Obesity in the Early
Childhood Years
STATE OF THE SCIENCE AND IMPLEMENTATION OF PROMISING SOLUTIONS
Workshop Summary
Steve Olson, Rapporteur
Roundtable on Obesity Solutions
Food and Nutrition Board
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
This activity was supported by Contract No. 20132685 from The California Endowment, Contract No. 10002863 from Highmark, Inc., Contract No. 10001561 from The JPB Foundation, Contract No. 10001518 from Kaiser Permanente, Contract No. 10001539 from The Kresge Foundation, and Contract No. 10001565 from the Robert Wood Johnson Foundation, with additional support from the Academy of Nutrition and Dietetics; Alliance for a Healthier Generation; American Academy of Pediatrics; American College of Sports Medicine; American Council on Exercise; American Heart Association; American Society for Nutrition; Bipartisan Policy Center; Blue Cross Blue Shield of North Carolina; ChildObesity180/Tufts University; Edelman; General Mills, Inc.; Greater Rochester Health Foundation; HealthPartners, Inc.; Healthy Weight Commitment Foundation; Kellogg Company; Mars, Inc.; Nemours Foundation; Nestlé Nutrition, North America; Nestlé USA; The Obesity Society; Partnership for a Healthier America; President’s Council on Fitness, Sports & Nutrition; Reebok, International; Salud America!; Sesame Workshop; and YMCA of the USA. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-43921-3
International Standard Book Number-10: 0-309-43921-3
Digital Object Identifier: 10.17226/23445
Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.
Copyright 2016 by the National Academy of Sciences. All rights reserved.
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Cover credit: Design by Casey Weeks.
Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2016. Obesity in the early childhood years: State of the science and implementation of promising solutions: Workshop summary. Washington, DC: The National Academies Press. doi: 10.17226/23445.
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PLANNING COMMITTEE ON OBESITY IN THE EARLY CHILDHOOD YEARS: STATE OF THE SCIENCE AND IMPLEMENTATION OF PROMISING SOLUTIONS—A WORKSHOP1
MARY T. STORY (Chair), Professor of Global Health and Community and Family Medicine and Associate Director of Education and Training, Duke Global Health Institute, Duke University
ANNE M. DATTILO, Associate Director of Nutrition Science, Nestlé Infant Nutrition
ALLISON GERTEL-ROSENBERG, Director of National Prevention and Practice, Nemours
JENNIFER MacDOUGALL, Healthy Living Senior Program Officer, Blue Cross Blue Shield North Carolina Foundation
BRENT A. McBRIDE, Professor of Human Development and Director, Child Development Lab, University of Illinois, Urbana-Champaign
RAFAEL PÉREZ-ESCAMILLA, Professor of Epidemiology (Chronic Diseases), Director of Office of Public Health Practice, and Director of Global Health Concentration, Yale University School of Public Health
SONYA SHIN, Associate Physician, Brigham and Women’s Hospital; Assistant Professor, Harvard Medical School; Director of COPE Project: Navajo Nation
ELSIE M. TAVERAS, Chief of Division of General Academic Pediatrics; and Director of Pediatric Population Health Management, Massachusetts General Hospital for Children; Associate Professor of Pediatrics and Population Medicine, Harvard Medical School; Associate Professor of Nutrition, Harvard School of Public Health
DIANNE S. WARD, Professor of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
Health and Medicine Division Staff
LYNN PARKER, Scholar
LESLIE J. SIM, Senior Program Officer
HEATHER DEL VALLE COOK, Program Officer
AMANDA NGUYEN, Research Associate
DARA SHEFSKA, Research Assistant
RENEE GETHERS, Senior Program Assistant
Consultant
WILLIAM H. DIETZ, George Washington University, Washington, DC
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
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ROUNDTABLE ON OBESITY SOLUTIONS1
BILL PURCELL III (Chair), Farmer Purcell White & Lassiter, PLLC, Nashville, Tennessee
RUSSELL R. PATE (Vice Chair), University of South Carolina, Columbia
MARY T. STORY (Vice Chair), Duke University, Durham, North Carolina
SHARON ADAMS-TAYLOR, American Association of School Administrators, Alexandria, Virginia
NELSON G. ALMEIDA, Kellogg Company, Battle Creek, Michigan
JEANETTE BETANCOURT, Sesame Workshop, New York, New York
CAPT HEIDI MICHELS BLANCK, Centers for Disease Control and Prevention, Atlanta, Georgia
DON W. BRADLEY, Duke University, Durham, North Carolina
CEDRIC X. BRYANT, American Council on Exercise, San Diego, California
HEIDI F. BURKE, Greater Rochester Health Foundation, Rochester, New York
DEBBIE I. CHANG, Nemours, Newark, Delaware
ABBEY COFSKY, Robert Wood Johnson Foundation, Princeton, New Jersey
YVONNE COOK, Highmark, Inc., Pittsburgh, Pennsylvania
JOHN COURTNEY, American Society for Nutrition, Bethesda, Maryland
CHRISTINA ECONOMOS, Tufts University, Boston, Massachusetts
IHUOMA ENELI, American Academy for Pediatrics, Columbus, Ohio
DAVID D. FUKUZAWA, The Kresge Foundation, Troy, Michigan
LISA GABLE, Healthy Weight Commitment Foundation, Washington, DC
PAUL GRIMWOOD, Nestlé USA, Glendale, California
MARJORIE INNOCENT, National Association for the Advancement of Colored People, Baltimore, Maryland
SCOTT I. KAHAN, George Washington University, Washington, DC
SHIRIKI KUMANYIKA, University of Pennsylvania, Philadelphia
CATHERINE KWIK-URIBE, Mars, Inc., Germantown, Maryland
THEODORE KYLE, The Obesity Society, Pittsburgh, Pennsylvania
ALICIA LARA, United Way Worldwide, Alexandria, Virginia
MATT LONGJOHN, YMCA of the USA, Chicago, Illinois
LISEL LOY, Bipartisan Policy Center, Washington, DC
MARY-JO MAKARCHUK, Canadian Institutes of Health Research, Toronto, Ontario
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. Responsibility for the published workshop summary rests with the workshop rapporteur and the institution.
