reducing SSB consumption has been shown to
reduce baseline body weight.
Citations: de Ruyter, J. C., M. R. Olthof, et al. (2012). "Effect of sugar-sweetened beverages on
body weight in children: design and baseline characteristics of the Double-blind, Randomized
INtervention study in Kids." Contemporary Clinical Trials 33(1): 247-257.
REGULATE FOOD SALES:
REGULATE FOOD IN THE RETAIL ENVIRONMENT

9. ¡ Exposure to food environments and
retail spaces that have poor-quality
foods are associated with adolescent
eating patterns and the propensity to
become overweight. Limiting the
proximity of fast-food restaurants to
schools could help reduce adolescent
obesity.
Citations: Davis, B. and C. Carpenter (2009). "Proximity of fast-food restaurants
to schools and adolescent obesity." Journal Information 99(3).
REGULATE FOOD SALES: REGULATE
LOCATION OF FAST FOOD RESTAURANTS

10. ¡ Schools are a consistent source of nutrition for most children
regardless of their home environment and is a location that can be
effectively utilized to provide children with nutritious food that does not
lead to obesity or poor caloric intake.1
¡ Changes to school food environments by removing sugar-sweetened
beverages from school food stores and snack pars, improving a la carte
choices, and reducing the frequency of offering french fries lead to
improved dietary behaviors among children and adolescents.1
¡ State mandates to require daily physical education and quality nutrition
education in all primary and secondary schools can reduce obesity.2
Citations:
1. Briefel, R. R., M. K. Crepinsek, et al. (2009). "School food environments and practices affect
dietary behaviors of US public school children." Journal of the American Dietetic Association 109
(2): S91-S107.
2. Hayne, C. L., P. A. Moran, et al. (2004). "Regulating environments to reduce obesity." Journal
of Public Health Policy 25(3-4): 3-4.
REGULATE FOOD SALES:
REGULATE FOOD IN SCHOOLS

11. ¡ Despite the constitutional impediment of free speech, efforts
can be made to reduce direct marketing of unhealthy foods to
children and should be seriously considered in any policy
approach that is interested in reducing obesity in children.
ENCOURAGE HEALTHY BEHAVIOR: RESTRICT/
CONTROL MARKETING TO CHILDREN

12. ¡ Taxing sugar-sweetened beverages and other food items that
have high fat content can be done to deter unhealthy eating
habits by means of economic disincentive.
Citations: McGuinness, S. A. (2012). "Time to Cut the Fat: The Case for Government Anti-Obesity
Legislation." JL & Health 25: 41.
ENCOURAGE HEALTHY BEHAVIOR:
TAX CERTAIN FOODS

13. ¡ Increased access to healthy food in areas with higher poverty can
reduce obesity and encourage healthy choices. Development of
supermarkets in areas that only have convenience stores that do
not carry healthy, fresh foods can improve outcomes for those
neighborhoods.1
¡ Obesity prevalence increases as food and vegetable consumption
decreases with increasing distance to supermarkets in
metropolitan areas suggesting that increased access to
supermarkets that carry healthy foods can improve consumption
of healthier foods.2
Citations:
1. DeMattia, L. and S. L. Denney (2008). "Childhood obesity prevention: successful community-based efforts." The ANNALS of the
American Academy of Political and Social Science 615(1): 83-99.
2. Michimi, A. and M. C. Wimberly (2010). "Associations of supermarket accessibility with obesity and fruit and vegetable consumption in
the conterminous United States." International Journal of Health Economics.
ENCOURAGE HEALTHY BEHAVIOR:
TAX BREAKS FOR HEALTHY INITIATIVES

14. ¡ After-school programs can improve
physical activity levels and contribute to
reduction in weight gain.1
¡ Standards-based reform in physical
education must involve maximum
physical activity of much more than 20
min of physical education per day and
physical activity must involve more
pedagogical training, involving goal
setting and focused performance
outcomes for given grade levels.2
Citations:
1. Beets, M. W., A. Beighle, et al. (2009). "After-school program impact on physical
activity and fitness: a meta-analysis." American journal of preventive medicine 36(6):
527-537.
2. Erwin, H. E. and D. M. Castelli (2008). "National physical education standards: A
summary of student performance and its correlates." Research quarterly for exercise
and sport 79(4): 495-505.
ENCOURAGE HEALTHY BEHAVIOR:
ENCOURAGE PHYSICAL EDUCATION

15. ¡ Greater access to recreational facilities and living in
environments where physical activity is part of the “built”
environment is associated with lower obesity rates.
Citations: Salois, M. J. (2012). "Obesity and diabetes, the built environment, and the ‘local’food
economy in the United States, 2007." Economics & Human Biology 10(1): 35-42.
ENCOURAGE HEALTHY BEHAVIOR: BUILT
ENVIRONMENT, “SMART GROWTH LAWS”

16. ¡ Education and prevention strategies
should be incorporated into the school
environment where both children and
adults can benefit and be reached out to
¡ Education should also be a part of other
interventions because it can ensure the
success of interventions and improve
outcomes if those participating have a
higher level understanding
EDUCATION AND PREVENTION