Researchers call for obesity prevention efforts to focus on community-wide systems

National data show that currently more than 10 percent of preschoolers in the United States are obese, and an additional 10 percent are overweight. In a recently published article, a researcher from the Perelman School of Medicine at the University of Pennsylvania, in collaboration with peers and colleagues from across the nation, says that effective strategies to target pregnancy, infancy, and toddlers are urgently needed to stop the progression of childhood obesity. The call to action comes just weeks after the release of a recent report from the Institute of Medicine (IOM) and an HBO documentary, "The Weight of the Nation," both of which focused on the nation's growing obesity epidemic. The full text of the article is available in the June issue of Childhood Obesity.

The authors point to evidence which shows that over the past several generations behavioral and societal changes have led to the obesity epidemic, with attendant health and demanding new scientific approaches, policy, and actions. Obesity, they say, is a complex problem involving multiple factors including the family, community structures and services, and broad societal forces. That these contributors are interrelated only adds complexity to the issue, which ultimately results in a growing epidemic.

"A systems approach would link interventions in a variety of settings and take into account both behavioral and . The importance of taking a broader look at these factors is further evidenced by the recent IOM report which provides a for how we can continue to make progress in preventing obesity," said Shiriki Kumanyika, PhD, MPH, professor of at Penn Medicine. "In this article, we propose an ambitious but achievable approach that focuses on tackling obesity at the earliest stages of life, and within the larger community, not just at the individual level."

Evidence increasingly suggests that the risk for begins even before and during pregnancy via maternal obesity and excessive gestational weight gain. Studies show it is likely that obese preschoolers will continue to be obese later in childhood and they may begin to exhibit adverse effects of obesity as early as three years of age.

Additional research shows that progress toward implementing effective and sustainable child obesity prevention strategies requires strengthening current approaches to add a component that addresses pregnancy onward. A review of evidence from basic science, prevention, and systems research supports an approach that begins at the earliest stages of development, and uses a broader community approach to focus on implementing improved healthy behaviors and environmental changes in communities, including food industry and transportation policy.

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