SHELLIE PFOHL, President’s Council on Fitness, Sports & Nutrition, Rockville, Maryland
BARBARA PICOWER, The JPB Foundation, New York, New York
NICOLAAS P. PRONK, HealthPartners, Inc., Minneapolis, Minnesota
AMELIE G. RAMIREZ, Salud America!, San Antonio, Texas
OLIVIA ROANHORSE, Notah Begay III Foundation, Santa Ana Pueblo, New Mexico
SYLVIA ROWE, S.R. Strategy, LLC, Washington, DC
JOSE (PEPE) M. SAAVEDRA, Nestlé Nutrition, Switzerland
JAMES F. SALLIS, University of California, San Diego
EDUARDO J. SANCHEZ, American Heart Association, Dallas, Texas
BRIAN SMEDLEY, National Collaboration for Health Equity, Washington, DC
LAWRENCE SOLER, Partnership for a Healthier America, Washington, DC
LOEL S. SOLOMON, Kaiser Permanente, Oakland, California
MARION STANDISH, The California Endowment, Oakland, California
ALISON L. STEIBER, Academy of Nutrition and Dietetics, Chicago, Illinois
MAHA TAHIRI, General Mills, Inc., Minneapolis, Minnesota
KATHLEEN TULLIE, Reebok, International, Canton, Massachusetts
TISH VAN DYKE, Edelman, Washington, DC
HOWELL WECHSLER, Alliance for a Healthier Generation, New York, New York
JAMES R. WHITEHEAD, American College of Sports Medicine, Indianapolis, Indiana
TRACY WIEDT, National League of Cities, Washington, DC
Health and Medicine Division Staff
LYNN PARKER, Scholar
LESLIE J. SIM, Senior Program Officer
HEATHER DEL VALLE COOK, Program Officer
AMANDA NGUYEN, Research Associate
DARA SHEFSKA, Research Assistant
RENEE GETHERS, Senior Program Assistant
GERALDINE KENNEDO, Administrative Assistant
ANN L. YAKTINE, Director, Food and Nutrition Board
Consultant
WILLIAM H. DIETZ, George Washington University, Washington, DC
Reviewers
This workshop summary has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary:
Anne M. Dattilo, Nestlé Infant Nutrition
Janet A. Phoenix, George Washington University
Maha Tahiri, General Mills Bell Institute of Health and Nutrition
Jennifer Weber, American Heart Association and American Stroke Association
Although the reviewers listed above provided many constructive comments and suggestions, they did not see the final draft of the workshop summary before its release. The review of this workshop summary was overseen by Martin A. Philbert, University of Michigan. He was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the rapporteur and the institution.
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Contents
Prevalence and Trends of Overweight and Obesity in the Early Childhood Years
The Epigenetics of Childhood Obesity
The Flavor World of Childhood: Basic Biology and Health Implications
Discussion Session: Opportunities for Interventions
3 MODIFIABLE RISK AND PROTECTIVE FACTORS ASSOCIATED WITH OVERWEIGHT AND OBESITY THROUGH AGE 5
Pregnancy Factors in Relation to Childhood Obesity
Breastfeeding and the Risk of Childhood Obesity
Sleep, Activity, and Sedentary Behavior
Discussion Session: Guidelines for Young Children
4 EFFECTIVE INTERVENTIONS: WHAT WORKS?
Effective Interventions in Pregnancy and the First 2 Years of Life
A Clinician’s Perspective on Interventions Effective in Early Childhood
Effective Interventions in Early Care and Education
Effective Interventions in the Home Setting
5 PROMISING AND INNOVATIVE CROSS-SECTOR SOLUTIONS
Programs at the U.S. Department of Agriculture
Obesity Prevention in New York City
Obesity Prevention Through Health Care Partnerships