Preventing childhood obesity: can we do it?
OBJECTIVE
This review critically examines recent publications on prevention of childhood obesity and places these publications within a biologic, epidemiologic, public health, and policy context. It should help practitioners advocate effective preventive strategies and develop effective plans of action for research and policy.


RESULTS
Risk factors for childhood obesity include low socioeconomic status, maternal obesity, rapid infancy weight gain, and decreased physical activity. Changes in food availability and activity levels during the past 30 years are well documented. Obesity prevention programs have had limited success but they demonstrate that changes in school and community environments can decrease childhood weight gain. Legislative approaches to the obesity epidemic have not led to changes in governmental agricultural policy or in the food and marketing industry.


CONCLUSIONS
Obesity in childhood is a major public health problem and contributes to significant morbidity in adulthood. It is the natural biologic outcome of an unprecedented increase of food availability and intake, coupled with decreased energy output. Present obesity prevention measures have been small scale and timid. Public policy measures to address the obesity epidemic have not yet been sufficiently strong to be effective. Suggestions are made to intensify public education and change national behaviors.
Isganaitis
Elvira
E
Pediatric Endocrine Unit, Massachusetts General Hospital for Children, Boston, Massachusetts 02114, USA.
Levitsky
Lynne L
LL
D002648:Child; D002947:Cities; D030881:Disclosure / Q000331:legislation & jurisprudence; D006801:Humans; D018673:Nutrition Policy / Q000191:economics; D009765:Obesity / Q000209:etiology / Q000517:prevention & control*; D011315:Preventive Medicine / Q000191:economics / Q000331:legislation & jurisprudence / Q000379:methods; D012307:Risk Factors; D012572:School Health Services / Q000191:economics / Q000331:legislation & jurisprudence; D013660:Taxes; D015430:Weight Gain / Q000502:physiology