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Title: Childhood obesity prevention: Changing the focus

Author
item BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC)
item TAVERAS, ELSIE - Massachusetts General Hospital

Submitted to: Childhood Obesity
Publication Type: Other
Publication Acceptance Date: 11/15/2017
Publication Date: 1/1/2018
Citation: Baranowski, T., Taveras, E.M. 2018. Childhood obesity prevention: Changing the focus. Childhood Obesity. 14(1):1-3. https://doi.org/10.1089/chi.2017.0303.

Interpretive Summary:

Technical Abstract: Obesity in the United States and throughout the world remains highly prevalent, especially among children and adolescents. Innumerable child obesity prevention trials emphasizing diet, physical activity, sedentary behavior, and recently sleep have been designed, implemented, and evaluated with the best intentions and the highest hopes. The majority of these interventions have had no or very small effects on adiposity/obesity, but the quality of these studies has been relatively low. Some of the largest, more comprehensive, well designed, and well funded trials had no effects on adiposity/obesity. There may be a fundamental problem in our usual approaches. While obesity is almost by definition the result of a long-term imbalance between energy intake and expenditure, this simple statement ignores the factors contributing or predisposing to energy imbalance. Childhood obesity prevention investigators may want to refocus to incorporate alternative more biological possible predisposing and contributing factors, including what age(s) they may start or have their major effect and identifying the subgroups of influence. This refocus does not preclude investigation of diet, physical activity, sedentary behavior, and/or sleep, but attempts to clearly identify the subgroups of obesity, or high risk of obesity, in which they operate; the extent to which the predisposing factors interact with one or another of these behaviors to contribute to obesity; or the subset among whom inadequate self-control really is a primary cause. With a little luck and lots of effort, this refocus should result in new conceptual and measurement procedures, wherein existing cases of obesity can be attributed to their likely contributing and predisposing factors, and new corresponding triage systems can be generated for applying appropriate targeted and even tailored age and cause specific intervention procedures.