Reaching the healthy people goals for reducing childhood obesity: closing the energy gap

Am J Prev Med. 2012 May;42(5):437-44. doi: 10.1016/j.amepre.2012.01.018.


Background: The federal government has set measurable goals for reducing childhood obesity to 5% by 2010 (Healthy People 2010), and 10% lower than 2005-2008 levels by 2020 (Healthy People 2020). However, population-level estimates of the changes in daily energy balance needed to reach these goals are lacking.

Purpose: To estimate needed per capita reductions in youths' daily "energy gap" (calories consumed over calories expended) to achieve Healthy People goals by 2020.

Methods: Analyses were conducted in 2010 to fit multivariate models using National Health and Nutrition Examination Surveys 1971-2008 (N=46,164) to extrapolate past trends in obesity prevalence, weight, and BMI among youth aged 2-19 years. Differences in average daily energy requirements between the extrapolated 2020 levels and Healthy People scenarios were estimated.

Results: During 1971-2008, mean BMI and weight among U.S. youth increased by 0.55 kg/m(2) and by 1.54 kg per decade, respectively. Extrapolating from these trends to 2020, the average weight among youth in 2020 would increase by ∼1.8 kg from 2007-2008 levels. Averting this increase will require an average reduction of 41 kcal/day in youth's daily energy gap. An additional reduction of 120 kcal/day and 23 kcal/day would be needed to reach Healthy People 2010 and Healthy People 2020 goals, respectively. Larger reductions are needed among adolescents and racial/ethnic minority youth.

Conclusions: Aggressive efforts are needed to reverse the positive energy imbalance underlying the childhood obesity epidemic. The energy-gap metric provides a useful tool for goal setting, intervention planning, and charting progress.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Age Factors
  • Body Mass Index
  • Child
  • Child, Preschool
  • Continental Population Groups
  • Diet / statistics & numerical data
  • Energy Intake*
  • Exercise*
  • Female
  • Healthy People Programs / organization & administration*
  • Humans
  • Income
  • Male
  • Obesity / epidemiology*
  • Obesity / prevention & control*
  • Sex Factors
  • United States