SUPPLEMENT

Forum on Child Obesity Interventions

Introduction: The First Forum on Child Obesity Interventions1,2

Guillermo Melendez*
Fundacin Mexicana para la Salud AC Av. Perifrico 4809, Col. Arenal Tepepan CP 14610 Mexico City, Mexico

In the past 20 y, understanding the complex origin of childhood obesity has evolved from a simplistic thinking of a particular childs or parents awareness and responsibility in balancing his/her own energy intake and expenditure to a broader and more sophisticated recognition of environmental determinants that interact with the genetic, behavioral, and biological programming of the individual to induce his/her weight gain. This new comprehensive concept of childhood obesity involving the host, agents, and environment, as well as their interactions, is more in agreement with the fundamentals we have come to understand about epidemic diseases. Although important advances have been made in the recognition of factors inuencing childhood obesity, effective preventive actions at family, school, and community levels, or individual treatment interventions in clinical settings, are still not as sound as they should be. Too few satisfactory results are obtained, and outcomes are often not clearly understood. The First Forum on Child Obesity Interventions was the original idea of FUNSALUD, a nonprot organization dedicated to improving community health by addressing alternatives to public health problems among the Mexican population. FUNSALUD not only identied that the obesity
Published in a supplement to Advances in Nutrition. Presented at the conference Forum on Child Obesity Interventions held in Mexico City, Mexico, November 1719, 2009. The n conference was organized and cosponsored by Fundacio Mexicana para la Salud A.C. (FUNSALUD). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of FUNSALUD. The supplement coordinator for this supplement was Guillermo Melendez, FUNSALUD. Supplement Coordinator disclosures: Guillermo Melendez is employed by FUNSALUD, which received a research donation from Coca Cola, PEPSICO, and Pena Fiel, three major beverage companies in Mexico, to support the program of childhood obesity research and communication. The supplement is the responsibility of the Guest Editor to whom the Editor of Advances in Nutrition has delegated supervision of both technical conformity to the published regulations of Advances in Nutrition and general oversight of the scientific merit of each article. The Guest Editor for this supplement was Nanette Stroebele, University of Colorado, Denver. Guest Editor disclosure: Nanette Stroebele declared no conflict of interest. Publication costs for this supplement were defrayed in part by the payment of page charges. This publication must therefore be hereby marked "advertisement" in accordance with 18 USC section 1734 solely to indicate this fact. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publisher, Editor, or Editorial Board of Advances in Nutrition. 2 Author disclosure: G. Melendez is employed by FUNSALUD, which received a research donation from Coca Cola, PEPSICO, and Pena Fiel, 3 major beverage companies in Mexico, to support the program of childhood obesity research and communication. * To whom correspondence should be addressed. E-mail: melendez651@gmail.com.
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epidemic in children bears a number of similarities with other countries but also that decision makers tackle the same common obstacles when looking for cost-effective programs that affect the well-being of youngsters. The search for answers to these common problems was an important driver in creating a potential international arena where investigators dedicated to interventions and research on childhood obesity were able to come together and present their ideas on best practices, analyze current experiences, and learn from the approaches of others in regards to the problem of overweight children. The number of speakers who attended the meeting created a wealth of experience at the Forum and innovative proposals were immediately raised during the discussions, giving a sense of the potential to overcome the epidemic. The new journal, Advances in Nutrition, from the ASN has appeared at a convenient time. We are honored to introduce this journals supplement that contains a set of relevant presentations from the Forum on Childhood Obesity Interventions held in Mexico City on November 17 and 19, 2009, as a contribution to the scientific community and health professionals. Dr. Katherine Flegal and Dr. Cynthia Ogden (1) from CDC presented an enlightening dissertation entitled Childhood Obesity: Are We All Speaking the Same Language? that focuses on the existing references of different BMI cutoff points between overweight and obese children, concluding that a BMI over a particular cutoff point is not necessarily associated with clinical complications or health risks related to being overweight. Dr. Angelo Tremblay (2) from Laval University introduced the audience to the development of healthy packed lunches for students from a school with a low socioeconomic status, based on a new food design aimed at maximizing the satiating properties of a food or meal. He also addressed the ndings from his research group about new factors contributing to overweight children, such as shortened sleep patterns and increased demand in mental tasks. An analysis of the Aventuras para Nios study was addressed by Dr. John Elder (3) from San Diego State University. This was an appealing trial whose objective was to
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promote more physical activity by restructuring playgrounds and activities scheduled for children. Implemented across 6 schools, it looked at how childrens activity levels were modified during breaks. Dr. Jana Pazkov (4) from the Obesity Management r Center, Institute of Endocrinology in the Czech Republic, was asked to talk about the long path from an inactive, obese child to a fit one. From her personal experience, a lifelong devotion to physical activity started early in life is required to prevent obesity and its accompanying metabolic disorders. Nevertheless, she pointed out that any long term effort to accomplish a desirable level of body composition in children and adolescents can be lost in a relatively short amount of time if the physical activity protocol is interrupted. Dr. David Levy (5) from the Department of Economics at the University of Baltimore showed a clear example of how economics and, more important, public policies are being introduced to the study of the childhood obesity epidemic. He commented about his background on policies directed at the tobacco industry and shared his experience with shaping public policies to modify the inuence of sugar sweetened beverages on BMI. Dr. Charles Hillman (6) from the Department of Kinesiology and Community Health at the University of Illinois articulated the relationship between energy consumption and its storage and expenditure, as well as its effect on cognition, a new area of study in childhood obesity. Energy expenditure through the adoption of increased physical activity suggests improvement in cognitive health and function.

Dr. Manoj Sharma (7) from the University of Cincinnati, after reviewing school-based interventions aimed at preventing childhood obesity through the modication of dietary behavior, made recommendations for enhancing the effectiveness of school based dietary education interventions for childhood obesity prevention. Six of the talks presented at this meeting are included in this supplement. At the end of the day, solving means understanding the question, executing the best alternatives, communicating results, and improving performance, which is exactly what this Forum concerning the childhood obesity epidemic was about.

Literature Cited
1. Flegal K, Ogden CL. Childhood obesity: are we all speaking the same language? Adv Nutr. 2011;2:159S66S. 2. Tremblay A, Arguin H. Healthy eating at school to compensate for the activity-related obesigenic lifestyle in children and adolescents: The Quebec experience. Adv Nutr. 2011;2:167S70S. 3. Elder JP, McKenzie TL, Arredondo E, Crespo NC, Ayala GX. Effects of a multi-pronged intervention on childrens activity levels at recess: The Aventuras para Nios study. Adv Nutr. 2011;2:171S6S. 4. Parizkova J. From an inactive and obese to the fit child: how long is the way? Czech experiences. Adv Nutr. 2011;2:177S81S. 5. Levy DT, Friend KB, Wang YC. A review of the literature on policies directed at the youth consumption of sugar-sweetened beverages. Adv Nutr. 2011;2:182S200S. 6. Burkhalter TM, Hillman CH. A narrative review of physical activity, nutrition, and obesity to cognition and scholastic performance across the human lifespan. Adv Nutr. 2011;2:201S6S. 7. Sharma M. Dietary education in school-based childhood obesity prevention programs. Adv Nutr. 2011;2:207S16S.

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