Reaching the Healthy People Goals for Reducing Childhood Obesity

Closing the Energy Gap

Every 10 years, the Department for Health and Human Services (DHHS) releases objectives to guide health promotion and disease prevention efforts. Healthy People 2010 and Healthy People 2020 include goals for reducing childhood obesity rates. This paper argues that obesity prevention efforts are missing a metric that could link obesity prevalence targets to energy-balancing interventions at the population level. The authors provide a framework for estimating the reductions in daily per capita energy gap needed to reach obesity prevalence targets by 2020.

Researchers based their calculations on National Health and Nutrition Examination Surveys (NHANES) data on height and weight for children and teens age 2-19 from 1971-2010. They estimated the energy gap reductions needed to meet Healthy People goals by extrapolating changes in youth body weight and obesity prevalence.

Key Findings:

  • There was a small increase in mean height during the past 30 years among U.S. youth, but average body weights increased significantly (1.54kg).
  • Average Body Mass Index (BMI) increased 0.55 kg/m2 per decade, with greater increases among older children, adolescents and non-Hispanic Black youth.
  • To halt the rising trend in mean body weight, children in the U.S. would need to eliminate an average of 41 excess calories per day.
  • Reaching the Healthy People goals by 2020 would require an additional reduction of 23 cal/day per capita (Healthy People 2020 goal) and 120 cal/day per capita (Healthy People 2010 goal).

Required reductions in the energy gap are larger for children who already have higher rates of obesity, such as racial and ethnic minority youth and those living in lower-income areas. Obesity prevention strategies must consider the energy gap framework to create initiatives that address both energy intake and output.