moval of vending machines (Chapter 7); considers the nutrient quality and energy density of foods and beverages rather than focusing on specific types of products (e.g., soft drinks, chips, candy); and highlights the improvements needed and actions that can promote energy balance rather than addressing any one industry (e.g., fast food restaurants).


This report uses the term “obese” to refer to children and youth between the ages of 2 and 18 years who have BMIs equal to or greater than the 95th percentile of the age- and gender-specific BMI charts developed by CDC. For individuals, obesity prevention involves maintaining energy balance at a healthy weight while protecting overall health, growth and development, and nutritional status. Energy balance (calories consumed versus calories expended) is an extraordinarily complex concept when considering the multitude of genetic, biological, psychological, sociocultural, and environmental factors that affect both sides of the energy balance equation and the interrelationships among these factors.

Clear specification of obesity prevention goals is essential in shaping an action plan and evaluating its success. Relevant issues for setting obesity prevention goals for populations include concepts of optimum population BMI and healthy weight levels, potential effects on food intake and patterns of physical activity and inactivity, as well as attitudes and social norms related to food and eating, physical activity, inactivity, body size, and dietary restrictions. This chapter discusses a variety of influences on children’s diets and physical activity patterns including genetic variation and biological considerations, and sociocultural and other environmental factors.

Using an ecological systems theory model and a primary prevention evidence-based public health approach, this report focuses on how changes in the individual child’s behaviors are affected not only by individual factors but also through interactions with the larger social, cultural, and environmental contexts in which he or she lives (e.g., family, school, community, social and physical environments).


AAP (American Academy of Pediatrics), Committee on Nutrition. 2003. Prevention of pediatric overweight and obesity. Pediatrics 112(2):424-430.

ADA (American Dietetic Association). 2003. Position of the American Dietetic Association: Child and adolescent food and nutrition programs. J Am Diet Assoc 103(7):887-893.

ADA. 2004. Position of the American Dietetic Association: Dietary guidance for healthy children ages 2 to 11 years. J Am Diet Assoc 104(4):660-677.

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