Preventing childhood obesity: what works?

Area of Science:

• Pediatric Public Health
• Nutritional Epidemiology
• Behavioral Science

Background:

• North American childhood overweight and obesity rates have surged since the 1970s, reaching epidemic levels.
• Existing evidence for effective childhood obesity prevention programs, particularly for primary prevention, remains incomplete.
• Current programs often target school-aged children with limited success, necessitating broader approaches.

Purpose of the Study:

• To review primary childhood obesity prevention strategies and their evidence base.
• To identify promising, yet untested, intervention strategies using an ecological framework.
• To propose a multiphase method for developing and evaluating effective childhood obesity interventions.

Main Methods:

• Literature review of current prevention approaches and evidence.
• Analysis of experimental and epidemiological research on factors influencing children's eating and weight.
• Development of a multiphase strategy for screening, refining, and evaluating intervention components.

Main Results:

• Most school-based childhood obesity prevention programs have shown limited success.
• Intervention efforts should expand to family and childcare settings, prioritizing preschool-aged children.
• Early life factors (maternal weight, gestational gain, feeding practices) are potential targets, but require evaluation.

Conclusions:

• A shift towards early intervention, including infancy and preschool years, is crucial for childhood obesity prevention.
• Integrating family and childcare settings into prevention strategies is recommended.
• A systematic, multiphase approach is needed to develop and validate potent, optimized interventions for childhood obesity.