Dana E. Gerstein

Obesity : Dietary and Developmental Influences

Introduction The Obesity Epidemic The Obesity Prevention Network Determinants of Energy Imbalance Workgroup A Focus on Prevention Defining Target Behaviors: A First Step Methodology Search Process and Criteria Article Abstraction and Manuscript Format Lines of Evidence Critical Periods Intrauterine Growth and Birth Weight Infancy Adiposity Rebound Early Puberty Pregnancy Postpartum Menopause Elderly Dietary Influences on Energy balance Total Calories Energy Density Macronutrient Intake Minerals and Vitamins Vegetables and Fruits Sweetened Beverages and Fruit Juice Restaurant-Prepared Foods Dietary Patterns Variety of Foods Reduced-Fat Food Products Portion Size Meal and Snack Patterns Parenting Influences Breastfeeding Food Insecurity Conclusions When to Intervene: Critical Periods in the Development of Obesity What to Recommend: Dietary Influences on Energy Balance Implications Priorities for Further Research Reference Index

Energy Balance for Kids with Play: Design and Implementation of a Multi-Component School-Based Obesity Prevention Program

BACKGROUND Improving nutrition and physical activity behaviors associated with childhood obesity are significant national public health goals. Energy Balance for Kids with Play (EB4K with Play), developed through a partnership between the Academy of Nutrition and Dietetics Foundation and Playworks, is a multi-component school-based intervention designed to address youths nutrition and physical activity behaviors. This article describes the EB4K with Play intervention and evaluation study and presents the baseline data. METHODS The evaluation is a 2-year cluster-randomized design targeting third- to fifth-grade students enrolled in a low-income, urban school district in northern California. Six schools were recruited to participate. Four were randomized to the intervention group and two into a control group. Baseline student-level data pertaining to nutrition, physical activity, fitness, and BMI were collected in the fall of 2011. The EB4K with Play program, which includes direct-to-student nutrition and physical activity interventions, a school wellness component, and parent/community partner outreach components, began immediately after baseline data collection. RESULTS An ethnically diverse sample of students (n=844) was recruited to participate in the study. Baseline data showed a higher percent of eligibility for free and reduced-price school lunch and higher rates of obesity/overweight than the California state averages. Fitness levels and levels of moderate-to-vigorous physical activity were comparable to state averages. CONCLUSIONS End-point data will be collected after 2 years of the intervention. The findings from this study should help guide future efforts to design effective intervention programs to support the prevention of pediatric obesity.